Premium Subsidy for Benefit Recipients
STRS Ohio currently makes medical plan premiums more affordable for eligible service retirement and disability benefit recipients by paying a portion of the monthly costs. Covered dependents do not receive a premium subsidy.
As a benefit recipient, if you participate in the Defined Benefit or Combined Plan and have 15 or more years of qualifying service credit, STRS Ohio will subsidize your individual monthly medical plan premium. The 2018 premium subsidy rates are:
- 1.9% for non-Medicare enrollees, up to a maximum of 57%; and
- 2.1% for Medicare enrollees, up to a maximum of 63%.
Health Care Assistance Program
The Health Care Assistance Program (HCAP) is designed to help low-income benefit recipients who need financial assistance to pay for their STRS Ohio medical plan. The assistance program currently includes a $0 monthly premium for the benefit recipient and often lower out-of-pocket costs for all enrollees in the plan. Although covered family members may receive the same plan of coverage as the qualifying benefit recipient, they are not eligible for the $0 premium and must pay the full cost of their coverage.
The assistance program is currently available to:
- Service retirement benefit recipients with 25 or more years of qualifying service credit;
- Disability benefit recipients receiving STRS Ohio benefits; and
- Beneficiaries and survivors who are otherwise eligible for subsidized premiums.
New applicants must be eligible for a subsidy under the STRS Ohio Health Care Program to qualify for HCAP enrollment. Benefit recipients, beneficiaries and survivors who were enrolled in HCAP as of Dec. 31, 2015, are not subject to the subsidy requirement — as long as they continue to meet all other HCAP requirements and remain continuously enrolled in the program.
Depending on Medicare status, approved individuals may enroll in the Medical Mutual Health Care Assistance Plan or the Aetna Medicare Plan. Medicare-eligible participants must maintain their Medicare Parts A & B or Part B-only enrollment to remain eligible for HCAP.
To be eligible for the program:
- Your total annual family gross income (including any annual pension benefits and cost-of-living adjustments) must be at or below $23,800 for you, your spouse and any dependent children; and
- Liquid assets or funds readily available to your family, such as cash, savings, money market and checking accounts, trust funds, publicly traded securities and other investment vehicles, must not exceed $23,800. (A home is not considered a liquid asset.)
To apply for the program, you must submit a completed application to STRS Ohio, a copy of the previous year’s federal tax return and a copy of your Medicare card if applicable. Applications must be received no later than the 15th of the month to be considered for approval for an effective date starting the next month. STRS Ohio will requalify participants annually. For more information about the program, please call STRS Ohio.