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NYC Medicare Advantage Plus opt-out forms: use current retiree instructions

Old NYC Medicare Advantage Plus forms are not current universal enrollment instructions. Check OLR notices, active benefits and permitted changes.

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Do not submit an old NYC Medicare Advantage Plus opt-out form as if it applies to all current City retirees. The City's 2026 official statement says it is not moving forward with the proposed Medicare Advantage replacement. Historical proposal documents are not proof of a current required election.

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Confirm your actual City benefits

The NYC Health Benefits Program serves eligible employees, retirees and dependents; it is not a plan available to every Medicare beneficiary living in New York City. Start with your active enrollment record and current Office of Labor Relations notices.

Question Where to check
Which plan is active? Current City enrollment record and insurer.
Can I change or waive coverage? Current OLR retiree instructions and applicable window.
What happens to dependents? Health Benefits Program and welfare fund, if applicable.
Which form should I use? Official current forms linked by OLR.

Keep Medicare and non-Medicare notices separate

The City's 2026 statement distinguishes its new arrangement for active employees and pre-Medicare retirees from Medicare retiree coverage. A notice about a non-Medicare plan is not automatically an instruction for a Medicare-enrolled retiree.

Before signing a change request

  1. Verify the form title, current instructions and intended plan.
  2. Confirm whether the action changes a plan or waives City benefits.
  3. Ask how dependents and other benefits are affected.
  4. Submit through the official program channel.
  5. Keep the confirmation and effective date.

Do not send an obsolete form to a department named in an old article. Ask OLR which process applies now. If enrolling in outside coverage, check the consequences for City and welfare-fund benefits before submitting the application.

Related coverage questions

Official sources

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