Health Care Benefits in Retirement
Important Information about How Your FCPS Benefits are Impacted by Retirement
When Your Benefits End
Following your last day of employment, your health care insurance coverage will continue:
- Through the end of August if you retire in June, July, or August.
- Through the last month of employment if you retire in any other month.
At the time of retirement, FCPS provides eligible retirees a valuable benefit in the ability to retain health coverage. Your ability to retain coverage can vary based on your date of employment or retirement.
If you are enrolled in a flexible spending account (FSA), your FSA will end on the same schedule as health insurance. You must incur the eligible expense before your last day of employment, or by August 31 if your last day worked occurs in June, July, or August. The last day you may submit claims for your FSA is March 31 of the year following your retirement.
For more details about how retiring will impact your FCPS benefits, please read our "Preparing for Retirement" packet. There are two versions depending on your retirement system membership:
- ERFC/VRS members: Preparing for Retirement for ERFC/VRS Members packet
- FCERS members: Preparing for Retirement for FCERS Members packet
Maintenance of Health Care Coverage in Retirement
At the end of your career, FCPS provides eligible retirees a valuable benefit in the ability to retain health coverage at retirement. In order to retain FCPS health coverage as a retiree, you must first meet the following enrollment/tenure requirements:
Date of Hire/Retirement* | Enrollment or Tenure Requirement |
Actively employed as of 12/31/2018 | Covered for 60 or more continuous months immediately prior to retirement -or- Employed with FCPS for 15 or more years in a benefits-eligible position |
Hired on or after 1/1/2019 | Employed with FCPS for 15 or more years in a benefits-eligible position |
*Individuals who were retired and covered by an FCPS medical or dental plan (or the DHO plan) on 12/31/2018 meet the enrollment/tenure requirement.
In addition to the above criteria, a retiree must:
- Be covered by the FCPS health and/or dental plan immediately prior to retirement. For example, if you are retiring on July 1, 2019, you must be covered under the FCPS medical and dental plan on June 30, 2019, to retain coverage as a retiree.
- Elect Medicare Parts A and B when first eligible. For most retirees that occurs at age 65, but may occur earlier due to disability.
- Meet the definition of ‘retiree’ (transition from active status to immediately drawing a pension check from one of the FCPS-sponsored pension plans).
Eligibility FAQ
Yes, if you are covered under the FCPS plan at the time of retirement. If you do not have FCPS coverage at the time of retirement, you will not be able to retain coverage as a retiree, nor will you be able to re-enter the plan at a later date.
No. Breaks in service of more than one year do not count toward ‘time in service’ calculations and therefore do not count toward meeting the 15-year requirement.
No, only benefit-eligible service counts toward the 15-year calculation. However, employees hired prior to January 1, 2019, who qualified for coverage under the Affordable Care Act may satisfy the eligibility requirement by maintaining coverage for sixty consecutive months prior to retirement.
No. However, as in the case above, you may be able to satisfy the requirement by maintaining coverage for sixty consecutive months prior to retirement.
If you retired prior to January 1, 2019, your eligibility is based on the current criteria of maintaining coverage for sixty consecutive months. If you were eligible to retain coverage as a retiree - and you maintained continuous coverage with FCPS since retirement - you will not need to satisfy new criteria.
FCPS Subsidies
If you are a retiree age 55 or older (or if you retire due to disability), FCPS provides a subsidy toward the cost of your medical coverage, thereby reducing the amount you must pay.
The subsidy schedules for VRS/ERFC and FCERS members can be found on page 7 in the Retiree Benefits Handbook. The subsidy is not available for dental coverage, nor is it available to surviving spouses/dependents of deceased retirees.
For more information, view the FCPS Medical Plan Subsidies webpage.
Enrolling in Medicare
FCPS requires retirees and spouses who are eligible for Medicare to elect and maintain Medicare Parts A and B in order to maintain health coverage under an FCPS medical plan. This applies to retirees and spouses who will be turning age 65 as well as retirees or covered dependents who are eligible for Medicare due to disability. To learn more about Medicare and your FCPS health benefits, please review the Becoming Eligible for Medicare webpage.
Cancelling or Re-entering the FCPS Plan After Retirement
If you are eligible to retain coverage as a retiree, you may be eligible to drop coverage and re-enter the plan at a later date, provided that you are Medicare eligible and meet the established criteria.
Retiree Re-entry Rights
A covered retiree may drop FCPS coverage and re-enter the plan at a later date if all of the following criteria are met:
- Enrolled in an FCPS medical and/or dental plan at time of retirement; and
- Eligible for Medicare. If the retiree will also be covering dependents, all dependents must be eligible for Medicare; and
- Applies for coverage within 30 days of a qualifying event or during Open Enrollment, and
- Provides proof of other health/dental coverage for the preceding 12 consecutive months.
Retirees have only one re-entry right to the plan.
Frequently Asked Questions about Re-Entry Rights
No. Current retirees must be covered by the FCPS plan (or DHO program) as of 12/31/2018 in order to drop coverage and re-enter the plan when eligible for Medicare.
If you are currently covered under the FCPS plan as a retiree, you may add your spouse to your plan within 30 days of a qualifying event or during open enrollment.
If you retired on or after 1/1/2019 and dropped your FCPS coverage at time of retirement, your spouse may re-enter the plan when you do if you are both eligible for Medicare. You must request re-entry within 30 days of loss of coverage (or during open enrollment) and each of you must show documentation of 12 or more months of continuous coverage.
Yes, if you meet the stated eligibility criteria. Remember, you cannot re-enter the plan until you are Medicare eligible, and you must document at least 12 or more months of continuous coverage under another plan.
No. Only those individuals who are eligible for Medicare will have re-entry rights. If you re-enter the plan upon becoming eligible for Medicare, your spouse can re-enter the plan within 30 days of becoming eligible for Medicare (or during Open Enrollment) as long as you continue to be covered under the FCPS plan.
No. You must be covered under the FCPS plan in order for your spouse to remain covered.
Providing re-entry rights to eligible retirees serves the same purpose as the DHO program, so a separate program is no longer needed.
* The DHO program ended on December 31, 2018.
Yes. If you drop coverage and you and your spouse re-enter the plan later, you will need to provide an updated tax return to document your marital status in addition to documents showing that you and your spouse have been continuously covered by another plan for 12 or more consecutive months immediately prior to re-entry.