To learn more about enrolling in a Medicare managed care plan, contact Medicare at 1-800-MEDICARE (1-800-633-4227) or at www.medicare.gov (external link). You can enroll in a Medicare Advantage plan to get your Medicare benefits.
Full Answer
Can a federal employee have Medicare and retirement health insurance?
Federal Employee Retirement Health Benefits and Medicare. Beneficiaries eligible for FEHB and Medicare could enjoy having both types of insurance. The Federal Employee Health Benefits Program (FEHB) is for government employees and retirees. The FEHB is through the U.S. Office of Personnel Management for those who qualify.
Do retired federal workers need to sign up for Medicare Part B?
Do retired federal workers need to sign up for Medicare Part B? Medicare Part B is optional medical insurance coverage, and it comes with a standard premium of $148.50 per month in 2021. If you are entitled to FEHB and Medicare benefits, Medicare Part B would serve as the primary payer and FEHB would act as the secondary insurance payer.
Should retirees enroll in Medicare Part B and FEHB coverage?
A retiree enrolls in Medicare Part B AND keeps his FEHB coverage in place. On the surface, most people are not excited about this particular combination, because it means that they’re going to be paying both the Part B premium of $149/mo per person and their FEHB premium as well.
How long have you been covering federal employees and retirees?
For 60 years, we’ve been covering federal employees and retirees. What's Medicare? Medicare is a federal health insurance program for people age 65 or older, people under 65 who have certain disabilities and people of any age who have End-Stage Renal Disease.
Do retired federal employees pay for Medicare?
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.
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 employees have to take Medicare Part B?
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.
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.
Are federal retirees automatically enrolled in 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).
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.
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.
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 you really need Medicare and FEHB as a federal employee?
Yes, the vast majority of the time you are required to get on Medicare A and B at 65 if you are on Tricare even if you are also covered under FEHB or still working.
How Medicare works with FEHB plans?
Since you are retired but covered under your working spouse's policy, your spouse's policy is your primary coverage. Medicare will pay secondary benefits and your FEHB plan will pay third.
Do federal employees keep their health insurance after retirement?
Yes, you can keep your existing health benefits coverage if you meet all of the following conditions: You're enrolled in health care insurance under a federal plan when you retire.
What is the cost of FEHB for retirees?
For retirees and non-postal employees in the largest FEHB plan, Blue Cross/Blue Shield standard, biweekly enrollee rates for self-only are increasing by $6.54 to $123.45, for self plus one by $13.66 to $280.81 and for family coverage by $13.38 to $300.12.
Key Takeaways
Working for or retiring from the federal or state government means you have special considerations regarding Medicare coverage.
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How long do you have to be a federal employee to qualify for Medicare?
Federal employees are eligible for Medicare Part A if they, or their spouse, worked in Medicare-covered employment for at least 10 years (40 credits), are 65 years or older , and are a citizen or permanent resident of the US.
When did Fran retire?
Fran, age 66, is a federal employee and intends to retire from federal service on Dec. 31, 2016 at the age of 67. When Fran became age 65 in 2014, she enrolled in Medicare Part A but did not enroll in Part B. This is because she continued to work in federal service and is enrolled in a FEHB plan.
How long does it take to change a FEHB plan?
Since enrolling in Medicare is considered a “life event’, an annuitant or employee can change their FEHB plan to any available plan or option at any time beginning 30 days before becoming eligible for Medicare and ending 30 days after the day the individual becomes eligible for Medicare.
What age is Medicare?
This column discusses Medicare basics, including eligibility and enrollment rules. Medicare is a government-sponsored health insurance program for individuals: Age 65 and older; or. Under age 65 and who are either receiving Social Security disability or Railroad Retirement Board disability benefits for 24 months or who have end-stage renal disease. ...
What happens if you don't sign up for Part B?
If an individual did not sign up for Part B when he or she was first eligible, then the Part B monthly premium may be higher. In particular, the cost of Part B may go up 10 percent for each 12 month period that an individual could have been enrolled in Part B but did not sign up for it. The individual will have to pay this extra monthly premium as long as the individual has Part B, except in special cases.
Does Medicare pay first if an annuitant is reemployed?
Medicare must pay benefits first when an individual is an annuitant, unless the individual is a reemployed annuitant and either the individual or the individual’s covered spouse has Medicare. FEHB premiums will not be reduced when an employee or annuitant enrolls in Medicare.
When did Medicare Part B start paying more?
higher income Medicare Part B beneficiaries have been paying more for Part B since 2007 (when Medicare Part B became a “means-tested” program; that is, the higher a Part B recipient’s modified adjusted gross income, the more the Part B recipient pays in Part B monthly premiums) in the form of income-related monthly adjustment amounts (IRMAAs). As a result of recently passed legislation that sailed through Congress with bipartisan support and that was signed into law by President Obama in April 2015, costs for upper income Medicare beneficiaries will increase in the near future.
Key Takeaways
Federal workers enrolled in the Federal Employees Health Benefits Program (FEHBP) may want to delay taking Medicare Part B if you're still working past age 65. Most federal employees and retirees enrolled in FEHBP are not required to enroll into Medicare Part D since all FEHB plans offer prescription drug coverage as good as Medicare’s drug coverage. Activity duty and retired military personnel and veterans also have special considerations for how Medicare will work with TRICARE, TRICARE for Life, and veterans' health coverage..
What is the FICA Tax? And how does it relate to Medicare Part A?
The Federal Insurance Contributions Act or FICA payroll tax helps you earn credits toward Social Security, and helps to fund Medicare Part A and Social Security. Prior to 1983, federal government employees were exempt from contributing toward the Part A, or hospital insurance portion, of FICA.
Medicare & the Federal Employees Health Benefits Program (FEHBP)
Most federal employees participate in the Federal Employees Health Benefits Program (FEHBP), a type of federal health insurance available to non-military, federal government employees and retirees. FEHBP is administered through the Office of Personnel Management (OPM).
Expert Help to Understand Medicare Plan Options
Did you know that Medicare isn’t free, which means you need to consider plan coverage and prices before you enroll? Or that if you don’t enroll on time during your initial enrollment period, you could face a penalty? Navigating your Medicare selection needs and priorities may feel overwhelming.
How does Medicare work with service benefit plan?
Combine your coverage to get more. Together, the Service Benefit Plan and Medicare can protect you from the high cost of medical care . Medicare works best with our coverage when Medicare Part A and Part B are your primary coverage. That means Medicare pays for your service first, and then we pay our portion.
What is Medicare for seniors?
What's Medicare? Medicare is a federal health insurance program for people age 65 or older, people under 65 who have certain disabilities and people of any age who have End-Stage Renal Disease. It has four parts that cover different healthcare services.
How much does Medicare reimburse for a B plan?
Each member of a Basic Option plan who has Medicare Part A and Part B can get reimbursed up to $800 per year for paying their Medicare Part B premiums.
How to compare Medicare Advantage plans?
If you’re considering enrolling in a Medicare Advantage plan or a Medicare prescription drug plan, you can compare plans online for free or over the phone with the help of a licensed insurance agent. Learn about the costs, coverage and benefits of plans that may be available in your area.
What is Part B in Medicare?
Part B may provide coverage for goods and services for which FEHB give zero or limited coverage. Part B allows you to seek care any health care providers in the U.S. who accepts Medicare, while FEHB policies generally restrict you to a network of participating providers. Because Medicare coordinates benefits with FEHB, ...
Is FEHB a Medicare Part A?
There is coordination of benefits between Medicare and FEHB, so the FEHB policy acts as supplemental coverage to Medicare Part A. If you wish to enroll in other types of Medicare coverage such as Medicare Advantage, Medicare Part D or Medigap, you will need to be enrolled in Part A.
Can you have both Medicare Advantage and Medicare Supplement at the same time?
Medigap plans and Medicare Advantage plans are very different, and you cannot have both types of policies at the same time.
Does Medicare Advantage cover prescriptions?
Medicare Advantage plans provide all of the same basic benefits as Medicare Part A and Part B, and most plans also cover prescription drugs, which Original Medicare doesn’t cover. Many Medicare Advantage plans may also offer routine dental, vision and hearing coverage.
Do you have to be enrolled in Part B or Part C for Medicare Advantage?
If you wish to join a Medicare Advantage (Medicare Part C) plan that offers dental or vision coverage (which are not always included in FEHB plans), you must be enrolled in Part B.
Guide for Federal Retirees and Medicare Part B
Medicare Part B covers physician and outpatient services. Part B can include ambulance services and durable medical equipment as well as laboratory tests and x-rays.
To Take Part B or Not to Take Part B, that is the Question
If you don’t take Part B when you are first eligible there is a 10% penalty on the current year premium added for each year you delay enrollment. You will need to pay this penalty for as long as you have Medicare.
Part B Premium Determination
Medicare Part B premiums are determined by your Modified Adjusted Gross Income (MAGI). The higher your income, the higher your Part B premium. For many beneficiaries, the government pays a large portion of the Part B premium, about 75 percent, and the beneficiary pays the remaining 25 percent.
Health
As a Federal employee, you may be able to enroll in health, dental, vision and life insurance, flexible spending accounts, and apply for long term care insurance. You can find information about each program by clicking on one of the links below. Each section includes common questions to help guide you to the information you need. Learn More
Dental
Eligible employees and annuitants can choose among 4 nationwide and 3 regional dental plans. Nationwide plans also offer international coverage. Learn More
Vision
Eligible employees and annuitants can choose among 3 nationwide vision plans. Nationwide plans also offer international coverage. Learn More
Life
We offer the largest group life insurance program in the world, covering employees, retirees and family members. Learn More
Flexible Spending Accounts
Eligible employees can choose to enroll in up to three different flexible spending accounts during Open Season. Learn More
Long Term Care
Most Federal and U.S. Postal Service employees and annuitants, active and retired members of the uniformed services, and their qualified relatives are eligible to apply for insurance coverage under the FLTCIP. Learn More
How to apply for medicare before 65?
It's easy. Just call the Social Security Administration toll-fee number 1-800-772-1213 to set up an appointment to apply. If you do not apply for one or more Parts of Medicare, you can still be covered under the FEHB Program.
What is Medicare Advantage?
Medicare Advantage is the term used to describe the various health plan choices available to Medicare beneficiaries. If you are eligible for Medicare, you may choose to enroll in and get your Medicare benefits from a Medicare managed care plan. These are health care choices (like HMOs) in some areas of the country.
What happens when a FEHB plan is the primary payer?
When the FEHB plan is the primary payer, the FEHB plan will process the claim first. If you enroll in Medicare Part D and we are the secondary payer, we will review claims for your prescription drug costs that are not covered by Medicare Part D and consider them for payment under the FEHB plan.
How to contact SSA about FEHB?
For more information about this extra help, visit SSA online at www.ssa.gov (external link), or call them at 1-800-772-1213 (TTY 1-800-325-0778) . The FEHB health plan brochures explain how they coordinate benefits with Medicare, depending on the type of Medicare managed care plan you have.
What is the original Medicare plan?
It is the way everyone used to get Medicare benefits and is the way most people get their Medicare Part A and Part B benefits now. You may go to any doctor, specialist, or hospital that accepts Medicare. The Original Medicare Plan pays its share and you pay your share.
How to contact Medicare for managed care?
To learn more about enrolling in a Medicare managed care plan, contact Medicare at 1-800-MEDICARE (1-800-633-4227) or at www.medicare.gov (external link). You can enroll in a Medicare Advantage plan to get your Medicare benefits.
When can I get 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.
Medicare vs. FEHB Coverage
Suspending FEHB For Medicare Plus Supplemental Coverage
- If you have Original Medicare and FEHB but want coverage through a Medicare Advantage, you’ll need to suspend your FEHB coverage. Suspending FEHB is not the same as canceling. Meaning, you can re-enroll if you decide to suspend your FEHB. However, if you enroll in a Medicare Supplement plan, you will be required to cancel your FEHB. Advantage plans, also known as Med…
Mail Handlers Insurance and Medicare
- The Mail Handlers Benefit Plan (MHBP) has been serving federal and postal employees for over 50 years. Aetnaadministers the MHBP, whose plan options include Self Only, Self Plus One, and Self and Family – similar to FEHB. It’s best to have MHBP and Medicare when you become Medicare-eligible. Medicare will be the primary insurance and MHBP will give you access to thin…