Retiree Medical Plans
Choosing and personalizing your benefits depends on your specific health care needs, doctor preferences, budget and the type of plan you prefer.
For retirees, we offer three types of medical plans. View more information about Medicare eligibility or select one of the plans below to learn more. Read the Retiree Medical Plan FAQ to learn more about becoming an official retiree, different contribution methods and the break in service policy.
1. Medicare Advantage Plans
We offer a variety of Medicare Advantage plans that work hand-in-hand with your Medicare benefits. You assign your Medicare benefits to the Medicare Advantage HMO you select, and the HMO coordinates with Medicare. There are no claim forms to fill out and your only out-of-pocket costs are your copayments.
How These Plans Work
Medicare Advantage plans work the same as your active employee HMO. Except for Kaiser, you select a primary care physician (PCP) from your plan's network of doctors to coordinate all your care. With Kaiser, all care must be within a Kaiser facility. And for all HMOs, you receive no benefits if you go outside your network, unless you have an emergency.
We currently have 2 Medicare Advantage Plans:
- Kaiser Senior Advantage
- Health Net Seniority Plus
If you enroll in one of these plans you have to complete a Medicare Advantage Form prior to the effective date of coverage. CMS (Centers for Medicare & Medicaid Services) requires that you use a physical address for your permanent/home address. A PO Box may be used for your mailing address. If you change your address (with Social Security, CMS, the Post Office, the health plan or Stanford) to an address outside of the local service area, regardless of whether you are just living or traveling temporarily, you will become ineligible for this Medicare Advantage Plan.
If you choose to leave a Medicare Advantage plan to join a non-Medicare Advantage plan you will need to complete a Disenrollment form.
2. Medicare Supplement Plans
Under a Stanford Medicare Supplement plan, Medicare is the primary medical plan for you and your dependents. You can go to any provider; however, you will have lower costs if you use a provider who accepts Medicare assignment. The Medicare Supplement plan pays benefits after you receive payment from Medicare.
Remember: If you choose to go outside your supplement plan's network of doctors, your benefits will be limited to services covered under Medicare only and must be provided by a doctor who accepts Medicare assignments.
3. Non-Medicare Plans
If both you and your dependents are non-Medicare eligible, you receive active employee medical benefits.
Transparency in Coverage - Machine Readable Files
The Transparency in Coverage rule released by the Department of Health and Human Services (HHS), the Department of Labor, and the Department of the Treasury requires group health plans, such as Stanford’s, and health insurers to make price information available to consumers. We are required to post the following links for each of our medical plan vendors effective July 1, 2022. The information available through these links is provided in good faith compliance with the Machine-Readable Files approach. These files display negotiated rates for covered items and services between the health plans and in-network providers for the plans. Some in-network provider arrangements do not prescribe rates for all covered items and services. In those cases, the provider’s reimbursement might be determined in several different ways, but this file would not contain that information. Pharmacy Machine readable files are not an enforced requirement and will not be available.