Critical Rule for All Ohio Public Retirees
All three Ohio public retirement systems — OPERS, STRS, and SERS — require you to enroll in Medicare Part B when you turn 65. If you don’t, your retiree health coverage may be reduced or terminated.
OPERS: The HRA + Via Benefits Model
OPERS no longer provides group health coverage for Medicare-eligible retirees. Instead, they fund a Health Reimbursement Arrangement (HRA) and partner with Via Benefits to help you choose your own individual Medicare plan.
- OPERS uses an HRA (Health Reimbursement Arrangement) + Medicare Connector model through Via Benefits
- When you become Medicare-eligible, OPERS deposits a monthly HRA allowance into your account
- You use Via Benefits to shop for and enroll in an individual Medicare plan (Advantage, Supplement, or Part D)
- The HRA reimburses your plan premiums and eligible out-of-pocket medical expenses
- You are choosing your OWN plan — OPERS no longer provides group health coverage for Medicare-eligible retirees
Key requirement: You must enroll in Medicare Parts A and B to receive your HRA funds.
STRS: Group Aetna Medicare Plan
Unlike OPERS, STRS continues to offer group health coverage through a dedicated Aetna Medicare Plan for eligible retirees. STRS subsidizes a portion of the premium, but retirees are still responsible for both Medicare Part B and STRS plan costs.
- STRS offers a group Aetna Medicare Plan directly to eligible retirees
- Retirees must enroll in Medicare Part B to remain eligible for STRS health coverage
- STRS pays a portion of the Medicare supplement costs
- Recent improvements include eliminated in-network deductibles for the Aetna Medicare Plan
- Retirees pay both a Medicare Part B premium ($202.90/month in 2026) and their STRS plan premium
SERS: Medicare Advantage Plan Option
SERS offers a Medicare Advantage plan for eligible retirees and provides a monthly reimbursement toward your Medicare Part B premium. Timely Part B enrollment is essential to maintain full coverage.
- SERS provides a Medicare Advantage plan option for eligible retirees
- Offers a $45.50/month reimbursement toward Medicare Part B premiums
- Must enroll in Medicare Part B when first eligible at age 65
- Coverage changes if you delay Part B enrollment
The Public Retiree Medicare Transition Timeline
- 6 Months Before 65: Contact your retirement system (OPERS, STRS, or SERS). Verify your Medicare eligibility and understand your transition options.
- 3 Months Before 65: Enroll in Medicare Parts A and B through Social Security. This is your Initial Enrollment Period — don’t miss it.
- At Age 65: Your retirement system health coverage transitions to a Medicare-based model.
- After Transition: OPERS: Begin using Via Benefits to select your individual Medicare plan. STRS: Transition to STRS Aetna Medicare Plan. SERS: Transition to SERS Medicare Advantage plan.
Common Mistakes Public Retirees Make
Not Enrolling in Part B on Time
Results in a late enrollment penalty of 10% per year delayed AND loss of your retiree health coverage. This penalty is permanent.
Assuming Coverage Continues Unchanged After 65
All three retirement systems change how your health coverage works once you become Medicare-eligible. Your pre-65 plan does not simply continue.
Not Understanding the OPERS HRA Model
OPERS no longer provides group health coverage. You must actively choose your own Medicare plan through Via Benefits. Your HRA reimburses costs — it’s not automatic coverage.
Missing the Medigap Open Enrollment Window
Your 6-month Medigap Open Enrollment period starts when you turn 65 AND are enrolled in Part B. During this window, insurers cannot deny you coverage or charge more due to health conditions.
Not Comparing Plans Annually
Even within the Via Benefits marketplace, plan options, premiums, and benefits change every year. What was the best plan last year may not be the best plan this year.
Frequently Asked Questions
Do I have to enroll in Medicare Part B?
Yes. All three Ohio public retirement systems require Part B enrollment at 65. Without it, your retiree health coverage may be reduced or terminated.
How does the OPERS HRA work?
OPERS deposits a monthly allowance into a Health Reimbursement Arrangement. You choose your own Medicare plan through the Via Benefits marketplace, and the HRA reimburses your premiums and eligible expenses.
Can your team help me choose a plan through Via Benefits?
Yes. Our team can review the plans available in the Via Benefits marketplace alongside all other Medicare options in your area to help you find the best fit.
What is the Part B premium for 2026?
The standard Medicare Part B premium is $202.90 per month. Higher-income retirees may pay more due to IRMAA surcharges.
When should I start planning my Medicare transition?
At least 6 months before you turn 65. This gives you time to enroll in Medicare, understand your retirement system’s requirements, and compare plan options.
What happens if I delay Part B enrollment?
You may face a permanent late enrollment penalty (10% added to your Part B premium for each full 12-month period you were eligible but not enrolled), and your retirement system may reduce or terminate your health coverage.