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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.

  • Please note the followingCoverage 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, prescription drug and dental coverage and take advantage of a program designed exclusively for you.

Medicare and the Health Options Program

Watch our short video that explains how Medicare works with the Health Options Program.

(Read a transcript)

Your Coverage Options

If you are Medicare-Eligible:

Use this decision guide to help you explore the Health Options Program coverage options for eligible PSERS retirees.

  • Medicare Supplement Plans. A supplement to Original Medicare that provides coverage anywhere in the United States and abroad when you are traveling. The Health Options Program offers two Medicare Supplement plans:
    • HOP Medical Plan
    • Value Medical Plan
  • Medicare Prescription Drug Plans (Medicare Part D coverage). You can enroll in a qualified Medicare Part D prescription drug plan with or without a Medicare Supplement. If you or your spouse or dependent enrolls in a Medicare Advantage plan, prescription drug coverage will be provided by that plan. The Health Options Program offers three Medicare prescription drug plans:
    • Enhanced Medicare Rx Option
    • Basic Medicare Rx Option
    • Value Medicare Rx Option
  • MetLife Dental Plan. You can enroll in the MetLife Dental Plan if you enroll in either the HOP Medical Plan or the Value Medical Plan. The MetLife Dental Plan is not available on a standalone basis or with a Medicare Advantage plan.

  • Medicare Advantage Plans. Instead of choosing Original Medicare supplemented by the HOP Medical Plan or the Value 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 a Medicare Supplement 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 three Medicare prescription drug (Part D) plans and a dental plan.
  • Competitive premiums. Shop around! If you're 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.

The Health Options Program for Medicare-Eligible Participants (PDF) (1.72MB) and the Health Options Program Pre-65 Medical Plan (PDF) (1.50MB) brochures provide an overview of the Health Options Program, the benefits it offers and the type of coverage available.

Health Options Program Guide for Medicare-Eligible Members

Enrollment Guide for Pre-65 Members

 

Medicare Star Rating

Each year, Medicare evaluates prescription drug plans and awards a star rating to each plan based on performance. The Health Options Program’s prescription drug plans have maintained a 4-star rating or better since inception, indicating that the program is highly rated in comparison to other prescription drug plans nationwide. Learn more about the Health Options Program 2019 Medicare Star Rating here.

Notice of Non-Discrimination and Language Assistance

PSERS and the Health Options Program provide a notice of non-discrimination and information to get assistance with language translation services for reading and understanding Health Options Program's materials.

Notice of Non-Discrimination and Language Assistance (PDF) (277KB)


Page last modified August 26, 2019