Eligibility and Enrollment

Continuing Group Health Coverage

Detailed information on the rules to continue health insurance as a retiree can be found in the 2026 Local Government 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’s group health plan for local government and must continue offering retiree coverage. If your former agency leaves the state’s local government plan, or opts out of offering retiree coverage, your coverage on the local government plan will be cancelled.

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’s group health insurance, you may continue coverage as a dependent on their 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.

For TCRS vested members the eligibility guidelines for continuing health insurance are:

• Ten years (120 months) of creditable service, must be age 55 or older and at least three years of continuous insurance coverage in the plan immediately prior to final termination
  of employment.
• Twenty years (240 months) of creditable service, must be age 55 or older and at least one year of continuous insurance coverage in the plan immediately prior to final termination date.
• Thirty years of creditable service and at least one year of continuous insurance coverage in the plan immediately prior to final termination date.

The Retirement Date (effective date of retirement with TCRS) must be on or before the date your active coverage ends.  This requirement for immediate commencement of benefits will be waived if you become insured by the state, a participating local education agency or another participating local government agency with no lapse in coverage.  The one-year and three-year participation requirements will be waived if the local government agency has joined the state plan for the first time and has not participated in the plan for that length of time.

 

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.

 

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 eligible for Medicare, you are no longer eligible for the group health plan and are not eligible to apply to cover your dependents on the group health plan. The Tennessee Plan is available to you if you were initially hired by a qualifying agency prior to July 1, 2015, are covered by Medicare, and are a retired county judge, county official, or employee of employer participating in TCRS drawing a monthly retirement allowance from TCRS.

 

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:

1. The date after active coverage ends ; or
2. 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. 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 LGA that is participating in the state dental plan at the time of retirement. If the LGA subsequently terminates participation in the state dental plan, its retirees are no longer eligible to continue retiree dental coverage. This restriction does not apply to county officials as defined in 8-34-101(9)(A) and (B).

 

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:

1. The date after active coverage ends ; or
2. 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, you are eligible for retiree vision coverage. If you do not select vision coverage at retirement, you can enroll during the annual enrollment period.