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This is a checklst for choosing your plan during an enrollment period that has been currently extended by court order to March 31.

[NOTE; This checklist was developed before a 3/3/22 court order ruling that the City could not charge a premium if members opted out of MA+ in order to stay on their current healthcare plan, including NYC GHI Senior Care.]

If you choose to enroll in the Alliance Medicare Advantage Plus Program:

Do nothing. If you are a retiree covered by an NYC Health Benefits Program (NYC HBP) Medicare supplemental health plan (such as GHI Senior Care), you and the Medicare-eligible dependents currently on your plan will be automatically enrolled in the new Medicare Advantage plan for April 1, 2022 (or later if a current Temporary Restraining Order (TRO) pushes back the date of implementation). Dependents on your plan who are not Medicare-eligible will continue to be covered by their current insurance plan (such as GHI-CBP). 

If you choose to opt out:

You must complete the opt-out form in the enrollment packet you receive in the mail or download online. As of this writing, the City is stipulating that you can only opt out by (1) staying on your current NYC Health Benefits Program plan OR (2) waiving NYC Health Benefits Program Retiree Health insurance coverage altogether. 

You must complete a separate opt-out form for each Medicare-eligible participant (i.e., you, your spouse and/or other dependent). A Medicare-eligible spouse or dependent must also opt out if that is what the retiree member chooses.

If you choose to keep your current plan:

[See the note at the top of this page about the 3/3/22 court order ruling that the City cannot charge a premium if you opt out to stay on your current NYC healthcare plan. This paragraph only applies if NYC wins on appeal to reverse the 3/3/22 court order.] You will pay a premium for your current NYC HBP plan. (Here are the plan rates.) If your pension plan is TRS, any monthly premium payment will be deducted from your monthly check (or deposit).  For those in TIAA, click here for information on payment options.

The PSC is pressing the City on how one signs up for the 365 day hospital rider ($2.83 a month) if one opts out for the NYC Empire/Emblem/GHI Senior Care plan.

If you wish to waive your NYC Health Benefits Program coverage altogether:

Complete the NYC Health Benefits Application/Change Form linked here:

Please be advised, you will NOT be eligible for the reimbursement by the City for the Medicare Part B premium (or IRMAA) if you waive NYC retiree health coverage. You may re-enroll in City retiree health benefits during the next Transfer Period. 

NYC will continue to reimburse for Medicare Part B and IRMAA only if you are enrolled in the new Alliance Medicare Advantage plan or opt to stay on your current NYC Health Benefits Program plan. The PSC is checking into the legality of these reimbursement restrictions.  

How to submit the opt-out form(s).  

The form gives you several choices: electronic submission, mail, fax, phone, email.  The electronic submission is encrypted and to date has provided automatic email confirmations. If so, these might be the safest methods of submission.

How to check on your Medicare Status

Go to the Medicare website There you can create an account and see the status of your Medicare coverage.

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