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:
A few days before your appointment, you’ll receive a reminder email.
Each year, if needed, the Centers for Medicare & Medicaid Services (CMS) adjust Medicare’s premiums, deductibles, and copays. 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. For most people, the premium is deducted from their Social Security benefit. 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 2023 and 2024 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 your 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.
| Part A | 2023 | 2024 |
|---|---|---|
| First-day hospital deductible | $1,600 | $1,632 |
| Coinsurance for days 1–60 of a hospital stay | $0 | $0 |
| Coinsurance for days 61–90 of a hospital stay | $400 per day | $408 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 | $200 per day | $204 per day |
| Part B | 2023 | 2024 |
|---|---|---|
| Standard monthly premium for most new enrollees and Medicare beneficiaries | $164.90 | $174.70 |
| Deductible | $226 | $240 |
| Coinsurance | 20% | 20% |
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 send you an information packet 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 packet 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.
We also conduct webinars (virtual group information sessions) several times a year. During the webinars, you can learn more about the Health Options Program and ask questions. Check our website for the live webinar meeting schedule. If you’re unable to attend a live webinar, you can watch a recorded session. Our virtual benefits fair offers another opportunity for you to learn more about the Health Options Program. Visit discoverHOPbenefits.com for information from Health Options Program partners and more about all the great benefits available to you as a PSERS retiree.
Medicare requires that all Medicare prescription drug plans (including those provided by a Medicare Advantage plan) make certain changes each year. For 2024, the dollar thresholds for certain coverages are increasing:
What this means for you: If you meet the catastrophic coverage threshold, you will then pay $0.
There are no changes to the copay or coinsurance that you pay for medication in the Initial Coverage stage under the Basic or Value Medicare Rx Options.
For the Value Medicare Rx Option, the annual deductible for 2024 increased to $545.
Need more info? Refer to the benefit tables for specific copay amounts.
The HOP Administration Unit, customer service teams, program advocates, and case managers are specially trained on Health Options Program benefits. Not sure where to start? Call 1-800-PSERS25 (1-800-773-7725). Here are certain ways the Health Options Program can help.
Experiencing a serious health condition or treatment, or have a hospital admission?
Call the Luminare Health Care Management team at 1-800-480-6658. Note that they may reach out to you if you have a hospital stay or need skilled nursing care.
Looking for ways to enhance your well-being?
The Elder Care program can help you find resources, such as local transportation options, getting answers to utility questions, help with finding prescription drug delivery, discount programs, and support for improving nutrition. For assitance, call 1-866-794-0685, and ask to speak to an advocate.
Want to be more active? Give SilverSneakers a try for fitness and social connections. If you are 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 features access to gyms for classes and fitness. Plus, SilverSneakers FLEX®, SilverSneakers LIVE, SilverSneakers On-DemandTM, and the mobile app all provide options to get active outside of traditional gyms.
Spend some time exploring our updated website. You’ll find that we’ve added some helpful resources, like content for caregivers and explanations of how Health Options Program coverage works with Medicare. Not only have we improved our look, we’ve also streamlined it to make it easier for you to find what you’re looking for.
If you’re a registered member, you may notice the new logo for Luminare Health when you log in to the secure member area. Luminare Health (formerly Trustmark) manages our secure member website and administers our Health Options Program benefits. Only the name is new—our benefits program will continue to be supported with the high-quality service you’ve come to expect.
As a reminder, registered members can access their personalized information about their Health Options Program coverage, contact customer service, and pay their premium online, as well as find a doctor, check claim status, get ID cards, and more. Here’s how to access the member area:
We take the security of our members’ information seriously. Our website uses industry-standard security to protect our members’ information. It also meets the stringent data security requirements of HIPAA (the Health Insurance Portability and Accountability Act of 1996). Note: If you are enrolled in a Medicare Advantage plan, ask your insurance provider about the online resources available to you.
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.
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.
Diabetes is a chronic condition that affects the amount of insulin a person’s body produces. You can prevent or lower your risk of diabetes by making healthier food choices, increasing your physical activity, losing weight, quitting smoking, or reducing your alcohol intake.
Diabetes prevention is especially important if you are overweight or have a family history of the disease. It’s important to visit your doctor for regular glucose screenings if you fall into one of these categories. Early detection can also help you avoid serious health complications of diabetes down the road. Learn more about diabetes at diabetes.org.
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 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 2023, we received over 6,100 responses! Your voice matters—let us know what you think.
