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.
For complete information on Medicare enrollment, review Section 4 of the STRS Ohio Health Care Program Guide.
Medicare Information Packet and Checklist
A Medicare Information Packet is mailed to all health care program enrollees when it is time for them to enroll in Medicare. Enrollees with an email address on file will also receive an electronic notice from STRS Ohio. You can use this Medicare enrollment checklist to help you track key steps in the enrollment process.
Once you enroll in Medicare, you’ll need to submit your Medicare information to STRS Ohio through your Online Personal Account. If you have already enrolled in Medicare, log in to your personal account to submit your Medicare information.
Understanding Medicare and its requirements can sometimes be confusing. That’s why we offer the webinar, Medicare Enrollment and STRS Ohio. We’ll guide you through the Medicare enrollment process, provide information specific to new Medicare enrollees and address any questions you submit during the presentation. There is no cost to participate.
If you’re unable to attend a live webinar, you can view the presentation at any time.
What is Medicare?
Medicare is a federal health insurance program for people age 65 and older, some people with disabilities under age 65 and people with end-stage renal disease or amyotrophic lateral sclerosis (ALS). A common misconception is that Ohio educators do not qualify for Medicare because they did not contribute to Social Security. However, you are eligible for Medicare when you turn age 65 even if you are not eligible for Social Security retirement benefits.
Medicare Enrollment Requirements
- Part A (hospital insurance) is required if it is premium free.
You must enroll in Medicare Part A if coverage is available to you at no cost (premium free). If you have to pay a Part A premium to Medicare, you do not need to enroll. However, if you later become eligible for premium-free Medicare Part A through your current or former spouse, you must sign up for Part A at no cost.
- Part B (medical insurance) is required for a monthly premium.
You must enroll in Medicare Part B and pay a monthly premium to Medicare. If you do not enroll in Part B or you stop paying your monthly Part B premium to Medicare, you will no longer be eligible for STRS Ohio medical coverage.
Not Required — Do Not Enroll
- Part C (Medicare Advantage plans) is not required; do not enroll.
You do not need to enroll in Part C. Enrollment in Parts A & B or Part B-only qualifies you for coverage under our group Medicare Advantage plan (Aetna Medicare Plan). You must not enroll in any other Medicare Advantage plan if you want to keep your coverage under the Aetna Medicare Plan.
- Part D (prescription insurance) is not required, do not enroll.
If you want to remain enrolled in an STRS Ohio plan, you cannot enroll in any other Part D plan. All of the medical plans we offer for enrollees with Medicare Parts A & B or Part B-only already include Medicare Part D prescription coverage. Enrollment in any other Part D plan will cancel your STRS Ohio medical and prescription coverage.
How Medicare Works With Your STRS Ohio Coverage
Medicare Parts A & B do not replace your STRS Ohio coverage. Instead, Medicare works with your STRS Ohio plan to provide maximum hospital and medical coverage. In general, when you enroll in Medicare Parts A & B, Medicare becomes the primary payer of your hospital and medical expenses; STRS Ohio becomes the secondary payer. If you are enrolled in the Aetna Medicare Plan, the plan assumes responsibility for paying for covered services and receives payment from Medicare.
After you enroll in Medicare, you must pay two separate monthly premiums: a premium for STRS Ohio coverage (paid to STRS Ohio) and a premium for Medicare Part B coverage (paid to Medicare).
Enrolling in Medicare
When to Enroll in Medicare
Initial enrollment period
You have a seven-month initial enrollment period in which to sign up for Medicare. This period begins three months before you turn age 65, includes the month you turn age 65 and ends three months after the month of your birthday.
For coverage to be effective the month you turn age 65, you must sign up during the first three months of the initial enrollment period (one to three months before the month of your birthday). If you wait to sign up during the last four months of the period, your effective date of Medicare will be delayed.
General enrollment period
If you miss the initial enrollment period, you can enroll during a general enrollment period from Jan. 1 through March 31 each year. Coverage begins the month after you enroll. A lifetime Medicare late enrollment penalty will apply if you don’t qualify for a special enrollment period.
Special Enrollment Period
If you delay Medicare enrollment at age 65 because you or your spouse is still employed and covered by a group health plan through the employer, you can enroll in Medicare Part B during a special enrollment period. Special enrollment allows you to enroll without paying a Part B late enrollment penalty during either of the following time frames:
- At any time while you have employer health coverage (your own or through your spouse); or
- During the eight-month period that begins the month employer health coverage ends or the month employment ends (whichever comes first). If you do not enroll by the end of the eighth month, general enrollment guidelines apply.
How to Enroll in Medicare
Enrolling in Medicare is an easy two-step process. However, it may take more than one month for the entire application process to be completed. For best results, we recommend applying for Medicare three months before your 65th birthday.
Step 1 — Sign up for Medicare
Apply for Medicare three months before your 65th birthday so there is no delay in Medicare coverage.
If you are enrolling in both Medicare Parts A & B, you can complete your Medicare application online at www.ssa.gov. If you are not eligible for premium-free Part A and are enrolling in Part B-only, you must visit your local Social Security Administration office or call Social Security toll-free at 800-772-1213 to enroll. If you visit your local office, find out which documents to bring with you to your appointment.
Step 2 — Send proof of Medicare Enrollment to STRS Ohio
Once you enroll in Medicare, you must provide proof of Medicare enrollment to STRS Ohio by submitting your Medicare information through your Online Personal Account. (Your Medicare information can be found on your Medicare card.) To submit your information:
- Log in to your Online Personal Account.
- Click “Health Care.”
- Click “Submit Medicare Information” under Useful Links.
If you do not have an Online Personal Account, visit the Account Setup page to create your account. Then follow the instructions above to submit your Medicare information.
Note: Please check all information on your Medicare card for accuracy. If it is incorrect, contact Medicare to request a new card with the correct information.
After You Enroll in Medicare
After you submit proof of Medicare enrollment to STRS Ohio, you will be enrolled in the Aetna Medicare Plan. The Aetna Medicare Plan has lower premiums and out-of-pocket costs than the Aetna Basic Plan. View plan features and premiums.
If you do not want the Aetna Medicare Plan, you may opt out and select the Aetna Basic Plan. To opt out of the Aetna Medicare Plan, select “AMA Opt Out” when you submit your Medicare information through your STRS Ohio Online Personal Account.
Premiums for benefit recipients with Medicare are lower than non-Medicare premiums. Also, premiums for benefit recipients with Medicare are reduced by a $30 Medicare Part B premium credit.
You can review your new plan options and premiums in your STRS Ohio Online Personal Account or contact STRS Ohio for this information.
Note: If you are not currently enrolled in an STRS Ohio plan, initial eligibility for and enrollment in Medicare is a qualifying event that allows you to add STRS Ohio coverage outside of open enrollment. You can enroll in a plan through your STRS Ohio Online Personal Account.