SERS Health Care Rule Change

The SERS Board approved a new health care rule earlier this year impacting some non-Medicare retirees who are currently on the SERS health care plan (approximately 500 current retirees are affected.)  SERS is currently mailing all of the impacted individuals and following up by phone, but  a majority are not reading the letter.

Non-Medicare plan enrollees whose gross benefit amount is below the income amount established for Medicaid eligibility will receive a letter telling them to contact HealthSCOPE Benefits (1-888-236-2377).  HealthSCOPE Benefits will evaluate benefit recipients’ Medicaid eligibility using healthcare.gov.

There are three possible outcomes:

  1. If determined potentially eligible for Medicaid, HealthSCOPE Benefits can forward the application to Medicaid.  SERS HC eligibility will end December 31, 2020, unless the member requests an earlier termination date by submitting a health care waiver form.
  2. If determined NOT potentially eligible for Medicaid, HealthSCOPE Benefits will inform SERS’ health care and coverage will continue as is.
  3. If a benefit recipient fails to contact HealthSCOPE Benefits, their SERS’ health care coverage will be terminated effective December 31, 2020.

HealthSCOPE Benefits will report all of its findings to SERS.

Also posted information on the SERS website:  https://www.ohsers.org/have-you-been-contacted-by-sers-about-medicaid-eligibility-if-so-you-need-to-take-action/

It is in the News and Events section on the homepage and is now the featured article in the Retirees dropdown menu.