OPERS offers the Humana Medicare Advantage plan to Medicare-eligible participants and their covered, Medicare-eligible dependents in 2014. The Humana Medicare Advantage Plan is the only medical coverage choice for Medicare-eligible participants at retirement. The primary exceptions include participants who:
- live outside the United States
- live in certain Ohio counties who elect to participate in HealthSpan (formerly Kaiser Permanente)
- have another Medicare Advantage plan or Medicare Plus plan
- have other coverage that is primary through another retirement plan
Medicare-eligible participants may enroll family members that are not yet eligible for Medicare. All participating family members not yet eligible for Medicare will be enrolled in the OPERS Retiree Health Plan administered by Medical Mutual. Once all covered family members are eligible and enrolled in Medicare, all covered family members will be automatically enrolled in the Humana Medicare Advantage Plan.
With the Humana Medicare Advantage Plan, Humana serves as a single point of contact for medical coverage and processes all medical claims on behalf of both Medicare and OPERS.
Humana has a broad network of primary care doctors, specialists and hospitals. OPERS retirees participating in the Humana Medicare Advantage Plan are strongly encouraged to use network providers. Using network providers costs OPERS less, which helps maintain the solvency of the health care fund. Your share of the costs may be higher for services you receive outside of the network. Humana processes claims for any provider that accepts Medicare or Medicare assignment.
The plan offers access to a phone line staffed by registered nurses 24 hours a day (1-800-622-9529) and a web page (www.humana.com/opers) where participants can review their individual coverage. Also included is a fitness program offering a free membership at your choice of over 11,000 participating fitness centers nationwide through the SilverSneakers program.
All participants will receive an ID card from Humana once enrolled.