Premium Assistance

You are eligible for Premium Assistance if you are a retiree who meets one of the following retirement type requirements:

All classes with at least 24½ eligibility points regardless of age, or
Class T-C and T-D: You terminate school employment at or after reaching age 62 with at least 15 eligibility points, or
Class T-E and T-F: You terminate school employment at or after reaching age 65 with at least 15 eligibility points, or
Class T-G and T-H: You terminate school employment at or after reaching age 67 with at least 15 eligibility points, or
You are receiving a disability retirement benefit from PSERS.

Receiving Premium Assistance

If you meet the eligibility requirements, you can receive Premium Assistance if you have an out-of-pocket premium from a medical plan offered through the Health Options Program or your former school employer’s approved plan.

Premium Assistance is not payable:

for separate dental, vision or prescription drug plans, including the Medicare Rx Options offered through the Health Options Program
for out-of-pocket premiums for a retiree’s spouse or dependents, or
if your school employer provides coverage to you at no cost or with nontaxable contributions.

If you elect a standalone prescription drug coverage option, you are not eligible for Premium Assistance.

*The amount of the Premium Assistance benefit is determined by the Pennsylvania legislature and is subject to change.

Last Modified: March 19, 2024

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HOP Administration Unit | PO Box 1764 | Lancaster, PA 17608-1764

Medicare Complaint Form:

Click the following link to submit feedback directly to Medicare about the Enhanced, Basic or Value Medicare Rx Options:

Have questions about your coverage or claims?

Registered members can contact the Health Options Program online by logging in to their Member Dashboard. If you have general comments about the web site, send us your feedback .