Who qualifies
RHIA is set by ORS 238.420 and PERS rules (OAR 459-035-0030). PHIP lists the requirements as:
- You're a Tier One or Tier Two retiree receiving a PERS service or disability retirement allowance.
- You had eight or more years of qualifying service at retirement, or receive a disability allowance computed as if you had.
- You're entitled to Medicare and enrolled in both Part A and Part B.
- You're enrolled in a PHIP Medicare plan.
A surviving spouse or dependent may also qualify if they receive a PERS allowance or benefit, or were covered by the retiree's PHIP plan and the retiree retired before May 1, 1991. They need Parts A and B as well.
How the subsidy is paid
You never receive a check. PHIP subtracts the subsidy from your monthly PHIP Medicare premium automatically. The statute pays 60 dollars or the total monthly cost of the coverage, whichever is less, and you pay any amount above that. PHIP notes that it can't confirm eligibility until PERS finalizes your retirement benefit calculation; once it does, your premium is adjusted and any credit is refunded.
The subsidy doesn't reduce your Medicare Part B premium ($202.90 a month for most people in 2026), which you still pay to Medicare.
RHIA versus RHIPA
| RHIA | RHIPA | |
|---|---|---|
| For | Medicare retirees (Tier One and Tier Two) | State retirees not yet on Medicare |
| Amount | 60 dollars a month or plan cost if less | Based on years of state service |
| Ends | Continues while you keep a PHIP Medicare plan | When you become Medicare eligible |
When a state retiree becomes Medicare eligible, RHIPA stops and the retiree must move to a Medicare plan; PHIP applies RHIA to its Medicare coverage automatically.
The 2025 bill
Senate Bill 847 (2025), requested by the Governor for PERS, would have raised the subsidy to 100 dollars a month and made OPSRP members eligible for RHIA and RHIPA. The Legislature's record shows it still in the House Committee on Labor and Workplace Standards when the 2025 session ended, so it did not become law. For your own eligibility, call PERS Health at 1-800-768-7377. To compare PHIP with other Medicare options, you can request a call from a licensed insurance agent.
Related questions
What is PHIP for Medicare retirees?
Plans, rules and deadlines.
What happens to my PEBB coverage at 65?
When RHIPA and PEBB end.
Do I need Part B if I have retiree coverage?
RHIA requires it.
Sources
- ORS 238.420 — Retirement Health Insurance Account
- OAR 459-035-0030 — RHIA eligibility
- PERS Health Insurance Program — PHIP premium subsidies
- Oregon PERS — About supplementary plans
- Oregon Legislature — SB 847 (2025) measure history
More questions in this guide
- Do I need Medicare Part B if I have retiree health coverage in Oregon?
- What happens to my OEBB coverage when I get Medicare?
- What happens to my PEBB coverage when I turn 65?
- What is the PERS Health Insurance Program (PHIP) for Medicare retirees?
Part of the guide: PEBB retirees and Medicare in Oregon · All questions
Frequently asked questions
Did the 2025 Legislature raise the RHIA subsidy?
No. Senate Bill 847 (2025) would have raised it to 100 dollars and opened it to OPSRP members, but it stayed in a House committee when the session ended, so the amount is still 60 dollars a month.
Can I use RHIA for a Medigap or Medicare Advantage plan I buy on my own?
No. ORS 238.420 pays the subsidy toward coverage under a PERS-contracted plan, which means a PHIP Medicare plan.
Do OPSRP retirees get RHIA?
No. PERS describes RHIA as a benefit for Tier One and Tier Two retirees. A proposal to extend it to OPSRP members did not pass in 2025.
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