STRS Ohio Health Care Eligibility Retirees

The 15-Year Threshold

Defined Benefit and Combined Plan retirees need at least 15 years of qualifying service credit to access the STRS Ohio Health Care Program. Defined Contribution Plan members are ineligible entirely — the health care program is tied to the DB and Combined plan structures.

For retirements on or after August 1, 2023, at least 20 years of qualifying service credit are required to qualify for a monthly premium subsidy.

This is an optional benefit, not a guaranteed entitlement. The State Teachers Retirement Board retains the authority to modify or terminate coverage, premiums, and subsidies at any time. That said, the program has been in place for decades and remains a major component of STRS Ohio's retirement package.

How the Premium Subsidy Works

STRS Ohio subsidizes a portion of your monthly health insurance premium based on your total years of qualifying service credit. More years means a larger subsidy and a lower out-of-pocket premium.

The board established a long-term subsidy glidepath starting in 2027:

• 2027 baseline: 2.17% per year of service for Medicare-enrolled retirees; 2.47% per year of service for non-Medicare enrollees
• Annual adjustment: The subsidy per year of service decreases by 0.03% annually from 2027 through 2040
• Maximum subsidy: Achieved at 30 or more years of qualifying service credit

The practical difference between Medicare and non-Medicare coverage is dramatic. For 2027, a Medicare-enrolled retiree with 30+ years of service in the Aetna Medicare Plan pays roughly $45 per month after applying the Medicare Part B credit. A non-Medicare retiree with the same service in the Aetna Basic Plan pays about $387 per month.

Medicare Part B Is Not Optional

Once you reach age 65 or qualify for Medicare due to disability, you must enroll in both Medicare Part A and Part B to maintain your STRS Ohio health coverage. This is not a suggestion — it's a program requirement. Proof of Medicare Part B enrollment must be uploaded to STRS Ohio before your health plan effective date.

STRS Ohio provides a monthly Medicare Part B premium credit to eligible Medicare-enrolled retirees, partially offsetting the Part B premium. But you must be enrolled first.

If you're already 65 or older at retirement, have your Medicare Part B card ready when you submit your health care application. If you're under 65, plan to enroll in Medicare during your Initial Enrollment Period (the 7-month window around your 65th birthday) and notify STRS Ohio immediately.

The 31-Day Enrollment Window

You must submit your STRS Ohio Health Care Program application within 31 days of your retirement effective date or within 31 days of benefit finalization. Miss this window and you're locked out until the next annual open enrollment period, unless you experience a qualifying life event.

This deadline is easy to overlook in the flurry of retirement paperwork. Submit your health care application at the same time you file your Service Retirement Application — don't wait for your first benefit payment to arrive.

Prescription Coverage

All STRS Ohio health plans include prescription drug coverage administered through CVS Caremark. The formulary and copay structure depend on which plan tier you select. Compare the prescription coverage across plan options during your enrollment window, especially if you take ongoing medications that could fall into different tiers.

Health Care Assistance Program (HCAP)

STRS Ohio offers a Health Care Assistance Program for retirees who meet specific financial need criteria. HCAP provides additional premium subsidies beyond the standard service-based subsidy. Eligibility requirements and benefit levels are set annually by the board.

Our STRS Ohio Retirement Guide covers the full health care enrollment process, including how to calculate your expected premium based on your years of service and whether you'll be on Medicare or non-Medicare coverage at retirement.

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