STRS Ohio Health Care Program Logo
 
Address & Phone Number
STRS Ohio Optional Health Care Image
STRS Ohio Optional Health Care

Your Plan Options
All information displayed in the STRS Ohio Optional Health Care section applies only to benefit recipients in the Defined Benefit and Combined Plans.

Plans & Premiums for Enrollees Without Medicare
Premium information for this plan is listed after the plan features.

Commercial HMO Plans

Kaiser Permanente

Plan Features
Annual Deductible Per Enrollee
No deductible
Out-of-Pocket Maximum (Annual amount enrollees pay excluding the annual deductible and prescription drug copayments)

$2,000 per single enrollee

$6,000 per family

Lifetime Benefits Maximum per Enrollee
No benefit maximum
Health Provider Access
Use HMO provider
Physician, Hospital, Skilled Nursing & Home Health Care
Physician Office Visit
Enrollee pays $15
Hospital Inpatient Services
Enrollee pays 0%
Hospital Charges for Outpatient Surgery and Preadmission Testing
Enrollee pays $15
Emergency Room Care
Enrollee pays $50; waived if admitted

Skilled Nursing Facility

Enrollee pays 0% for up to 100 days per benefit period; after 100 days, enrollee pays 100%

Inpatient Mental Health
Enrollee pays 0%; no limit on days
Home Health Care
Enrollee pays 0%; no visit limit
Preventive Services

Physical Exam

Enrollee pays $15 (age/gender coverage guidelines may apply to immunizations/inoculations)
Bone Density Screening
Immunizations/Inoculations
Colorectal Cancer Screening
Prostatic Specific Antigen (PSA)
Pap Smear
Mammogram
Outpatient Services
Diagnostic X-ray and Lab Testing
Enrollee pays 0%
Outpatient Mental Health
Enrollee pays $15; no visit limit
Additional Services
Dental Care
No coverage
Vision Care
Enrollee pays $15 for annual eye exam at United Optical
Prescription Drug Coverage
Retail Network Provider
Kaiser Medical Facilities and other network pharmacies
Retail Copayment/
Coinsurance

Formulary generic: $15

Formulary brand-name: $30

Services must be received by pharmacies participating in the HMO network.

Maximum Day Supply at Retail
31
Mail-Order Provider
Kaiser Mail-Order
Mail-Order Copayment

Formulary generic: $15

Formulary brand-name: $30

Maximum Day Supply at Mail Service
90

 

Kaiser Permanente
Monthly Premiums — Without Medicare

Eligibility Group

TOTAL COST: $680

Benefit Recipient Years of Service STRS OHIO PAYS YOU PAY
30+ 620 60
29 600 80
28 579 101
27 558 122
26 538 142
25 517 163
24 496 184
23 476 204
22 455 225
21 434 246
20 414 266
19 393 287
18 372 308
17 351 329
16 331 349
15 310 370
Less than 15 Years of Service1 0 680
NOTE: The “Total Cost” listed above is the amount a benefit recipient would pay if he or she paid 100% of the premium cost for coverage under each plan.
Spouse 0 625
Dependent Children 0 197
Sponsored Dependent, Adult N/A N/A
Sponsored Dependent, Children N/A N/A
NOTE: The “Total Cost” for eligible dependent coverage varies by plan and is listed in the “You Pay” columns.

1 Benefit recipients with a benefit effective date of Jan. 1, 2004, or later need 15 years of qualifying service credit to purchase health care coverage through STRS Ohio. Benefit recipients with a benefit effective date before Jan. 1, 2004, who have less than 15 years of service credit have access to coverage, but will pay 100% of their health care premium.

Personal Account Information
SSN 
Password 
  Login

Forgot Your Password?

Problems Logging In?

Related Links