Public retirees

SERS and Medicare

When you have Medicare, SERS covers you through one group Medicare Advantage PPO plan with Part D drug coverage, available throughout the U.S. Everyone must enroll in Medicare Part B, and SERS coverage ends if you miss your Part B enrollment window or let Part B lapse. SERS still pays a monthly Part B reimbursement to retirees and disability recipients in its coverage. If Part A isn't premium-free for you, SERS says not to buy it.

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

How SERS coverage works with Medicare

The School Employees Retirement System of Ohio (SERS) covers non-teaching employees of Ohio's public schools: bus drivers, food service workers, custodians, aides, secretaries and other staff. Its Medicare-age coverage is simple to describe:

One group plan. SERS offers one Medicare Advantage PPO plan to Medicare enrollees. It includes Part D prescription coverage and is available throughout the United States, which matters for retirees who winter out of state.
One SERS premium. SERS deducts the plan premium from your monthly benefit. It depends on your years of qualified service credit and whether you qualify for a premium subsidy. If your benefit is too small, SERS bills you for the rest.
Your Part B premium is separate. You pay it to Medicare, or it comes out of a Social Security check if you get one.
A Part B reimbursement. SERS adds a monthly Part B reimbursement to your benefit payment (see below).

SERS starts your Medicare coverage the first of the month after it receives your Medicare card or Letter of Entitlement showing your Part B effective date and Medicare number, so send it as soon as you get it.

To be eligible for SERS health care at all, you need at least 10 years of qualified service credit at retirement; a premium subsidy generally requires at least 20 years (or a disability benefit). SERS also offers a 25% premium discount for medical and drug coverage when household income is below its limits; call SERS for the application.

Part A: enroll if premium-free, otherwise don't

SERS's guide says to enroll in premium-free Part A if you're eligible, on your own work record or a current or former spouse's. Most SERS retirees hired after March 31, 1986 paid Medicare tax on their school job and qualify on their own record.

If you don't qualify, SERS's instruction is the opposite of OPERS's: "If Social Security says you are not eligible to receive Part A for free, and you are enrolling in SERS' Medicare coverage, do not sign up for Medicare Part A." The SERS Medicare Advantage plan covers your Part A services. (OPERS requires premium Part A and reimburses it; see OPERS and Medicare.)

SERS also warns that a Social Security representative "occasionally" tells a member wrongly that they aren't eligible for Medicare because they didn't pay into Social Security. You are eligible; SERS can help correct the record.

Part B: required, with a reimbursement

"Everyone must enroll in Part B, and everyone pays a monthly premium." The standard 2026 premium is $202.90 a month; higher incomes pay more (see the IRMAA calculator).

The SERS Part B reimbursement. Ohio Revised Code 3309.69 directs the SERS board to pay a monthly amount toward Part B, with a minimum set in the law, to health care participants who pay for Part B. SERS's 2027 guide confirms the reimbursement for service and disability benefit recipients enrolled in SERS coverage and Part B. The current amount is in the SERS Member Health Care Guide. The rules:

It appears as a separate addition on your pension statement.
Spouses and children aren't eligible.
People who receive Part B at no cost aren't eligible. If Ohio Medicaid or a Medicare Savings Program pays your Part B premium, tell SERS. See Medicare Savings Programs in Ohio.
You must tell SERS if another source reimburses your Part B premium.

What happens if you don't enroll

SERS is strict, and the rules come straight from its guide:

Miss Part B at 65: "Eligibility for SERS' healthcare coverage ends if you do not enroll in Medicare Part B during your Medicare Initial Enrollment Period at age 65 or Special Enrollment Period following the loss of employer coverage."
Let Part B lapse: "Failure to maintain Medicare Part B enrollment will also result in a loss of eligibility."
Lose Part D: SERS coverage also ends if your Part D enrollment ends, "most commonly due to amounts owed for Part D Income-Related Monthly Adjustment Amount." If Social Security says your income means you owe Part D IRMAA, pay the bill Medicare sends you. CMS, not SERS, decides when Part B and Part D end and restart.
Join another Part D or Medicare Advantage plan: both your SERS medical plan and its drug coverage are cancelled.

SERS's May 2026 board materials describe a self-funded plan available only while a retiree has a disruption in Part B enrollment. Call SERS right away if your Part B ends.

Retiree coverage doesn't protect your Part B window. Only coverage from current employment lets you delay Part B without a Medicare penalty. If you're 65 and retired, enroll in Part B in your Initial Enrollment Period. Medicare's late penalty is 10% of the standard premium for each full 12 months without Part B, for as long as you have Part B. See the penalty calculator.

Enrollment windows

Situation	When you can enroll in SERS coverage
Retiring or starting a disability benefit	At that time.
Becoming eligible for Medicare	Within 90 days of becoming eligible.
Losing other coverage involuntarily	Within 31 days, with proof (not paying a premium doesn't count).
Coming off a spouse's or new employer's plan	Within 31 days after that employer coverage ends.
Dental and vision	SERS's biennial dental and vision open enrollment, or within 31 days of losing other dental or vision coverage.

Because SERS has one Medicare plan, Medicare Open Enrollment (Oct. 15 – Dec. 7, 2026) isn't a time to switch plans for SERS members; changing to an outside plan ends SERS coverage. If you go back to work and become eligible for an employer's medical plan, you may temporarily lose SERS eligibility, though SERS says this doesn't affect people enrolled in Part B.

Spouses and dependents

You can enroll your spouse within 31 days of marriage, within 90 days of you or your spouse becoming eligible for Medicare, or within 31 days of an involuntary loss of other coverage.
The spouse premium is based on your qualified service credit. Spouses don't receive the Part B reimbursement.
If your spouse is eligible for health care through another Ohio public retirement system, your spouse can't be on your SERS coverage. And if your spouse is retired from another Ohio system, you can't waive SERS coverage to join your spouse's plan.
To keep coverage for a surviving spouse, a service retiree must choose a joint-survivor payment plan (Plan A, C, D or F) with the spouse as beneficiary.

How to contact SERS

SERS: 800-878-5853 or 614-222-5853, ohsers.org.
Social Security: 1-800-772-1213, TTY 1-800-325-0778 (Medicare enrollment, IRMAA notices).

Compare SERS with the other systems on OPERS vs. STRS vs. SERS retiree coverage or start at Ohio's public retirement systems and Medicare.

Sources

Frequently asked questions

Does SERS reimburse Medicare Part B?

Yes. SERS pays a monthly Medicare Part B reimbursement to service and disability benefit recipients who are enrolled in SERS health care coverage and Medicare Part B. It appears as a separate addition on your pension statement. Spouses and children aren't eligible, and you must tell SERS if another source reimburses your Part B premium.

Will a Medicare Savings Program stop my SERS Part B reimbursement?

It can. SERS says people who receive Medicare Part B at no cost aren't entitled to its Part B reimbursement, and you must tell SERS if another source pays or reimburses your Part B premium. If Ohio Medicaid or a Medicare Savings Program starts paying your Part B premium, report it to SERS so you aren't overpaid.

Do SERS retirees need Medicare Part A?

Enroll in Part A if it's premium-free for you, through your own or a spouse's work record. If Social Security says you aren't eligible for premium-free Part A and you're enrolling in SERS Medicare coverage, SERS says do not sign up for Part A: its Medicare Advantage plan covers your Part A services.

Can SERS retirees join another Medicare plan?

Not without losing SERS coverage. Medicare allows only one Part D plan at a time, and SERS says that if you enroll in another Part D plan, both your SERS Medicare Advantage plan and its drug coverage are cancelled.

Why could unpaid IRMAA end my SERS coverage?

SERS coverage requires Medicare Part D enrollment, and Medicare ends Part D if you don't pay the Part D income-related monthly adjustment amount (IRMAA) it bills you. SERS says this is the most common reason members lose Part D and, with it, SERS coverage.

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