Retiree Health Insurance - Managerial and Professional

Yale is committed to offering comprehensive pre-and post-65 healthcare coverage to retirees and eligible dependents. 

Managerial and Professional staff who retire may be eligible to receive a subsidy for part of their health insurance.

Eligibility for retiree healthcare coverage is defined as follows:

• Age 55 or greater,

and

• the sum of age and vested service is greater than or equal to 75 (e.g., age 55 and 20 years of vested service, or age 60 and 15 years of vested service);

or

• age 65 and 5 or more years of vested service

Retirees and their spouses who are not Medicare eligible at the time of retirement can continue to participate in the same medical plans as an active employee.

Retirees and their spouses eligible for Medicare (age 65 or Social Security defined disability) at the time of retirement must enroll in Medicare Parts A and B. Centers for Medicare and Medicaid Services (CMS), the federal agency that administers Medicare and issues guidelines for the program, requires timely enrollment in Medicare Parts A and B.  Faculty and staff must be enrolled in Medicare Parts A and B in order to enroll in a Yale Medicare plan.   Retirees can contact Social Security Administration to enroll in Medicare 90 days prior their 65th birthday, date of Medicare eligibility, or their retirement date by calling 800-772-1213 or by visiting www.ssa.gov.

Yale offers retirees and their spouses three Medicare plans:

Medicare-eligible retirees and spouses (typically age 65 or Social Security Disability) may choose from three Aetna PPO plans -Aetna Medicare Advantage Choice ESA Open Access Plan, Aetna Medicare Advantage Legacy ESA Open Access Plan, or Aetna Medicare PPO Plan. Enrollment in these plans includes Medicare Part D prescription coverage.

Medicare Choice ESA Open Access Plan provides access to any provider who participates in the Medicare program. Yale Health members will continue to have limited access to Yale Health services and departments (if enrolled in Yale Health before retiring). You will pay a copay for non-preventive care services such as Specialist Visits, Inpatient Hospital stays and Diagnostic Procedures.

The Medicare Advantage Legacy ESA Open Access PPO is Aetna’s national Medicare Advantage plan providing comprehensive coverage and availability to any provider who participates in the Medicare program. Yale Health members will continue to have limited access to Yale Health services and departments.

The Aetna Medicare PPO Plan is a Medicare Advantage Plan (PPO) that provides access to in-network and out-of-network providers, except for Yale Health, which is excluded from the plan’s network and cannot be accessed as an out-of-network provider.

Medicare advantage plans include Aetna Medicare prescription drug plan (PDP) benefits.

The maximum subsidy for retirees and their spouses is attained with completion of 30 years of service. All subsidies are pro-rated for years of service less than 30.

Additional resources to start planning for retirement are on this page in the Financial and Benefits Planning for Retirement checklist.

If you have further questions regarding retiree medical benefits, please contact an Employee Services representative by phone at 203-432-5552 or send an e-mail to employee.services@yale.edu.