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Health Options Program Medicare Supplement

How to Access Your Claims Online

If you are enrolled in the HOP Medical Plan, the Value Medical Plan or the Pre-65 Medical Plan, you have convenient, secure access to your medical claims.

Login to the secure Member Area section of the website to:

  • Review claims
  • Pay your bill online
  • View your personalized statement
  • Find a drug or pharmacy
  • Find coverage and compare plans
  • Request electronic EOBs

Once logged in, to access your claims click on “view medical claims” in the “Your HOP Tools” section of your dashboard.

If you are not registered you can create an account. Enter your member ID or SSN, your last name, zip/postal code, and date of birth.

Then you will be prompted to select a username, password and security questions. We take the security of our members’ information very seriously. Our website meets the stringent data security requirements of HIPPA (the Health Insurance Portability and Accountability Act of 1996).

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Awareness Benefits Health Options Program Prevention

We’ve Got You Covered

Should you get a flu shot and the COVID-19 vaccine? Health experts are recommending that the best protection against both viruses is vaccination. If you don’t want to make two trips, talk to your doctor about getting both at the same time.

The flu and COVID-19 vaccines are for different illnesses. A seasonal flu shot will not protect you from COVID-19. Getting both vaccines will give you the highest level of protection.

Medicare covers both vaccines at 100%, which means you will have no out-of-pocket costs. The Centers for Disease Control and Prevention (CDC) recommends annual flu shots, because the vaccine is updated each year to better match circulating influenza viruses. The flu generally peaks in January or February and can still be around through May.

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Awareness Benefits Option Selection Period OSP

Return Your OSP Survey Card!

Each year we include a survey in the Option Selection Period (OSP) materials. We ask that members fill out this survey and drop it in the mail. We review all the surveys and use them to determine how the Health Options Program is meeting the needs of our members—and if we need to make any changes to improve our service to you!

If you have not returned your survey card, please do so as soon as possible.

In 2022, we received over 3,400 responses! Your voice matters—let us know what you think.

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Benefits Health Options Program Materials Medical Medicare Advantage Medicare Supplement Option Selection Period OSP

Attention Health Options Program Members: Mark Your Calendar

The Option Selection Period—the time when individuals currently enrolled in the Health Options Program can make changes to their coverage for 2023—runs through November 15. If you’re a current enrollee, this is a great time to evaluate your options and decide if you want to make any changes to your Health Options Program coverage for 2023.

Watch your mail for more information. You’ll receive your Option Selection Period materials explaining what’s new for 2023 and the coverage options available. Consider these materials carefully, particularly if you have moved, or are about to move, to a new area. If you’re currently enrolled in the Enhanced, Basic or Value Medicare Rx Option, the package will also include information about these plans. Unless you notify us otherwise during the Option Selection Period, your current medical and/or prescription drug or dental and vision coverage will continue in 2023.

Don’t delay! The Option Selection Period ends November 15, 2022, so be sure to review all the information and submit all necessary forms before then. If you have any questions about the coverage options available to you, call the HOP Administration Unit at 1-800-773-7725.

Note: These mailings are exclusively for members currently enrolled in the Health Options Program. If you are not enrolled in health coverage under the Health Options Program, you will not receive the materials described above. If you are not enrolled in the Health Options Program, you may enroll if you experience a Qualifying Event (i.e., turning 65 or losing employer-sponsored coverage).

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Awareness Benefits Health Options Program Medicare Medicare Advantage Medicare Supplement Office Hours Premium Assistance PSERS

Individual Phone Consultations: Fall 2022

You can schedule a 30-minute individual telephone consultation (not a group meeting) with a staff member of the Health Options Program by following the steps below:

  • Call the HOP Administration Unit at 1-800-773-7725.
  • Let the representative know you want to schedule an individual telephone consultation.
  • After you make your appointment, you'll receive a confirmation email with the date and time.

As it gets closer to your appointment, you'll receive a reminder email.

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Awareness Benefits Prescription Drugs

Are You Taking Multiple Medications? Get Assistance.

The Health Options Program offers the Medication Therapy Management Program (MTMP) to help you understand how to properly take your medications, and any adverse drug interactions that could occur.

If you or any of your dependents are eligible for the MTMP, you may receive a call from OptumRx, the administrator for the Medicare Prescription Drug Options. OptumRx representatives will call from 855-773-8254 or 866-352-5305.

If you qualify for the program and do not opt out, you will be automatically enrolled in the program. There is no additional cost for you to enroll. The brochure sent in the mail explains how you can opt-out of the MTMP. The services available help to better manage multiple conditions by:

  • Ensuring medications are taken correctly
  • Improving medication adherence
  • Detecting potentially harmful medication uses or combinations of medications
  • Educating members and health care providers
Categories
Awareness Benefits Health Options Program Materials Medicare Medicare Advantage Medicare Supplement PSERS

Are You Almost 65?

If you’re a PSERS retiree about to turn age 65, we’re eager to tell you about the benefits of joining the Health Options Program. We take a number of steps to make sure you understand how the program works.

First, we’ll send you a package of information from four to nine months before your 65th birthday. We mail these twice a year—in the winter for people turning age 65 during the first six months of the following year and in the spring for people turning age 65 in the second half of the year. The package contains a description of the medical and prescription drug benefits available under the Health Options Program—plus a personalized statement that has information specific to you—including your monthly premiums for all your coverage options.

In addition, we conduct virtual group meetings multiple times a year where you can learn about the Health Options Program and ask questions. If you’re unable to attend a live virtual group meeting, you can watch one of the recorded sessions. The live meeting schedule is posted to our website.

Also, if you register on this website, you’ll find a personalized statement with all the same information as the printed statement you receive in the mail. Plus, if you misplace or want another copy of your statement, a printer-friendly version is available.

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Awareness Benefits Health Health Options Program PSERS

Vote for the SilverSneakers Member of the Year Award

Each year SilverSneakers honors a SilverSneakers member who has improved their life through a healthy lifestyle that incorporates physical activity while inspiring and motivating others along the way. The Member of the Year Award was established in memory of SilverSneakers founder Mary Swanson’s father, who served as the inspiration for the nationally acclaimed program.

Vote for a PSERS member!

Thomas Laffey is a member of the Pennsylvania Public School Employees' Retirement System—and he has been nominated to win for 2022! You have until August 14 to vote. Vote today!

Thomas Laffey is a retired school psychologist, who has been living with Alzheimer’s for the past seven years. It affects his memory as well as his speech and understanding. Before the pandemic, Tom volunteered at a local memory unit because he wanted to be able to help others who were struggling with the same issues he is facing. He is no longer able to volunteer, but he continues to be active and social. He ran multiple times a week until about six months ago, and only retired from doubles tennis a few months ago. The highlight of his week is using his Silver Sneakers membership to enjoy working out at the Jewish Community Center of the Lehigh Valley under the guidance of a personal trainer. This physical activity has helped maintain strength, balance and coordination while also improving his mood and helping him sleep. Throughout his life, he has embodied the desire to serve family, friends, and community, and to maintain the highest level of health he can. Despite his diagnosis and its limitations, Tom continues to have a positive attitude toward people and life.

Join SilverSneakers

SilverSneakers is available to members enrolled in the HOP Medical Plan or the HOP Pre-65 Medical Plan. Health Options Program members enrolled in a Medicare Advantage plan may also have access to a wellness program. Contact the Medicare Advantage plan directly, or visit SilverSneakers.com for more information. Always consult with your physician before beginning a physical activity program.

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Benefits Health Options Program Premium Assistance

What’s Premium Assistance?

Participating in the Health Options Program may entitle you to a special financial incentive that is not available with a commercial program such as AARP or Blue Cross/Blue Shield. PSERS provides Premium Assistance to help eligible retirees pay for health coverage through the Health Options Program or another Commonwealth public school employer or district health plan.

If you are eligible for Premium Assistance and enroll in either a Medicare Supplement plan or a Medicare Advantage plan through the Health Options Program, PSERS will pay up to $100 per month toward your monthly premium. The amount of the Premium Assistance benefit is determined by the Pennsylvania legislature and is subject to change.

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Awareness Benefits Health Options Program Internet

The Tools to Use

Our website tools make it easy for you to get answers to your questions and maximize your benefits.

  • Find a Plan: Determine the medical, prescription drug, and dental and vision plan options available through the Health Options Program that are best for you.
  • Find a Drug: Search for drugs by name, tier or therapeutic class.
  • Find a Pharmacy: Search for participating pharmacies near you by street address, city and state, or ZIP code. You can also search by types of service, such as being open 24 hours, providing vaccinations, or offering specialty drugs.
  • Find Premiums: Find out which plans are available where you live and their associated premiums.

Not registered? Sign up today for personalized information.