OPERS Medicare Connector Health Reimbursement Arrangement
OPERS provides eligible retirees with a Health Reimbursement Arrangement (HRA) allowance to use toward the purchase of an individual Medicare Advantage or a Medigap (Medicare Supplement) plan and a Medicare Part D prescription drug plan.
To be eligible to receive a health care allowance, you must be:
- Currently eligible for OPERS health care coverage as a primary pension recipient
- Enrolled in both Medicare Parts A and B
- Enrolled in an individual Medicare medical plan through OneExchange
The amount of your HRA will depend on your years of service and age when you first enroll in the OPERS health care plan. The monthly HRA allowance amount ranges between $229 and $405 with more than 90 percent of current retirees receiving $337 or more per month. Both retirees and spouses will receive an HRA allowance in 2017, however beginning in 2018 only retirees will receive the allowance.
|Total 2018 HRA Allowance =||$337|
Most retirees will have remaining allowance funds that could be applied toward Medicare Part B premiums, a spouse's premium or other eligible health care expenses now or in the future. Additionally, account balances will roll over from month-to-month and year-to-year.
How it works:
- You select an individual medical plan through OneExchange. Then, OneExchange opens an HRA for you.
- You pay your insurance premium directly to your insurance carrier and pay out-of-pocket for other eligible expenses (prescriptions, copays, etc.).
- You submit your reimbursement claim to OneExchange.
- OneExchange reimburses you from your HRA balance. Your reimbursement is deposited into your designated bank account.
For more information on how to use your HRA, be sure to check out the HRA Quick Reference Guide and the Get HRA Ready brochure.
Submitting a Claim
There are two ways to submit a reimbursement claim: Manual and Automatic
If you choose manual reimbursement, your first reimbursement comes within approximately three days from when your claim was approved. This is an ideal solution for out-of-pocket expenses which will change from month to month.
If you choose automatic reimbursement, you are responsible for paying the premium cost directly to your insurance carrier. This is an ideal solution for premium payments. You will receive your reimbursement at the same time each month. You can set up automatic reimbursement for your insurance premium by calling OneExchange or logging into your OneExchange online account.
Claim Reimbursement Forms
There are three different kinds of claim reimbursement forms: Manual and Recurring, and the Recurring Medicare Part B premium form. For additional information on the submission process, read this chart that explains the various HRA Reimbursement Forms.