The basic test
Eligibility for retiree insurance is not the same as retirement eligibility; only PEBA decides. For any retiree coverage, the last five years must be served consecutively in a full-time, insurance-eligible permanent position with an employer in the State Health Plan. Premium share depends on earned service, employer type and date hired into an insurance-eligible position (before or on/after May 2, 2008). Retiree Insurance Eligibility, Funding (state), PDF p. 1
Tables apply when the last employer is a state agency, public higher education institution, public school district or charter school in both insurance and retirement (participates in the Retiree Health Insurance Trust Fund). Optional employers decide the retiree share themselves. Retiree Insurance Eligibility, Funding (state), PDF p. 2
Uses earned service credit with an employer in the State Health Plan; purchased service that is not earned service (e.g. non-qualified service) does not count. State ORP years count as earned service for this test. Retiree Insurance Eligibility, Funding (state), PDF p. 1 That matters if you're buying service credit.
Hired into an insurance-eligible position before May 2, 2008
| Earned years | If you left work after reaching retirement eligibility |
|---|---|
| 5 to under 10 | You pay the full premium (employee and employer share). |
| 10 or more | You pay only the employee share. |
| Earned years | If you left work before reaching retirement eligibility |
|---|---|
| 0 to under 20 | Not eligible for retiree insurance. |
| 20 or more | Eligible on reaching retirement eligibility; you pay only the employee share. |
Hired into an insurance-eligible position on or after May 2, 2008
| Earned years | If you left work after reaching retirement eligibility |
|---|---|
| 5 to under 15 | You pay the full premium (employee and employer share). |
| 15 to under 25 | You pay the employee share and 50% of the employer share. |
| 25 or more | You pay only the employee share. |
| Earned years | If you left work before reaching retirement eligibility |
|---|---|
| 0 to under 20 | Not eligible for retiree insurance. |
| 20 to under 25 | Eligible on reaching retirement eligibility; employee share + 50% of employer share. |
| 25 or more | Eligible on reaching retirement eligibility; employee share only. |
The dividing date is May 2, 2008.
The retiree health premium-share rules come from a PEBA flyer good through 2026.
We use the 2026 flyer.
Retiree Insurance Eligibility, Funding (state)2027 premiums for funded retirees
- Medicare Supplemental: $97.68 a month
- Standard Plan (not on Medicare): $97.68 a month
- Savings Plan (not on Medicare): $9.70 a month
Retiree-only coverage for funded retirees. 2027 funded-retiree premiums (retiree only): Medicare Supplemental $97.68, Standard Plan (non-Medicare) $97.68, Savings Plan $9.70 a month; tobacco-use premium $40. 2027 Monthly insurance premiums for funded retirees, PDF pp. 1-2
Medicare-eligible retirees: PEBA's checklist asks you to enroll in Medicare Parts A and B if that applies to you; see SCRS and Social Security.
Common reasons people don't qualify
Top reasons for ineligibility: a break in the last five years or those years not full-time, insurance-eligible and consecutive; a refund that was never repaid; retiring ineligible then returning to work (working retirees earn no service). Retiree Insurance Eligibility: It's Complicated!, PDF p. 1
From the sources
- Qualifying to retire doesn't mean you qualify for retiree health insurance. Only PEBA can decide, so check with them before you set your date.Retiree Insurance Eligibility, Funding (state), PDF p. 1
- For any retiree coverage, your last five years must be consecutive, full-time and permanent with an employer in the State Health Plan.Retiree Insurance Eligibility, Funding (state), PDF p. 1
- If you were hired into an insurance-eligible job before May 2, 2008 and retire from a school district: with 5-9 years of earned service you pay the full premium, and with 10 or more you pay only the employee share.Retiree Insurance Eligibility, Funding (state), PDF p. 2
- Hired on or after May 2, 2008: with 5-14 years you pay the full premium. With 15-24 you pay the employee share plus half the employer share. With 25 or more you pay only the employee share.Retiree Insurance Eligibility, Funding (state), PDF p. 2
- Leave before you're eligible to retire with fewer than 20 years and you get no retiree coverage.Retiree Insurance Eligibility, Funding (state), PDF p. 2
- In 2027 a funded retiree pays $97.68 a month for retiree-only Medicare Supplemental or Standard Plan coverage, or $9.70 for the Savings Plan. There's an extra $40 if you use tobacco.2027 Monthly insurance premiums for funded retirees, PDF pp. 1-2
Questions
Is retiree health the same as retirement eligibility?
No. They're separate tests, and only PEBA decides your retiree insurance eligibility.
Do bought years count?
Not all of them. The tables use earned service. Non-qualified service you buy doesn't count. State ORP years do.
What's the most common reason people aren't eligible?
A break in the last five years, or those years not being full-time, insurance-eligible and consecutive.
Related: going back to work can change your coverage; see working after retirement.
Source: South Carolina Retirement System Member Handbook, Fiscal year 2027 (SCPEBA 082026, expires June 30, 2027), p. 16. Also: Retiree Insurance Eligibility, Funding (state); Get Set for Retirement: Retiree insurance and eligibility funding (2026); 2027 Monthly insurance premiums for funded retirees; Retiree Insurance Eligibility: It's Complicated!; S.C. Code 9-1-1515. Last reviewed .