Categories
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.

Categories
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).

Categories
Awareness Benefits Health Options Program Materials PSERS

Step Right Up (to Your Computer) for the Health Options Program Virtual Benefits Fair!

Interested in learning more about the Health Options Program? No need to travel, just visit our virtual benefits fair at discoverhopbenefits.com.

You can learn about the available Health Options Program plans, including Medicare Supplement plans, Medicare Advantage plans, and Pre-65 plans. You’ll find lots of information from our Health Options Program partners, such as Highmark, Aetna, and Independence Blue Cross. You’ll also get an overview of all the great health benefits available to you as a PSERS retiree.

Categories
Benefits

Benefit Info on the Go

Our vendors offer apps for your smartphone (or tablet, in some cases), so no matter where your travels take you, you’ll have easy access to all your benefits information. Visit the App Store or Google Play, and search for the app you want.

  • Optum Rx: View all your medications in one place, check the status of your orders, manage auto-refill of your prescriptions, and access your ID card.
  • MetLife US App: Access coverage details and claims, find a dentist, read reviews, and book an appointment. Get personalized estimates for dental procedures, and access your ID card.
  • EyeMed: Check your benefits, find an eye doctor, and view claims.
  • SilverSneakers GO: Get fit, stay active, and develop healthy exercise habits with this app. Use the fitness location and class finder to access virtual and in-person classes; select from 200+ SilverSneakers on-demand fitness and wellness videos.
Categories
Health Options Program Office Hours PSERS

Sign Up Now for Your Fall 2024 Individual Phone Consultation

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.
  • As it gets closer to your appointment, you’ll receive a reminder email.
Categories
Benefits Health Options Program

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.

1. 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.

2. 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.

3. We offer a virtual benefits fair at discoverhopbenefits.com, where you’ll get an overview of all the great health benefits available to you as a PSERS retiree. You can learn about the Health Options Program plans available to you, including Medicare Supplement plans, Medicare Advantage plans, and Pre-65 plans. You’ll also find lots of information from our Health Options Program partners, such as Highmark, Aetna, and Independence Blue Cross.

Categories
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 to learn about any adverse drug interactions that could occur. MTMP services help you better manage 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

If you or any of your dependents are eligible for the MTMP, you may receive a call from Optum Rx, the administrator for the Medicare Prescription Drug Options. Optum Rx representatives will call from 1-855-773-8254 or 1-866-352-5305. 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. 

Categories
Benefits Health Options Program Internet Materials

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.

Log in 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 or 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 HIPAA (the Health Insurance Portability and Accountability Act of 1996).

Categories
Benefits Health Options Program

Here’s a Sample of the VIP Treatment You Get With the Health Options Program

  • Secure Member Dashboard. Members can get personalized information about their Health Options Program coverage online. Plus, they can contact a Health Options Program customer service representative and pay their premium online.
  • No age-related premium increase. With HOP, members have the security of knowing that, as they age and use benefits more, their monthly premium is not based on their age. The Health Options Program’s premiums for the Medicare Supplement plans are set to a standard rate for age 70 and older. In comparison, many commercial plans increase their monthly premiums relative to a person’s age.
  • Age 65 discount. Once you turn 65, your monthly premium for the HOP Medical Plan—one of the medical plan options for Medicare-eligible participants—will be discounted by 15% if you enroll within the three months before or after the month in which you turn 65. As long as you remain enrolled in the HOP Medical Plan, you’ll receive a discount on your premium each year until the year in which you turn 70.
  • Premium Assistance for eligible retirees. Premium Assistance through PSERS helps pay for health coverage through the Health Options Program or another Commonwealth public school employer or district health plan. This special financial incentive through HOP is not available with a commercial program such as AARP or Blue Cross Blue Shield.

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. Not sure if you are eligible for Premium Assistance? Call 1-800-PSERS25 (1-800-773-7725).

Categories
Health Options Program Internet Materials

Online Tools Make It Easy to Use Your Benefits

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 or pharmacy: This page highlights your drug coverage and provides pharmacy locator tools and tools to help you search for drugs by name, tier, or therapeutic class.
  • Look up coverage options or premiums: Find out which plans are available where you live and their associated premiums.
  • Check out the virtual benefits fair: Explore your health care options from the comfort of home.
  • Electronic EOBs: To view your Explanation of Benefits online, log in to view your benefit statements. If you are not registered, you’ll need to create an account.
  • Get an ID card: Log in to the secure Member Area to access your member ID.
  • Pay your bill online: Make premium payments online by logging in to your Health Options Program account. To get started, log in, 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, you’ll need 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.