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Awareness Health Options Program Internet PSERS

Pay Your Bill Online!

Make premium payments online by logging in to your Health Options Program account.

To get started, sign in to the Member Dashboard (select For Members in the top right corner) and click Pay My Bill to go to the payment portal. Once you are in the payment portal, you will also be able to view your statement, payment history, and balance due, or set reminders about payments.

If you are not registered, select For Members to create an account. Note: The option to pay your premium online is only available if your premium is larger than your pension. Otherwise, your premium is deducted automatically from your pension.

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Benefits Health Options Program Option Selection Period

The Results are In: Option Selection Period Materials

Last fall, we included a survey in the materials our members received for the Option Selection Period. The survey asked members to rate the materials on a scale from 1 to 10. The results are in and were similar to past years’:

  • 90% rated the materials as 7 or higher on a scale of 1 (not satisfied) to 10 (very satisfied).
  • 85% felt they received the right amount of information—not too much or too little.
  • About 90% rated the personalized statement’s understandability as 7 or higher on a scale of 1 (not understandable) to 10 (very understandable).
  • Over 88% of members felt they had the right number of coverage options for medical, prescription drug, dental, and vision coverage.

Thank you to the more than 3,455 members who responded. We work hard to meet your needs and provide useful and relevant materials. We hope you continue to find the materials informative and helpful.

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Prescription Drugs PSERS Safety

Pharmacy Quality Alliance Award

The prescription drug options under the PSERS Health Options Program are being recognized by the Pharmacy Quality Alliance for maintaining high standards in medication quality measures. These categories are part of the overall CMS star rating. The Program received an overall rating of 5 out of 5 stars for 2022. The Program also received a 4.5 star rating in 2021 and 2020. CMS awards a star rating to prescription drug plans based on performance in categories such as customer service, overall member satisfaction, and patient safety. The Pharmacy Quality Alliance works with CMS on these measures and recognizes plans with an Excellence in Quality Award and the Quality Improvement Award. The Health Options Program is pleased to share this recognition.

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Benefits Health Medical Safety

Traveling? No Problem. Healthcare on the Go

If you’re traveling this summer, it’s important to have a plan if you get sick.

Telehealth, also called telemedicine, provides access to a board-certified doctor from anywhere via telephone or live, online video. These virtual visits are secure and confidential. You’ll just need access to the internet and a computer, tablet, or smart phone device. With telehealth, you have access to care no matter where you are located.

Medicare will cover a telehealth visit as long as you have had a prior in-person office visit with the health care provider or another provider in the same office. Before leaving on your trip, contact your doctor to find out what your telehealth options are. That way, you can travel with the ease of knowing your doctors are only a phone call away.

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Benefits Health Options Program Medicare

Medicare Star Rating for the Health Options Program

Each year, Medicare evaluates prescription drug plans and awards a star rating to each plan based on performance. This star rating can be used to help you determine which plans excel based on measured categories, including: customer service, overall member satisfaction, and patient safety. Ratings range from 1 to 5 stars, with five being the highest score. The Health Options Program’s prescription drug plans received a 5-star rating for 2022, indicating that the program is highly rated in comparison to other prescription drug plans nationwide.

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Awareness Benefits Health Options Program Medicare Supplement Prevention

Kick Off Your Health Journey

If you spent the winter pushing aside your healthy habits for dinner parties and cocktails, that’s okay—let’s get back on track. If you are enrolled in the HOP Medical Plan or the Pre-65 Medical Plan, you have access to the SilverSneakers exercise program.

Being physically active and eating healthy foods can benefit everyone. Refocus on your health with these quick tips:

  • Limit portion size: Be mindful of what a portion size is. It is often less than we realize.
  • Add healthy snacks throughout the day: Choose an apple or a handful of peanuts instead of those crunchy chips.
  • Engage in physical activity: Even a little bit can go a long way.
  • Talk to your doctor if you are concerned about your weight.

Benefits of exercise

Having an active lifestyle has many benefits, not just on the scale. Exercise can help lower the risk of heart disease, diabetes, stroke, high blood pressure, osteoporosis, and certain cancers. Regular exercise may help you with your daily activities and help you keep up with grandchildren, prevent falls, and stay independent.

How much exercise do you need?

The Centers for Disease Control and Prevention recommends that adults get 150 minutes of moderate-intensity activity, or 75 minutes of vigorous-intensity activity, each week. Using the “talk test,” moderate-intensity exercise is when you’re breathing hard but can still have a conversation. Vigorous exercise is when you can only say a few words before having to take a breath. But remember, you can start small and build up. Many exercises can be done in a seated position, so you can stay active at any level.

Get started with SilverSneakers and the Health Options Program

SilverSneakers is available to members enrolled in the HOP Medical Plan or the HOP Pre-65 Medical Plan. In fact, members enrolled in these plans average over seven gym visits a month! 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.

Sources: nia.nih.gov/health/maintaining-healthy-weight, hsph.harvard.edu/obesity-prevention-source/obesity-causes/physical-activity-and-obesity, health.gov/sites/default/files/2019-11/PAG_MYW_Adult_FS.pdf, cdc.gov/physicalactivity/basics/adults/index.htm

SilverSneakers is a registered trademark of Tivity Health, Inc. SilverSneakers On-Demand, SilverSneakers LIVE, and SilverSneakers GO are trademarks of Tivity Health, Inc. © 2021 Tivity Health, Inc. All rights reserved. SSFP2125_0821

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Awareness Benefits Health Options Program Office Hours PSERS

Individual Phone Consultations: Spring 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 Medicare

2022 Medicare Highlights

Each year, if needed, the Centers for Medicare & Medicaid Services (CMS) adjust Medicare’s premiums, deductibles, and copays. Most people do not pay a month premium for Medicare Part A if they or their spouse paid Medicare taxes while working. However, to be covered under Medicare Part B, you must pay a monthly premium, which is deducted from the Social Security benefit for most people. As required by law, the standard monthly premium is set each year at 25% of the cost for senior beneficiaries. The government pays the remaining 75%.

The chart below compares 2021 to 2022 costs. The Health Options Program is designed to pay some or all of these deductibles and coinsurances. For example, the HOP Medical Plan pays your Part A deductible and coinsurance for stays in the hospital and skilled nursing facilities, as well as the Part B deductible. The Value Medical Plan also pays 100% of Medicare’s hospital deductible and daily copays but only after you pay the first $300.

Amount You Pay (without supplemental insurance)

2021 2022
Part A
First-day hospital deductible $1,484 $1,556
Coinsurance for days 1-60 of a hospital stay $0 $0
Coinsurance for days 61-90 of a hospital stay $371/day $389/day
Coinsurance for days 1-20 of a skilled nursing facility $0 $0
Coinsurance for days 21-100 of a skilled nursing facility $185.50/day $194.50/day
Part B
Standard monthly premium for most new enrollees and Medicare
beneficiaries		 $148.50 $170.10
Deductible $203 $233
Coinsurance 20% 20%
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Benefits Health Options Program Premium Assistance

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 an online version of the personalized statement. Plus, if you misplace or want another copy of your statement, a printer-friendly version is available.

Categories
Benefits Health Options Program Medical Medicare Prescription Drugs

2022 Updates for the Medicare Rx Options

Medicare requires that all Medicare prescription drug plans (including those provided by a Medicare Advantage plan) make certain changes each year. For 2022, these changes include:

  • Increasing the dollar thresholds for reaching the Coverage Gap and Catastrophic Coverage to $4,430 and $7,050 respectively.
  • If you meet the Catastrophic Coverage threshold, you pay: ­
    • Generic drugs: the greater of 5% or $3.95, up to the maximum ­
    • Brand-name drugs: the greater of 5% or $9.85, up to the maximum

In addition, the Value Medicare Rx Option’s annual deductible is now $480. Otherwise, there are no changes to the copay or coinsurance you pay for medication in the Initial Coverage stage under the Enhanced, Basic, or Value Medicare Rx Option.

Not registered? Sign up today for personalized information.