Retiree Medical Plan Options

The City offers you a variety of Medical Plan options for which you may be eligible, depending on your Medicare eligibility status. Each of the plans cover 100% of in-network preventive care, even before you meet the deductible.

Non-Medicare Retiree Medical Plan Options

These options are available to you and your dependents and are the same as those offered to active employees.

Medicare Advantage Medical Plan Options

If you and/or your spouse are eligible for Medicare, you also may wish to enroll in one of the following supplement plans.

  • UnitedHealthcare Medicare Advantage PPO (Parts A & B)
  • Anthem BCBS Medicare Advantage PPO (Parts A & B)
  • Kaiser Permanente Senior Advantage HMO (Parts A & B)
  • UnitedHealthcare Medicare Advantage PPO (Part B only)
  • Medicare Advantage Plan Comparison Chart 2024

If you sign up for any Medicare Advantage Plan (other than the Medicare Advantage plans offered by the City) that may be offered to you directly by various vendors, YOUR COVERAGE THROUGH THE CITY OF ATLANTA WILL BE TERMINATED. If you have any questions about this, please call the DHR – Employee Benefits at 404-330-6036 before signing up for another plan.

Medicare Advantage SPLIT Retiree Medical Plan Options

If your family is enrolling for Medical Plan benefits but not all covered persons are Medicare-eligible, you must choose from our SPLIT plan options. At least one person must be Medicare-eligible.

The Anthem BCBS POS Blue Open Access option available to you and your dependents is the same as that offered to active employees. For information about the plan, click here.

The Kaiser Permanente HMO option available to you and your dependents is the same as that offered to active employees. For information about the plans, click here.

The UnitedHealthcare Group Medicare Advantage PPO is a Medicare Advantage plan that coordinates with Medicare Parts A and B. (UnitedHealthcare also offers a plan that coordinates with Medicare Part B only.)

The plan is a Preferred Provider Organization (PPO) that gives you the freedom to go to any provider that accepts Medicare, anywhere in the United States. The provider does not have to be part of the UnitedHealthcare network. You pay the same copay or coinsurance whether your provider is in- or out-of-network.

For help in finding a network provider, call Customer Service at the number listed on the back of your ID card or view the online directory at www.retiree.UHC.com.

Solutions for Caregivers

This program is designed to support family caregivers in helping aging family members stay healthier, function as independently as possible, and live with dignity. Caregivers are given assistance in:

  • Maintaining their own health,
  • Mitigating stress,
  • Coping with caregiver burnout, and
  • Maximizing available community resources and support.

Treatment Decision Support

Registered Nurses with specialized training are available to assist retirees in making care decisions. Members will receive help in selecting appropriate treatment and accessing cost-effective care.

Housecalls

Housecalls offer care coordination service to retiree members, including:

  • Personalized in-home visits by health care practitioners to assess the member’s health conditions
  • Refer members into care management programs as needed

Retirees and/or their spouses covered by Parts A & B of Medicare who enroll with Kaiser Permanente are only eligible for Senior Advantage. Other family members may enroll in the HMO plan. When joining Kaiser Permanente Senior Advantage, you must complete a separate application. When/if you terminate your Kaiser Senior Advantage, you must complete a Medicare disenrollment form.

The Kaiser Senior Advantage HMO covers in-network services only. If you go out-of-network, the plan will not cover that care.

When you join Kaiser Permanente, you pick a Primary Care Physician (PCP) within the Kaiser network. You may choose a physician in family medicine, general practice, adult medicine, or pediatrics/adolescent medicine as a personal physician. If you do not choose a PCP during enrollment, one will be assigned to you.

Specialty Care

You may self-refer for Mental Health/Chemical Dependency, Dermatology and OB/GYN care. All other specialty care services require prior authorization from your PCP.

Currently, Kaiser Permanente has 26 conveniently located medical centers throughout metro Atlanta. For a listing of the providers covered under the Kaiser Permanente plan, please visit www.kp.org.

No referral is required for specialty services available at the Kaiser Permanente Medical Centers. A referral is required for specialty care outside of a Kaiser Permanente Medical Center.

Customer Service and Health Line

There is one number to call to make or cancel appointments, speak with an advice nurse, or access after-hours urgent care — regardless of which Kaiser Permanente Medical Center you use. Call the Health Line at 404-365-0966 locally or 800-611-1811 long distance.

To schedule or cancel appointments, you may call Monday through Friday from 7 a.m. to 7 p.m. The Health Line is open so you can speak with an advice nurse 24 hours, seven days a week. You also may schedule and cancel appointments yourself by logging into www.kp.org.

If you have questions about the plan, call Senior Advantage Customer Services Department from 8:30 a.m. to 5 p.m., Monday through Friday, at 404-233-3700 or 800-232-4404 (TTY: 800-255- 0056). You also can visit www.kp.org.

The Anthem BCBS Medicare Advantage Plan PPO is a Medicare Advantage plan available to those enrolled in Medicare Parts A and B.

When you enroll in the Anthem BCBS Medicare Advantage PPO Plan, your prescription drugs also are covered (with coverage coordinated with Medicare). The plan covers a portion of your costs up to your initial coverage limit, and during the coverage gap (“donut hole”).