Two models: a group plan or an HRA
Every Ohio public retiree with Medicare has Medicare Parts A and B as the base. What sits on top depends on the system:
Group plan: STRS Ohio and SERS
The system contracts for a group Medicare Advantage plan with built-in Part D and enrolls you once it has proof of Medicare. You pay the system's premium from your benefit. STRS Ohio also offers a group plan that pays after Original Medicare. You don't shop; the system chooses the plan.
HRA and marketplace: OPERS, OP&F and HPRS
The system funds a health reimbursement arrangement. You buy an individual Medicare Advantage plan, or a Medigap policy with a Part D plan, through the marketplace vendor the system chose, and get reimbursed for premiums and other qualified costs. You choose the plan; the system sets the allowance.
Side by side
| OPERS | STRS Ohio | SERS | OP&F | HPRS | |
|---|---|---|---|---|---|
| Who | State and local government employees | Teachers and faculty | Non-teaching school employees | Police officers and firefighters | State Highway Patrol members |
| Coverage with Medicare | Individual plan through the OPERS Medicare Connector + monthly HRA deposit | Group Medicare Advantage with Part D (default) or group plan that pays after Medicare | Group Medicare Advantage PPO with Part D, available throughout the U.S. | Individual plan through OP&F's vendor + stipend in an HRA | Individual plan through the HPRS Medicare Connector + monthly HRA allowance |
| Part A if premium-free | Required | Required | Enroll | Required | Required for the HRA |
| Part A if it costs a premium | Must buy it; OPERS reimburses 100% (eligible spouses 50%) under ORC 145.584 | Not required; Part B only is allowed; no reimbursement | "Do not sign up"; the plan covers Part A services | Rule requires A and B; ask OP&F | Required for the HRA; board may add a supplemental allowance |
| Part B | Required | Required | Required | Required | Required for the HRA |
| Part B premium help | None separately since Dec. 31, 2016; HRA can reimburse it | Monthly premium credit on the STRS Ohio premium (since 2023) | Monthly reimbursement on your benefit payment (ORC 3309.69) | Monthly reimbursement (ORC 742.45) | None since 2017; HRA can reimburse it |
| Drug coverage | Part D plan or Medicare Advantage plan you choose | Included in the group plans | Included in the group plan | Part D plan or Medicare Advantage plan you choose | Part D plan or Medicare Advantage plan you choose |
| If you join an outside plan | No HRA deposits | STRS Ohio medical and drug coverage cancelled | SERS medical and drug coverage cancelled | Ineligible until a qualifying life event | No HRA allowance |
| If you drop or skip Part B | No HRA deposits | No longer eligible | Eligibility ends | No stipend | HRA participation ends |
| Health care service needed (recent retirees) | 20 years of qualified health care service credit (benefits on or after Jan. 1, 2022) | 20 years (benefits after Aug. 1, 2023) | 10 years for coverage; 20 for a subsidy | No service test stated; not eligible if you have other group coverage | 20 years (pensions on or after Nov. 1, 2023) |
| 2027 changes window | Oct. 15 – Dec. 7, 2026 through the Connector | Nov. 1 – 24, 2026 | One plan; enroll within 90 days of Medicare eligibility | Dec. 7, 2026 deadline for Jan. 1 | Oct. 15 – Dec. 7, 2026 through the Connector |
| Phone | 1-800-222-7377 | 888-227-7877 | 800-878-5853 | 1-888-864-8363 | 614-431-0781 |
| Our guide | OPERS | STRS Ohio | SERS | OP&F | HPRS |
Dollar amounts (HRA deposits, the STRS Ohio credit, the SERS and OP&F reimbursements, system premiums) change every year and aren't Medicare figures, so we don't print them here. Each system's guide links to its current amounts.
What the differences mean for you
- Travel and second homes. SERS's plan works throughout the U.S. OPERS, OP&F and HPRS retirees choose their own plans, so they can pick Original Medicare with Medigap (any provider in the U.S. that accepts Medicare) or a Medicare Advantage plan with the network they want. See Florida snowbirds and Medicare.
- Choice vs. simplicity. STRS Ohio and SERS retirees don't have to shop. OPERS, OP&F and HPRS retirees must choose and re-check a plan each fall; the Medigap-vs.-Medicare-Advantage decision matters, because Ohio has no Medigap birthday rule (see Medigap vs. Medicare Advantage in Ohio).
- Plan exits. If you bought an individual Medicare Advantage plan that isn't renewing for 2027, you get a special enrollment period and Medigap guaranteed-issue rights; see plans ending in 2027. Group plans run by STRS Ohio and SERS are handled by the system.
- Low income. SERS offers a premium discount, and OP&F a stipend increase, below income limits. Separately, Medicare Savings Programs and Extra Help are open to anyone who qualifies, but if a Medicare Savings Program pays your Part B premium, the SERS or OP&F Part B reimbursement stops.
Two-retiree households. When both spouses are Ohio public retirees, each system's coordination rules decide who covers whom; for example, SERS won't cover a spouse eligible for another Ohio system's coverage, and OP&F's stipend excludes people with other retirement coverage. Call both systems before either of you waives coverage.
Sources
- OPERS — 2026 Health Care Program Guide
- OPERS — 2027 OPERS Health Care Program Open Enrollment
- OPERS — 2025 Health Care Report to the Ohio Retirement Study Council
- STRS Ohio — Medicare Enrollment
- STRS Ohio — Open-Enrollment Resource Center
- STRS Ohio — 2025 Health Care Report to the Ohio Retirement Study Council
- SERS — Member Health Care Guide (effective January 1, 2027)
- Ohio Police & Fire Pension Fund — Health Care
- Ohio Administrative Code 742-7-11 — OP&F stipend eligibility
- HPRS — Retiree Pre-Medicare and Medicare HRA Plan Document
- Ohio Administrative Code 5505-7-04 — HPRS health care
- Ohio Revised Code 145.584 — OPERS Part A benefit
- Ohio Revised Code 3309.69 — SERS Part B payment
- Ohio Revised Code 742.45 — OP&F Part B payment
Frequently asked questions
Which Ohio retirement systems still reimburse Medicare Part B?
SERS and OP&F pay a monthly Part B reimbursement; Ohio law sets a minimum for each (ORC 3309.69 and 742.45). STRS Ohio applies a monthly Part B premium credit to its own premium instead. OPERS ended its separate Part B reimbursement after 2016 and HPRS in 2017; both let you use HRA money to pay the Part B premium.
Which systems require me to buy Part A if it isn't premium-free?
OPERS requires it and reimburses the full premium for eligible retirees (and half for eligible spouses). OP&F's rule requires both Part A and Part B for its stipend, and HPRS's HRA requires both, with a possible supplemental allowance. STRS Ohio requires Part A only if it's premium-free, and SERS tells members not to sign up for Part A if it isn't premium-free.
If my spouse and I are both Ohio public retirees, can we choose one system's coverage?
Each system has its own coordination rules. For example, SERS won't cover a spouse who is eligible for coverage at another Ohio retirement system, and OP&F's stipend isn't available to people with access to other retirement coverage. Ask both systems before deciding which coverage each of you keeps.
Can I move from my system's plan to a plan of my own choice?
With OPERS, OP&F and HPRS you already choose your own individual plan, but you must buy it through the system's marketplace to keep the HRA. With STRS Ohio and SERS, joining any other Medicare Advantage or Part D plan cancels your system medical and drug coverage.
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