A. No, as long as you follow Medicare’s rules. Almost anybody who is retired but has group health coverage from the employer of a spouse who is still working does not need to sign up for Medicare Part B on reaching 65.
Full Answer
When does my spouse become eligible to receive Medicare?
If your spouse is younger than 65 and receives disability benefits from Social Security for a period of 24 months, they automatically become eligible for Medicare on the 25th month. What Happens if Your Spouse is Older Than You?
Do I have to get Medicare if I'm covered by my spouse's plan?
Do I Have to Get Medicare If I’m Covered by My Spouse’s Employer Plan? Most people are first eligible to sign up for Medicare when they turn 65, and many choose to enroll during this time. For individuals who are covered by a spouse’s employer health care plan, it may not be necessary, or ideal, to enroll in Medicare immediately upon turning 65.
What happens to my health insurance if my spouse is 65?
If your spouse is not working and is 65 years old, he or she also has the option to remain on your employer health insurance policy while at the same time enrolling in Medicare Part A (with no premium) if you have reached 62 years of age.
Can I suspend my FEHB and enroll in Medicare Advantage?
You can suspend your enrollment in FEHB to enroll in Medicare Advantage or other eligible coverage by contacting your agency’s retirement system, and providing them documentation that you enrolled. If you do this, you’ll be allowed to leave your Medicare Advantage plan and return to FEHB.
Can federal employees have both FEHB and Medicare?
The answer: yes! FEHB coverage is comparable to Medicare coverage. Therefore, beneficiaries in the federal program may delay joining a Part D plan; likewise, they're exempt from any Part D late enrollment penalties.
Do I need Medicare Part B if I have FEP insurance?
You don't have to take Part B coverage if you don't want it, and your FEHB plan can't require you to take it. There are some advantages to enrolling in Part B: You must be enrolled in Parts A and B to join a Medicare Advantage plan.
Does Fepblue pay Medicare deductible?
Is combining our coverage with Medicare right for you? Even though you pay a premium for Part B and your Service Benefit Plan coverage, when you combine, we wipe out all your other out-of-pocket costs (deductibles, copays and coinsurance) for covered medical services.
Do federal retirees pay for Medicare Part A?
Most Federal employees and annuitants are entitled to Medicare Part A at age 65 without cost. When you don't have to pay premiums for Medicare Part A, it makes good sense to obtain coverage. It can reduce your out-of-pocket expenses as well as costs to FEHB, which can help keep FEHB premiums down.
Can I add my spouse to FEHB after I retire?
Technically, you can add your spouse during any open season while working or after retirement as retirees have the same open seasons as federal employees. Should your wife lose her non-federal health insurance coverage, you have 60 days after the loss of coverage to add her to your policy outside of the open season.
Do most federal retirees get Medicare Part B?
About 70% of federal retirees enroll in Part B, which means paying two premiums and in essence two duplicative insurance programs. A portion of the retirees that join Part B might do so as a hedge against the elimination of FEHB retiree benefits.
How do I qualify for Medicare Part B refund?
How do I know if I am eligible for Part B reimbursement? You must be a retired member or qualified survivor who is receiving a pension and is eligible for a health subsidy, and enrolled in both Medicare Parts A and B.
How do I get my Medicare Part B refund?
Call 1-800-MEDICARE (1-800-633-4227) if you think you may be owed a refund on a Medicare premium. Some Medicare Advantage (Medicare Part C) plans reimburse members for the Medicare Part B premium as one of the benefits of the plan. These plans are sometimes called Medicare buy back plans.
Who is eligible for Medicare reimbursement account?
Reimbursement Account for Basic Option Members Enrolled in Medicare Part A and Part B. Basic Option members enrolled in Medicare Part A and Part B are eligible to be reimbursed up to $800 per calendar year for their Medicare Part B premium payments. The account is used to reimburse member-paid Medicare Part B premiums.
Does Federal Blue Cross decrease when a retiree goes on Medicare?
FEHB premiums are not reduced if you enroll in Medicare, but having Medicare Part A and B can allow you to switch to a less expensive version of your current FEHB plan, because some FEHB insurers waive cost-sharing (like deductibles, co-pays and coinsurance) when you have Medicare Parts A and B.
Can Medicare premiums be deducted from federal pension?
Frequently Asked Questions Retirement If you are not receiving social security benefits, you can have Medicare premiums withheld from your annuity payments. We must receive a request for the withholding from the Centers for Medicare and Medicaid Services.
Is Medicare Advantage better than FEHB?
Most MA plans are comparable to FEHB plans in hospital and medical benefits, but the prescription drug benefits will not be as good as in the FEHB program because the plans have a “coverage gap” where you are responsible for all or most drug costs until you reach a catastrophic limit.
What age can you get Medicare if your spouse is not insured?
Primary Medicare recipients and their non-insured spouses are entitled to the same benefits under Medicare if both have reached the age of 65. So, what happens if your spouse is not 65 years old when you become eligible? Let’s look at what happens in these situations.
When can a non-working spouse get Medicare?
Your non-working spouse is eligible for premium-free Medicare Part A coverage at the age of 65 based on your work record and if you meet the necessary requirements for Medicare coverage mentioned above.
How old do you have to be to get Medicare?
In a case such as this, you must be at least 62 years old.
How long do you have to work to qualify for Medicare?
In the United States, as soon as you turn 65 you are eligible for Medicare benefits if you are citizen or have been a legal resident for five years or more and have worked for at least 40 quarters (10 years) paying federal taxes.
When do you have to enroll in Medicare?
Most people get Part A (Hospital Insurance) premium-free at the age of 65 based on taxes paid while working. If you wish to sign up for Medicare Part B (Medical Insurance), and/or Part D (prescription drug insurance), you must enroll separately during your initial enrollment period, Open Enrollment or during Special Enrollment Period to avoid paying late enrollment penalties. If you and your spouse are different ages, you will likely become eligible at different times.
Does Medicare cover my spouse?
Your personal Medicare insurance policy does not cover anyone but you. Your spouse or family members cannot be included in your coverage. For your spouse to have Medicare coverage, he or she must have a separate, individual policy.
Do you have to enroll in Medicare Part B or D?
If you wish to sign up for Medicare Part B (Medical Insurance), and/or Part D (prescription drug insurance), you must enroll separately during your initial enrollment period, Open Enrollment or during Special Enrollment Period to avoid paying late enrollment penalties.
When do spouses have to enroll in Medicare?
Check whether your spouse’s employer plan requires you, as a covered dependent, to enroll in Medicare when you turn 65. Some plans — notably the military’s TriCare-for-Life coverage and health benefits provided by an employer with fewer than 20 employees — automatically become secondary to Medicare when an enrollee becomes entitled to Medicare.
How long does a spouse have to sign up for a new employer?
This period lasts for up to eight months after employer coverage comes to an end.
How to disenroll in Social Security?
You'll need to fill out a CMS-1763 form (pdf) and submit it to SSA. A personal interview with a Social Security representative is also required to disenroll; call 800-772-1213 or contact your local SSA office to arrange one.
How long does it take for Medigap to sell?
After six months, Medigap providers can deny to sell you a plan, or can alter your premiums, based on preexisting conditions. Under various laws, employers with 20 or more workers must offer exactly the same health benefits to employees and their spouses over age 65 as are offered to younger workers and spouses.
What is creditable coverage?
Creditable coverage means that Medicare considers it to be as good as Part D. The benefits administrator of the employer plan can tell you whether this is so. If you lose this coverage at some stage, you will then receive a special enrollment period of two months to sign up with a Part D plan without incurring a late penalty.
What happens if you don't have Medicare?
In this case, if you’re not enrolled in Medicare, you would receive almost no coverage from the employer plan. If you are not married but living in a domestic partnership and you are covered by your partner's health insurance at work, you should enroll in Part A and Part B during your initial enrollment period at age 65 to avoid late penalties. ...
Do you have to enroll in a special enrollment period?
You’re not obligated to enroll, of course. But if you don’t, and some years down the line those retiree benefits come to an end for some reason, you would not then be entitled to a special enrollment period and would therefore be liable for permanent late penalties.
What is Medicare Made Clear?
Medicare Made Clear is brought to you by UnitedHealthcare to help make understanding Medicare easier. Click here to take advantage of more helpful tools and resources from Medicare Made Clear including downloadable worksheets and guides.
When Would I Enroll If I Delay or Only Take Part A?
If you are able to delay enrolling in either all or part of Medicare, you will have a Special Enrollment Period of eight months that begins when the employer coverage is lost or when your spouse retires. During this time, you’ll be able to enroll in Medicare Parts A & B. You can also enroll in a Part D prescription drug plan. And, after you enroll in Part B, you’ll be able to enroll in a Medicare supplement insurance plan or a Medicare Advantage (Part C) plan.
What is the gap in Medicare?
If you decide to enroll in Medicare when you’re first eligible at 65, Medigap can fill in the gaps of Original Medicare. Some of these gaps are Medicare’s deductibles, copays, coinsurance, and an additional 365 hospitalization days.
What is the phone number for Medicare?
If you have an urgent matter or need enrollment assistance, call us at 800-930-7956. By submitting your question here, you agree that a licensed sales representative may respond to you about Medicare Advantage, Prescription Drug, and Medicare Supplement Insurance plans.
What is Medicare for 2021?
Last Updated: Apr 27, 2021 2:19 pm. Original Medicare is federal health coverage for those 65 and older and for those younger than 65 with a disability, but what happens with a younger spouse’s health coverage when you enroll in Medicare? Many Medicare-eligible citizens wonder whether their younger spouse (especially non-working younger spouse) ...
Can a disabled spouse get Medicare?
However, younger spouses who have a disability can enroll in a Medicare Advantage plan. This might be a good choice for a younger spouse to limit their out of pocket costs and have extras offered like drug, hearing, vision, and dental coverage.
Does Senior65 sell your information?
Senior65 believes in your privacy. We will not sell your personal information. This is a solicitation for insurance.
Does Medicare Cover Younger Spouses?
Medicare does not cover younger spouses, unless they have a disability, until they turn 65. There are a few options for your younger spouse to maintain health insurance, especially if they do not have their own job-based insurance:
When should I change my FEHB coverage?
You may want to make changes to your FEHB coverage when you are nearing Medicare eligibility, and will have the option to do this starting 30 days before you qualify for Medicare. Changes can only be made once during this window. You can also wait until FEHB Open Season to change your coverage.
What happens if I decline FEHB coverage?
If you decline FEHB coverage, you would give up the subsidy the government pays toward it, which ranges from a low of about $350 for self-only coverage to $1,000 or more if you’re also covering family members. (These amounts are from premiums for federal employees other the Postal Service, which pays different rates.) If your family members are covered under FEHB, their coverage would end if you terminate yours.
Will I pay less for FEHB premiums if I enroll in Medicare?
FEHB premiums are not reduced if you enroll in Medicare, but having Medicare Part A and B can allow you to switch to a less expensive version of your current FEHB plan, because some FEHB insurers waive cost sharing (like deductibles, co-pays and coinsurance) when you have Medicare Parts A and B. Contact your FEHB insurer if you’re wondering whether your plan waives cost sharing for people enrolled in Medicare.
Should I enroll in Medicare Part D if I have FEHB coverage?
You generally don’t have to sign up for a Part D plan if you are covered through FEHB. The prescription coverage through your FEHB plan may have fewer restrictions (like quantity limits or drugs requiring prior-authorization) than the Part D plans in your area. FEHB plans limit what you’ll have to pay each year in covered medical and prescription drug costs, but Part D plans do not. (Part D enrollees pay an uncapped 5 percent coinsurance after they reach the catastrophic coverage level .) If you do sign up for Part D, it will usually be your primary insurer.
What is the Federal Employee Health Benefits Program (FEHB)?
The FEHB provides comprehensive health insurance to federal retirees and their spouses. If you qualify for FEHB as a retiree, optional Medicare coverage can lower your out-of-pocket costs, but you’ll have to pay a premium for this extra coverage.
Should I suspend my FEHB cover to enroll in other coverage?
You can suspend your enrollment in FEHB to enroll in Medicare Advantage or other eligible coverage by contacting your agency’s retirement system, and providing them documentation that you enrolled. If you do this, you’ll be allowed to leave your Medicare Advantage plan and return to FEHB. You usually have to wait until Medicare’s fall open enrollment and FEHB’s Open Season to re-enroll in FEHB. (These periods coincide.) You won’t have to wait until an enrollment period if your Medicare Advantage plan ends through no fault of your own. In that case, you could re-enroll between 31 days before and 60 days after your Medicare Advantage plan ends. The FEHB coverage would begin the day after the Advantage plan terminates.
Is FEHB covered by Medicare?
While FEHB plans cover most of the same types of expenses that Medicare covers, FEHB plans’ coverage may be more limited than Medicare Part B when it comes to orthopedic and prosthetic devices , durable medical equipment, home healthcare, medical supplies, and chiropractic care.
How long does it take to sign up for a spouse's medical plan?
It takes about 15 minutes to register and sign up online. If you are retired but covered under a working spouse’s medical plan or you are still working, sign up for Part A and then advise them that you do not want part B because you are covered by your employer or under a working spouse plan as the case may be.
What happens if you only pick up Part A?
If you only pick up Part A your FEHB plan will remain your primary coverage for your medical Insurance including doctor’s visits while Medicare A will be primary for your hospital coverage. If your spouse is under age 65 their primary provider will be your FEHB plan until they reach age 65.
How to get a suspension form for an annuitant?
Annuitants can call OPM’s Retirement Information Office at 1-888-767-6738 to obtain a suspension form. Callers within the local Washington, DC calling area must call 202-606-0500. Section 9 of your FEHB plan covers the different Medicare options and what costs they will waive and pay when you sign up.
What is Medicare Advantage Part C?
Original Medicare (Part A & B) or Medicare Advantage Part C? Secondly, you must decide on whether to sign up for the Original Medicare plan (Part A and B) or Medicare Advantage Part C that offers private sector Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs) coverage.
Is Medicare Advantage Part C FEHB coverage necessary?
If you sign up for Medicare Advantage Part C FEHB coverage isn’t necessary.
Is Medicare worse than health insurance?
They found that 30% say they’ve called a doctor who wasn’t accepting new Medicare patients and 18% thought their Medicare coverage is worse than health insurance they had before becoming eligible for Medicare. The article quotes a MedPAC survey that found one-in-four Medicare patients in 2012 who were looking for a new primary care physician had trouble finding one.
Does Medicare require FEHB?
It’s important to know that when Medicare A coverage limits are reached most plans require the patient to pay any difference between the FEHB provider allowance and the billed amount or pay the inpatient hospital per-day copayments depending on the plan you are enrolled in.
What does it mean to have two health insurance plans?
Having two health plans can help cover normally out-of-pocket medical expenses, but also means you'll likely have to pay two premiums and face two deductibles.
Who pays the medical bill?
The primary insurance payer is the insurance company responsible for paying the claim first. When you receive health care services, the primary payer pays your medical bills up to the coverage limits. The secondary payer then reviews the remaining bill and picks up its portion.
What is the most common example of carrying two health insurance plans?
The most common example of carrying two health insurance plans is Medicare recipients, who also have a supplemental health insurance policy, says David Mordo, former national legislative chair and current regional vice president for the National Association of Health Underwriters.
What are some examples of two insurance plans?
Other examples of when you might have two insurance plans include: An injured worker who qualifies for worker's compensation but also has his or her own insurance coverage. A military veteran who is covered by both Veterans Administration benefits and his or her own health plan. An active member of the military who is covered both by military ...
Can a married couple have two health insurance plans?
It’s also possible that a married couple could have two health insurance plans, even if each spouse is covered through a health insurance plan at their workplace. “They’re both covered under their own policies with their companies, but one of the spouses decides to (also) jump on their spouse’s plan,” Mordo says.
Does secondary insurance cover deductibles?
Your secondary insurance may pick up some or all of the remaining costs. However, you still might be responsible for some cost-sharing. For example, it’s a mistake to think your secondary insurance will kick in and cover the deductible attached to your primary insurance.
Is dual health insurance considered primary?
With dual health insurance plans, one is considered "primary" while the other is deemed "secondary." In some situations, having two health insurance plans can reduce your out-of-pocket costs. But in other cases, the added premium payment and deductible might increase your overall health expenses and cause further complications.
What is the impact of FEHB and Medicare?
Because many people covered by FEHB plans also have Medicare coverage (or other group health insurance), all FEHB plans have a coordination of benefits (COB) coverage provision for the interaction of FEHB and Medicare. The purpose of this provision is to enable enrollees and covered family members to recover as much ...
What to do if you have questions about FEHB?
Contact your local Social Security Administration office for assistance if you have any questions concerning whether your FEHB plan or Medicare is the primary payer of your, or a covered family member’s health benefits expenses.
Is FEHB a lower cost plan?
Once Medicare becomes the primary payer, you may find that a lower cost FEHB plan is adequate for your needs, especially if you are currently enrolled in a plan’s high option. Also, some plans waive deductibles, coinsurance, and copayments when Medicare is primary.
Can you get Medicare reimbursement if you are a FEHB HMO?
If you are enrolled in an FEHB HMO, you may go outside of the plan’s network for Part B services and receive reimbursement by Medicare (only when Medicare is the primary payer).
Does FEHB cover coinsurance?
This will help cover some of the costs that your FEHB plan may not cover, such as deductibles, coinsurance, and charges that exceed the plan’s allowable charges. There are other advantages to enrolling in Part A, such as being eligible to enroll in a Medicare managed care plan. You don’t have to take Part B coverage if you don’t want it, ...
Does Medicare cover dental care?
Some FEHB plans also provide coverage for dental and vision care. Medicare covers some orthopedic and prosthetic devices, durable medical equipment, home health care, limited chiropractic services, and medical supplies, which some FEHB plans may not cover or only partially cover. Check your plan brochure for details. ADVERTISEMENT.
Does FEHB cover dental?
FEHB plans also provide coverage for routine physicals, emergency care outside of the United States and some preventive services that Medicare doesn’t cover (in addition, Medicare prescription drug coverage is optional and comes at an additional cost). Some FEHB plans also provide coverage for dental and vision care.
