Medicare & Post-65 Retiree Coverage
This page is for retirees age 65 and older, members who are Medicare-eligible due to disability, and anyone preparing to turn 65. Looking for eligibility rules, pre-65 medical plans, billing, or other benefits at retirement? See Retiree Benefits.
2027 Open Enrollment for retirees: Monday, October 26, 2026 through Monday, November 9, 2026 (11:59 p.m.)
If you are already enrolled and do not need to make any changes, no action is required. Changes take effect January 1, 2027. Enroll in FlexOnline. See 2027 Open Enrollment for Medicare-Eligible Retirees below for the steps.
Age 65 or older: you are on this page. Under age 65: see Pre-65 Retiree Medical on the Retiree Benefits page.
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What's Changing for 2027 2027 Open Enrollment Turning Age 65 and Medicare Common Questions Post-65 Medical (DCMS) Prescription Drug Coverage IRMAA and Medicare Links Who to Contact
What's Changing for 2027
- Out-of-pocket maximum: the medical out-of-pocket maximum increases from $450 to $900. The deductible stays at $250, and coinsurance stays at 20%.
- Prescription copays (1 to 30 day supply) for generic, preferred brand, and non-preferred brand drugs increase from $5 / $25 / $40 to $10 / $30 / $50. The prescription out-of-pocket maximum increases from $450 to $900.
- How DCMS works with Medicare: DCMS moves from the Standard Coordination of Benefits (COB) model to the Maintenance of Benefits (MOB) model. Medicare still pays first. DCMS then pays what is left of your covered costs, without using a benefit reserve.
- One Medical at Dartmouth will no longer collect copays at check-in. After Cigna processes your claim, One Medical will bill you for any amount you owe.
- Wellness: the Fitness Reimbursement Benefit is being discontinued on December 31, 2026. Submit any eligible 2026 expenses to Cigna by December 31, 2026.
2027 Open Enrollment for Medicare-Eligible Retirees
If you are already enrolled and do not need to make any changes, no action is required.
Dates and How to Enroll
Open Enrollment runs from Monday, October 26, 2026 through Monday, November 9, 2026 (11:59 p.m.). To enroll, add or remove dependents, change plans, or cancel coverage, use the FlexOnline benefit enrollment system. Select Access Your Retiree Benefits (FlexOnline). Changes take effect January 1, 2027. After Open Enrollment, changes are allowed only within 30 days of a qualifying life event.
- Select Access Your Retiree Benefits (FlexOnline).
- Enter your Dartmouth ID (found on your monthly invoice). If your Dartmouth ID starts with the letter D, do not enter the D. If this is your first time logging in, your mailed Open Enrollment letter explains how to create your password, and the Benefits Office can help.
- Click the green Visit the Enrollment Center button, then Enroll Now. Review your demographic and family information, and select Continue.
- On the Open Enrollment page, add or remove coverage and dependents, or change plans. Review and confirm your choices, and select Complete Enrollment. Print and save a copy of the confirmation page.
- Upload your dependent verification documents using Upload Verification Documents in the main menu. You can keep making changes to your 2027 elections until 11:59 p.m. on November 9, 2026.
Enrolling yourself or a dependent in DCMS for the first time? Send a copy of your Medicare ID card, showing Parts A and B, to the Benefits Office by November 9, 2026, to start coverage on January 1, 2027.
Adding Family Members
Eligible family members may be covered on a Dartmouth medical plan for an additional monthly cost. To add or remove a family member, take action in FlexOnline before November 9, 2026. Your own cost depends on your Dartmouth subsidy and is shown in your Open Enrollment materials and in FlexOnline.
| Family members covered | DCMS |
|---|---|
| Spouse, under age 65 | Not available |
| Spouse, age 65 or older | $1,017.63 |
| Child(ren), under age 26 | Not available |
| Spouse under age 65 plus child(ren) under age 26 | Not available |
"Not available" means that coverage is not available for that family member. If you have dependents under age 65 covered on a Dartmouth medical plan, you will also receive the Medical Plans Summary of Material Modifications.
Billing
If your monthly total is more than $0.00, you will receive a monthly statement from Dartmouth Accounts Receivable starting in mid-January 2027. Pay the full amount each month. Partial payments cannot be accepted, and if full payment is not received, your coverage will end on the first day of the month the payment is due. If your total is $0.00, you will not receive a bill. To set up Speedpay for electronic payments, contact the Accounts Receivable Office at 603-646-3899 or visit dartgo.org/ar-speedpay.
Death Benefit
Retirees who retired on or before December 31, 2010 have a $5,000 Death Benefit. Family members are not covered. To update your beneficiaries, contact the Benefits Office for a Beneficiary Form and mail the completed form to the Office of Human Resources, 7 Lebanon St., Suite 203, Hanover, NH 03755.
Questions?
Contact the Benefits Office at 603-646-3588 during Open Enrollment office hours on November 2 and November 5, from 9 a.m. to 12 p.m. and 1 to 3 p.m., or email Human.Resources.Benefits@dartmouth.edu.
Turning Age 65 and Medicare
What to know whether you're still working, retiring soon, or already retired.
I Plan to Continue Working Past Age 65
Dartmouth employees and their eligible dependents can stay covered on the active Dartmouth health plan until the primary subscriber (the employee) retires.
- You do not need to enroll in Medicare Part B or Part D right now if you continue working. Medicare lets you delay enrollment as long as you have Creditable Coverage through your employer or your spouse's employer. Creditable Coverage is coverage that is equal to or better than what Medicare offers. Note: COBRA coverage is not considered Creditable Coverage by Medicare.
- Enrolling in Medicare Part A at this time is optional. Part A is premium free, and enrolling does not affect your active Dartmouth coverage. However, you cannot contribute to an HSA if you're enrolled in any part of Medicare or Social Security. Stop contributing to your HSA at least 6 months before enrolling in either, to avoid a penalty. See the Medicare and You booklet for details.
- If you enroll in Medicare Part B, you pay a monthly premium.
I Plan to Retire Soon
If you're eligible for Dartmouth retiree health coverage (at least age 55, with at least ten consecutive years of service in a benefits-eligible position immediately before retiring):
- Enroll in Medicare. Contact Social Security at 800-772-1213 three months before your retirement date to enroll in Medicare Part B, and Part A if you are not already enrolled, for yourself and any Medicare-eligible household members you plan to continue covering. If you already receive a monthly Social Security benefit, Social Security automatically enrolls you in Parts A and B. Social Security sets your Part B premium and collects it directly from you.
- Contact the Benefits Office. Schedule a meeting 3 to 4 months before your retirement date to set up your DCMS coverage. See Considering Retirement on the Retiree Benefits page.
- Send your Medicare card. Send a copy of your new Medicare card, showing Part A and Part B, to the Benefits Office within 45 days before your coverage effective date. Parts A and B must be in place before DCMS can pay your claims, and a late card may cause a lapse in coverage.
- Do not enroll in a separate Medicare Part D plan. DCMS includes Part D prescription drug coverage through Express Scripts.
- Return your Retiree Health Election form to enroll in DCMS and the Medicare Part D plan.
When your coverage starts: your DCMS and Medicare Part D coverage begin on the first of the month following your retirement date, to coincide with your Medicare Part B start date. For example, if you retire on May 15, your active benefits end May 31, and your DCMS plan and Medicare Part B begin June 1.
For everything to do before you leave, including your department notice, payroll authorization, and retirement accounts, see the Retirement Checklist on the Retiree Benefits page.
If you're not eligible for Dartmouth retiree health coverage:
- Contact Social Security 3 months before your last day of work to enroll in Medicare Part B (and Part A, if not already enrolled) for yourself and any Medicare-eligible household members currently on your Dartmouth plan.
- Find more on Medicare.gov.
- Visit the Leaving Dartmouth page for how your benefits will be affected when you retire.
I Retired Prior to Turning Age 65
If you are a retiree, or the spouse of a retiree, turning 65:
- Contact Social Security 3 months before your 65th birth month to sign up for Medicare Part B, and Part A if you have not already.
- Send a copy of your new Medicare card, showing the Part A and Part B effective dates, to the Benefits Office within 45 days before your effective date. If we do not receive it in time, your enrollment and coverage for services may be delayed.
- Your Medicare coverage should begin on the first of your birth month. If your birthday is on the 1st, it should begin on the first of the prior month. For example, if you were born on August 2, your Medicare Part B and DCMS plan begin August 1. If you were born on August 1, they begin July 1.
- If you enroll in DCMS, do not enroll in a separate Medicare Part D plan. DCMS supplements Medicare Parts A and B and includes Part D prescription drug coverage.
What changes when you enroll in DCMS:
- DCMS replaces your existing medical insurance plan.
- Your DCMS and Part D coverage begin on the same date as your Part B coverage.
- A spouse under 65 who is covered on your Retiree Health plan may stay on the same plan until they turn 65.
- Dependent children covered on your Retiree Health plan may stay on the same plan through age 26.
Late enrollment penalty: Medicare may charge a late enrollment penalty if you are not enrolled in Creditable Coverage by your effective date. Creditable Coverage is coverage that is as good as or better than what Medicare offers.
Common Questions About Retiring and Medicare
How do I enroll in Medicare?
Contact Social Security at 800-772-1213 three months before your retirement date to set up your Medicare coverage. If you already receive a monthly Social Security benefit, Social Security automatically enrolls you in Medicare Part A and Part B.
When does my retiree health coverage begin?
Coverage in the Dartmouth College Medicare Supplement (DCMS) plan begins on the first of the month following your retirement date, to coincide with your Medicare Part B start date. For example, if you retire on May 15, your active benefits end May 31, and your DCMS plan and Medicare Part B begin June 1. Late submission of the required documents delays your Medicare Part D prescription drug plan.
When will my active employee benefits end?
All active benefits end on the last day of the month in which your benefits-eligible position ends. For example, if your last day of employment is July 10, your active benefits end July 31.
Which insurance pays first, Medicare or my Dartmouth plan?
Medicare pays your claims first. What Medicare does not cover goes to Cigna to pay second. Your Cigna plan is your primary medical insurance while you are an active employee, but once you retire and enroll in DCMS, Cigna pays after Medicare. You pay the balance, up to your plan's out-of-pocket maximum.
How does the DCMS plan work?
To enroll in DCMS, you must have Medicare Part A and Part B through Social Security, which pay as your primary insurance in retirement. DCMS is your secondary plan and helps pay for covered services that Medicare does not completely cover. You pay the balance, subject to the DCMS annual out-of-pocket maximum.
How do I pay Dartmouth if I owe a premium for my retiree health coverage?
After you enroll in a Dartmouth retiree health plan, you receive a monthly invoice from Dartmouth for any unsubsidized portion of your household retiree health plan costs. The invoice includes a remittance address where you can mail a check or money order. If you have a 100% subsidy and owe no premium, you do not receive an invoice. See Billing and Premiums on the Retiree Benefits page.
Post-65 Retiree Medical (DCMS)
Cigna Health Insurance
Customer Service: (855) 869-8619
mycigna.com
The Dartmouth College Medicare Supplement (DCMS) Plan is available to qualifying Dartmouth retirees age 65 and above, and to members who are Medicare-eligible due to disability. DCMS pays second after Medicare Parts A and B, and includes Medicare Part D prescription drug coverage. One Medical at Dartmouth primary care practice is available to those enrolled in DCMS.
DCMS at a Glance (2027)
These are the 2027 amounts. The 2026 amounts and what changed are listed under What's Changing for 2027 at the top of this page.
| Medical coverage | 2027 |
|---|---|
| Deductible | $250 |
| Coinsurance | 20% |
| Medical out-of-pocket maximum | $900 |
| Supply | Generic | Preferred brand | Non-preferred brand |
|---|---|---|---|
| Retail pharmacy, 1 to 30 day supply | $10 | $30 | $50 |
| Retail pharmacy, 31 to 60 day supply | $20 | $60 | $100 |
| Retail pharmacy, 61 to 90 day supply | $30 | $90 | $150 |
| Home delivery or CVS retail pharmacies, 90 day supply | $20 | $60 | $100 |
The prescription out-of-pocket maximum is $900. The full terms are in the Summary Plan Description and the Summary of Material Modifications below.
Plan Overview
All buttons below open PDF files.
DCMS Summary of Benefits (2026) DCMS Summary Plan Description
To request a printed copy, an accessible copy, or help finding information in these documents, contact the Benefits Office at (603) 646-3588.
Eligibility and Medicare
To be eligible for DCMS, you must meet the plan's minimum qualifications and be enrolled in Medicare Part A and Part B, per Social Security Administration rules.
Do not enroll in a separate Medicare Part D if you want DCMS coverage. DCMS pays second after Medicare Parts A and B and already provides Part D prescription coverage.
For more on Medicare, visit Medicare.gov or the Social Security Administration website, or find your local SSA office with the office locator.
Open Enrollment Materials
Mailed to your home each year, and available here:
All buttons below open PDF files.
Creditable Coverage Notice 2027 Summary of Material Modifications: DCMS
The DCMS summary lists the 2027 changes to your plan.
Changing Your Election
You may change your DCMS election during Open Enrollment, or any time during the year following a qualifying event. Notify the Benefits Office in writing within 30 days of the event.
Active Employees Becoming Medicare-Eligible
If you're not yet a retiree but are Medicare-eligible (for example, turning 65 or due to a disability), contact the Benefits Office for more information about your coverage options.
Billing and Subsidy
Questions about your premium, Dartmouth's subsidy, or monthly invoices? See Billing and Premiums on the Retiree Benefits page.
Prescription Drug Coverage
The Medicare Part D plan offered through Dartmouth includes a flat tiered copayment for each prescription, until you've met the annual out-of-pocket maximum ($450 in 2026 and $900 in 2027). See the 2026 Formulary (PDF) for the current list of covered medications (subject to change). The 2027 formulary will be added here when it is available.
Using a PO Box? If your mailing address is a PO Box, you must also provide a separate residence address to use Dartmouth's Medicare Part D plan. Express Scripts will mail to a PO Box, but it uses your residence address to verify your US residency.
Key Features
- A broad retail network of more than 69,000 pharmacies nationwide, including independents and chains like CVS and Walgreens.
- 90-day supplies of maintenance medications can be filled through Express Scripts Medicare (PDP) mail service or at a CVS pharmacy.
- Your actual copay depends on which tier your drug falls into (Generic, Preferred Brand, or Non-Preferred Brand). Call Express Scripts Medicare Customer Care at 1-877-788-5810 (24/7) to check your drug's tier or any restrictions.
IRMAA and Medicare Links
Medicare Income-Related Monthly Adjustment Amounts (IRMAA)
Your Medicare Part B premium is based on your income, as reported on your federal tax return. IRMAA is an amount you may pay in addition to your Part B or Part D premium if your income is above a certain level. The Social Security Administration sets four income brackets that determine your (or you and your spouse's) IRMAA, based on the adjusted gross income reported on your tax return two years prior, plus other tax-exempt income. If you're expected to pay IRMAA, SSA will notify you of the higher premium. See the Social Security Administration's Medicare premiums page for the current IRMAA brackets and premium amounts.
Extra Help With Prescription Costs
Extra Help, also called the Low Income Subsidy (LIS), is a Medicare program that helps people with limited income and resources pay Medicare prescription drug costs. You may qualify if your yearly income and resources are below the program limits. See the Medicare Extra Help Program link below and your Medicare and You booklet for details.
Helpful Medicare Links
These buttons open PDF files, except Medicare Website (a web page), Who Pays First (Coordination of Benefits) (a web page), Medicare Extra Help Program (a web page), and TRICARE for Life (a web page).
Medicare Website Medicare and You Booklet Who Pays First (Coordination of Benefits) Medicare Extra Help Program TRICARE for Life
Who to Contact
- Medicare questions: Medicare.gov or the Social Security Administration.
- DCMS plan questions: Cigna Health Insurance at 1-855-869-8619. Claims go to P.O. Box 182223, Chattanooga, TN 37422-7223. Account access is at mycigna.com.
- Coverage changes or eligibility questions: contact the Benefits Office at (603) 646-3588, fax (603) 646-1108.
Need help? Contact Benefits | Benefit Plan Cost Estimator | Access Your Retiree Benefits (FlexOnline) | Leaving Dartmouth
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