Jane Dotson
CalSTRS does not provide health or dental insurance coverage as these are collectively bargained at the local school district level. However, under the CalSTRS Medicare Premium Payment Program, CalSTRS pays Medicare Part A hospital insurance premiums for eligible retired members. Similarly, STRS Ohio offers medical plans that include medical and prescription coverage.
Characteristics and Values Table for CA STRS Medical Insurance
| Characteristics | Values |
|---|---|
| Health Insurance Coverage | CA STRS does not provide health or dental insurance coverage as they are collectively bargained at the local school district level |
| School Districts, Community Colleges, and County Offices of Education's Responsibility | They must offer retiring CA STRS members and their spouses or registered domestic partners the opportunity to continue their medical and dental insurance at their own cost |
| Medicare Enrollment | CA STRS members can enroll in Medicare Parts A & B or Part B-only |
| Medicare Part A | Covers inpatient hospital costs |
| Medicare Part B | Covers outpatient medical and physician costs |
| Medicare Part D | Covers prescription drug costs |
| STRS Ohio | Offers medical plans that include medical and prescription coverage |
| Aetna Medicare Plan | Assumes responsibility for paying for covered services and receives payment from Medicare |
| STRS Ohio Coverage Premium | Paid to STRS Ohio after enrolling in Medicare |
| Medicare Part B Coverage Premium | Paid to Medicare after enrolling in Medicare |
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What You'll Learn
- CalSTRS does not provide health or dental insurance coverage
- School districts must offer retiring CalSTRS members the opportunity to continue their medical and dental insurance at their own cost
- STRS Ohio plans include medical and prescription coverage
- CalSTRS Medicare Premium Payment Program
- Enrolling in both Medicare Parts A and B
CalSTRS does not provide health or dental insurance coverage
Each district has its own policies, and coverage may be part of your union contract, so your benefits may differ from others in your district. It is recommended that you contact your employer to learn about any health benefits in retirement and consider setting aside extra money now for future health benefits.
CalSTRS provides retirement, disability, and survivor benefits for full-time and part-time California public school educators through a hybrid retirement system. This includes the Defined Benefit Program, a traditional defined benefit plan that provides retirement, survivor, and disability benefits. The Defined Benefit Supplement is a hybrid cash balance plan that provides additional savings for retirement. The Cash Balance Benefit Program is an optional program designed for part-time educators and adjunct faculty.
As a CalSTRS member, you and certain family members may be eligible for the CalPERS Long-Term Care Program. It is important to note that as a California public school educator, you do not pay into Social Security, so you will not receive Social Security benefits for your CalSTRS-covered position. Therefore, it is crucial to plan accordingly and consider setting aside extra funds for future health benefits.
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School districts must offer retiring CalSTRS members the opportunity to continue their medical and dental insurance at their own cost
While CalSTRS does not provide health or dental insurance coverage, school districts must offer retiring CalSTRS members and their spouses or registered domestic partners the opportunity to continue their medical and dental insurance at their own cost. This is in accordance with the California Education Code sections 7000-7008. Each district has its own policies, and coverage may also be part of a union contract, so benefits may differ between members.
Retiring members are advised to contact their employer to find out if they will have any health benefits in retirement and to consider setting aside extra money for future health benefits.
The CalSTRS Medicare Premium Payment Program (MPPP) is funded in part by employer contributions. Under the MPPP, CalSTRS pays Medicare Part A hospital insurance premiums for eligible retired members. The Medicare Premium Deduction Service (MPDS) is available to CalSTRS members enrolled in Medicare, allowing them to deduct their Medicare Part B premiums directly from their monthly benefit.
Medicare is a nationwide, federally administered health insurance program for eligible individuals, usually those aged 65 and over. It consists of three parts: Part A covers inpatient hospital costs, Part B covers outpatient medical and physician costs, and Part D covers prescription drug costs.
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STRS Ohio plans include medical and prescription coverage
The plan options for Medicare enrollees are the Aetna Medicare Plan and the Aetna Basic Plan. Prescription coverage for both plans is administered by SilverScript, a Medicare Part D plan. Non-Medicare enrollees are eligible for the Aetna Basic Plan.
STRS Ohio requires all medical plan participants to be enrolled in Medicare Parts A & B at age 65 or when eligible. Medicare Part B is required for all enrollees. Medicare Part A is also required if it is available to you at no cost (premium-free). If you decline Medicare Part B or premium-free Part A, you will no longer be eligible for STRS Ohio medical coverage.
After you enroll in Medicare, you must pay two separate monthly premiums: a premium for STRS Ohio coverage (paid to STRS Ohio) and a premium for Medicare Part B coverage (paid to Medicare). You have a seven-month initial enrollment period in which to sign up for Medicare. This period begins three months before you turn 65, includes the month you turn 65, and ends three months after the month of your birthday.
If you are enrolling in both Medicare Parts A & B, you can complete your Medicare application online. Once you enroll in Medicare, you must provide proof of Medicare enrollment to STRS Ohio by submitting your Medicare information through your Online Personal Account.
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CalSTRS Medicare Premium Payment Program
CalSTRS does not provide health or dental insurance coverage as these are collectively bargained at the local school district level. However, CalSTRS offers the optional Medicare Premium Payment Program (MPPP) to eligible retired members.
The MPPP is available to members of the CalSTRS Defined Benefit Program who retired before July 1, 2012, and who meet certain other eligibility criteria. To be eligible, you must not qualify for premium-free Medicare Part A, be at least 65 years old, and be enrolled in both Medicare Part A and Part B. Additionally, if your retirement date was after January 1, 2001, but before July 1, 2012, you must be over 65 and enrolled in Medicare Parts A and B prior to July 1, 2001.
Under the MPPP, CalSTRS pays Medicare Part A hospital insurance premiums for eligible retired members. Members can also use the Medicare Premium Deduction Service to deduct their Medicare Part B premiums directly from their monthly benefit. It is important to note that this service is provided as a courtesy, and there is no fee.
To apply for the MPPP, you must submit the completed Medicare Payment Authorization form and a copy of the unpaid bill to CalSTRS via mail or fax. CalSTRS will then determine your eligibility for the program. If you are deemed ineligible, you will be responsible for paying Medicare Part A premiums directly to CMS.
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Enrolling in both Medicare Parts A and B
If you are enrolling in both Medicare Parts A and B, you can also complete your Medicare application online at www.ssa.gov. If you are not eligible for premium-free Part A and are enrolling in Part B-only, you must visit your local Social Security Administration office or call Social Security toll-free at 800-772-1213 to enrol. If you visit your local office, find out which documents to bring with you to your appointment.
Individuals already receiving Social Security or Railroad Retirement Board (RRB) benefits at least four months before being eligible for Medicare and residing in the United States (except Puerto Rico) are automatically enrolled in both premium-free Part A and Part B. People who are automatically enrolled have the choice of whether they want to keep or refuse Part B coverage.
It is important to note that you have a seven-month initial enrollment period in which to sign up for Medicare. This period begins three months before you turn 65, includes the month you turn 65, and ends three months after the month of your birthday. If you want your coverage to be effective the month you turn 65, you must sign up during the first three months of the initial enrollment period (one to three months before your birthday). If you miss the initial enrollment period, you can enrol during a general enrolment period from January 1 through March 31 each year.
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Frequently asked questions
No, CA STRS does not provide health or dental insurance coverage as these are collectively bargained at the local school district level. However, under California Education Code sections 7000-7008, school districts, community colleges and county offices of education must offer retiring CA STRS members and their spouses or registered domestic partners the opportunity to continue their medical and dental insurance at their own cost.
You can enrol in Medicare Parts A and B by calling Social Security at 800-772-1213 or visiting your local Social Security office. If you are not eligible for premium-free Part A and are enrolling in Part B-only, you must visit your local Social Security Administration office or call the number provided above.
Medicare Part A covers inpatient hospital costs, Part B covers outpatient medical and physician costs, and Part D covers prescription drug costs.
The CA STRS Medicare Premium Payment Program is funded in part by employer contributions. Under the MPPP, CA STRS pays Medicare Part A hospital insurance premiums for eligible retired members.
