Answers to OPERS member questions
This month: Learn about Medicare allowances and surviving-spouse COLAs
By Michael Pramik, Ohio Public Employees Retirement System
Aug. 11, 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.
This month we’re addressing questions about COLA amounts for surviving spouses, the health care allowance and refund timing.
Q: You stated in a recent blog that next year all OPERS retirees who are eligible for a COLA will receive the 3 percent COLA. Does that also apply to surviving spouses who receive a monthly benefit?
A: Yes. Beneficiaries receiving a monthly survivor benefit also are eligible for COLA increase every year. As a reminder, that COLA is paid on the anniversary of the retiree’s effective date of retirement or the anniversary of the first benefit payment. The increase is always calculated based on the original benefit amount, not the current benefit amount.
Q: I was receiving a 75 percent health care allowance amount. But recently that changed to 57 percent. Why?
A: Some retirees who had been receiving a 75 percent allowance saw a lower amount beginning in 2022 with the latest round of health care changes, reflecting their actual position on our allowance table.
OPERS has grandfathered some retirees in the past to protect them from the full impact of changes to the health care program. Under the new program implemented this year, current retirees’ eligibility for health care coverage was grandfathered, but the allowance amount was not. Depending on retirees’ age and years of service when they retired and first enrolled in OPERS health care, the previous grandfathering status might have changed.
For those who retired and enrolled prior to 2015 with 20 or more years of service, the allowance could change depending on where they fall on the allowance table. Specifically, this would impact retirees who had an allowance percentage on the table less than 75 percent but were grandfathered at 75 percent. The allowance was reduced based on their actual position on the allowance table with a floor of 51 percent. This OPERS website page contains instructions on how to find your allowance amount.
Those who retired and enrolled prior to 2015 with less than 20 years of service were subject to the 75 percent allowance grandfathering, and their allowance percentage was reduced to 51 percent.
Q: I am retired and receiving the Pre-Medicare health care allowance. I will turn 65 on May 15, 2023. Will my allowance automatically change at that time?
A: Members are eligible for Medicare the first of the month of their 65th birthday. In order to receive the Medicare HRA allowance, they have to be enrolled in Medicare Parts A and B and enrolled in a plan with the Medicare Connector through Via Benefits. Then they would be eligible for the Medicare HRA.
So if you are turning 65 on May 15, you would be eligible for Medicare on May 1. If you’re enrolled in Medicare Parts A and B, and in a plan through Via Benefits effective May 1, 2023, OPERS will provide the Medicare HRA starting May 1. If you do not enroll in Medicare, and a plan with Via Benefits, your allowance will end.
Remember that the HRA allowance is not the same for Pre-Medicare and Medicare retirees. In 2022 the base, monthly allowance for Pre-Medicare is $1,200, and for Medicare it’s $350.
Q: If I were to quit my public service job, at what point could I receive what I paid into OPERS?
A: After you have separated from employment you can use your OPERS online account to apply for a refund. Two months must pass from your termination date, as certified by the employer, before the refund can be released. Remember that by refunding you are forfeiting all of your service credit and future benefits.
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.
18 thoughts on “Answers to OPERS member questions”
Hi how do I add my beneficiaries (sister and brother) onto my online record that do not live in the US and Mexico and live in a residence in Europe.
The form online on OPERS requires a state to be chosen (or MX one) and it requires a zipcode be entered? I cannot get past these to fill in the European address and postal code for there.
Deirdre, Please send your questions through the online account message center or contact our Member Services Center at 1-800-222-7377.
With inflation hitting seniors really hard, why is our cost of living increase only 3%?
According to Ohio law, those who retired from OPERS on or after Jan. 7, 2013, have their COLA tied to inflation. That’s measured as the one-year change in the CPI-W, with the adjustment capped at a maximum of 3 percent.
I am still confused about HRA allowance once you are eligible for Medicare. I will be 65 next summer. I know I have to sign up for Medicare A & B. In my situation, I have been retired since 2013 And last enrollment period it was more cost effective for me to join my husbands healthcare versus going through Viabenefits. I am currently receiving my HRA allowance to help fund my costs through my husbands employer. What benefits will I receive once I receive Medicare and how do I let OPERS/Viabenefits know I’m getting Medicare? Does the amount change and is it automatic? What number can I call for help as I understood they would not assist me once I declined to take their coverage?
Cynthia, Once a member becomes Medicare eligible they must enroll in Medicare Parts A and B through Social Security then enroll in a plan with the OPERS Medicare Connector Via Benefits in order to receive the Medicare HRA if eligible. The Medicare HRA base allowance is $350. Once you are enrolled in Medicare Parts A and B you may contact Via Benefits at 1-844-287-9945 to enroll in a plan. Please forward any additional questions through the online account message center so we can review your account and provide account specific answers or contact our Member Services Center at 1-800-222-7377.
Are there different tiers to the Medicare HRA allowance. It was stated in this reading that the 2022 medicare base HRA allowance is $350. I was informed that my Medicare HRA allowance was less than this. Thank you.
The $350 is the base allowance. Your actual HRA deposit depends on your years of qualifying service and your age when you initially opted for OPERS health care.
My Medicare A premium penalty was removed effective this past July. I notified OPERS; however, you keep requiring a “Premium Penalty Removal Notice” from Social Security. I contacted the national office as well as the local Hamilton, OH, office, and neither knew anything about this notice. I also contacted the national Medicare office and they were clueless.
The Hamilton Social Security office send a message to the national office about one month ago requesting this notice. I never received a letter. I contacted Hamilton again yesterday and they said they would resubmit the request.
I sent OPERS scans of all Medicare premium invoices and scans of the payment receipts from January, 2022, through July, 2022. They show that the reduction occurred effective July, 2022. You [incorrectly] reimbursed the penalty amount in July’s warrant but [correctly] adjusted the warrant for August.
A Google search results in:
No results found for Medicare part a “premium penalty removal notice”.
Just what do you need? There is no such documentation on my “my Social Security” account, and Google cannot find any such item.
John, Please forward your question through the online account message center so we can review your account and provide account specific answers or contact our Member Services Center at 1-800-222-7377.
Mike I was wondering does the Medicare allowance ever increase as we go along because as you know the supplements are getting more and more expensive.
Eugene, Currently the Medicare base allowance is $350 through 2024. They will be evaluated in the future. Keep in mind health care is not a guaranteed benefit.
What are the requirements for disability?
We have a section of our website dedicated to disability benefits.
Will the amounts for the Pre-Medicare HRA deposit amounts stay the same in 2023? In other words-will I receive the same amount in 2023 as I do in 2022?
Yes, the base allowance for the Pre-Medicare HRA is not changing for 2023.
Wondering if there is any update on the Windfall policy between SS and OPERS? I retired in 2011 and he passed away in 2011. Due to him being employed in only SS positions and me being in an OPERS position I am not eligible to receive any of his SS pension. I’ve read articles regarding this issue in the past but nothing recently. Thank you.
Our most-recent PERSpective post on that issue was in May. If meaningful actions take place in Congress on the WEP/GPO, we will provide an update.