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Awareness Benefits Health Options Program Office Hours

Are You Almost 65?

If you’re a PSERS retiree about to turn age 65, we’re eager to tell you about the benefits of joining the Health Options Program. We take a number of steps to make sure you understand how the program works.

First, we send you an information packet four to nine months before your 65th birthday. We mail these twice a year—in the winter for people turning age 65 during the first six months of the following year and in the spring for people turning age 65 in the second half of the year. The packet contains a description of the medical and prescription drug benefits available under the Health Options Program—plus a personalized statement that has information specific to you, including your monthly premiums for all your coverage options.

We also conduct webinars (virtual group information sessions) several times a year. During the webinars, you can learn more about the Health Options Program and ask questions. Check our website for the live webinar meeting schedule. If you’re unable to attend a live webinar, you can watch a recorded session. Our virtual benefits fair offers another opportunity for you to learn more about the Health Options Program. Visit discoverHOPbenefits.com for information from Health Options Program partners and more about all the great benefits available to you as a PSERS retiree.

Categories
Benefits Prescription Drugs

You Need to Know: 2024 Updates for the Medicare Rx Options

Increases to Coverage Gap and Catastrophic Coverage Thresholds

Medicare requires that all Medicare prescription drug plans (including those provided by a Medicare Advantage plan) make certain changes each year. For 2024, the dollar thresholds for certain coverages are increasing:

  • The coverage gap dollar threshold increased to $5,030.
  • The catastrophic coverage dollar threshold increased to $8,000.

What this means for you: If you meet the catastrophic coverage threshold, you will then pay $0.

Enhanced, Basic, and Value Medicare Rx Options

There are no changes to the copay or coinsurance that you pay for medication in the Initial Coverage stage under the Basic or Value Medicare Rx Options.

For the Value Medicare Rx Option, the annual deductible for 2024 increased to $545.

Need more info? Refer to the benefit tables for specific copay amounts.

Categories
Benefits Health Options Program

Take Full Advantage of Health Options Program Resources—Here’s How

The HOP Administration Unit, customer service teams, program advocates, and case managers are specially trained on Health Options Program benefits. Not sure where to start? Call 1-800-PSERS25 (1-800-773-7725). Here are certain ways the Health Options Program can help.

Experiencing a serious health condition or treatment, or have a hospital admission?

Call the Luminare Health Care Management team at 1-800-480-6658. Note that they may reach out to you if you have a hospital stay or need skilled nursing care.

Looking for ways to enhance your well-being?

The Elder Care program can help you find resources, such as local transportation options, getting answers to utility questions, help with finding prescription drug delivery, discount programs, and support for improving nutrition. For assitance, call 1-866-794-0685, and ask to speak to an advocate.

Want to be more active? Give SilverSneakers a try for fitness and social connections. If you are enrolled in the HOP Medical Plan or HOP Pre-65 Medical Plan, you have access to SilverSneakers instructors who lead specially designed group exercise classes. SilverSneakers features access to gyms for classes and fitness. Plus, SilverSneakers FLEX®, SilverSneakers LIVE, SilverSneakers On-DemandTM, and the mobile app all provide options to get active outside of traditional gyms.

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Benefits Health Options Program Internet

Welcome to a New Year and a New Look for Us!

Spend some time exploring our updated website. You’ll find that we’ve added some helpful resources, like content for caregivers and explanations of how Health Options Program coverage works with Medicare. Not only have we improved our look, we’ve also streamlined it to make it easier for you to find what you’re looking for.

If you’re a registered member, you may notice the new logo for Luminare Health when you log in to the secure member area. Luminare Health (formerly Trustmark) manages our secure member website and administers our Health Options Program benefits. Only the name is new—our benefits program will continue to be supported with the high-quality service you’ve come to expect.

As a reminder, registered members can access their personalized information about their Health Options Program coverage, contact customer service, and pay their premium online, as well as find a doctor, check claim status, get ID cards, and more. Here’s how to access the member area:

  • If you’re already registered, log in using your same username and password to get to the Member Area. Or, if you have forgotten your login information, you can reset them.
  • To register, create an account.

We take the security of our members’ information seriously. Our website uses industry-standard security to protect our members’ information. It also meets the stringent data security requirements of HIPAA (the Health Insurance Portability and Accountability Act of 1996). Note: If you are enrolled in a Medicare Advantage plan, ask your insurance provider about the online resources available to you.

Categories
Benefits Internet

Benefit Info on the Go

Our vendors offer apps for your smartphone (or tablet, in some cases), so no matter where your travels take you, you’ll have easy access to all your benefits information. Visit the App Store or Google Play, and search for the app you want.

  • OptumRx: View all your medications in one place, check the status of your orders, manage auto-refill of your prescriptions, and access your ID card.
  • MetLife US App: Access coverage details and claims, find a dentist, read reviews, and book an appointment. Get personalized estimates for dental procedures, and access your ID card.
  • EyeMed: Check your benefits, find an eye doctor, and view claims.
  • SilverSneakers GO: Get fit, stay active, and develop healthy exercise habits with this app. Use the fitness location and class finder to access virtual and in-person classes; select from 200+ SilverSneakers on-demand fitness and wellness videos.
Categories
Awareness Benefits Health Health Options Program

We’ve Got You Covered

Should you get a flu shot and the COVID-19 vaccine? Health experts are recommending that the best protection against both viruses is vaccination. If you don’t want to make two trips, talk to your doctor about getting both at the same time.

The flu and COVID-19 vaccines are for different illnesses. A seasonal flu shot will not protect you from COVID-19. Getting both vaccines will give you the highest level of protection. Medicare covers both vaccines at 100%, which means you will have no out-of-pocket costs. The Centers for Disease Control and Prevention (CDC) recommends annual flu shots, because the vaccine is updated each year to better match circulating influenza viruses. The flu generally peaks in January or February and can still be around through May.

Categories
Awareness Benefits

Take Small Steps to Lower Your Risk of Diabetes or to Manage It

Diabetes is a chronic condition that affects the amount of insulin a person’s body produces. You can prevent or lower your risk of diabetes by making healthier food choices, increasing your physical activity, losing weight, quitting smoking, or reducing your alcohol intake.

Diabetes prevention is especially important if you are overweight or have a family history of the disease. It’s important to visit your doctor for regular glucose screenings if you fall into one of these categories. Early detection can also help you avoid serious health complications of diabetes down the road. Learn more about diabetes at diabetes.org.

Categories
Health Options Program Option Selection Period OSP

Return Your Option Selection Period Survey Card!

Each year we include a survey in the Option Selection Period materials. We ask that members fill out this survey and drop it in the mail. We review all the surveys and use them to determine how the Health Options Program is meeting the needs of our members—and if we need to make any changes to improve our service to you.

If you have not returned your survey card, please do so as soon as possible. In 2023, we received over 6,100 responses! Your voice matters—let us know what you think.

Categories
Option Selection Period OSP

2024 Plan Materials

If you’ve misplaced any of the 2024 plan materials that you received in the mail, you can get another copy online. Here’s how:

  • Go to the 2024 Option Selection Period page to find PDF versions of all the materials that were mailed to current members.
  • Sign in to the HOPbenefits.com Member Area page. If you are a registered user, you can view your Personalized Statement online. This statement provides an overview of your current (2023) coverage and your 2024 options and premiums based on where you live.

If you have any questions about the coverage options available to you, call the HOP Administration Unit at 1-800-773-7725.