The rule
Washington's Public Employees Benefits Board (PEBB) program, run by the Health Care Authority (HCA), offers retiree health coverage to eligible retirees from state agencies, higher education, and participating employer groups, as well as school employees who retire from SEBB-covered jobs. WAC 182-12-171(3) says that a retiring employee or school employee who retired after July 1, 1991, and their enrolled dependents, must enroll and maintain enrollment in both Medicare Part A and Part B if eligible. The same applies if a retiree or dependent becomes eligible for Medicare later. If an enrollee doesn't meet this requirement, they are no longer eligible for a PEBB retiree health plan.
For Part A, "eligible" here means eligible without a monthly premium, which describes most people with 40 quarters of work under Social Security or a spouse who has them.
When to sign up
- Turning 65 while retired: HCA says you and your dependents are required to enroll in Part A and Part B as soon as you are eligible. Sign up during your Initial Enrollment Period, the seven months around your 65th birthday month, so Medicare starts when PEBB expects it.
- Retiring after 65: while you had employee coverage from current work, you could delay Part B. When you retire, sign up with Social Security before your employee coverage ends. You'll need your employer to complete a form showing your group coverage, which also protects you from the Part B late penalty.
- Applying for PEBB retiree coverage: the PEBB program must receive your retiree enrollment form no later than 60 days after your employer-paid, COBRA or continuation coverage ends. Medicare Advantage and certain PEBB Medicare plans can't start retroactively, so send the forms early.
Your PEBB Medicare plan choices
Once you have Part A and Part B, PEBB offers Medicare plans for retirees: Medicare Advantage plans with prescription drug coverage, a Medicare supplement plan, and a PEBB-sponsored plan that works with Original Medicare. HCA says all PEBB medical plans except the Medicare supplement plan include Part D or creditable drug coverage. PEBB doesn't offer a stand-alone Part D plan, and if you or your spouse enroll in an outside stand-alone Part D plan, your only PEBB medical option is the Medicare supplement plan. PEBB retirees can change plans during PEBB's annual open enrollment, which for 2027 coverage runs October 26 through November 23, 2026.
Before you join an outside plan: HCA warns that buying a Medicare Advantage or other Medicare plan from a private company may cost you your right to enroll in PEBB retiree insurance coverage. Check with the PEBB program first.
Get help
For questions about PEBB eligibility, forms and PEBB plans, contact HCA's PEBB program. For signing up for Part A and Part B, contact Social Security at 1-800-772-1213. If you are comparing PEBB coverage with other Medicare options, a licensed insurance agent with Benefits Life can explain the trade-offs at no cost to you: (206) SENIORS (206-736-4677), TTY 711. See also PEBB and Medicare and SEBB and Medicare.
Related questions
Do I need Part B if I'm still working?
When job-based coverage lets you wait.
How do I sign up for Medicare in Washington?
Applying with Social Security.
When does Medicare start?
Start dates for Part A and Part B.
Sources
- WAC 182-12-171 — Eligibility and enrollment in PEBB retiree insurance coverage (Medicare Parts A and B requirement)
- Washington State Health Care Authority — Medicare and turning age 65 (PEBB retirees)
- Health Care Authority — PEBB retiree eligibility
- Medicare.gov — When does Medicare coverage start?
- Social Security — Sign up for Medicare
Frequently asked questions
Do I need Part B while I'm still working for the state?
No. The requirement applies to retirees. While you have PEBB or SEBB employee coverage from current work, you can delay Part B without a penalty and sign up later during a special enrollment period.
Do I have to take Part A if I'd have to pay for it?
No. For this PEBB rule, being eligible for Part A means being eligible for Part A without a monthly premium. If you'd have to buy Part A, the requirement covers Part B.
Can I buy my own Medicare Advantage plan instead of a PEBB plan?
You can, but HCA warns that if you buy a private Medicare Advantage or other Medicare plan, you may lose your right to PEBB retiree insurance coverage. Ask the PEBB program before you enroll in any outside plan.
Do I need a separate Part D plan?
Not with most PEBB retiree medical plans, which include Part D or creditable drug coverage. The exception is PEBB's Medicare supplement plan, which has no drug coverage; if you choose it, you should get a stand-alone Part D plan to avoid a late penalty.
Medicare in your Washington county
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