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New Retiree Enrollment

The transition of your health benefits from active employee to retiree status does not happen automatically. Follow these steps for a smooth enrollment in retiree health benefits.

You can use our Retiree Health Benefits Premium Calculator to help you research costs and plan for your retirement benefits. 

Ideally, you should begin the process of enrolling in retiree health benefits 30 to 60 days prior to your retirement date. Retirement processing at the San Francisco Health Service System (SFHSS) must be completed no later than 30 calendar days after your retirement date. If you do not submit all required documentation by that deadline, you will not have HSS retiree health coverage for yourself and any covered dependents when your active employee benefits end. You must then wait until the next Open Enrollment period to enroll in SFHSS retiree benefits.

If you were hired after January 9, 2009*, the amount of subsidy you will receive for health benefits when you retire will vary based on the number of credited service years you have with employers of the City and County of San Francisco. Click here to learn more.

* "Hired on or Before January 9, 2009" as used in this section means employees hired on or before January 9, 2009, by the City and County, the School District, the San Francisco Community College District, or the Redevelopment Agency, excluding the following categories of employees: (1) as-needed employees who have never earned 1,040 or more hours of compensation during any 12-month period ending on or before January 9, 2009; (2) employees who have separated from employment with the Employers or the Redevelopment Agency on or before January 9, 2009, and have less than 5 years of Credited Service with the Employers or the Redevelopment Agency; (3) former employees of the Redevelopment Agency who became employees of the City and County after February 28, 2015; (4) former employees of the Redevelopment Agency who left employment with the Redevelopment Agency and became employees of the City and County before February 1, 2012; and (5) former employees of the Redevelopment Agency who have received retiree health care coverage under the Public Employees Medical and Hospital Care Act (PEMCHA) on or before February 28, 2015. 

Visit this webpage for a more comprehensive Prop. B information and definition of Hired on or Before January 9, 2009.

STEP 1: Complete the Retirement Process with your Retirement System

Depending on your City employment status, your retirement system will be either SFERS, CalPERS, CalSTRS or PARS. Contact your personnel supervisor if you have questions about which retirement system you belong to. 

Once your pension benefits have been processed, save copies of all the documents that you receive from your retirement system related to your retirement processing.

Get a detailed overview of the retirement process and important deadlines and how to prepare by watching our Pre-Retiree video below.

STEP 2: Enroll in Medicare

All retiree members and dependents enrolled in SFHSS medical coverage must also be enrolled in Medicare, if eligible due to age or disability. SFHSS requires enrollment in Medicare Part A and Part B (some people will only be eligible for Part B). Check with the Social Security Administration if you have questions about eligibility for Medicare.

If you and/or your Medicare-eligible dependent is not yet enrolled in Medicare, SFHSS will complete the Social Security Request for Employment Information form. You must bring this form back to the Social Security office to complete Medicare enrollment. Please note that there is a monthly premium paid to the federal government for Medicare Part B. When you meet with Social Security, request a letter confirming your Medicare enrollment and the date your Medicare coverage will begin. 

Individuals who are not eligible for non-contributory (free) Medicare Part A are not required to enroll in Medicare Part A. In that case, you must obtain a letter from Social Security documenting ineligibility for Part A, and submit the letter to SFHSS. Individuals who are ineligible for Part A must still enroll in, and pay premiums for, Part B. SFHSS requires proof of enrollment in Medicare Part B, and the date Part B takes effect.

SFHSS cannot cover a Medicare eligible spouse or partner on your retiree medical coverage without proof of that dependent’s Medicare enrollment. If you have questions about Medicare enrollment for your spouse or domestic partner, contact the Social Security Administration - (800) 772-1213 or visit ssa.gov for office locations. 

If you and/or your spouse or partner are under age 65 and do not have a Social Security-qualified disability, skip to step 4. If you are not yet eligible, you do not need to enroll in Medicare at the time of your retirement. However, you will need to provide proof of enrollment in Medicare to SFHSS whenever you (or your dependent) becomes eligible: upon age 65, or sooner due to disability.

STEP 3: Call SFHSS for a New Retiree Consultation

Call SFHSS to speak with a Benefits Analyst for a retirement consultation.

STEP 4: SFHSS Retiree Health Benefits Enrollment

Visit SFHSS with following documents to complete your enrollment in retiree health benefits:

  • Bring your complete retirement packet from your retirement system to SFHSS.
  • If you or any of the dependents you would like to enroll on your retiree health plan are Medicare eligible, you must bring a Medicare card or a letter from the Social Security Administration confirming Medicare enrollment for yourself and those dependents.

Once you are retired, you must maintain continuous enrollment in Medicare by paying all required Medicare premiums to the federal government. Please remember to notify SFHSS whenever you have a change of address because your retirement system does not share address information. This way SFHSS can notify you about any important events, like information about annual Open Enrollment (which takes place every year during the month of October), and changes to your health benefits and retiree premium contributions. 

We wish you and your family a happy, healthy and enjoyable retirement!

Additional Resources: Documents List/Form/Calculator

Before coming to SFHSS, please review the Retiree Application Required Documents List. When you're ready to visit, please bring your Application for Retirement from your retirement system, and your SFHSS Retiree Health Benefits Enrollment Application, and proof of Medicare if you are Medicare eligible.

If you have turned 65 while working, you can download the CMS L564-508 Form, fill out your part, request that SFHSS fill out the employer part and submit to Social Security when you apply for Medicare, 90 days prior to your retirement date.

Use this Retiree Health Benefits Premium Calculator to help you estimate your health plan premiums based on current year premium rates. 

Posted On

May 7, 2026