Answers to OPERS member questions
This month: Learn about health care open enrollment for 2023
By Michael Pramik, Ohio Public Employees Retirement System
Nov. 17, 2022 – Members and retirees often ask us questions through our social media channels that others could benefit from. Periodically we post these questions and answers in our PERSpective blog.
Because we’re in the midst of open enrollment for 2023, this month we’re answering questions about health care for next year.
Q: I’m Pre-Medicare, and I didn’t opt in to the HRA last year. What do I need to do to opt in during open enrollment?
A: You can change your funding decision through your Via Benefits online account each open enrollment period, and your new election will take effect January 1 of the following year. Sign in to your online profile and select Your Funding Decision to make changes through Dec. 15.
Remember, though, that opting in to the HRA is not the same as having medical insurance. While you’re free to secure coverage on your own, we recommend scheduling an appointment with a Via Benefits licensed benefit advisor to review your options and then enroll in a plan.
Q: I’m a Medicare retiree, and I’d like to keep things the same next year. Do I need to do anything?
A: We encourage you to review the 2023 medical and prescription drug plan details provided by your plan administrator. Look for changes in premiums, plan design and prescription drug formulary. If you’re unsure of any changes to your medical plan for 2023 or have questions, reach out to Via Benefits.
If then you discover you’d like to make any changes, contact Via Benefits by Dec. 7 at 1-844-287-9945. An appointment is not required, but you might want to schedule a phone appointment with a Benefits Advisor to discuss your 2023 medical plan.
Q: Am I able to get health care outside of Via Benefits and still receive contributions to my HRA from OPERS?
A: If you are Pre-Medicare, you can secure coverage anywhere you’d like and still receive money from OPERS after you opt in to your Health Reimbursement Arrangement. We do, however, encourage you to review all of your options with Via Benefits.
If you’re a Medicare retiree, you must choose a medical plan through Via Benefits in order to receive the HRA contribution.
Q: I’m over 65. Can I purchase a medical plan through Via Benefits then go on my own for prescription drug coverage?
A: Yes. You can secure Medicare Part D coverage on your own, but you do have to sign up for a Medigap or Medicare Advantage plan through Via Benefits in order to receive HRA contributions.
Q: I’ve found that my optometrist isn’t covered in the new MetLife insurance. What are my options for vision coverage other than the OPERS plan if I want to keep my optometrist?
A: While we encourage our benefit recipients to use in-network providers due to the lower costs, we recognize that you may want to continue your relationship with your current provider. Should you continue to use your same provider, you may experience greater out-of-pocket costs. You could also ask your provider to join the MetLife Superior Vision network. They can sign up for the network at https://superiorvision.com/eye-care-professionals/join/apply/.
Q: I’m an OPERS retiree who’s under 65, and I’m covered by my spouse’s medical insurance. Do I still receive HRA deposits?
A: Yes. The Pre-Medicare HRA is an “open” HRA, meaning you receive contributions as long as you meet eligibility requirements. You can use the funds within your HRA to be reimbursed for qualified out-of-pocket medical expenses such as deductibles and copays. You also can be reimbursed for premiums, but the premiums have to be paid on a post-tax basis.
There are additional implications if you are re-employed in an OPERS-covered positions. We recommend reading the section on Re-employment and the HRA on the OPERS website if that applies to you.
Michael Pramik
Michael Pramik is communication strategist for the Ohio Public Employees Retirement System and editor of the PERSpective blog. As an experienced business journalist, he clarifies complex pension policies and helps members make smart choices to secure their retirement.
Just wondering what you mean by the premium must be post tax if I go on my wife’s healthcare? Can you explain the pre tax and post tax on the premiums.
Thank you
Bob
Bob,
If the premiums are taken out of your wife’s salary before taxes are calculated on the salary, then it’s a pre-tax benefit. If she pays the premium after all taxes are taken out of her salary, then it’s a post-tax benefit.
What day is Jan 2023 payment please
Theresa,
That will be on Jan. 3, the first business day of the new year.
ifI make no changes to my vision and dental plan for next year, will I be safe?
No action is required on your part if you are not making any changes to your vision and dental coverage for 2023.
Thanks,
OPERS
I’ve had a very hard time getting hard time getting a medicare supplement that I could afford or that would take me . Because of my health condition.
I finally have been excepted by AARP Medicare Advantage Choice Plan 2PPO. While its not the best plan its one that will help with some of my medical bills as I’m on a fixed income. My question is what do I do now to start receiving HRA again since I had no insurance I was unable to receive payments from HRA.
If you are having questions about your eligibility for the HRA you will need to contact our office at 1-800-222-7377.
Thanks,
OPERS
I am premedicare but turn 65 middle of next year. I have decided to stay with my spouses insurance until that time. When I do apply for Medicare next year and have to choose a plan mid year, do I have to pay for parts A & B and am I billed for them? I’m a little confused on how that works. I have not worked long enough or paid much into SS system since most of my adult life I’ve been with OPERS. I haven’t decided if I will switch back to Viabenefits or stay with my spouses plan mid year.
You can send your questions through the Message Center on your OPERS online account at http://www.opers.org or you can contact our office to speak with a representative at 1-800-222-7377.
Thanks,
OPERS
I am an OPERS retiree that will be medicare eligible March 1, 2023. My health insurance is through Medical Mutual but not through VIA benefits. My wife is primary on our policy and will be 65 in November of 2023. From what I have read, I am eligible to collect my HRA but just read that I can only collect it if I have coverage through Via Benefits. How do I make this work? What is my HRA benefit amount? (When I went to my OPERS account I could not find it.) I keep getting notices that I have to sign up for it by December 15th. Do I stay with Medical Mutual until February 28th? I was hoping to stay with them for my health insurance along with Medicare but that does not seem to be an option with Via Benefits. I would really like to talk to someone. Rodney and Linda Goodwin
You can send your questions through the Message Center on your OPERS online account at http://www.opers.org or you can contact our office to speak with a representative at 1-800-222-7377.
Thanks,
OPERS
Dear Sir’s , Sense dental and vision is being moved to MetLife, How come I haven’t seen an increase in my monthly pension or will I see an increase. I use to pay for those benefits out of my pension, Then VIA Benefits got involved and reimbursed me for those expenses ,why I don’t know, But it shorted my health care reimbursement for my medical premiums by three months, I’m now Medicare eligible. How will I be paying for dental and vision care once it’s transferred to MetLife ? Will VIA Benefits be paying those also or do I pay upfront and get reimbursed I’m confused. Thank you for clarification.
The vision and dental premiums will continue to be deducted from the benefit payments each month and then you are reimbursed from your HRA for those premium payments.
Thanks,
OPERS
Will my spouse and myself be changed to Metlife for vision and dental in 2023 and will that be changed automatically or do I have to make changes – we have Metlife and Aetna but want to change Aetna to Metlife for vision and dental. Thanks for your help.
Bonnie, Effective 1/1/2023 MetLife will administer both the OPERS Dental and Vision Plans. For those enrolled in the OPERS Vision Plan and wish to remain enrolled, you don’t need to take any action. Those already enrolled will automatically be enrolled in the OPERS Vision Plan administered by MetLife for 2023. To confirm your coverage you may contact OPERS by phone at 1-800-222-7377 to speak to a Member Services Representative or submit an online message through the message center in your online account. Thank you, OPERS.
when will we get our new met life vision and dental cards?
Rebecca,
MetLife plans to mail those on Dec. 22.
Is OPERS aware that Via Benefits has changed the length of time for processing HRA reimbursement requests? Yesterday Dec. 6, 2022 I was told by a Via Benefits representative that reimbursements take 6 weeks! 6 weeks is excessively longer than the turnover time quoted in the instruction booklet Via Benefits sent us when OPERS transferred pre-Medicare retirees to the connector! I was told reimbursements take 6 weeks when I phoned Via Benefits yesterday to check on the status of a monthly pre-Medicare medical insurance premium reimbursement request. I had received an email notification on November 29 that Via Benefits received my request. Usually within a week of receiving notification Via Benefits has received my request, I receive a second email notification indicating if the request has been approved. ( As a side note: I submit monthly medical premium reimbursement requests by U.S. mail because I do not have mobile technology to do so electronically and because I was also told pre Medicare retirees could not submit for an automatic recurring health care premium reimbursement.) Granted Via Benefits has had this most recent reimbursement request for just over a week. What I can’t understand is why the change to a 6 week period for reimbursements to be processed? This most recent reimbursement request is for the same monthly medical premium amount for which I’ve submitted paper work in prior months. None of the other reimbursements took 6 weeks to process. Plus there are ample funds in my HRA to cover the amount requested. It’s hard to understand why Via Benefits now needs 6 weeks to process a medical insurance premium reimbursement requests.
Lynn, please contact OPERS directly at 1-800-222-7377 or through the online account Message Center at opers.org so we can review your account and better assists. Thank you, OPERS
I’m turning 65 in jan..I applied for part a-b medicare .got my card…well picked a plan through via benefits united health care premium says $19..part b$170. So why do I get a medicare bill for $670..part a like $506..part b $165..via benefits says I only get $248..why do I have to pay over $400 out of my picket because of no ss credits…no one hascan answer. This is ridiculous
Joann, please contact OPERS directly at 1-800-222-7377 for further discuss Medicare part A reimbursement since you do not receive premium free part A. Thank you, OPERS
I’m 65.
My current Health Care Eligible service credit is: 4.667
Approximately how much $$ can I expect to receive monthly for my Medicare cost?
I have been unable to get through at 1-800-222-7377 due to high volume of calls.
Faye,
That’s a question we can’t answer in the blog. Please call us at the number you posted. Try calling early in the day. We will reopen at 8 a.m. on Dec. 27 after the Christmas holiday.