If you are a retired UFT member under age 65 and enrolled in the GHI CBP health plan, you will be automatically enrolled in the new NYC Employees PPO (NYCE PPO) plan effective Jan. 1, 2026. Here are some commonly asked questions about the new city health plan specifically for pre-Medicare retirees.

Does the new city health plan affect retirees enrolled in Medicare?

No. The city health plans for retirees on Medicare are not changing.

Are Medicare-eligible retirees enrolled in GHI Senior Care affected? 

No. If you are enrolled in the GHI Senior Care plan, you will remain in that plan with no changes. However, if you have dependents who are not Medicare-eligible and are enrolled in the GHI CBP plan, those dependents will be automatically transferred to the NYCE PPO plan.

Are retirees who are not enrolled in the GHI CBP plan affected by this change?

No. No other city health plans are changing.

I am a pre-Medicare retiree. Can I switch to the NYCE PPO plan if I am not currently in the GHI CBP plan? 

Yes. If you are currently enrolled in another city health care plan and wish to switch to the NYCE PPO plan, you may do so during the city’s annual open enrollment period in November. Any changes made during that period take effect on Jan. 1, 2026.

Will there be more in-network doctors available for pre-Medicare retirees living outside the New York area? 

Yes. Under the NYCE PPO plan, pre-Medicare retirees will have access to a national network of doctors and hospitals without needing a referral. Members living outside New York City and its eight surrounding counties will have access to 1.6 million providers nationwide through the UnitedHealthcare Choice Plus network. If you are traveling or on vacation, you can access care anywhere in the country without special approval.

For hospital coverage outside New York City and the surrounding eight counties, the NYCE PPO plan also uses the UnitedHealthcare’s Choice Plus network, ensuring broad in-network hospital access nationwide.

Will pre-Medicare retirees’ prescription drugs continue to be covered through an optional rider under the NYCE PPO plan? What will the new cost be?

Yes. Pre-Medicare retirees who purchase the optional prescription drug rider will receive coverage through the NYCE PPO plan’s pharmacy benefit manager, Prime Therapeutics. The new formulary will include more than 20,000 medications and 98% of prescriptions currently filled under the GHI CBP plan. A mail order service will still be available.

The cost for the optional rider is generally determined leading up to January and July each year based on overall plan utilization. While a specific rate is not yet available, it is expected to be comparable to the current cost.