Health Insurance Subsidy for Members

As a retired member, you may be eligible for a health insurance subsidy.

At age 65, you are required to enroll in Medicare to the fullest extent of your entitlement to continue your participation in the Health Subsidy Program. Members who become eligible for Medicare before turning age 65 must contact the Medical and Dental Benefit Section.

Who is eligible?

You qualify for a health insurance subsidy if you meet the following requirements:

What is the subsidy amount?

Your monthly subsidy depends on whether you are enrolled in Medicare:

  • If you are not enrolled in Medicare or are enrolled in Medicare Part B only: As of July 1, 2010, the current monthly maximum amount is $1,025.62. You are allowed 4% of the maximum amount for each year of service (YOS):
Formula: YOS x 4% x Maximum Subsidy Amount = Monthly Subsidy
Example: If you have 20 years of service, $820.50 is your monthly subsidy, which would be applied toward your health premium. (20 YOS x 4% x $1,025.62 = $820.50)
  • If you are enrolled in Medicare Parts A & B, there is a unique subsidy formula and you are reimbursed the cost of the Part B premium. At age 65, if you do not qualify for Medicare Part A, you will continue to use the age 55 or older subsidy formula and you must pay for the cost of Part B.

If your health premium is greater than your available subsidy, the City will provide only the subsidy amount and you will need to pay the remainder. If your premium is less than your subsidy, the Department will provide only up to the amount of the premium.

How do I enroll? It is not necessary to apply for this benefit. Any eligible retiree or qualified surviving spouse/ domestic partner enrolled in a City-approved health plan will automatically receive this benefit.