Ohio's public retirement systems and Medicare

Quick answers

Do Ohio public retirees get Medicare if they never paid into Social Security?

Yes. Medicare eligibility at 65 doesn't depend on Social Security benefits. Public employees hired after March 31, 1986 paid Medicare tax, so most qualify for premium-free Part A; others may qualify through a spouse or pay a Part A premium.

Is Medicare Part B required by Ohio's retirement systems?

Yes. OPERS, STRS Ohio, SERS and OP&F require Part B, and HPRS's HRA plan requires Parts A and B. Dropping Part B ends or cuts off your system health care.

Do I have to buy Part A if it isn't premium-free?

It depends on the system. OPERS requires it and reimburses the premium; STRS Ohio doesn't require it; SERS tells members not to sign up. Check your system's rule before you enroll.

Can STRS Ohio or SERS retirees join another Medicare plan?

Not without losing system coverage. Joining another Medicare Advantage or Part D plan cancels STRS Ohio or SERS medical and drug coverage.

Did the Social Security Fairness Act give retirees premium-free Part A?

No. The 2025 law repealed WEP and GPO, which raises many Social Security checks, but premium-free Part A still depends on Medicare-covered work by you or a spouse.

The five systems at a glance

Ohio has five statewide public pension systems. Each runs its own retiree health care program, and each changes how it works once you have Medicare. This table sums up the rules that apply when a retiree becomes eligible for Medicare. Dollar amounts (HRA deposits, Part B credits and reimbursements, premiums) change every year, so we link to each system instead of printing them.

Sources: each system's 2026 or 2027 health care guide and web pages, its 2025 health care report to the Ohio Retirement Study Council, and the Ohio Revised and Administrative Code sections listed under Sources. Side-by-side detail is on OPERS vs. STRS vs. SERS retiree coverage.

Can you get Medicare if you never paid into Social Security?

Yes. Most Ohio public employees don't pay Social Security tax on their public job, and many people assume that means no Medicare. STRS Ohio calls this "a common misconception": you're eligible for Medicare at 65 even if you aren't eligible for Social Security retirement benefits. SERS adds that a Social Security representative occasionally tells a member the wrong thing, and that SERS can help correct it.

What differs is whether you pay a premium for Part A (hospital insurance):

• Hired after March 31, 1986: federal law (the Consolidated Omnibus Budget Reconciliation Act of 1985) made Medicare tax mandatory for state and local government employees hired after that date. Those years count toward premium-free Part A, which takes about 10 years (40 quarters) of Medicare-covered work.
• Hired before April 1, 1986: if you stayed with the same public employer since March 31, 1986, you may never have paid Medicare tax on that job. OPERS puts it plainly: if you didn't pay this tax, you can't get Part A without paying a monthly premium, unless you qualify another way.
• Through a spouse: you can get premium-free Part A on the work record of a current spouse (married at least a year), a former spouse (if the marriage lasted at least 10 years) or a deceased spouse who has enough Medicare-covered work.
• Other work: private-sector jobs, military service and any other work where Medicare tax was withheld all count toward the 40 quarters.

If you don't qualify for premium-free Part A, you can buy it. In 2026 the Part A premium is $565 a month with fewer than 30 quarters of Medicare-covered work and $311 with 30 to 39 quarters. Part B costs the same for everyone at the standard rate ($202.90 a month in 2026), with higher amounts for higher incomes. CMS announces the 2027 amounts each fall; see Medicare costs in 2027.

Part A rules differ by system

This is the most common mistake we see: assuming every Ohio public retiree must buy Part A, or that none should. The rules are opposite from one system to another:

Part B is required everywhere

Every system ties its health care to Part B, and the consequences of not enrolling are serious:

• STRS Ohio: if you don't enroll in Part B or stop paying for it, "you will no longer be eligible for STRS Ohio medical coverage."
• SERS: eligibility ends if you don't enroll in Part B during your Initial Enrollment Period at 65 (or your Special Enrollment Period after employer coverage ends), or if you let Part B lapse. Losing Part D because of unpaid Part D income-related amounts (IRMAA) also ends SERS coverage.
• OPERS: if you don't enroll in Medicare "because of active employment or any other reason," or don't buy a plan through the OPERS Medicare Connector, you don't receive HRA deposits.
• OP&F and HPRS: no Parts A and B, no stipend or HRA allowance.

Medicare itself adds a lifelong Part B late enrollment penalty of 10% for each full 12 months you could have had Part B and didn't, unless you had health coverage from current employment. Retiree coverage from an Ohio system is not current-employment coverage. See the late enrollment penalty calculator.

What the Social Security Fairness Act changed, and what it didn't

The Social Security Fairness Act, signed January 5, 2025, repealed the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO) for Social Security benefits payable for months after December 2023. Many Ohio public retirees and their spouses who had a reduced Social Security benefit, or none at all because of the GPO, now receive more, and Social Security paid retroactive amounts in 2025.

The Act changes Social Security cash benefits, not Medicare eligibility. Premium-free Part A still depends on Medicare-covered work by you or a spouse, which WEP and GPO never affected. In practice:

• If you now receive a Social Security benefit, your Part B premium is normally taken out of that check instead of being billed to you.
• A larger Social Security benefit is income. If you get help from a Medicare Savings Program or Extra Help, report the change; see Medicare Savings Programs in Ohio and Extra Help in Ohio.
• The Act doesn't change any retirement system's health care rules.

What to do as you approach 65

1. Read your system's mailing. Each system sends Medicare information before you turn 65 (STRS Ohio mails a Medicare packet and checklist; OP&F and the OPERS and HPRS Connectors set up phone appointments). Note your system's Part A rule.
2. Check your Medicare work record. Your Social Security statement at ssa.gov/myaccount shows your Medicare earnings. Ask Social Security whether you qualify for premium-free Part A on your own or a spouse's record.
3. Sign up through Social Security yourself. If you don't already get Social Security benefits, you won't be enrolled automatically. Apply during your Initial Enrollment Period, which starts 3 months before the month you turn 65; signing up in the first 3 months means coverage starts the month you turn 65. Part B only must be done by phone (1-800-772-1213) or at an office.
4. Send proof of Medicare to your system. STRS Ohio wants it through your online account; SERS starts Medicare coverage the first of the month after it receives your Medicare card or letter; OP&F wants a copy of your card.
5. Choose your plan the way your system requires. STRS Ohio and SERS: you're placed in the group plan; don't join another Medicare Advantage or Part D plan. OPERS, OP&F and HPRS: buy an individual plan through the system's marketplace within its deadline (OP&F: 60 days) to get the HRA.
6. Pay Part B on time. If it isn't taken from a Social Security check, Medicare bills you. Medicare Easy Pay can deduct it from your bank account.

2027 open enrollment dates

Medicare's own Open Enrollment for 2027 runs Oct. 15 – Dec. 7, 2026; see Medicare Open Enrollment in Ohio.

Retiree health care is not guaranteed

None of the five systems is required by law to offer retiree health care, with one exception. STRS Ohio says "coverage is not guaranteed" and its board "has the authority to modify or eliminate the program at any time." OP&F calls its support "a discretionary benefit and not a vested right." HPRS offers health care "although it is not mandated by statute." OPERS says the same, except for the Part A benefit that ORC 145.584 requires. Each system's board reviews costs and funding every year, and each files an annual health care report with the Ohio Retirement Study Council.

Because Medicare is the base layer under every system's coverage, keeping Parts A and B in force is what protects you if a system changes its program.

Guides to each system

If you're also deciding whether Medigap or Medicare Advantage fits better (for OPERS, OP&F and HPRS retirees choosing an individual plan), see Medigap in Ohio and Medigap vs. Medicare Advantage in Ohio.

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 (June 2026)
• STRS Ohio — Medicare Enrollment
• STRS Ohio — FAQ: 2027 Health Care Changes
• STRS Ohio — Open-Enrollment Resource Center
• SERS — Member Health Care Guide (effective January 1, 2027)
• Ohio Police & Fire Pension Fund — Health Care
• OP&F — Medicare FAQ
• Ohio Highway Patrol Retirement System — Medicare Connector Information
• HPRS — 2025 Health Care Report to the Ohio Retirement Study Council
• Ohio Revised Code 145.584 — Benefits equivalent to Medicare (OPERS)
• Ohio Administrative Code 742-7-11 — OP&F health care stipend eligibility
• Social Security Administration — Mandatory Medicare Coverage for state and local government employees
• Social Security Administration — Social Security Fairness Act: WEP and GPO update
• Medicare.gov — Medicare costs
• Medicare.gov — When can I sign up for Medicare?
• Medicare.gov — Avoid late enrollment penalties

Every question in this guide

• Can STRS Ohio retirees join a different Part D plan?
• Do federal retirees in Ohio need Medicare Part B with FEHB?
• Do Ohio teachers have to pay for Medicare Part A?
• Do OPERS retirees have to enroll in Medicare?
• Do postal retirees in Ohio need Medicare Part B for PSHB?
• Do STRS Ohio retirees need Medicare Part B?
• Does OPERS pay for Medicare Part B?
• Does SERS reimburse Medicare Part B?
• Does the Social Security Fairness Act change Medicare for Ohio public retirees?
• How does HPRS retiree health care work with Medicare?
• How does the OPERS Medicare Connector work?
• What happens to OP&F retiree health care when I turn 65?

Frequently asked questions

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