Retirees

Florida state retirees and Medicare

Florida state retirees who keep State Group Insurance once they have Medicare choose between two paths: stay in a State Group Insurance health plan, which then pays after Medicare, or join one of the State's group Medicare Advantage and Prescription Drug (MA-PD) plans. Either way you should have Part B. If you cancel State coverage as a retiree, you can't re-enroll later.

By the Benefits Life Editorial Team, licensed insurance agents · Reviewed November 14, 2026

Quick answers

What Medicare options does State Group Insurance offer retirees?: Two paths: keep a State Group Insurance health plan (a nationwide PPO or a regional HMO), which pays after Medicare and includes drug coverage, or join one of the State's optional group MA-PD plans, which replace Original Medicare and include Part D.
Do Florida state retirees need Part B?: In practice, yes. The State plan pays as if you had Part B even if you don't, so without it you pay the share Medicare would have paid (about 80 percent). The MA-PD plans require Parts A and B.
Do I need a separate Part D plan?: No. The State says its drug coverage is creditable and that members of its secondary plan should not enroll in a separate Part D plan. The MA-PD plans already include Part D.
Can I cancel State coverage and come back later?: No. The State says a retiree who cancels, or whose coverage ends for nonpayment, may not re-enroll as a retiree later.
Can I get the FRS Health Insurance Subsidy with Medicare?: Yes. The FRS Pension Plan HIS form lists Medicare Part A and/or Part B as qualifying coverage. The subsidy is a monthly payment based on your years of service, added to your retirement benefit.

Who can keep State Group Insurance in retirement

The State Group Insurance Program is run by the Division of State Group Insurance in the Florida Department of Management Services (DMS); enrollment goes through the People First Service Center. According to DMS, you can continue State health coverage as a retiree if you were covered by the Plan when you retired and you:

retire under a State of Florida retirement system (or a state optional annuity or retirement program, or disability retirement) and begin receiving benefits immediately; or
retire under the FRS Investment Plan, meet the normal retirement age or service requirements (or the age in Internal Revenue Code 72(t) with six years of creditable service), take an immediate distribution, and keep continuous coverage until you receive it. DMS says the distribution generally takes about 2 months, so Investment Plan members use COBRA in the meantime.

FRS Pension Plan members who had employee health coverage are enrolled in retiree health coverage automatically. The decision you make at retirement matters: DMS says that if you don't continue health coverage when you retire, you can't elect it later as a retiree unless you return as a benefits-eligible employee.

Your two Medicare paths

Once you or a covered dependent has Medicare, you move to a Medicare coverage tier and choose how State coverage works with Medicare:

Path	How it works with Medicare	Drug coverage
State Group Insurance health plan (nationwide PPO, or an HMO in its service area)	Medicare pays first; the State plan pays second for covered services, and pays first when Medicare doesn't pay.	The State plan's own coverage, which pays first for most drugs. Medicare has approved it as creditable.
A State group Medicare Advantage and Prescription Drug (MA-PD) plan, HMO or PPO	Replaces Original Medicare for your Part A and Part B care. Requires Part A and Part B.	Included (Part D).

DMS says MA-PD enrollment is optional and open year-round, and that the MA-PD plans aren't offered to active employees. Which MA-PD plans you can join depends on where you live. More: what Medicare options State Group Insurance offers.

Part B: what the State says

On the secondary State plan: the State plan pays after Medicare "even if you don't sign up for or purchase Medicare Part B." Without Part B, you pay the portion Medicare would have paid, which DMS puts at about 80 percent. DMS calls buying Part B "in your financial interest," and the same applies to Medicare-eligible dependents.
In an MA-PD plan: you and every covered family member must be enrolled in Part A and Part B.
Who pays the premium: you do. The standard Part B premium is $202.90 a month in 2026, more with an income-related amount (IRMAA). CMS publishes the 2027 amounts in the fall.

Skipping Part B when you're first eligible, without coverage from current work, can mean waiting for the General Enrollment Period and a lifelong late penalty; retiree coverage doesn't count as current work. See do Florida state retirees need Part B? and the penalty calculator.

When you become eligible for Medicare

Sign up for Part A and Part B. DMS tells retirees to contact Social Security about three months before their 65th birthday. If you already get Social Security benefits, you're enrolled automatically.
Send your Medicare card to People First. Upload it or mail a copy to People First, P.O. Box 6830, Tallahassee, FL 32314, so claims are paid in the right order.
Decide on an MA-PD plan, if you want one. There's no automatic enrollment. People First needs your Medicare card for Part A and Part B. Requests completed by the 20th take effect on the first of the next month; after the 20th, the first of the second month.
Not enough work history? Ask Social Security for an ineligibility letter and send a copy to People First so your State coverage continues without interruption.

More: what happens to State Group Insurance at 65 and turning 65 in Florida.

Canceling is permanent

You can't come back. DMS says a retiree who cancels State Group Insurance, or lets it end by not paying premiums, "may not re-enroll at a later date as a retiree." DMS also says that if you buy Part C, Part D or Medigap coverage on the private market, you should cancel your State plan, and that members of the secondary State plan should not enroll in a separate Part D plan.

Medicare also lets you be in only one Medicare Advantage or Part D plan at a time. Before joining any individual Medicare plan, ask People First how it would affect your State coverage. DMS says "You will never be called to enroll" in an MA-PD, and its official communications carry the DMS or division logo, so treat unexpected calls as a warning sign (is this Medicare call a scam?). If you're weighing a switch, read State Group Insurance vs. individual Medicare plans first.

Two different open enrollments

Period	When	What it changes
State Group Insurance Open Enrollment	Each fall; DMS says the 2027 plan year's has ended	Your State plan, coverage level and dependents. Outside it, you need a qualifying status change (generally within 60 days).
State MA-PD enrollment	Year-round	Joining or leaving a State MA-PD, by the 20th-of-the-month timeline
Medicare Open Enrollment	Oct. 15 to Dec. 7, 2026 (for 2027)	Individual Medicare Advantage and Part D plans you buy yourself, not State coverage

Once you're enrolled in Medicare Parts A and B and keep State coverage, DMS says you may change your health plan election at any time during the plan year, and you can lower your coverage level (family to individual), but not raise it, outside Open Enrollment or a qualifying status change.

Spouses and surviving spouses

Medicare tiers: Medicare I covers you alone; Medicare II covers you and eligible dependents when at least one of you is eligible for Medicare; Medicare III covers you and one dependent when both of you are eligible for Medicare.
MA-PD and family: if you enroll in an MA-PD, every member on your family policy must be enrolled in Medicare.
Surviving spouses who were covered when the retiree or employee died can continue coverage; they must tell People First within 60 days. Coverage ends on the first of the month after remarriage, with COBRA available for a limited time.

The FRS Health Insurance Subsidy (HIS)

The HIS, created by Florida Statutes 112.363, is a monthly payment added to the retirement benefit of eligible retirees of a state-administered retirement system to help with health insurance costs. It is based on your years of creditable service, with a minimum and maximum set in the statute; years in DROP don't count. Key points:

You don't need State Group Insurance: the law says participating in a former employer's group plan "is not a requirement."
Medicare counts. The FRS Pension Plan form HIS-1 lists Medicare Part A and/or Part B as qualifying coverage, along with health, dental, vision and TRICARE coverage. You can attach a copy of your Medicare card, and your HIS can't start earlier than your Medicare effective date.
Medicaid and Medically Needy coverage don't qualify.
Send the form within six months after your retirement benefits begin to be paid back to your retirement date; after that, back pay is limited to six months.

More: the FRS Health Insurance Subsidy and Medicare.

County, city and school district retirees

Florida Statutes 112.0801 requires counties, cities, special districts, community colleges and district school boards that offer group health coverage to let retirees and their eligible dependents continue in the group plan, with the same coverage as active employees at a premium no higher than active employees'. The employer or the retiree may pay it, and retirees on Medicare may be rated separately. How each employer's plan works with Medicare differs, so ask your former employer's benefits office. More: local government retirees and Medicare.

Federal retirees in Florida

Federal retirees use the Federal Employees Health Benefits (FEHB) Program, not State Group Insurance. The U.S. Office of Personnel Management (OPM) says that once you retire and enroll in Medicare, Medicare pays first, FEHB continues, and FEHB drug coverage is creditable, so you won't owe a Part D penalty for waiting. OPM also warns that delaying Part B can mean a wait before coverage starts and a lifelong penalty. Postal Service retirees in the Postal Service Health Benefits (PSHB) Program have separate rules; see OPM.

Where to get help

People First Service Center: 866-663-4735 (TTY 866-221-0268), weekdays 8 a.m. to 6 p.m. ET, for State Group Insurance eligibility, enrollment and MA-PD questions.
FRS Division of Retirement, Retired Payroll: 844-377-1888, for the Health Insurance Subsidy.
Social Security: 1-800-772-1213 (TTY 1-800-325-0778), to sign up for Part A and Part B.
Medicare: 1-800-MEDICARE (1-800-633-4227; TTY 1-877-486-2048) or Medicare.gov.
To see how individual Medicare plans from the companies they work with would compare to your State coverage, you can request a call from a licensed insurance agent.

Sources

Every question in this guide

Frequently asked questions

Can my spouse stay on State Group Insurance after I go on Medicare?

Yes, as a dependent on family coverage. The Medicare II tier covers you and your eligible dependents when at least one of you is eligible for Medicare. If you join a State MA-PD plan, every member on your family policy must be enrolled in Medicare.

Can FRS Investment Plan retirees get the Health Insurance Subsidy?

Yes, if they meet the Investment Plan's normal retirement age or service requirements under Florida Statutes 112.363, and they certify health coverage such as Medicare. Investment Plan members use their own HIS form.

Do Florida teachers and state workers pay into Social Security and Medicare?

Most do. The Congressional Research Service reports that in 2023, 88.5% of Florida's state and local government employees had Social Security coverage, so most qualify for Part A with no premium through their own or a spouse's work.

What if I don't have enough work history for Medicare at 65?

The State tells retirees who haven't worked enough quarters to ask Social Security for an ineligibility letter and send a copy to People First, so their State health coverage continues without interruption.

Is the State Group Insurance MA-PD the same as an individual Medicare Advantage plan?

No. It is a group plan offered only through the State program to eligible retirees and others enrolled in State Group Insurance. You enroll through People First, not through Medicare's Open Enrollment, and enrollment is open year-round.

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