Eligibility and Enrollment
for TCRS participants
Continuing Group Health Coverage
Detailed information on the rules to continue health insurance as a retiree can be found in the 2026 Local Education Medical Plan Document. This document is available on the publications webpage of the Partners for Health website.
To continue health insurance benefits, the agency from which you retire must continue to participate in the state plan. If your former agency leaves the State Group Insurance Program, your coverage on the state retiree group health will be canceled.
You must receive a monthly TCRS retirement benefit to continue coverage. If you choose a lump-sum retirement benefit, you are not eligible to continue health insurance at retirement.
If your spouse is also an employee enrolled in state group health insurance, you may continue coverage as a dependent on his/her contract instead of choosing retiree coverage. When your spouse ends employment, you may be eligible to apply via the special enrollment provision under your own eligibility as a retiree.
Retiree health coverage is only available to employees hired by a participating agency before July 1, 2015. If you started working for a participating local education agency or the state of Tennessee for the first time on or after July 1, 2015, you are not eligible to continue or enroll in insurance at retirement. If you started working for the state of Tennessee or a participating local education agency for the first time before July 1, 2015, you will not be prohibited from continuing or enrolling in insurance at retirement, provided you did not accept a lump sum payment from the TCRS before July 1, 2015 and that you satisfy all other eligibility requirements.
The eligibility guidelines for continuing health insurance are:
Ten years (120 months) of creditable service and at least three years of continuous insurance coverage in the plan immediately prior to final termination of employment. The date retirement pension benefits start (effective date of retirement with TCRS) must be on or before the date your active state coverage ends. This requirement for immediate commencement of benefits will be waived if you leave the Local Education plan and become insured by an agency that participates in one of the other state-sponsored health plans.
Twenty years (240 months) of creditable service and at least one year of continuous insurance coverage in the plan immediately prior to final termination of employment. The date retirement pension benefits start (effective date of retirement with TCRS) may be up to five years. The five-year requirement will be waived if you leave the state plan and become employed by an agency participating in one of the other state-sponsored health plans, resulting in no lapse in coverage on a state plan.
Creditable Service:
- You can count employment with the state of Tennessee, a state higher education institution or a local education agency that participates in the State Group Insurance Program to calculate total employment. Unused sick leave may also be counted. Military service that did not interrupt employment, service that was previously cashed out and not paid back to TCRS, educational leave, leave of absence or service with a local government agency cannot be counted.
- Only creditable service will count. Years of service applies to the minimum length of service required to continue coverage at retirement. It does not necessarily count toward premium reduction. State premium support is provided on teaching service only.
- If you are eligible to combine creditable state and local education service, you will be classified as a retiree under the plan from which you ended employment prior to retirement.
- If you are eligible for retiree coverage without combining creditable service under more than one plan, you may choose to be classified as a retiree in the plan in which you first satisfied eligibility criteria, or in the plan from which your employment ended immediately preceding retirement.
Application to Continue Group Health Coverage
You must submit an application to continue coverage at retirement to Benefits Administration within one full calendar month of the end of active insurance or the date of the TCRS notice of retirement letter, whichever is later. If enrollment is approved, you will continue in the same health insurance option in which you are currently enrolled.
If you have 20 or more years of service and there is an allowed gap between your date of termination and date of retirement (the effective date of your TCRS pension benefit), you must submit the application to Benefits Administration within one full calendar month of the end of active insurance or the date of the TCRS notice of retirement letter, whichever is later.
Effective Date of Retiree Group Health Coverage
Retiree coverage is effective on the first day of the month following the end of active insurance coverage or the retirement date, whichever is later. If you have an allowed gap between your termination date and date of retirement, coverage will be effective on the first day of the month following the retirement date or end of active insurance coverage, whichever is later. The retirement date is the date you start your retirement benefits.
Individuals Eligible for Medicare
If you are enrolled in health insurance and meet the service requirements, you may continue coverage at retirement until you become eligible for Medicare due to age. You may also continue coverage on covered dependents until they become eligible for Medicare due to age or no longer qualify as eligible dependents.
You and your dependents who become entitled to Medicare prior to age 65 must enroll in Medicare parts A and B to continue group health coverage until becoming entitled to Medicare due to age or for covered children, until they turn 26 or meet plan provisions for incapacitated dependents.
Retirees who are Medicare eligible due to age are no longer eligible for the group health plan and are not eligible to apply to cover their dependents on the group health plan via the special enrollment provision.
If your initial date of employment with a qualifying employer is prior to July 1, 2015, you may be eligible to apply for the state’s Supplemental Medical Insurance for Retirees with Medicare program called The Tennessee Plan.
Application for The Tennessee Plan Coverage
The Tennessee Plan is a supplemental medical insurance program designed to cover certain expenses not fully paid by your Medicare parts A and B coverage. It does not cover prescription drugs. If you participate in The Tennessee Plan, you will need a separate Part D plan for your prescription drug needs. The Tennessee Plan will not coordinate benefits if you are currently enrolled in or join a Medicare Advantage plan. This means if you have a Medicare Advantage plan, The Tennessee Plan will not pay out any benefits.
If you are enrolled in at least Medicare Part A and receive a monthly TCRS pension benefit at retirement, you can select The Tennessee Plan coverage on the Application to Continue Insurance at Retirement. You may also apply to cover your dependents who are eligible for Medicare when you enroll in The Tennessee Plan. You have 60 days from the initial eligibility date to enroll. If you qualify and enroll within 60 days of initial eligibility, you cannot be turned down for coverage due to age or health. The initial eligibility date is the date of TCRS retirement, the date active state group health coverage ends or the date of Medicare eligibility, whichever is later.
Coverage is effective the first of the month following the end of your active insurance coverage or the first of the month following your date of retirement, whichever is later. If the date of retirement is the later date and falls on the first of the month, your coverage may be effective on that date.
If you become eligible for Medicare due to age after retirement you will be sent an application approximately three months before your 65th birthday. The application must be submitted within 60 days of Medicare eligibility. Coverage will become effective on your date of Medicare entitlement provided the application is received timely. If you enroll in The Tennessee Plan and your spouse becomes entitled to Medicare at a later date, you have 60 days from the date of your spouse’s eligibility to apply to add him/her to coverage.
If enrollment is not selected within 60 days of initial eligibility, you and your eligible dependent may apply through medical underwriting. Enrollment is subject to approval and may be denied. Benefits Administration will submit the application for review to the vendor. You must be enrolled in The Tennessee Plan to cover a dependent.
Once approved, you will receive an ID card from the vendor. It will show your name and identification number. If you are not satisfied with The Tennessee Plan, you can cancel it within 30 days after receipt. You will receive a refund of premiums paid in advance. Any claims paid during this period will be recovered.
End-stage Renal Disease
If you are eligible for Medicare as a result of end-stage renal disease, you may be eligible for extended group health benefits. Contact Benefits Administration for information on the eligibility criteria.
Dental Coverage
Continuation of dental insurance is NOT automatic at retirement. If you are enrolled in a state-sponsored dental plan, you have two options for continuing coverage:
COBRA Dental
You can continue your coverage for 18 months under COBRA. A notice will be mailed to your home once your active coverage ends. The COBRA enrollment form is separate from the Application to Continue Insurance at Retirement. If you choose to continue dental through COBRA, you must submit the enrollment form to Benefits Administration within 60 calendar days after the later of the following dates:
- The date after active coverage ends; or
- The date notice of a right to elect COBRA continuation coverage is sent.
Please note on the COBRA enrollment form that you are a TCRS retiree.
Retiree Dental
You may also choose to enroll in retiree dental coverage. Just select dental on your Application to Continue Insurance at Retirement. To enroll you must receive a monthly TCRS pension benefit and have been hired prior to July 1, 2015. If you do not select dental coverage at retirement, you can enroll during the annual enrollment period. Dependent-only coverage is not available.
Effective January 1, 2026, and thereafter, eligibility to participate in the state retiree dental plan is only open to Retirees of an LEA that is participating in the state dental plan at the time of retirement. If the LEA subsequently terminates participation in the state dental plan, its retirees are no longer eligible to continue retiree dental coverage.
Vision Coverage
Continuation of vision insurance is NOT automatic at retirement. If you are enrolled in the state-sponsored vision plan, you have two options for continuing coverage:
COBRA Vision
You can continue your coverage for 18 months under COBRA. A notice will be mailed to your home once your active coverage ends. The COBRA enrollment form is separate from the Application to Continue Insurance at Retirement. If you choose to continue vision through COBRA, you must submit the enrollment form to Benefits Administration within 60 calendar days after the later of the following dates:
- The date after active coverage ends; or
- The date notice of a right to elect COBRA continuation coverage is sent.
You will be billed directly for the premiums due. COBRA vision premiums cannot be deducted from your TCRS pension check.
Retiree Vision
If you receive a monthly pension from TCRS based on your own service and were hired prior to July 1, 2015. Effective January 1, 2026, and thereafter, eligibility to participate in the state retiree vision plan is only open to Retirees of an LEA that is participating in the state vision plan at the time of retirement. If the LEA subsequently terminates participation in the state vision plan, its retirees are no longer eligible to continue retiree vision coverage.
You are eligible for retiree vision coverage. If you do not select vision coverage at retirement, you can enroll during the annual enrollment period.