What health insurance do Oregon PERS retirees get?

The PERS Health Insurance Program, the two premium subsidies (RHIA and RHIPA), who qualifies, and the enrollment windows you can't afford to miss.

Rules checked October 18, 2026, against oregon.gov/pers, pershealth.com and medicare.gov

What PHIP is

The PERS Health Insurance Program is an optional group health plan for retired Oregon public employees and their families. It offers Medicare plans for people 65 and older, non-Medicare plans for younger retirees, and dental coverage. Retirees pay the premiums, usually deducted from the monthly pension or withdrawn from a bank account (PERS: Understanding PERS retiree health insurance).

Who can join

• Retirees receiving a PERS retirement allowance or benefit, including Tier One, Tier Two and OPSRP retirees, and people who took a lump-sum option.
• Spouses of eligible retirees.
• Domestic partners who meet IRS dependent rules: you lived together for at least 12 months before enrolling and you provide more than half their support.
• Children under 26, and some older dependents with a disability.
• Surviving spouses and dependents of a retiree, or of a member who was eligible to retire when they died.

Source: PHIP: Eligibility requirements. Tier One and Tier Two members who take a Total Lump Sum or get a benefit under $200 a month keep the right to join PHIP.

There's no service requirement to join PHIP itself. The 8-year rule applies only to the subsidies below.

When you can enroll

PHIP doesn't let you join whenever you like. You need an "enrollment opportunity" (PHIP: Enrollment opportunities):

If you'll be losing other coverage, PHIP suggests sending the form 60 days before it ends so there's no gap. Spouses gained new enrollment windows on August 1, 2026, including one tied to a Social Security award letter.

The 2026 open enrollment

PHIP is holding an open enrollment from October 1 to November 15, 2026 for coverage starting January 1, 2027. PHIP describes it as a one-time opportunity: retirees, spouses and dependents can join even if they turned PHIP down before, and retirees who left can come back. You can also choose a dental-only plan. Send the 2027 Enrollment Request Form by November 15 (PHIP: Open enrollment, October 1 to November 15). After that, you'll need another qualifying event to join.

RHIA: help with Medicare plan premiums

The Retirement Health Insurance Account (RHIA) pays $60 a month toward a PHIP Medicare plan premium. To qualify, you need all of these (PHIP: Premium subsidies):

• Tier One or Tier Two membership.
• Eight or more years of qualifying service at retirement, or a PERS disability retirement figured as if you had eight years.
• A PERS service or disability retirement allowance.
• Enrollment in Medicare Part A and Part B, and in a PHIP Medicare plan.

PHIP applies the subsidy automatically once PERS confirms you qualify, which can't happen until PERS finalizes your pension. A surviving spouse or dependent can also qualify in some cases, for example if they were covered under PHIP when the retiree died.

RHIPA: help for state retirees before Medicare

The Retiree Health Insurance Premium Account (RHIPA) helps Tier One and Tier Two retirees from state agencies pay for a PHIP non-Medicare plan until they qualify for Medicare. You must:

• Have at least eight years of state service. Only state service counts; years with a city, county or school district don't.
• Retire directly from a state agency, with a PERS effective date on the first of the month after you leave state employment.
• Not be eligible for Medicare. Once you are, RHIPA ends, and RHIA can take over if you move to a PHIP Medicare plan.

Source: PHIP: 2026 RHIPA rates. The subsidy comes off your monthly premium. PHIP may bill the full premium until PERS verifies your eligibility, then refund the difference.

OPSRP retirees and local government retirees

PERS describes both subsidies as being for "eligible Tier One/Tier Two retirees." OPSRP retirees can enroll in PHIP but don't get RHIA or RHIPA. Retirees from cities, counties and school districts can't get RHIPA, though their employer may offer its own retiree plan. PERS's preretirement guide notes that PHIP may not be the best choice before Medicare, and suggests checking your employer's retiree options too. Our guide to health insurance before Medicare compares the choices.

Lining PHIP up with Medicare

Your Medicare Initial Enrollment Period is the seven months around your 65th birthday: three months before, the birthday month, and three months after. Part B late enrollment penalties can last as long as you have Part B, unless you qualify for a Special Enrollment Period (Medicare.gov: When does Medicare coverage start?).

PHIP's Medicare plans require you to have both Part A and Part B. Your 90-day PHIP window at Medicare eligibility starts on your Medicare eligibility date, so sign up for Part B on time and send the PHIP form promptly. PHIP publishes a Medicare enrollment guide with the steps.

What to do next

1. Mark your 90-day window from your PERS effective retirement date, and decide before it closes.
2. Compare PHIP with other coverage, such as your employer's retiree plan, a spouse's plan, or the marketplace if you're under 65.
3. If you missed earlier windows, look at the open enrollment that ends November 15, 2026.
4. Call PHIP at 800-768-7377 (503-224-7377 in Portland) for plan rates and forms.

General information, not advice. We aren't part of Oregon PERS or PHIP. For plan rates and whether you qualify for a subsidy, call PHIP at 800-768-7377.