If a member signs up for Medicare D, does that person have to terminate his/her STRS health care coverage according to STRS? Gary Russell responds

From Shirlee Zerkel
Monday, October 17, 2005

Dear Damon or Gary:

If a member signs up for Medicare D, does that person have to terminate his/her STRS health care coverage according to STRS? Can a member be a part of the STRS health care coverage even if they decide to sign up for a Medicare D program? Your information in the health care package (green sheet) could be a little confusing to some members. You speak of the member terminating the health care coverage to take the Medicare D and what will happen. He/she will not be covered for hospital, etc. Can you please clarify this for me and some other members. Thank you

Shirlee Zerkel


From Gary Russell
10/18/05

Dear All;

From the various e-mails that have been sent there appears to be some confusion about reentering the STRS Ohio health care plan if you drop our plan. First, the creation of Medicare Part D has not in any way modified the rules for enrolling in the STRS Ohio health care program. A member can enroll with no waiting period if the member is replacing major medical and prescription coverage or during the STRS Ohio open enrollment period. If the member is not replacing coverage or is adding STRS Ohio coverage to existing coverage then there is a six-month wait before the STRS Ohio health care coverage becomes effective.

A person enrolled in an Aetna, Medical Mutual or Aultcare plan who signs up for Medicare Part D does not have to terminate STRS Ohio coverage; however, that person would be paying for duplicate Rx coverage and most likely this wouldn't be a good financial decision unless the person qualifies for extra help due to low income. What we would expect is that if a member finds that a Medicare Part D plan is better then he/she would drop the STRS Ohio coverage and enroll in the Medicare Part D plan and also enroll in a Medicare hospital and medical supplement.

If a person is enrolled in Kaiser Permanente Medicare Plus or Paramount Elite and decides to enroll in a Medicare Part D drug plan, the Kaiser or Paramount hospital/medical and prescription drug benefits will be terminated by Medicare.

If a member drops the STRS Ohio plan to enroll in a Medicare Part D plan and a Medicare hospital and medical supplement and then later decides to come back to the STRS Ohio plan, then the member would have to be dropping the Medicare Part D plan and the supplemental plan in order to enroll in the STRS Ohio plan with no waiting period.

I hope this helps,
Gary Russell
Director, Member Services
STRS Ohio