CalSTRS Medicare Premium Payment Program (MPPP): Eligibility and Rules

What the MPPP Covers

The CalSTRS Medicare Premium Payment Program pays Medicare Part A (hospital insurance) premiums for eligible retired members who do not qualify for premium-free Part A through their own or a spouse's work history. Under California Education Code Section 25940, CalSTRS pays the Part A premium for eligible members. Confirm the current premium amount with Medicare or the Social Security Administration.

The program does not cover Medicare Part B premiums, Part D (prescription drug) premiums, Medigap supplemental plan premiums, or any late-enrollment penalties.

The Critical Eligibility Cutoff

The MPPP has a hard statutory deadline that cannot be waived: your most recent effective CalSTRS service retirement date must be on or before June 30, 2012. Members who retired after that date are permanently ineligible, regardless of their age, service credit, or Medicare status.

Members also had to retire on or after January 1, 2001, from a school district that conducted a Medicare Division before their retirement date. This means that any California educator retiring today — or at any point in the future — cannot access the MPPP. The program was effectively closed to new retirees more than fourteen years ago.

Why This Matters for Current Pre-Retirees

Because California public school teachers generally do not pay Social Security taxes through their CalSTRS-covered employment, many educators reach age 65 without accumulating the 40 quarters of Medicare-covered employment needed for premium-free Medicare Part A. Before the MPPP cutoff, CalSTRS paid those premiums for eligible members from participating districts.

If you are retiring after June 30, 2012, and you lack 40 quarters of Medicare-eligible employment, you have three paths to Medicare Part A coverage:

Qualify through a spouse's work record. If your spouse has 40 or more quarters of Medicare-covered employment, you can enroll in premium-free Part A based on their record.

Earn the quarters yourself. Some educators work summer jobs, part-time positions, or pre-teaching careers that contributed to Social Security. Check your Social Security statement at ssa.gov to verify your quarter count.

Pay the premium out of pocket. Without enough quarters, you must pay the applicable Part A premium yourself unless you qualify through a spouse's work record. Confirm the current premium with Medicare or the Social Security Administration.

Medicare Part B Is Separate

The MPPP does not cover Medicare Part B. All MPPP recipients must enroll in Part B and pay its monthly premiums themselves; confirm your enrollment timing and current premium with Medicare or the Social Security Administration.

How MPPP Interacts with District Health Benefits

CalSTRS does not provide health insurance. Your medical, dental, and vision coverage as a retiree is determined entirely by your school district's collective bargaining agreement. Some districts provide retiree health benefits until age 65, at which point Medicare becomes primary and district coverage becomes supplemental. Other districts offer no retiree health coverage at all.

Members who were eligible for the MPPP used it alongside their district benefits — MPPP covered Part A premiums, district coverage (if available) filled the remaining gaps, and Part B premiums remained the retiree's responsibility.

For post-2012 retirees, coordinating Medicare enrollment with district health coverage transitions is one of the most important logistics in the retirement timeline. The CalSTRS Retirement Guide covers the health coverage bridge from your last district paycheck through Medicare enrollment, including how to set up direct premium deductions from your CalSTRS benefit check.

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