Coverage Considerations

Main coverage considerations are listed below. For additional considerations, including changes in eligibility, changing plans after enrollment and canceling coverage, see Section 1 of the STRS Ohio Health Care Program Guide.

Residency Requirement

To be eligible and remain eligible for coverage, the individual must reside physically in the United States with a permanent residence in one of the U.S. 50 states or U.S. territories.

Medicare Coverage

STRS Ohio requires all medical plan participants to be enrolled in Medicare Parts A & B at age 65 or when eligible. Medicare Part B is required for all enrollees. Medicare Part A is also required if it is available to you at no cost (premium free). If you decline Medicare Part B or premium-free Part A, you will no longer be eligible for STRS Ohio medical coverage. See Medicare Enrollment for more information.

Coverage Under More Than One Account or Retirement System

If you are eligible for medical coverage under more than one STRS Ohio account, you are limited to coverage under only one account. Additionally, if you are eligible for medical coverage through more than one Ohio public retirement system, guidelines determine which system is responsible for your coverage. Contact STRS Ohio for details.

Limited Coverage for Employed Non-Medicare Enrollees

STRS Ohio medical coverage for employed individuals not eligible for Medicare is limited to secondary coverage under STRS Ohio’s Aetna Basic Plan when they: (1) are eligible for medical and prescription coverage through their employer, or (2) hold a position for which other similarly situated employees are eligible for medical or prescription coverage. The rule applies to all employed enrollees who are not eligible for Medicare, regardless of hire date or type of employment. If you think you might be affected, contact STRS Ohio.

Prescription Coverage

CVS Caremark (CVS) administers the prescription coverage included with STRS Ohio’s medical plans. Enrollees with Medicare are covered by SilverScript, a Medicare Part D plan. SilverScript is an affiliate of CVS. Non-Medicare enrollees are covered by CVS Caremark. Learn more about your prescription coverage.

Foreign Travel

Coverage outside the United States is limited. Before traveling to a foreign country, check with your medical and prescription plan administrators to learn how your coverage will be affected while you are abroad.