Retiree Health Insurance Information
Overview
The District offers retiree health care plans (“Plans”) to eligible retirees and their dependents. This information is for reference only. Any conflict between this summary and official Plan Documents or provider information, the latter will govern.
Availability
Plans are offered at the sole discretion of the District Board of Commissioners. Membership in the Retirement Fund does not guarantee plan availability or eligibility. MWRD Retiree Health Insurance benefits are not provided or governed by the Illinois Pension Code.
Eligibility
Retirees and dependents who meet the District’s eligibility requirements may enroll. Active employee coverage ends on the last day of the month in which employment ends regardless of the day of departure. Current Eligibility Policy
Plans Offered
- Medicare Eligible (Age 65+): Humana Medicare Advantage Plan with Part D (MAPD) – The only District-sponsored coverage for retirees and dependents age 65 and older, or under 65 with disabilities..
- Non-Medicare Eligible (Under 65): Blue Cross Blue Shield PPO or Blue Advantage HMO (HMO available only to Illinois residents). Plan comparison HMO v. PPO
Plan Summaries
Rates effective January 1, 2026 – December 31, 2026.
Retirees pay 50% of the premium; the District subsidizes the remaining 50%.
Rates below reflect the member's portion of the premium.
Non-Medicare Eligible
| Coverage Type | BCBS PPO | Blue Advantage HMO |
|---|---|---|
| Member | $795.81 | $547.76 |
| Couple | $1,591.62 | $1,095.50 |
| Family (3+) | $1,989.53 | $1,369.38 |
Medicare Eligible (Humana MAPD*)
| Coverage Type | Rate |
|---|---|
| Member (Medicare Eligible) | $113.38 |
| Couple (Both Medicare Eligible) | $226.77 |
| Family (3 Medicare Eligible) | $340.15 |
Mixed Coverage (Medicare* + Non-Medicare)
| Coverage Type | BCBS PPO | Blue Advantage HMO |
|---|---|---|
| Couple (one Medicare - Humana MAPD*) | $909.19 | $661.14 |
| Family (one Medicare - Humana MAPD*) | $1,307.10 | $935.02 |
| Family (two Medicare - Humana MAPD*) | $624.67 | $500.65 |
*Must have Medicare Parts A & B to qualify for MAPD. Tax implications may apply for domestic partner coverage. Call 312-751-3222 for details.
Reaching 65, Medicare Enrollment, and mapd
MWRD retiree health insurance eligibility policy requires that you must enroll in Medicare Parts A and B upon attainment of age 65. To provide administrative processing time, annuitants and their dependents should enroll in Medicare three months in advance of their Medicare effective date. Failure to submit the Medicare card prior to the Medicare effective date may result in loss of coverage. Additionally, failure to enroll in Medicare in a timely manner may result in Late Enrollment Penalties, imposed by Medicare.
MWRD Eligibility Policies and Late Enrollment information links:
- MWRD Mandatory Medicare Policy
- MWRD Retiree Health Insurance Eligibility Administrative Policy
- Further information about mandatory Medicare enrollment.
- Medicare Late Enrollment Information
Effective 1/1/2026, Humana is the MAPD carrier. Resources:
- Video from Humana regarding MWRD MAPD benefits.
- 2026 Humana Evidence of Coverage
- 2026 Humana Summary of Benefits
- 2026 Humana Prescription Drug Benefit Summary
- MyHumana Online Account Information
Prescription Drug Coverage
Co-payments for prescription drugs are the same for all enrollees, regardless of the insurance carrier (Humana, BCBS PPO, or Blue Advantage HMO)
| Category | Local Pharmacy | Mail Order* |
|---|---|---|
| Generic | $10 | $20 |
| Formulary Brand | $30 | $60 |
| Non-Formulary Brand | $50 | $100 |
| Specialty | $100 | N/A |
Mail order saves ~33% and is recommended for maintenance medications.
Mail order providers are dependent on the insurance carrier.
- Blue Cross PPO and Blue Advantage HMO: Express Scripts
- Blue Cross PPO and Blue Advantage HMO: Specialty drugs: Accredo (833-721-1619)
- Humana MAPD: CenterWell:
Vision Benefits
The District does not offer comprehensive vision coverage but provides discounts:
- Humana MAPD: See page 138 of Humana’s Evidence of Coverage or call the number on your card.
- Blue Cross Plans: Discounts via EyeMed or Davis Vision. Call 1-844-684-2254 or visit Blue365.
