Bottom line
STRS Ohio health care is available under the DB and Combined Plans when eligibility rules are met, but it is not guaranteed. New retirees since August 1, 2023 generally need 20 years of service.Key facts
- 20 years of service is the current health-care eligibility threshold for new retirees beginning August 1, 2023.
- $37 is the 2026 Aetna Medicare Plan premium shown for a maximum-subsidy Medicare recipient, including the Part B credit structure.
- $340 is the 2026 Aetna Basic Plan premium shown for a maximum-subsidy non-Medicare benefit recipient.
Health-care eligibility is a separate rule from pension vesting and retirement eligibility
STRS Ohio’s plan FAQ says retiree health-care access is available under the Defined Benefit and Combined Plans when the health-care eligibility requirements are met. Beginning August 1, 2023, new retirees generally need 20 years of service for eligibility. That is a different threshold from the five-year minimum that can create a pension at older ages, so a member can be eligible for a monthly retirement benefit without yet qualifying for the STRS Ohio Health Care Program.
STRS Ohio also emphasizes that the Health Care Program is not guaranteed. The Retirement Board can change or discontinue all or part of the program for eligible recipients and dependents. For that reason, a retirement projection should not treat today’s premium and coverage as a lifetime contractual pension benefit. The member should verify health eligibility separately when choosing a retirement date, particularly if health coverage is the main reason for working additional years.
2026 premiums depend on Medicare status and years of service
STRS Ohio approved 2026 medical premiums with Aetna continuing as medical-plan administrator and CVS Caremark continuing prescription coverage. For benefit recipients with Medicare and the maximum service-based subsidy, the published monthly premium is $37 for the Aetna Medicare Plan after the Medicare Part B credit structure, while the Aetna Basic Plan is substantially higher. The system publishes separate premium tables for spouses, children and recipients with fewer service years.
For a non-Medicare benefit recipient receiving the maximum subsidy, STRS Ohio’s June 2025 board notice lists a $340 monthly Aetna Basic Plan premium for 2026. That number should not be copied to every retiree because service credit affects the subsidy and dependents have separate rates. Medicare enrollment can also change which plan applies. Before retiring, compare the personalized 2026 premium from STRS Ohio with employer coverage, a spouse’s plan and Medicare timing.
Employment after retirement can make STRS Ohio coverage secondary before Medicare
STRS Ohio requires employed enrollees who are not eligible for Medicare to verify employment status and access to employer health coverage. If the retiree is eligible for employer medical and prescription coverage, or holds a position for which similarly situated employees are eligible, STRS Ohio medical coverage is limited to secondary coverage under the Aetna Basic Plan. This rule applies regardless of hire date or whether the post-retirement job is public or private.
A retiree who returns to work should therefore evaluate pension reemployment rules and health-insurance coordination together. The job may be permissible under the two-month pension waiting rule but still change which medical plan pays first. If the retiree prefers not to keep secondary STRS coverage, the system allows cancellation through the applicable process. Do not assume that paying the STRS premium makes it primary coverage while employed; verify the coordination rule before medical claims begin.
Confirm the health-care service threshold independently of pension eligibility
A member can qualify for an STRS Ohio pension before qualifying for STRS health coverage. For new retirees beginning August 1, 2023, STRS Ohio’s current plan FAQ says 20 years of service are required for retiree health-care eligibility under the DB and Combined Plans. The separate threshold is important when a member is considering retirement with only five or ten years of service.
Check the service-credit total used by the Health Care Program rather than assuming it matches a rough career count. Purchased credit, transferred service and the retirement effective date can affect the record. A member approaching the 20-year threshold should confirm health-care eligibility with STRS Ohio before giving final notice to an employer, because pension eligibility alone does not establish medical coverage.
| Decision | Threshold to check |
|---|---|
| Monthly pension | Retirement age and service rules |
| Retiree health coverage | Current STRS health-care service rule |
| Dependent coverage | Separate enrollment and premium rules |
Use the 2026 premium table that matches Medicare status and subsidy
The 2026 STRS Ohio premium tables vary by Medicare status, years of service and dependent type. Maximum-subsidy examples include a $37 Aetna Medicare Plan premium for an eligible Medicare benefit recipient and a $340 Aetna Basic Plan premium for a non-Medicare recipient. Those are not universal prices; fewer service years and dependent coverage can produce higher premiums.
Premium comparisons should use the same coverage category. A Medicare recipient with the maximum subsidy, a non-Medicare retiree, a spouse and a retiree with fewer service years can all see different prices. Record the plan name, Medicare status, service tier and whether the quoted premium includes the Part B credit so a low headline premium is not accidentally applied to the wrong household member.
| 2026 example | Monthly premium |
|---|---|
| Medicare recipient, maximum subsidy, Aetna Medicare Plan | $37 |
| Non-Medicare recipient, maximum subsidy, Aetna Basic Plan | $340 |
| Spouse/child or lower subsidy | Use current STRS table |
Reemployment can change primary-versus-secondary coverage before Medicare
An employed STRS Ohio enrollee who is not yet eligible for Medicare may be limited to secondary STRS coverage when employer medical and prescription coverage is available or offered to similarly situated employees. STRS Ohio requires verification of employment and employer coverage access. A retiree returning to work should therefore coordinate the health-plan rule with the separate pension reemployment waiting rules.
When returning to work, ask the new employer whether similarly situated employees are eligible for medical and prescription coverage. That answer can determine whether STRS Ohio becomes secondary coverage before Medicare. Complete the system’s employment verification promptly; otherwise the retiree may plan claims around primary STRS coverage even though the current coordination rule assigns primary responsibility elsewhere.
| Employment situation | STRS Ohio medical role |
|---|---|
| Employer coverage available | STRS coverage can be secondary |
| No Medicare yet | Employment verification required when applicable |
| Medicare eligible | Use Medicare-specific STRS plan rules |
Before you make a decision
- Confirm the service credit used for STRS Ohio health-care eligibility.
- Identify Medicare status for every person who will be enrolled.
- Use the current premium table for the correct subsidy and dependent category.
- Compare STRS coverage with any employer or spouse plan before retirement.
- Report post-retirement employment when STRS Ohio requires coverage verification.
Frequently asked questions
How many years do I need for STRS Ohio retiree health insurance?
STRS Ohio’s current plan FAQ says new retirees beginning August 1, 2023 generally need 20 years of service for health-care eligibility under the Defined Benefit or Combined Plan. This is separate from pension eligibility, so someone can qualify for a monthly pension without yet qualifying for STRS Ohio retiree health coverage.
Is STRS Ohio retiree health insurance guaranteed for life?
No. STRS Ohio expressly states that its Health Care Program is not guaranteed and that the Retirement Board may change or discontinue all or part of the program for eligible recipients or dependents. Retirement planning should therefore use current eligibility and premiums without treating them as a contractual pension benefit.
How much is STRS Ohio health insurance in 2026?
Premiums depend on Medicare status, years of service, subsidy level and dependent coverage. Published maximum-subsidy examples for 2026 include $37 monthly for the Aetna Medicare Plan and $340 for the non-Medicare Aetna Basic Plan. Use the current STRS premium table for the member’s exact service level.
What happens to STRS Ohio health coverage if I work after retirement?
For employed enrollees who are not Medicare eligible, STRS Ohio can limit its medical plan to secondary coverage when employer medical and prescription coverage is available. The retiree must verify employment and access to employer coverage. This health rule is separate from the pension system’s reemployment waiting-period rules.
Do Defined Contribution Plan retirees get STRS Ohio retiree health insurance?
STRS Ohio describes retiree health-care access as a feature of the Defined Benefit and Combined Plans when eligibility requirements are met. The Defined Contribution Plan does not provide the same STRS Ohio retiree health-care eligibility. A DC participant should verify available coverage separately before choosing or reselecting a plan.
Official sources
Sources were reviewed on September 2, 2026. Rules and member records maintained by the retirement system control.
STRS Ohio — 2026 Health Care PremiumsOfficial source ↗STRS Ohio — Plan Benefits FAQOfficial source ↗STRS Ohio — Employment and Health Coverage VerificationOfficial source ↗This article provides general educational information. It is not a benefit determination or financial, tax, or legal advice. Confirm account-specific information with the retirement system.