2025 Option Selection Period
Plan Materials for 2025
If you have questions, contact the applicable customer service unit:
- The HOP Medical Plan, Value Medical Plan or HOP Pre-65 Medical Plans: Call the HOP Administration Unit 1-800-PSERS25 (1-800-773-7725).
- The Medicare Plus Rx Option or Medicare Standard Rx Option: Call Optum Rx at 1-888-239-1301; TTY/TDD: 1-800-498-5428.
- The Medicare Prescription Payment Plan (new for 2025): In November, Optum Rx is mailing a letter to members who are likely to benefit from this plan. If you have questions after reviewing the letter, call Optum Rx at 1-844-368-8729.
- The Medicare Advantage plans (i.e. plans administered by Aetna, Capital Blue Cross, Highmark, Independence Blue Cross and UPMC): Contact the plan directly at the number shown on the Contact Information page.
- We have free interpreter services to answer any questions you may have about our health or drug plan.
Medicare Star Rating (in Spanish)
Each year, Medicare evaluates prescription drug plans and awards a star rating to each plan based on performance. The Health Options Program’s prescription drug plans received a 4.5-star rating for 2025, indicating that the program is highly rated in comparison to other prescription drug plans nationwide.
Materials for Medicare-Eligible Members
Enrollment Guide for Medicare-Eligible Members (PDF 1.72 MB)
Overview of the Health Options Program, the benefits it offers, and the type of coverage available.
Large Print Medicare-Eligible Enrollment Guide (PDF 3.3 MB)
Spanish Medicare-Eligible Enrollment Guide (PDF 2.9 MB)
Personalized Statements
Current participants receive a personalized statement in October showing their current coverage, the available options for the next year, and monthly premium rates. To see your personalized statement, log in to your Member Dashboard.
Managed Care Plans for Medicare-Eligible and Non-Medicare-Eligible Members
Find out which Managed Care Plans are available where you live, the benefits they offer and their rates.
- North & Central PA (PDF 722KB)
- Southeast PA (PDF 676KB)
- Southwest PA (PDF 663KB)
- Outside of PA (PDF 816KB)
Large Print
- North & Central PA (PDF 849KB)
- Southeast PA (PDF 895KB)
- Southwest PA (PDF 844KB)
- Outside of PA (PDF 992KB)
Spanish
Health Options Program News (Fall 2024) (PDF 977 KB)
- Plan Ahead: Your 2025 Option Selection Period Checklist
- The Medicare Prescription Payment Plan in 2025
- Online Materials for 2025
- Medicare Launches Innovative Caregiver Program for Dementia
Medicare Plus Rx Option
- Abridged Formulary Revised December 2024 (PDF 562 KB)
An abridged listing of the most common covered drugs. - Coming soon: Comprehensive Formulary
Listing of all of the covered drugs. - Online Prescription Drug List
- Annual Notice of Changes Revised December 2024 (PDF 378 KB)
Overview of changes to the Medicare Plus Rx Option. - Evidence of Coverage (PDF 2.12 MB)
Overview of the Medicare Plus Rx Option, including how to get your Medicare prescription drug coverage through the Health Options Program, your rights and responsibilities, what is covered, and what you pay as a member of the plan. - Pharmacy Locator
- Prescription Drug Pricing Tool
Medicare Standard Rx Option
- Abridged Gold5 Formulary Revised December 2024 (PDF 320 KB)
An abridged listing of the most common covered drugs. - Coming soon: Comprehensive Gold5 Formulary
Listing of all of the covered drugs. - Online Prescription Drug List
- Annual Notice of Changes Revised December 2024 (PDF 249 KB)
Overview of the changes to the Medicare Standard Rx Option. - Evidence of Coverage (PDF 2.12 MB)
Overview of the Medicare Standard Rx Option, including how to get your Medicare prescription drug coverage through the Health Options Program, your rights and responsibilities, what is covered, and what you pay as a member of the plan. - Pharmacy Locator
- Prescription Drug Pricing Tool
Download the Health Options Program Change Form if you want to make changes to your coverage.
Use this tool to determine the medical, prescription drug and dental plan options available through the Health Options Program that are best for you. Also available in Spanish and large print formats.
Materials for Pre-65 Members
Pre-65 Medical Plan Guide (PDF 1.3 MB)
Overview of the HOP Pre-65 Medical Plan and the benefits it offers for pre-65 participants.
Personalized Statements
During the Option Selection Period, current participants receive a personalized statement showing current coverage, available coverage for the next year, and monthly premium rates. To see your personalized statement, log in to your Member Dashboard.
Critical Care Drugs List (PDF 82KB)
Critical Care Drugs are high-cost drugs that may have few or no alternatives for equivalent treatment that are used to treat conditions like certain cancers, enzyme disorders, and HIV. The list of Critical Care Drugs is updated every calendar year but does not change during the year.
Last Modified: December 19, 2024
