A. No, you aren’t exempt from the late enrollment penalty. Only those FEHB enrollees who are currently employed by the federal government can avoid that penalty. P.S. Whoever told you that if you enrolled in Medicare Part B, your wife would have no coverage under Kaiser Permanente was wrong.
Full Answer
Can I switch my FEHB plan to Medicare Advantage?
If you have Part A and Part B, you may be able to switch to a less expensive FEHB plan. You may choose to suspend your FEHB coverage to enroll in Medicare Advantage or other eligible coverage.
What happens if I Lose my FEHB program coverage?
However, if you lose your FEHB Program coverage and want to join a Medicare prescription drug program, you must join within 63 days of losing your FEHB coverage or your monthly premium will include a late enrollment penalty.
What happens to my health insurance when my spouse goes on Medicare?
If your health insurance coverage comes through your spouse’s job, you may lose that coverage when he or she retires and goes on Medicare. Not so long ago, this was a scary and expensive prospect, but things have changed.
What happens if I don’t enroll in Medicare or FEHB?
Medicare’s rules for you are different, however, if you’re a federal retiree. As a federal retiree, if you don’t enroll in Medicare, your FEHB plan will act as your primary insurer and won’t pay less because you qualify for Medicare. Will FEHB be my primary coverage? or Medicare?
How Medicare works with FEHB plans?
Medicare law and regulations determine whether Medicare or FEHB is primary (that is, pays benefits first). Medicare automatically transfers claims information to your FEHB plan once your claim is processed, so you generally don't need to file a claim with both.
When I go on Medicare is my spouse covered?
Does Medicare cover people's spouses? Medicare offers federal health insurance coverage for those aged 65 years and over, as well as those with a permanent disability. Medicare does not cover spouses specifically.
What happens to my FEHB when I turn 65?
Your FEHB coverage will continue whether or not you enroll in Medicare. If you can get premium-free Part A coverage, we advise you to enroll in it. Most Federal employees and annuitants are entitled to Medicare Part A at age 65 without cost.
Do I need Medicare Part B if I have FEP insurance?
Do I Have to Take Part B Coverage? 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.
How does Medicare work for married couples?
Medicare has no family plans, meaning that you and your spouse must enroll for Medicare benefits separately. This also means husbands, wives, spouses and partners pay separate Medicare premiums.
Can my spouse get Medicare if I am 65?
Traditional Medicare includes Part A (hospital insurance) and Part B (medical insurance). To qualify for Medicare, your spouse must be age 65 or older. If your spouse is age 62 (or any age under 65), he or she could only qualify for Medicare by disability.
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.
Do federal retirees with FEHB need Medicare Part B?
If you are working and have FEHB or you are covered under your spouse's group health insurance plan, then you do not have to enroll in Part B when you turn 65. You will have a special enrollment period when you retire or your spouse retires to enroll in Part B without paying a penalty.
Do I need Medicare Part D if I have FEHB?
You may choose to suspend your FEHB coverage to enroll in Medicare Advantage or other eligible coverage. You generally don't have to enroll in Medicare Part D if you have FEHB coverage.
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.
Do federal retirees have to take Medicare?
Unlike most people with retiree coverage, who must enroll in Medicare Part A and Part B when they're first eligible, enrollment in Medicare is not mandatory if you have federal retiree coverage through the Federal Employee Health Benefits Program (FEHB).
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.
How long after losing vision insurance can you enroll in a FEDVIP?
If you lose other vision insurance coverage you may enroll in a FEDVIP vision plan within 60 days after the effective date of the loss of coverage as a "Qualifying Life Event". Do not miss these dates, or you will have to wait until the next Federal Benefits Open Season to enroll.
How long do you have to change your insurance coverage?
You must enroll or change your enrollment within the period beginning 31 days before and ending 60 days after the loss of coverage. You can also change your premium conversion status if the enrollment change is on account of and consistent with a qualifying life event.
Can you cancel FEHB?
Health. If you and all your eligible family members gain other coverage under FEHB or another group insurance plan, you may cancel your FEHB. If you are in Self Plus One or Self and Family, you may change to Self Only if a family member gains other coverage and this causes you to be the only person covered under your enrollment.
How long can a spouse be covered by self plus one?
The five-year rule doesn’t apply to a covered spouse.
Does the 5 year rule apply to a spouse?
The five-year rule doesn’t apply to a covered spouse. The same is true of a covered child under the age of 26. Continued coverage isn’t an issue if you were still employed when you died, since your widow (er) would automatically be entitled to a full survivor annuity.
Can a widow continue FEHB?
However, if you choose that latter course, your widow (er) would not be able to continue coverage in an FEHB plan, unless he or she had the right to do so by virtue of being a current federal employee or retiree.
How long do you have to pick a new insurance plan after losing your spouse's insurance?
Losing the coverage you had under your spouse's plan will make you eligible for a time-limited special enrollment period in the individual insurance market, on- or off-exchange (note that in this case, you have 60 days before the loss of coverage, and 60 days after the loss of coverage, during which you can pick a new plan).
How long does it take to get Medicare if you don't have Cobra?
If you’re not going to be eligible for Medicare yourself within 18 months (or up to 36 months, depending on the circumstances), you’ll have to come up with another plan for coverage when your COBRA continuation coverage runs out.
Is Medicaid a separate program from Medicare?
It’s easy to confuse Medicaid and Medicare, but they're separate programs with different benefits and different eligibility criteria. In many states, low-income people making up to 138% of federal poverty level are eligible for Medicaid.
Can I get medicaid if my income is low?
If your income is low enough, you may be eligible for government-provided health insurance through Medicaid. In some states, the Medicaid program goes by another name like SoonerCare in Oklahoma or Medi-Cal in California. It’s easy to confuse Medicaid and Medicare, but they're separate programs with different benefits and different eligibility criteria.
How to contact Medicare for health insurance?
Other useful publications, such as the Guide to Health Insurance for People with Medicare, are also available at the Medicare number (1-800-633-4227) or from your State Health Insurance Assistance Program (SHIP) counseling office.
What is the difference between Medicare PPO and Medicare HMO?
Medicare HMOs – You must get your care from primary care doctors, specialists, or hospitals on the HMO's list of network providers, except in an emergency. Medicare PPO Plans – In most plans your share of plan costs is less when you use in-network primary care doctors, specialists and hospitals.
What is Medicare Advantage Part C?
Medicare Advantage is the term used to describe the various private health plan choices available to Medicare beneficiaries.
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. I Want to Join a Medicare Advantage Plan.
Does FEHB cover coinsurance?
This may 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 Part A, such as (if you also enroll in Part B,) being eligible to enroll in a Medicare Advantage Plan.
Does FEHB cover dental?
Generally, plans under the FEHB Program help pay for the same kind of expenses as Medicare. FEHB plans also provide coverage for emergency care outside of the United States which Medicare doesn't provide . Some FEHB plans also provide coverage for dental and vision care.
Is FEHB better than Medicare?
Because all FEHB Program plans have as good or better coverage than Medicare, they are considered to offer creditable coverage. So, if you decide not to join a Medicare drug plan now, but change your mind later and you are still enrolled in FEHB, you can do so without paying a late enrollment penalty.
How long before you can change your 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. Back to top.
What is FEHB insurance?
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. Back to top.
What happens if you don't enroll in Medicare?
As a federal retiree, if you don’t enroll in Medicare, your FEHB plan will act as your primary insurer and won’t pay less because you qualify for Medicare.
What happens if you decline FEHB?
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.)
Is FEHB more generous than Medicare?
Although FEHB coverage can be more generous overall than Medicare Advantage or Original Medicare, having additional coverage may not be helpful if you can’t afford its premiums. If you qualify for the Medicare Savings Program (MSP) or Medicaid, you may find your healthcare costs are lower overall if you don’t use FEHB.
Can you suspend your Medicare Advantage plan?
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.
Does FEHB cover dental?
Conversely, FEHB plans cover emergency care received outside the United States, and this isn’t covered by Original Medicare at all – and is rarely covered by Medicare Advantage. FEHB plans may also pay for vision and dental care that’s not covered by Original Medicare and is limited in Medicare Advantage.