The April 1986 rule
Ohio's public school teachers are covered by STRS Ohio instead of Social Security, so many assume they can't get Medicare. That's a misconception, STRS Ohio says: you're eligible for Medicare at 65 even if you aren't eligible for Social Security retirement benefits. What varies is whether Part A costs a premium.
- Hired after March 31, 1986: federal law makes state and local government employees hired (or rehired) after that date pay Medicare tax, even without Social Security. Enough Medicare-taxed work, generally 10 years (40 quarters), gives premium-free Part A.
- Hired before April 1, 1986 and continuously employed by the same employer: Social Security says these employees can remain exempt from Medicare tax. Without other Medicare-covered work, you may not have premium-free Part A on your own record.
- Other work or a spouse: quarters from private-sector jobs count, and so can a current or former spouse's record.
If Part A would cost a premium
People with 30 to 39 Medicare-taxed quarters pay a reduced Part A premium; fewer than 30 pay the full premium. In 2026 those are $311 and $565 a month. What your retirement system tells you to do differs:
| System | If Part A isn't premium-free |
|---|---|
| STRS Ohio (teachers) | You don't need to buy Part A; enroll in Part B only. Sign up for Part A later if you become eligible for it premium-free. |
| SERS (school staff) | Don't sign up for Part A; SERS's Medicare Advantage plan covers Part A services. |
| OPERS | You must buy Part A; OPERS reimburses the premium under ORC 145.584. |
Part B costs a premium for everyone ($202.90 for most people in 2026), and STRS Ohio and SERS both require it.
How to check your Part A status
- Look at your Social Security earnings record. A my Social Security account at ssa.gov shows your Medicare-taxed earnings.
- Ask Social Security about a spouse's record. Call 1-800-772-1213 or visit an Ohio Social Security office.
- Enroll the right way. STRS Ohio notes that Part B-only enrollment can't be done online; call or visit Social Security.
- Send proof to your retirement system. STRS Ohio and SERS need your Medicare information to start Medicare-age coverage.
More in our guides to STRS Ohio and Medicare and Medicare Part A.
Related questions
Do STRS Ohio retirees need Part B?
Yes, for everyone.
Does the Social Security Fairness Act change Medicare?
What changed in 2025.
Does SERS reimburse Part B?
School employees' rules.
Sources
- STRS Ohio — Medicare Enrollment
- Social Security — Mandatory Medicare coverage for state and local government employees
- Medicare.gov — Medicare costs
- CMS — 2026 Medicare Parts A & B premiums and deductibles (Part A quarters of coverage)
- SERS — Member Health Care Guide
- OPERS — 2026 Health Care Program Guide
More questions 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 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?
Part of the guide: Ohio's public retirement systems and Medicare · All questions
Frequently asked questions
Can I get premium-free Part A through my spouse?
Yes. Medicare.gov says Part A is premium-free if you or your spouse paid Medicare taxes long enough. A former spouse's record can count too; STRS Ohio notes you must sign up if you become eligible that way.
Does the Social Security Fairness Act give me premium-free Part A?
No. The Act ended the Windfall Elimination Provision and Government Pension Offset, which reduced Social Security checks. Premium-free Part A still depends on Medicare-taxed work, yours or a spouse's.
I'm told I'm not eligible for Medicare because I didn't pay into Social Security. Is that right?
No. STRS Ohio and SERS both say you're eligible for Medicare at 65 even without Social Security retirement benefits. SERS says Social Security staff occasionally tell members otherwise and offers to help correct it.
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