PERS Gold Supplement to Original Medicare plan

PERS Gold Supplement to Original Medicare plan: January 1, 2026 - December 31, 2026

• Evidence of Coverage
• Reimbursement Request Form
• Travel Reimbursement Form

PERS Gold Supplement to Original Medicare plan: January 1, 2025 - December 31, 2025

• Evidence of Coverage
• 2025 Pharmacy Benefits
• Reimbursement Request Form
• Travel Reimbursement Form

PERS Platinum Supplement to Original Medicare plan

PERS Platinum Supplement to Original Medicare plan: January 1, 2026 - December 31, 2026

• Evidence of Coverage
• Reimbursement Request Form
• Travel Reimbursement Form

PERS Platinum Supplement to Original Medicare plan: January 1, 2025 - December 31, 2025

• Evidence of Coverage
• 2025 Pharmacy Benefits
• Reimbursement Request Form
• Travel Reimbursement Form