ENROLLING UNDER SPECIAL CIRCUMSTANCES


Turning 65

Required Documentation: Submit a copy of both sides of your signed Medicare card showing Part A and Part B coverage.

Effective Date: Generally, the effective date is the first day of the month following the date the SDCERA Health Plans Service Center receives your completed enrollment form(s) and documentation, but not prior to the month in which you turn 65. However, if your birthday is on the first of the month, your coverage can be effective the first of the month prior to your 65th birthday.

Enrolling Outside of Open Enrollment Period with a Qualifying Life Event

Required Documentation: Submit proof of the qualifying event, such as a retirement letter, a letter confirming loss of insurance coverage, a marriage certificate, domestic partner affidavit, birth certificate or proof of adoption for qualified dependents.

Effective Date: The first of the month following the date the SDCERA Health Plans Service Center receives your completed enrollment form(s) and required documentation.

Enrolling Your Spouse or Qualified Dependents

Required Documentation: Submit proof of the dependent’s status. To enroll a spouse or partner, provide a copy of your marriage certificate, Certificate of Registration of Domestic Partnership from the California Secretary of State, or a completed Affidavit of Domestic Partnership available from the SDCERA Health Plans Service Center. To enroll eligible dependent children, provide a birth certificate or proof of adoption for each qualified dependent.

Effective Date: The first of the month following the date the SDCERA Health Plans Service Center receives your completed enrollment form(s) and required documentation.

Plan Selection Restrictions: If you and your dependents are both enrolled in a Medicare plan, you must both be enrolled in the same plan. If one of you is in a Medicare plan, and the other is in a Non-Medicare plan, you must both be enrolled with the same insurance carrier.

If you have questions, please contact the SDCERA Health Plans Service Center at 866.751.0256 from 5:30 a.m. to 6:00 p.m. Pacific Time, M-F.