Welcome to the Program
The Health Options Program operates for the sole benefit of participants of the Pennsylvania Public School Employees' Retirement System (PSERS), their dependents and survivors. The Health Options Program offers comprehensive medical coverage before and after you become eligible for Medicare.
- Coverage under the Health Options Program is not automatic. Eligible retirees, dependents or survivors, must decide whether or not to participate in the hospital, medical/surgical, and prescription drug coverage and take advantage of a program designed exclusively for you.
Your Coverage Options
If you are Medicare-Eligible:
- HOP Medical Plan. A supplement to Original Medicare that provides coverage anywhere in the United States and abroad when you are traveling.
- HOP Prescription Drug Plans (Medicare Part D coverage). You can choose either the Basic or Enhanced Medicare Rx Option with the HOP Medical Plan or by itself. If you or your spouse or dependent enrolls in a Medicare Advantage Plan, prescription drug coverage will be provided by that plan. A spouse or dependent who is not eligible for Medicare can add prescription drug coverage to the HOP Pre-65 Medical Plan.
- Medicare Advantage Plans. Instead of choosing Original Medicare supplemented by the HOP Medical Plan, you can choose a Medicare Advantage Plan, which requires you to use the plan's network of providers to receive the maximum benefit.
If you are NOT eligible for Medicare:
- HOP Pre-65 Medical Plan. This Plan offers benefits for non-Medicare-eligible participants and covered spouses or dependents. If you or your dependents choose this option, you can add prescription drug coverage (see above).
- Managed Care Plans. Instead of choosing the HOP Pre-65 Medical Plan, you can choose a Managed Care Plan, which requires you to use the plan's network of providers to receive the maximum benefit.
Reasons to Join the Health Options Program
- Designed with you in mind. Unlike health care programs created for the public at large, the Health Options Program was designed especially for PSERS retirees, and we continually look to our participants for input on how we can improve.
- Substantial Premium Subsidy. If you meet the requirements for Premium Assistance, you can receive up to $100 a month reimbursement.
- Choice. You can choose between a Medicare supplement plan and a Medicare Advantage Plan. Additionally, the Health Options Program offers a choice of two Medicare prescription drug (Part D) plans.
- Competitive premiums. Shop around! If you are eligible for Premium Assistance, it's unlikely that you'll find a less expensive program.
- Convenience. In most cases, your monthly premiums will be deducted automatically from your retirement benefit payment.
- Flexibility. Once enrolled, you can change your option annually or any time you experience a Qualifying Event.
- Resources. As a Health Options Program member, you have a wide selection of printed and online resources to help you make informed health care decisions.