Medical Plans for Pre-65 Retirees

Post-65 Retiree Open Enrollment for Calendar Year 2025: Nov. 4 - Dec. 4, 2024

The open enrollment period is your opportunity to review your benefit options and change your current elections. No action is required unless you are making changes, opting in for the first time, or opting out of coverage.

You are encouraged to review the 2025 Post-65 Retiree Health Care Plans Summary Guide, for detailed information about the available medical, dental, and vision plans; information about the Defined Dollar Benefit (DDB) program; enrollment information, contact information; and more.

Interested in learning more about your post-65 retiree benefits? Join us for our Calendar Year 2025 Virtual Information Session on Thursday, Nov. 7, 2024 at 10 a.m. Register today.

Questions about your benefits as a post-65 retiree or about the enrollment period should be directed to Benefit Management Services (BMS) by emailing PITT-BMSdocs@upmc.edu or by calling 1-888-499-6885. BMS hours are Monday through Friday from 8 a.m. to 6 p.m.

Retirees and their eligible spouses/domestic partners that are between the ages of 62 and 65 have two choices:

  • Continue with the same coverage as active faculty and staff. You will continue to be responsible for your cost share which on average is 20% of the total cost, OR
  • Start receiving the Defined Dollar Benefit (DDB) credits. The credits adjust annually. You may take the credits and purchase retirement coverage elsewhere or you may “bank” the credits for future use if you have other coverage. Please refer to the chart in the section titled Defined Dollar Benefit Program. DDB credits cannot be used to purchase active coverage through another employer.
  • Spouses/domestic partners under age 62 are responsible for the full premium until cost sharing begins at age 62.

As a reminder, the medical plans offered to eligible spouses/domestic partners prior to age 65 are:

Panther Gold HMO

The most popular of Pitt's medical plans, Panther Gold HMO has a low deductible and lower costs per visit than other plans when members choose providers within the UPMC Advantage and UPMC Health Plan networks. Members are responsible for copayments except for wellness and preventative care services.

The Panther Gold plan meets the current J1 Visa status requirements.

Note: If you live, or are planning to live, outside of the Western PA area, it is recommended that you do not select the Panther Gold Plan. The coverage/in-network area for the Panther Gold (HMO) plan is limited to the Western PA area. Counties excluded from this Western PA network include: Bucks, Chester, Delaware, Franklin, Fulton, Juniata, Mifflin, Montgomery, Montour, and Philadelphia.

Panther Gold with Advantage Network - Applies to Oakland and Titusville campuses only | Schedule of Benefits | Summary of Benefits and Coverage (SBC) | SBC for MHSF

Panther Gold Plan - Applies to Bradford, Greensburg and Johnstown campuses only | Schedule of Benefits | Summary of Benefits and Coverage (SBC)  | SBC for MHSF

 

Panther PPO

The Panther PPO offers members the ability to select from a wider array of providers, but with a higher deductible and cost per visit than the Panther Gold Plan. 

Schedule of Benefits | Summary of Benefits and Coverage (SBC) | SBC for MHSF

Panther Basic PPO

The Panther Basic PPO Plan has been adjusted to meet the requirements of a Qualified High Deductible Health Plan (QHDHP).  This plan allows participants the option to open a new Health Savings Account (HSA). Learn more about HSAs in the "Health Expense and Savings Account" section of this UPMC FAQ.

Employees can newly enroll, waive, or make changes to their HSA elections at any time throughout the year by submitting the HSA contribution change form. The change will be effective the first of the month following the submission of the form (for example, a form submitted on October 31 will be effective on November 1).

Please note: you cannot participate in/contribute to the HSA through the Panther Basic plan if you or your spouse/domestic partner are age 65 or older and enrolled in Medicare.

Schedule of Benefits | Summary of Benefits and Coverage (SBC) | SBC for MHSF

 

Listed below are a few examples of what usually takes place if someone retires prior to age 65:

  1. Many retired faculty and staff members who had University coverage prior to retirement continue with that same coverage until they reach age 65.
  2. Some retired faculty and staff enroll in a spouse/domestic partner’s employer’s plan. That spouse may be employed by the University of Pittsburgh or elsewhere.
  3. Some retired faculty and staff enroll in the active medical plan of another employer. 

In examples two and three above, you are eligible to receive DDB credits if you have coverage elsewhere. The only exception is that you cannot obtain active coverage from the University of Pittsburgh and receive DDB credits at the same time.