Premium Subsidy for Benefit Recipients
STRS Ohio currently makes medical plan premiums less expensive for eligible service retirement and disability benefit recipients by subsidizing a portion of the monthly costs. Covered dependents do not receive a premium subsidy.
Benefit recipients who participate in the Defined Benefit Plan or Combined Plan are eligible for a premium subsidy based on years of total service credit. To qualify for a premium subsidy:
- Benefit recipients who retire on or after Aug. 1, 2023, must have 20 or more years of total service credit.
- Benefit recipients who retired before Aug. 1, 2023, must have 15 or more years of total service credit.
Health Care Assistance Program
The Health Care Assistance Program (HCAP) is designed to provide qualified benefit recipients with financial assistance to help 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 total service credit, and
- Disability benefit recipients receiving STRS Ohio benefits.
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 Aetna Basic Health Care Assistance Plan or the Aetna Medicare Plan. Medicare-eligible participants must maintain their Medicare 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 175% of the current year’s federal poverty level for a family of two; 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 175% of the current year’s federal poverty level for a family of two. (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.