Public retirees

OPERS and Medicare

Once you're eligible for Medicare, OPERS no longer offers a group medical plan. You must enroll in Medicare Parts A and B, then buy an individual Medicare plan (Medicare Advantage, or Medigap with a Part D plan) through the OPERS Medicare Connector to receive a monthly HRA deposit. The HRA reimburses qualified costs, including your Part B premium. OPERS stopped paying a separate Part B reimbursement at the end of 2016.

By the Benefits Life Editorial Team, licensed insurance agents · Reviewed November 13, 2026

How OPERS coverage works once you have Medicare

The Ohio Public Employees Retirement System (OPERS) covers state, county and local government employees. Its retiree health care for Medicare-eligible benefit recipients has three parts:

Medicare Parts A and B. Medicare pays first. You pay your Part B premium to Medicare (and a Part A premium if you don't qualify for premium-free Part A).
An individual Medicare plan bought through the OPERS Medicare Connector. The Connector is a private Medicare marketplace run by a vendor OPERS chose. You pick either a Medicare Advantage plan (usually with Part D included) or a Medigap policy plus a standalone Part D plan. The plan is yours, not a group plan, and you pay its premium.
A monthly HRA deposit from OPERS. OPERS funds a health reimbursement arrangement (HRA). You pay costs first, then claim reimbursement from your HRA balance.

The OPERS HRA is a "closed" HRA: deposits are made only while you're enrolled in a Medicare medical plan through the Connector. A plan you buy elsewhere doesn't qualify, even if it's the same plan.

What the HRA pays for, and how much you get

According to OPERS's 2025 health care report, the HRA can reimburse:

post-tax medical plan premiums (Medicare Advantage, Medigap and Part D);
the Medicare Part B premium;
vision and dental premiums;
deductibles, coinsurance and other out-of-pocket medical costs;
qualifying medical expenses for a spouse or child; and
future qualifying medical expenses, including premium increases as you age.

Your monthly deposit is a percentage of a base allowance set by the OPERS board, from 51% to 90% depending on your qualifying service credit and your age when you first became HRA-eligible. OPERS mails each eligible retiree a personalized statement with the 2027 monthly HRA amount. OPERS has said the Medicare base allowance is expected to stay at its current level through 2030, though it could change sooner depending on costs and funding.

Who is eligible: for benefits effective on or after January 1, 2022, you generally need at least 20 years of Qualified Health Care Service Credit (with additional age and service combinations for retirement before 65). Not every kind of service counts. OPERS's eligibility pages and your Online Account show your status.

Part A: required, and reimbursed if it isn't premium-free

OPERS requires Medicare-eligible benefit recipients to enroll in Part A. Most OPERS retirees qualify for premium-free Part A, because public employees hired after March 31, 1986 paid Medicare tax. If you were hired before April 1986 and didn't pay Medicare tax, and you don't qualify through other work or a spouse, you must buy Part A.

That's where OPERS is unusual. Ohio Revised Code 145.584 requires OPERS to offer retirees 65 and older who don't qualify for premium-free Part A either equivalent hospital coverage or reimbursement of their Part A premium. OPERS reimburses:

100% of the Part A premium, and any late-enrollment penalty, for eligible benefit recipients; and
50% of the Part A premium for eligible spouses.

Ask OPERS for the Medicare Part A Reimbursement Form as soon as you enroll: reimbursement isn't retroactive to your Medicare start date. OPERS mails a Part A certification form each December to confirm the next year's premium, and you must repay OPERS if you drop Part A, leave your Connector plan or your premium changes without telling OPERS. In 2026 the full Part A premium is $565 a month ($311 with 30 to 39 quarters of Medicare-covered work).

Part B: required, paid through your HRA

OPERS requires Part B. The standard 2026 Part B premium is $202.90 a month; higher-income retirees pay more (see the IRMAA calculator). OPERS discontinued its separate Part B premium reimbursement as of December 31, 2016. Today the Part B premium is one of the expenses your HRA can reimburse; the Connector handles the reimbursement claims.

If you don't get Social Security benefits, Medicare bills you for Part B every month or quarter; you can pay online or use Medicare Easy Pay.

What happens if you don't enroll

No Parts A and B: OPERS says that if you decide not to enroll in Medicare "because of active employment or any other reason," you aren't eligible for HRA deposits.
No plan through the Connector: no HRA deposits, even if you have Medicare and another plan.
Medicare penalties: separately, Medicare charges a lifelong Part B penalty of 10% for each full 12 months you go without Part B after your Initial Enrollment Period, unless you had coverage from current employment. OPERS retiree coverage isn't current-employment coverage. See the penalty calculator.

Medicare before 65? If you qualify for Medicare early because of a disability or end-stage renal disease, OPERS requires you to enroll in Parts A and B, send OPERS your Social Security notice, and notify OPERS and the Connector within 30 days of that notice. Your HRA amount changes once you have Medicare; late notice can create overpayments you must repay.

Enrollment windows for 2027

What	When
Turning 65	Enroll in Parts A and B through Social Security during your 7-month Initial Enrollment Period, then enroll in a Medicare plan through the Connector so HRA deposits can begin.
Medicare Advantage and Part D changes for 2027	Contact the OPERS Medicare Connector Oct. 15 – Dec. 7, 2026.
Medigap changes	Any time of year, but a new Medigap policy may require medical underwriting outside your Medigap open enrollment period or a guaranteed-issue right. OPERS suggests changing Medigap outside the busy fall period.
OPERS vision and dental plans	Return the open enrollment form or call OPERS by Dec. 15, 2026.
Leaving a Medicare Advantage plan Jan. 1 – Mar. 31, 2027	Medicare's Medicare Advantage Open Enrollment Period allows one change; work through the Connector to keep your HRA.

If your Medicare Advantage plan isn't renewing for 2027, you have a special enrollment period and, for Medigap, a guaranteed-issue right; see plans ending in 2027.

Spouses and dependents

Your HRA can reimburse qualifying medical expenses for your spouse or dependent child.
An eligible spouse 65 or older who must pay for Part A can be reimbursed for 50% of the premium (ORC 145.584).
Medicare is individual: your spouse enrolls in Medicare and chooses a plan separately, even through the same Connector.

If you go back to work

If you're re-employed in an OPERS-covered position (full-time, part-time or seasonal), your monthly HRA deposits go into a separate Re-employed Accumulated HRA, as long as you stay enrolled in a Medicare plan through the Connector. You can't use that account during re-employment; it becomes available when the job ends. Expenses from months outside re-employment can still be reimbursed from your regular HRA balance. If your new job offers group health coverage, Medicare rules about who pays first apply; see working past 65.

How to contact OPERS

OPERS: 1-800-222-7377, opers.org (eligibility, HRA questions, Part A reimbursement, vision and dental).
OPERS Medicare Connector: 1-844-287-9945 (choosing, enrolling in or changing a Medicare plan; HRA reimbursement claims).
Social Security: 1-800-772-1213, TTY 1-800-325-0778 (Medicare enrollment, Part A eligibility).

OPERS health care isn't guaranteed. OPERS says it's neither guaranteed nor required by law, except for the Part A benefit in ORC 145.584. See how OPERS compares with the other systems on Ohio's public retirement systems and Medicare and OPERS vs. STRS vs. SERS.

Sources

Frequently asked questions

Do OPERS retirees have to enroll in Medicare?

Yes. OPERS says benefit recipients must enroll in both Medicare Parts A and B as soon as they become eligible. If you don't enroll in Medicare, for any reason including active employment, or don't buy a Medicare plan through the OPERS Medicare Connector, you won't receive HRA deposits.

Does OPERS pay for Medicare Part B?

Not directly. OPERS discontinued Part B premium reimbursement as of December 31, 2016. You can be reimbursed for your Part B premium from your OPERS HRA balance, along with plan premiums and other qualified medical costs.

How much is the OPERS HRA deposit for Medicare retirees?

It depends on your qualifying service credit and your age when you first became eligible: OPERS pays from 51% to 90% of a base allowance set by the OPERS board. Your 2027 amount is on the personalized statement OPERS mailed for open enrollment, and OPERS has said the Medicare base allowance is expected to stay at its current level through 2030.

Can an OPERS retiree go back to work and keep the Medicare HRA?

Yes, with limits. While you're re-employed in an OPERS-covered job, your monthly HRA deposits go into a separate Re-employed Accumulated HRA that you can't use until the re-employment ends. Expenses from outside the re-employment period can still be reimbursed from your regular HRA balance. You must stay enrolled in a Medicare plan through the Connector.

Who do I call about OPERS Medicare Connector enrollment?

Call the OPERS Medicare Connector at 1-844-287-9945 to enroll or change your medical plan, and OPERS at 1-800-222-7377 for eligibility, Part A reimbursement and vision or dental plans. For 2027 changes, OPERS says to contact the Connector between October 15 and December 7, 2026.

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