Author: sfrick

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Benefits Health Options Program Internet Materials

How to Access Your Claims Online

If you are enrolled in the HOP Medical Plan, the Value Medical Plan, or the Pre-65 Medical Plan, you have convenient, secure access to your medical claims.

Log in to the secure Member Area section of the website to:

  • Review claims
  • Pay your bill online
  • View your personalized statement
  • Find a drug or pharmacy
  • Find coverage and compare plans
  • Request electronic EOBs

Once logged in, to access your claims, click on View medical claims in the Your HOP Tools section of your dashboard.

If you are not registered, you can create an account. Enter your member ID or SSN, your last name, ZIP or postal code, and date of birth. Then you will be prompted to select a username, password, and security questions. We take the security of our members’ information very seriously. Our website meets the stringent data security requirements of HIPAA (the Health Insurance Portability and Accountability Act of 1996).

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Benefits Health Options Program

Here’s a Sample of the VIP Treatment You Get With the Health Options Program

  • Secure Member Dashboard. Members can get personalized information about their Health Options Program coverage online. Plus, they can contact a Health Options Program customer service representative and pay their premium online.
  • No age-related premium increase. With HOP, members have the security of knowing that, as they age and use benefits more, their monthly premium is not based on their age. The Health Options Program’s premiums for the Medicare Supplement plans are set to a standard rate for age 70 and older. In comparison, many commercial plans increase their monthly premiums relative to a person’s age.
  • Age 65 discount. Once you turn 65, your monthly premium for the HOP Medical Plan—one of the medical plan options for Medicare-eligible participants—will be discounted by 15% if you enroll within the three months before or after the month in which you turn 65. As long as you remain enrolled in the HOP Medical Plan, you’ll receive a discount on your premium each year until your 70th birthday.
  • Premium Assistance for eligible retirees. Premium Assistance through PSERS helps pay for health coverage through the Health Options Program or another Commonwealth public school employer or district health plan. This special financial incentive through HOP is not available with a commercial program such as AARP or Blue Cross Blue Shield.

If you are eligible for Premium Assistance and enroll in either a Medicare Supplement plan or a Medicare Advantage plan through the Health Options Program, PSERS will pay up to $100 per month toward your monthly premium. The amount of the Premium Assistance benefit is determined by the Pennsylvania legislature and is subject to change. Not sure if you are eligible for Premium Assistance? Call 1-800-PSERS25 (1-800-773-7725).

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Health Options Program Internet Materials

Online Tools Make It Easy to Use Your Benefits

Our website tools make it easy for you to get answers to your questions and maximize your benefits.
  • Find a plan: Determine the medical, prescription drug, and dental and vision plan options available through the Health Options Program that are best for you. 
  • Find a drug or pharmacy: This page highlights your drug coverage and provides pharmacy locator tools and tools to help you search for drugs by name, tier, or therapeutic class.
  • Look up coverage options or premiums: Find out which plans are available where you live and their associated premiums.
  • Check out the virtual benefits fair: Explore your health care options from the comfort of home.
  • Electronic EOBs: To view your Explanation of Benefits online, log in to view your benefit statements. If you are not registered, you’ll need to create an account.
  • Get an ID card: Log in to the secure Member Area to access your member ID.
  • Pay your bill online: Make premium payments online by logging in to your Health Options Program account. To get started, log in, and click Pay My Bill to go to the payment portal. Once you are in the payment portal, you will also be able to view your statement, payment history, and balance due, or set reminders about payments. If you are not registered, you’ll need to create an account. Note: The option to pay your premium online is only available if your premium is larger than your pension. Otherwise, your premium is deducted automatically from your pension.
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Uncategorized

You Are a VIP With the Health Options Program!

Your time is valuable, and you have important things to do! That’s why the Health Options Program wants to make sure it’s as easy as possible for you to find information you need quickly.

Our secure Member Area of the website has personalized information just for you, such as:

  • Copies of your claims
  • Explanation of benefits
  • ID cards
  • A bill-paying portal (available only if your premium is larger than your pension)

You can also send a secure email to the Health Options Program using the Contact HOP Online email link!

Here’s how to access your information: 

  • Log in to the secure Member Area. If you are already registered, just sign in with your username and password. You can reset them if you’ve forgotten them.
  • Register for the secure Member Area if you haven’t already. Note that the registration page will say “Luminare Health,” the new name for Trustmark. Luminare 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.

Visit the Documents and Forms page for HOP Medical Plan, Value Medical Plan, and Pre-65 Medical Plan documents and forms. No need to log in to view these.

Need help? Call 1-800-PSERS25 (1-800-773-7725) to talk to a representative 8:00 a.m. to 8:00 p.m. ET, Monday–Friday. If you are calling from outside the United States, dial the exit code of the local country, then +1 717-305-7388.

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Benefits Health Health Options Program

You’re Free to Move With SilverSneakers

SilverSneakers® is more than a fitness program. It’s an opportunity to improve your health, gain confidence, and connect with your community, at no additional cost, with the HOP Medical Plan or the HOP Pre-65 Medical Plan.

SilverSneakers supports you in any way you decide to move:

In participating fitness locations

  • Thousands of participating locations1 with various amenities
  • Ability to enroll at multiple locations at any time
  • SilverSneakers classes2 designed for all levels and taught by instructors trained in senior fitness

In your community

  • Group activities and classes2 offered outside the gym
  • SilverSneakers community fitness classes, walking groups, and workshop at parks, community centers, and more
  • Events, including shared meals, holiday celebrations, and class socials

At home or on the go

  • SilverSneakers LIVE virtual classes and workshops throughout the week
  • SilverSneakers On-Demand™ fitness classes available 24/7
  • SilverSneakers GO™ mobile app with adjustable workout plans and more

Call 877-871-7020 (TTY 711) to check your eligibility or activate your account. Or get started at silversneakers.com/starthere. You can also search for fitness locations with an interactive map.

Always talk to your doctor before starting an exercise program.

1. Participating locations (PL) not owned or operated by Tivity Health, Inc. or its affiliates. Use of PL facilities and amenities limited to terms and conditions of PL basic membership. Facilities and amenities vary by PL.

2. Membership includes SilverSneakers instructor-led group fitness classes. Some locations offer Members additional classes. Classes vary by location. SilverSneakers, SilverSneakers FLEX, and the SilverSneakers shoe logotype are registered trademarks of Tivity Health, Inc. SilverSneakers LIVE, SilverSneakers On-Demand, and SilverSneakers GO are trademarks of Tivity Health, Inc. © 2022 Tivity Health, Inc. All rights reserved

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Benefits Health Options Program Materials Option Selection Period OSP

The Results Are In: Members Love HOP

Last fall, we included a survey in the materials our members received for the Option Selection Period. The survey asked members to rate the materials on a scale from 1 to 10.  The results are in and were similar to past years’:

  • 94% rated the materials as 7 or higher on a scale of 1 (not satisfied) to 10 (very satisfied).
  • 90% felt they received the right amount of information—not too much or too little.
  • 89% rated the personalized statement’s understandability as 7 or higher on a scale of 1 (not understandable) to 10 (very understandable).
  • 90% felt they had the right number of coverage options for medical, prescription drug, dental, and vision coverage.

Thank you to the more than 5,400 members who responded. We work hard to meet your needs and provide useful and relevant materials. We hope you continue to find the materials informative and helpful.

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Benefits Health Options Program Medicare

Medicare Star Rating for the Health Options Program

Each year, Medicare evaluates prescription drug plans and awards a star rating to each plan based on performance. This star rating can be used to help you determine which plans excel based on measured categories, including customer service, overall member satisfaction, and patient safety. Ratings range from 1 to 5 stars, with 5 being the highest score. The Health Options Program’s prescription drug plans received a 4.5-star rating for 2024, indicating that the program is highly rated in comparison to other prescription drug plans nationwide.

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Health Options Program Office Hours

Individual Phone Consultations: Spring 2024

You can schedule a 30-minute individual telephone consultation (not a group meeting) with a representative of the Health Options Program by following the steps below:

  • Call the HOP Administration Unit at 1-800-773-7725.
  • Let the representative know you want to schedule an individual telephone consultation.
  • After you make your appointment, you’ll receive a confirmation email with the date and time.

A few days before your appointment, you’ll receive a reminder email.

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Awareness Medicare

2024 Medicare Highlights

Each year, if needed, the Centers for Medicare & Medicaid Services (CMS) adjust Medicare’s premiums, deductibles, and copays. Most people do not pay a monthly premium for Medicare Part A if they or their spouse paid Medicare taxes while working. However, to be covered under Medicare Part B, you must pay a monthly premium. For most people, the premium is deducted from their Social Security benefit. As required by law, the standard monthly premium is set each year at 25% of the cost for senior beneficiaries. The government pays the remaining 75%.

The chart below compares 2023 and 2024 costs. The Health Options Program is designed to pay some or all of these deductibles and coinsurances. For example, the HOP Medical Plan pays your Part A deductible and coinsurance for stays in the hospital and skilled nursing facilities, as well as your Part B deductible. The Value Medical Plan also pays 100% of Medicare’s hospital deductible and daily copays, but only after you pay the first $300.

Amount You Pay (without supplemental insurance)

Part A20232024
First-day hospital deductible$1,600$1,632
Coinsurance for days 1–60 of a hospital stay$0$0
Coinsurance for days 61–90 of a hospital stay$400 per day$408 per day
Coinsurance for days 1–20 of a skilled nursing facility stay$0$0
Coinsurance for days 21–100 of a skilled nursing facility stay$200 per day$204 per day
Part B20232024
Standard monthly premium for most new enrollees
and Medicare beneficiaries		$164.90$174.70
Deductible$226$240
Coinsurance20%20%
Categories
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.

Not registered? Sign up today for personalized information.