Eligibility

To purchase a Group Medicare Advantage health plan, you must be enrolled in Medicare Part A and Part B1 and satisfy the eligibility requirements listed below.

If you are a member of the clergy, you must:

  • Be a former employee of an Episcopal employer
  • Be age 65 or older
  • Have a vested benefit under the Clergy Pension Plan

If you were a lay employee, you must:

  • Be a former employee of an Episcopal employer
  • At the time of your separation from employment, have been an employee scheduled to work, and compensated for, 1,000 or more hours per year for a minimum of five years
  • Be age 65 or older
  • And either:
    • Have participated in a pension plan sponsored by The Church Pension Fund for a minimum of five years OR
    • Be a former employee of a group that participated in a health plan offered through The Episcopal Church Medical Trust (Medical Trust)

If you are a member of a religious order, you must:

  • Be age 65 or older
  • And either:
    • Meet the eligibility criteria for former members of the clergy described above, or
    • Be a former member of a religious order that participated in a health plan offered by the Medical Trust

If you are a pre-65 retired employee who is disabled, you must:

  • Be receiving long-term disability benefits and be enrolled in Medicare Parts A and B
  • Be a former employee of a group that participated in a health plan offered through the Medical Trust and, at the time your employment ended, you were:
    • Participating in a Medical Trust plan, or were eligible to participate in a plan
    • At least age 55 or, if younger, were eligible for a disability retirement benefit under a pension plan sponsored by The Church Pension Fund or its affiliates prior to December 31, 2017
    • Enrolled in Medicare Parts A and B
    • If you are a cleric, you have a vested benefit under the Clergy Pension Plan
    • If you were a lay employee, have five or more continuous years of service with The Episcopal Church

If you are in Early Retirement, please call us at (800) 480-9967 Monday – Friday, 8:30AM – 8:00PM ET (excluding holidays) about your eligibility for Medical Trust health plans.

Your Dependents

Dependents must also be enrolled in Medicare Part A and Part B. Eligible dependents include your:

  • Spouse
    • If your spouse is over age 65 and you are an active employee, your spouse will be covered by your active medical benefits
  • Surviving spouse
  • Former spouse, provided the eligibility requirements are met
  • Domestic partner
  • Surviving domestic partner
  • Disabled2 dependent child, if the disability began before age 25
  • Surviving disabled dependent child, if the disability began before age 25

If you have questions, please call us at (800) 480-9967 Monday – Friday, 8:30AM – 8:00PM ET (excluding holidays).

 

1 Enrollment in Medicare Parts A and B is required for participation in the Group Medicare Advantage health plan, but is not required for the dental plans.

2 You are considered disabled if you have a medically determinable physical or mental condition which prevents you from engaging in substantial gainful activity and which can be of long-continued or indefinite duration.

 

The Episcopal Church Medical Trust Disclaimer