Quick answers
- Do I need Part B with HealthChoice?
- Yes, in practice. EGID says you don't have to be enrolled in Part B for its Medicare supplement plans, but the plans pay benefits as if you are, so without Part B you'd pay most outpatient costs yourself. Its Medicare Advantage options require Part A and Part B.
- When can I change my EGID Medicare plan?
- During EGID's annual Option Period, October 15 to December 7, with changes effective January 1. If you don't return a form, your current coverage continues, unless your plan is ending.
- Do I keep the OTRS premium help if I buy my own Medicare plan?
- No. OTRS says it pays its health insurance supplement only if you stay with the insurance offered through your employer.
- Can I come back to EGID coverage if I leave?
- Generally not. EGID says that if you drop your health plan through EGID, you can't regain it later and you lose any premium contribution from your retirement system.
- How long do I have to keep coverage when I retire?
- Oklahoma law gives you 30 days from the date your service ends to elect to continue coverage. If you decline, it generally can't be reinstated later.
Who this page is for
This page is for Medicare-eligible retirees who kept their health coverage through the Oklahoma Office of Management and Enterprise Services (OMES) Employees Group Insurance Division (EGID), which runs HealthChoice. That includes many retirees of state agencies, who draw a pension from the Oklahoma Public Employees Retirement System (OPERS), and public school and education retirees, who draw a pension from the Teachers' Retirement System of Oklahoma (OTRS). Some education employers offer their own group plan instead of HealthChoice; ask your former employer which applies to you.
Keeping your coverage when you retire
Oklahoma law sets a short window. Under 74 O.S. § 1316.2 (OPERS) and 74 O.S. § 1316.3 (OTRS), you may continue your health and dental coverage if you elect to do so within 30 days from the date your service ends. If you decline, the coverage generally can't be reinstated later, with limited exceptions. For OTRS retirees, the statute requires at least 10 years of creditable service.
OTRS adds that you can't have a break in insurance coverage and still be eligible for coverage after retirement. One exception it describes: if you drop your own EGID coverage to be covered under your spouse's state plan, you may later continue your own coverage with EGID, as long as there's no break. EGID's retirement checklist also says retirement isn't an eligible event to change carriers; you change at the next annual Option Period.
Do you need Medicare Part B?
Yes, in practice. EGID's 2027 Medicare Options Benefit Guide says:
- HealthChoice Medicare supplement plans: you must be entitled to Medicare Part A. You aren't required to be enrolled in Part B, but the plan pays benefits as if you are. To get the full benefit, you need Part B. Without it, you would pay the share Part B normally pays for doctor visits and outpatient care.
- Medicare Advantage Prescription Drug (MAPD) plans: you must be enrolled in both Part A and Part B and keep paying your Part B premium.
Retiree coverage isn't coverage from current work, so it doesn't give you a special enrollment period to take Part B later. Medicare.gov warns that you have a limited time to sign up without a penalty and that retiree coverage might not pay for care during a time you were eligible for Medicare but didn't sign up. The Part B late penalty is $10% of the standard premium for each full 12-month period you went without it. See Medicare Part B and enrollment periods.
Watch out: If you're still working for the state or a school at 65, the rules are different: coverage from current work can let you delay Part B. See working past 65. The Part B rule above applies once you are a retiree.
Your EGID Medicare options for 2027
When you're eligible for Medicare, EGID changes your premium from the regular retiree rate to a Medicare plan rate, effective the month EGID learns of your Medicare eligibility, according to OTRS. For the 2027 plan year, EGID offers:
| EGID option | How it works | Who can join |
|---|---|---|
| HealthChoice Medicare supplement plans (High Option and Low Option) | Work with Original Medicare, which stays your primary insurance. No provider network: any provider that accepts Medicare. Both include Part D drug coverage; the drug benefit differs between the two. | Entitled to Part A; Part B strongly advised |
| Medicare Advantage PPO (MAPD) | Replaces Original Medicare and includes Part D. Covers providers anywhere in the U.S. that accept the plan's terms; no referrals. | Part A and Part B; available to retirees living anywhere in the U.S. |
| Medicare Advantage HMOs (MAPD) | Replace Original Medicare and include Part D. You choose a primary care doctor in the plan's network. | Part A and Part B; must live in the plan's Oklahoma service area (EGID lists eligible ZIP codes) |
EGID's guide also notes that two plans offered for 2026 aren't available for 2027, so members in those plans must pick a new plan during Option Period. Premiums are in EGID's guide; they don't reflect any contribution from your retirement system. Plan details come from each plan's own documents, listed in the guide.
When you can change: EGID's Option Period
EGID's annual Option Period for Medicare-eligible members runs October 15 to December 7, the same dates as Medicare's annual open enrollment. Changes take effect January 1.
- If you don't want to change, don't return your Option Period form; your coverage continues. The exception: if your plan is ending, you must choose a new one.
- If you switch health plans within EGID, you return the Option Period form plus the matching application (Medicare supplement with prescription drug plan, or MAPD). Forms must be postmarked by December 7.
- Each Medicare-eligible dependent needs a separate Part D application.
- If a provider leaves your MAPD plan's network, EGID says you can't change plans until the next Option Period.
Don't join a second Part D plan by mistake
Every EGID Medicare plan includes Part D drug coverage, and that coverage is creditable. Medicare lets you have only one Part D plan. EGID warns that if you enroll in another plan with Part D (for example, a Medicare Advantage plan or drug plan you buy on your own, or one a nursing home enrolls you in), Medicare will end your EGID Part D. EGID then moves you to a plan without Part D at a higher premium until the next Option Period.
At that point you can drop either the outside plan or your EGID coverage. EGID says that if you drop your health plan through EGID, you can't regain coverage through EGID in the future, and you lose any premium contribution made by your retirement system. Exceptions may apply if you get Extra Help.
Premium help from OTRS and OPERS
| Retirement system | What it pays | When it stops |
|---|---|---|
| Teachers' Retirement System of Oklahoma (OTRS) | A monthly health insurance supplement set by 74 O.S. § 1316.3, paid toward the premium of the state plan or a participating education employer's plan, for eligible retirees with at least 10 years of service. You pay any remaining premium. | OTRS says it pays only if you stay with the insurance offered through your employer. It stops when the retiree dies; a surviving spouse who keeps the coverage is billed the premium. |
| Oklahoma Public Employees Retirement System (OPERS) | A monthly contribution set by 74 O.S. § 1316.2, paid toward the premium of the state plan or another eligible employer group plan, for retirees who receive a monthly benefit. | OPERS rules say it isn't paid directly to retirees, beneficiaries or survivors, so it doesn't follow you to a plan you buy on your own. Retirees in OPERS's defined contribution system aren't included. |
The amounts are set in law and can change; check with OTRS or OPERS. To see how these choices compare, read HealthChoice vs. Medigap vs. Medicare Advantage for Oklahoma retirees.
Steps to take as you approach 65
- Sign up for Part A and Part B. Apply through Social Security (ssa.gov or 1-800-772-1213) during your Initial Enrollment Period, which starts 3 months before the month you turn 65.
- Complete EGID's Medicare paperwork. EGID's retirement checklist says a Medicare-eligible member enrolling in HealthChoice with Part D must also complete the Application for Medicare Supplement, and a member choosing an MAPD plan must complete the MAPD application. Questions go to EGID Member Services at 405-717-8780 or 800-752-9475 (TTY 711).
- Choose an EGID Medicare plan. Compare the HealthChoice supplement plans and the MAPD plans in EGID's Medicare Options Benefit Guide. For HMOs, check that you live in the service area and that your doctors are in the network.
- Think twice before leaving EGID. Leaving is generally permanent and ends your retirement system's premium contribution. Before you decide, compare what you'd pay on your own. To look at Medigap and Medicare Advantage plans from the companies they work with, you can request a call from a licensed insurance agent, or see plans for your ZIP code.
See also Medigap in Oklahoma, Medicare Advantage in Oklahoma and turning 65 in Oklahoma.
Sources
- OMES EGID — 2027 Medicare Options Benefit Guide
- OMES EGID — Medicare plans for former employees
- OMES EGID — Retirement insurance checklist
- OMES EGID — Option Period for Medicare-eligible members
- Teachers' Retirement System of Oklahoma — OMES Employees Group Insurance Division FAQ
- OSCN — 74 O.S. § 1316.3, TRS members, continuation of health and dental insurance
- OSCN — 74 O.S. § 1316.2, continuance of health and dental insurance for retired employees
- OPERS — Oklahoma Administrative Code Title 590, Chapter 10 (590:10-1-4, health insurance contribution)
- Medicare.gov — Retiree insurance
- Medicare.gov — Avoid late enrollment penalties
Every question in this guide
- Do I need Medicare Part B with the HealthChoice Medicare supplement?
- Do Oklahoma Teachers' Retirement (OTRS) retirees need Medicare Part B?
- Does the OTRS health insurance supplement pay toward any Medicare plan?
- What Medicare options do Oklahoma state and education retirees have?
- What do Oklahoma state retirees on HealthChoice need to do when they turn 65?
Frequently asked questions
Do Oklahoma state retirees have to sign up for Medicare Part B?
EGID's 2027 Medicare guide says that to join its HealthChoice Medicare supplement plans you must be entitled to Part A, and that you aren't required to have Part B, but the plan pays benefits as if you are. That means you'd owe the share Part B would have paid. Its Medicare Advantage options require both Part A and Part B, and retiree coverage doesn't give you a special enrollment period to sign up for Part B later without a penalty.
What Medicare plans does EGID offer for 2027?
For 2027, EGID offers two HealthChoice Medicare supplement plans (High Option and Low Option), which work with Original Medicare and include Part D drug coverage, and several Medicare Advantage Prescription Drug plans from outside insurers, including a nationwide PPO and HMOs available only in certain Oklahoma ZIP codes. Two plans offered for 2026 aren't available for 2027, so members in them must choose a new plan.
What happens if I join an outside Medicare drug plan?
EGID's plans include Part D, and Medicare allows only one Part D plan. If you join another plan with Part D, Medicare disenrolls you from your EGID plan's Part D, and EGID moves you to a plan without Part D at a higher premium until the next Option Period.
Who qualifies for the OTRS health insurance supplement?
Under 74 O.S. § 1316.3, OTRS retirees with at least 10 years of creditable service may continue their coverage, and OTRS pays a monthly amount toward the premium for eligible retirees who stay in the state plan or a participating education employer's plan. If it doesn't cover the full premium, you pay the rest. OTRS says the supplement stops when the retiree dies; a surviving spouse is billed for the full premium.
Does OPERS help pay my health insurance premium?
Yes, for eligible retirees. Under 74 O.S. § 1316.2 and OPERS rules, OPERS contributes a monthly amount toward the premium of the state plan or another eligible employer group plan, only for retirees who receive a monthly retirement benefit. It isn't paid directly to you or to beneficiaries or survivors, and retirees in OPERS's defined contribution system aren't included.
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