STRS Ohio Survivor Health Care: Coverage, Medicare, and Enrollment

The Service Credit Threshold That Determines Everything

Access to the STRS Ohio Health Care Program after a member or retiree dies hinges on one number: total service credit. The threshold depends on when the member retired or, for active members, when they died.

For members who retired or died as active members on or after August 1, 2023: The deceased must have had at least 20 years of total service credit for qualified survivors to participate in STRS health care. This increased from the earlier 15-year requirement and catches many families off guard.

For members who retired before August 1, 2023: The prior 15-year threshold still applies. A retiree who was already eligible for STRS health care before August 2023 locks in that eligibility for their survivors.

If the member didn't meet the applicable threshold, STRS health care is not available — regardless of how long the member worked or how much they contributed. Survivors in this situation must find coverage through the Health Insurance Marketplace, a spouse's employer, Medicare (if age-eligible), or Medicaid.

What STRS Ohio Health Care Covers

The STRS Ohio Health Care Program offers medical, prescription drug, dental, and vision coverage. Surviving spouses and dependent children who are receiving monthly survivor benefits under Plan II (Joint and Survivor Annuity) or as qualified survivors of an active member's death can enroll in:

• Medical coverage through Aetna Medicare Advantage or non-Medicare plans for survivors under 65
• Prescription drug coverage bundled with the medical plan
• Dental coverage through a separate dental plan
• Vision coverage through a separate vision plan

Dental and vision plans are available independently of medical enrollment, but all plans require the survivor to be an eligible benefit recipient.

Premium Subsidies and What Survivors Actually Pay

STRS Ohio provides premium subsidies to primary benefit recipients based on total service credit, but the subsidy structure is important to understand correctly. The subsidy applies to the primary benefit recipient — the surviving spouse or survivor receiving the monthly pension.

Dependents of the survivor (for example, a surviving spouse's own dependent children enrolled through the plan) receive no premium subsidy and pay the full group plan premium rate.

The premium subsidy percentage scales with service credit, and the board has signaled reductions to the subsidy schedule beginning in 2027. Survivors enrolled in STRS health care should monitor annual enrollment materials for premium changes.

The Medicare Part B Requirement

Every STRS Ohio health care enrollee must enroll in Medicare Part B at age 65, or earlier if eligible due to disability. This is not optional.

If a surviving spouse declines Medicare Part B enrollment or stops paying the Part B premium to the Centers for Medicare & Medicaid Services, STRS Ohio automatically terminates their health care coverage. Contact STRS Ohio promptly if Part B coverage lapses or STRS coverage ends.

For calendar years 2025 and 2026, STRS applies a $30 monthly Medicare Part B credit against the monthly medical plan premium for Medicare-enrolled benefit recipients. This credit partially offsets the Part B premium cost but does not cover it entirely.

Medicare Part B enrollment has specific windows. If you turn 65 and are not already enrolled through a prior application, the Initial Enrollment Period runs from three months before your 65th birthday through three months after. Missing this window can result in delayed enrollment and permanent premium penalties.

The 31-Day Health Care Enrollment Window

When a retiree or active member dies, survivors who are eligible for STRS health care must act quickly. There is a 31-day enrollment window from the date the survivor becomes eligible to enroll in or continue coverage.

For surviving spouses already enrolled as dependents on the retiree's STRS health plan, coverage transitions to survivor status. The Survivor Benefit Packet from STRS Ohio includes health care enrollment forms with specific instructions.

Missing the 31-day window can delay enrollment. Contact STRS Ohio to ask whether you can still enroll and when the next available enrollment period is.

Losing STRS Health Care After Choosing a Lump Sum

One of the most consequential trade-offs in the active-member death scenario: survivors who choose the lump-sum refund of accumulated contributions instead of monthly survivor benefits forfeit eligibility for STRS Ohio health care. The health care program is only available to survivors receiving monthly pension benefits.

This is permanent. There is no provision to reverse a lump-sum election and regain health care access later.

The STRS Ohio Survivor Benefits Guide includes a health care enrollment tracker and comparison of coverage options to help survivors make this decision with full information.

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