Why Members Love Us
About the Health Options Program
The Health Options Program operates for the sole benefit of participants of the Pennsylvania Public School Employees’ Retirement System (PSERS) and their dependents and survivors. Under the Health Options Program, you have access to comprehensive medical and prescription drug coverage before and after you become eligible for Medicare.
What’s available to you
What’s available to you under the Health Options Program depends on your eligibility for Medicare.
If you are Medicare-eligible:
- Medicare Supplement plans
- Medicare Advantage plans
- Medicare prescription drug plans (Medicare Part D coverage)
- MetLife Dental and EyeMed Vision Option
If you are not eligible for Medicare:
- HOP Pre-65 Medical Plan
- Managed care plans
Explore this virtual benefits fair to learn more about all the options available to you through the Health Options Program!
What makes you eligible
Generally, you first become eligible to enroll in the Health Options Program when you retire as a PSERS annuitant and you are eligible for a retirement benefit from PSERS.
You can also cover eligible family members under your Health Options Program coverage.
Comparable coverage for your spouse
If you and your spouse are both PSERS retirees, you may individually enroll in any option. If your spouse is NOT a PSERS retiree and is Medicare-eligible, he or she must enroll in the same plan that you enroll in. If your spouse is not eligible for Medicare, he or she must enroll in the same type of plan that you enroll in (the HOP Pre-65 Medical Plan if you enroll in the HOP or Value Medical Plan, or a managed care plan offered by the same insurance company if you enroll in a Medicare Advantage plan).
For your consideration: If your spouse will have a Qualifying Event in the next year and is also considering enrolling, but not at the same time you will enroll, you may want to consider electing an option now that is good for both of you. Otherwise, your next opportunity to change options will be next fall during the Option Selection Period.
Advantages of the Program
What sets the Health Options Program apart from other commercial plans?
- Substantial premium subsidy. If you meet the requirements for Premium Assistance (see below), you can receive up to $100 a month reimbursement.
- Age 65 discount. If you enroll in the HOP Medical Plan at age 65, you will pay a discounted premium. If you remain enrolled in the HOP Medical Plan, you’ll receive a discount on your premium each year until your 70th birthday.
- Choice. You can choose between a Medicare Supplement plan and a Medicare Advantage plan. Additionally, the Health Options Program offers a choice of three Medicare prescription drug (Part D) plans and a dental and vision option.
- Competitive premiums. Shop around! If you’re eligible for Premium Assistance, it’s unlikely that you’ll find a less expensive program. Plus, members have the security of knowing that, as they age and use benefits more, their monthly premium is not based on their age.
- Convenience. In most cases, your monthly premiums will be deducted automatically from your retirement benefit payment.
- Flexibility. Once enrolled, you can change your option annually or any time you experience a Qualifying Event.
- Resources. As a Health Options Program member, you have a wide selection of printed and online resources to help you make informed health care decisions.
Premium Assistance
Reduce your monthly premium by up to $100 with Premium Assistance! PSERS provides Premium Assistance—a special financial incentive—to help eligible retirees pay for health coverage through the Health Options Program or another Commonwealth public school employer or district health plan.
Here’s how it works:
- If you are eligible for Premium Assistance and enroll in Medicare-eligible medical coverage (Medicare Supplement or Medicare Advantage), PSERS will pay up to $100 per month toward your monthly premium.*
- Premium Assistance is not available under commercial programs like AARP or Blue Cross Blue Shield.
- Premium Assistance is added to your monthly retirement benefit as nontaxable income.
- If you are receiving Premium Assistance for coverage in your school employer plan and that coverage terminates, you must enroll in the Health Options Program to maintain your Premium Assistance.
Important!
If you elect a stand-alone prescription drug coverage option, you are not eligible for Premium Assistance.