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?
Everyone is accepted, and coverage is guaranteed
The Health Options Program offers guaranteed access to eligible members, with no medical exam or health questions. Once you’re enrolled in the Health Options Program, premiums don’t increase based on age or health status.
Affordable monthly premiums
The Health Options Program works with your monthly budget.
- Eligible members receive an employer subsidy (also called Premium Assistance) of up to $100 per month from the Commonwealth of Pennsylvania to help pay the premium. Over the course of a lifetime, on average, members could save up to $24,000 as a participant in the Health Options Program.
- Health Options Program premiums are set to a standard rate for age 70 and older, unlike many commercial plans, which increase their premiums related to a person’s age.
- Premium discounts are available for early enrollment (between ages 65 and 70) in certain Health Options Program plans.
Simplicity—all your options in one place
The Health Options Program offers pre-Medicare and Medicare benefits, so you can access all your coverage needs in one place.
- Pre-Medicare medical and prescription drug plans
- Medicare Supplement medical plans: HOP Medical Plan and Value Medical Plan
- Medicare Advantage plans from: Aetna, Capital Blue Cross, Highmark, Independence Blue Cross, and UPMC. These plans include prescription drug coverage and may include dental, vision, and hearing benefits.
- Prescription drug plans: Medicare Plus Rx Option and Medicare Standard Rx Option. Both have a Centers for Medicare & Medicaid Services star rating of 4.5 out of 5 for customer service and patient safety, which is the highest in Pennsylvania. Plus, there are no preferred pharmacies, so you can go to any pharmacy you want, and your cost will not change.
- SilverSneakers fitness benefit (if enrolled in the HOP Medical Plan or the Pre-65 Medical Plan)
- Dental and vision coverage and a hearing care discount (if enrolled in the HOP Medical Plan or the Value Medical Plan)
Developed specifically for PSERS members
Benefits are designed specifically for PSERS members and supported by years of trusted service and a strong reputation. In a recent survey, members gave the Health Options Program high grades:
- Ninety percent of respondents said the Health Options Program provides just the right number of options.
- Over 90% appreciate the personalized statements that are provided.
- Over 80% of members are very satisfied with the information they receive about their benefits.
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.
* The amount of the Premium Assistance benefit is determined by the Pennsylvania legislature and is subject to change.