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OPERS and Medicare

Medicare coverage

Medicare is federal health insurance for people age 65 and older, under age 65 with certain disabilities, and any age with End-Stage Renal Disease or ESRD (permanent kidney failure requiring dialysis or kidney transplant). Medicare costs vary depending on plan, coverage and the services used.

As an OPERS benefit recipient, you must enroll in both Medicare Parts A and B as soon as you become eligible. Once enrolled, you will select a Medicare Advantage plan or a Medigap plan (Medicare Supplement) and a Medicare D prescription drug plan using the OPERS Connector. Please note that most Medicare Advantage plans have prescription coverage included so you may not need to enroll in a separate Part D plan. During your enrollment appointment with Via Benefits, a Licensed Benefit Advisor will walk you through the plan selection process.

Medicare Part A and Part B coverage chart
Medicare Part C, Part D and Medigap coverage chart

Medicare Part A Reimbursement

Public employees hired prior to April 1986 were not required to pay Medicare tax through their public employer. If you did not pay this tax during your public employment career, you do not have access to Medicare Part A without paying a monthly premium. Ohio law allows OPERS to provide premium reimbursement to those who are not eligible for premium-free Medicare Part A. As a Medicare-eligible OPERS benefit recipient, you are required to enroll in and pay the monthly premium for Medicare Part A coverage through the Centers for Medicare and Medicaid Services.

OPERS provides a monthly reimbursement for your Medicare Part A premium cost and also provides a 50 percent Medicare Part A premium reimbursement to eligible spouses. Please contact OPERS to obtain the Medicare Part A Reimbursement Form (PDF opens in new tab).

If you disenroll or fail to pay your Medicare Part A premium to the Centers for Medicare and Medicaid Services, or your premium amount changes or you no longer need to a pay a premium, you will be responsible for repaying OPERS the amount OPERS reimbursed you. Notify OPERS immediately if your premium amount changes or you no longer need to pay a premium by submitting the Notice of Award or other documentation from Social Security that states the new amount and date the new amount went into effect (other than a premium bill).

Next: How does the HRA work if I return to employment?