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Awareness Benefits Health Options Program Materials Medicare Office Hours

Individual Phone Consultations: Spring 2025

You can schedule a 30-minute individual telephone consultation (not a group meeting) with a representative 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.
  • A few days before your appointment, you’ll receive a reminder email.

You can check our website for the schedule of live webinars. If you can’t attend a live session, don’t worry—you can watch a recorded one at your convenience.

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Medicare Medicare Advantage Medicare Supplement

2025 Medicare Highlights

Each year, the Centers for Medicare & Medicaid Services (CMS) may adjust Medicare premiums, deductibles, and copays as needed. Most people do not pay a monthly 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 typically deducted from your Social Security benefit. By law, the standard monthly premium is set each year at 25% of the cost for senior beneficiaries, with the government covering the remaining 75%.

The chart below compares the costs for 2024 and 2025. The Health Options Program is designed to cover some or all of these deductibles and coinsurances. For instance, the HOP Medical Plan covers your Part A deductible and coinsurance for hospital and skilled nursing facility stays, as well as your Part B deductible after you pay the first $50. The Value Medical Plan also covers 100% of Medicare’s hospital deductible and daily copays, after you pay the first $300.

 Amount You Pay (without supplemental insurance)
Part A20242025
First-day hospital deductible$1,632$1,676
Coinsurance for days 1–60 of a hospital stay$0$0
Coinsurance for days 61–90 of a hospital stay$408 per day$419 per day
Coinsurance for days 1–20 of a skilled nursing facility stay$0$0
Coinsurance for days 21–100 of a skilled nursing facility stay$204 per day$209.50 per day
Part B
Standard monthly premium for most new enrollees and Medicare beneficiaries$174.70$185
Deductible$240$257
Coinsurance20%20%

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Health Options Program Office Hours Premium Assistance

Are You Almost 65?

If you’re a PSERS retiree nearing your 65th birthday, we want to ensure that you fully understand the benefits available to you through the Health Options Program.

We send out an information packet four to nine months before your 65th birthday. These packets are mailed twice a year—in the winter for those turning 65 in the first half of the following year, and in the spring for those turning 65 in the second half. The packet includes a detailed description of the medical and prescription drug benefits under the Health Options Program, along with a personalized statement that outlines your specific monthly premiums for all coverage options.

Additionally, we host webinars several times a year. These virtual group information sessions are a great way to learn more about the Health Options Program and to get your questions answered. You can check our website for the schedule of live webinars. If you can’t attend a live session, don’t worry—you can watch a recorded one at your convenience.

Another fantastic resource is our virtual benefits fair. This website provides more information about the Health Options Program from our partners and highlights all the great benefits available to you as a PSERS retiree. Visit discoverHOPbenefits.com to explore more. We look forward to helping you make the most of your retirement benefits!

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Benefits Health Options Program

Unlock the Full Potential of Your Health Options Program Benefits 

The Health Options Program offers a range of resources to support your health and well-being. The HOP Administration Unit, customer service teams, program advocates, and case managers are all specially trained to assist you with your benefits. If you’re unsure where to begin, simply call 1-800-PSERS25 (1-800-773-7725). Here are some ways the Health Options Program can help you:

Facing a serious health condition or hospital admission? 

Reach out to the Luminare Health Care Management team at 1-800-480-6658. They may also contact you if you have a hospital stay or require skilled nursing care.

Looking to enhance your well-being? 

The Elder Care program can connect you with resources, such as local transportation options, answers to utility questions, prescription drug delivery services, discount programs, and nutritional support. For assistance, call 1-866-794-0685 and ask to speak with an advocate.

Want to stay active?  Try SilverSneakers for fitness and social connections. If you’re enrolled in the HOP Medical Plan or HOP Pre-65 Medical Plan, you have access to SilverSneakers instructors who lead specially designed group exercise classes. SilverSneakers also provides access to gyms for classes and fitness, as well as SilverSneakers FLEX®, SilverSneakers LIVE, SilverSneakers On-Demand™, and a mobile app for staying active outside of traditional gyms.

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Awareness Benefits Health Options Program

Important Changes to Your Benefits in 2025

As we step into the new year, we want to remind you about the 2025 changes to your Health Options Program benefits.

Medical Plans

The HOP Medical Plan has a new $50 annual deductible before the plan will pay benefits.

The Value Medical Plan deductible increased to $257 for 2025 (from $240 in 2024).

If you enrolled in a Medicare Advantage plan for 2025, review your specific plan information for details on plan changes.

Medicare Prescription Drug Options

The Enhanced, Basic, and Value Medicare Rx Options were replaced by two new options:

  • Medicare Plus Rx Option. This plan offers a broader list of drugs and a bonus list of medications not covered by Medicare or the Standard Rx Option. The 2025 annual deductible (which excludes generic medications) is $200.
  • Medicare Standard Rx Option. This plan is designed for retirees who prefer a lower monthly premium and are willing to pay a higher annual prescription drug deductible and cost share. The 2025 annual deductible (which excludes generic medications) is $590.

For both options, member out-of-pocket expenses for prescription drugs are capped at $2,000 per year.

MetLife Dental and EyeMed Vision Option 

There are no changes in the benefits coverage for 2025. If you have any questions or need further assistance, please reach out to the HOP Administration Unit. Here’s to a healthy and happy 2025!

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Awareness Benefits Health Options Program

Don’t Go It Alone

Caring for a loved one can be stressful. That’s why we put together a list of resources HOP offers that can help support you while you support your loved one who’s covered by HOP. You can find details about these programs on our Caregiver Resources page.

Questions? You can always reach out to The HOP Administration Unit at 1-800-PSERS25 (1-800-773-7725); 8 a.m. to 8 p.m. ET, Monday–Friday. They can connect caregivers to the right resource. If you’re family member is facing a hospital or skilled nursing facility stay, call the Health Care Management team right away at 1-800-480-6658.

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Awareness Medicare Medicare Advantage Medicare Supplement

Medicare Part—What Did You Say?

We get it. Medicare is confusing! Even the experts get tripped up from time to time on the different parts of the program and what they cover.

That’s why we put together Medicare 101—a primer on the federal health insurance for folks age 65 and older (or younger, if you have a disability). As Medicare coverage gets more complicated, we aim to make it easier to understand.

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Health Options Program Option Selection Period OSP

Return Your Option Selection Period Survey Card!

Each year we include a survey in the Option Selection Period 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 whether 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 2024, we received over 5,400 responses! Your voice matters; let us know what you think.

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Uncategorized

2025 Plan Materials

If you’ve misplaced any of the 2025 plan materials that you received in the mail, you can get another copy online. Here’s how:

  • Sign in to the HOPbenefits.com Member Area page. If you are a registered user, you can view your Personalized Statement online. This statement provides an overview of your current (2024) coverage and your 2025 options and premiums based on where you live.

If you have any questions about the coverage options available to you, call the HOP Administration Unit at 1-800-773-7725.

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Annual Enrollment Option Selection Period OSP

Attention Health Options Program Members: Mark Your Calendar for Option Selection Period

The Option Selection Period—the time when individuals currently enrolled in the Health Options Program can make changes to their coverage for 2025—runs through November 15. If you’re a current enrollee, this is a great time to evaluate your options and decide whether you want to make any changes to your Health Options Program coverage for 2025.

Watch your mail for more information. You’ll receive your Option Selection Period materials, explaining what’s new for 2025 and the coverage options available in your area.

If you’re currently enrolled in the Enhanced, Basic, or Value Medicare Rx Option, review your statement carefully. These Options are not available in 2025. The new Medicare prescription drug plans for 2025 are the Medicare Plus Rx Option or the Medicare Standard Rx Option. You can change to one of the options listed in your statement. If you do nothing, you’ll have the coverage and pay the premiums shown on the first page of your person

Unless you notify us otherwise during the Option Selection Period, your current coverage will continue in 2025.

Don’t delay! The Option Selection Period ends November 15, 2024, so be sure to review all the information and submit 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).

Not registered? Sign up today for personalized information.