Retiree Medical Benefit

termination) into GMS, the Office of Faculty and Staff Benefits will provide your information to the retiree benefits and billing administrator, AleraEdge.

AleraEdge will send an enrollment packet by email (or to your home address if an email is not available). This packet will include instructions on how to log in to the enrollment portal to make your benefit elections.

You must decide whether you want to elect, defer or waive your retiree medical coverage within 30 days of your last date of employment.

Because of these deadlines, we strongly suggest you notify your department of your plans to retire as soon as possible, so they can initiate the retirement process in GMS. Completion of the employment termination process within GMS is required in order to transmit your information to AleraEdge, initiate the retiree medical enrollment process, and to ensure a seamless transition between active and retiree medical coverage. 

Employees and spouses who are over age 65 and enrolling in a Georgetown retiree medical plan should apply for Medicare Parts A & B two to three months before retiring. Please reach out to benefitshelp@georgetown.edu to request CMS Form L564 that confirms you’ve had medical insurance from Georgetown University since becoming eligible for Medicare. You will need this when completing apply for Medicare at your local Social Security Office or online at ssa.gov/medicare.

Upon retiring from the University you may choose to defer your retiree medical coverage until a future date.  If you defer:

• You won’t be eligible for retiree dental benefits.
• You may be subject to any preexisting condition exclusions or limitations unless you are able to present proof of continuous medical coverage.

Medical Plan Options for Retirees Age 65 and Older
For retirees who are eligible, Medicare is the primary payer of benefits. Georgetown University offers the following plans to supplement your Medicare coverage.

• Kaiser Medicare Advantage Plan (must live in the DC metropolitan area)
• CareFirst BlueChoice Advantage POS (national coverage)
• UnitedHealthcare Choice Plus PPO (national coverage)
• UnitedHealthcare Medicare Standard  (national coverage)
• Via Benefits: This option give retirees access to a broader option of Medicare Supplemental and Advantage Plans, often at lower cost. Those retirees who are no longer employed by the university in any capacity are also eligible to be enrolled in a Healthcare Reimbursement Account (HRA) to which a monthly premium subsidy is credited and can be used for qualified medical expenses. Learn more on the Via Benefits enrollment website.

In some cases, you and your covered dependents may not all be eligible for Medicare. When this occurs, you must stay on the same medical provider, but coverage will differ based on each person’s Medicare status:

• Those who have Medicare will be covered under a Medicare plan.
• Those who do not have Medicare will be covered under the corresponding non-Medicare plan.
• Via Benefits plans are the only exception. Enrollment in a Via Benefits plan is limited to retirees and spouses who are both age 65 or older and enrolled in Medicare. In addition, only retirees who are not employed by Georgetown University are eligible to participate in the Via Benefits exchange.

Dependent Eligibility
You may enroll a legal spouse in your retiree medical plan at the time of retirement or during Open Enrollment. Premiums for spousal and dependent coverage are unsubsidized.

Under the Affordable Care Act (ACA), you may also enroll your dependent children up to age 26, regardless of whether they were covered at the time of your retirement.

If you pass away while your spouse and/or dependent child(ren) are covered under a Georgetown retiree medical plan, they will receive two years of free medical coverage. After this period (“premium holiday”), they are entitled to continue coverage for the rest of their lives at the unsubsidized rate.

Open Enrollment takes place from mid-October to mid-November. During this time you can make changes to your retiree coverages that will take effect on the upcoming January 1. You will receive an Open Enrollment guide and instructions for making changes with AleraEdge.

Once enrolled in the retiree medical insurance program, you can opt-out of it at any time you wish. If you drop coverage for yourself, all of your dependents will be dropped at the same time. If you wish to discontinue participation, you must notify AleraEdge in writing. It is critical that you understand that your decision to discontinue participation is irrevocable — once you elect to discontinue your participation, you will not be allowed to re-join at a later date.

When you enroll in a Georgetown retiree medical plan, the University’s contribution is determined by your years of eligible service at the time of retirement.

• Retirees with 10 to 14 years of service receive a University contribution of $125 per month toward their medical premium.
• Those with 15 to 24 years of service receive $175 per month, and
• those with 25 or more years of service receive $225 per month.

You are responsible for paying the remainder of your individual premium, along with the full premium for any covered dependents. For VIA Benefits participants, these amounts are credited each month to a Healthcare Reimbursement Arrangement (HRA) and available to you as long as you remain enrolled in a VIA plan.

This contribution formula does not apply to certain grandfathered populations or to Georgetown Hospital employees who retired between August 1, 1998 and June 30, 2000.

Medical premiums are recalculated each year. Please refer to the current Retiree Benefits Guide for the latest premium charts and details.