Health plan documents for CalPERS retirees
PERS Gold Supplement to Original Medicare plan
PERS Gold Supplement to Original Medicare plan: January 1, 2027 - December 31, 2027
- Evidence of Coverage (coming soon)
- Reimbursement Request Form (coming soon)
- Travel Reimbursement Form (coming soon)
PERS Gold Supplement to Original Medicare plan: January 1, 2026 - December 31, 2026
PERS Platinum Supplement to Original Medicare plan
PERS Platinum Supplement to Original Medicare plan: January 1, 2027 - December 31, 2027
- Evidence of Coverage (coming soon)
- Reimbursement Request Form (coming soon)
- Travel Reimbursement Form (coming soon)
PERS Platinum Supplement to Original Medicare plan: January 1, 2026 - December 31, 2026
Page Last Updated 11/03/2025