Any federal annuitant 65 and older enrolled in a fee-for-service (FFS) plan such as Blue Cross Blue Shield (BCBS), GEHA, or Mail Handlers should seriously consider enrolling in Medicare Part B. Medicare Part B enrollment and one’s FFS plan may combine to provide almost complete coverage for all medical expenses.
Full Answer
Does Medicare affect FEHB premiums if you retire under CSRS?
Once medicare kicks in, does that affect what you pay for premiums for FEHB if you retire under CSRS? Given that medicare was deducted from your paycheck while working. You're a bit confused about Medicare. The 1.45% that was deducted from your paycheck was for Medicare Part A (Hospitalization).
Can I Keep my FEHB coverage in retirement?
Generally, it will almost always be to a federal employee’s advantage to keep their FEHB coverage in retirement without any changes. The exception is for those with limited incomes and resources who may qualify for Medicare’s extra help with prescription drug costs.
Can I get Medicare if I retired under CSRS?
I retired in 2009 under CSRS. I am close to 65, and the answer to one of the questions asked states that people in CSRS are not eligible for Medicare because they didn’t pay into Social Security. I was in CSRS before the change to FERS and stayed with CSRS.
Should I enroll in Medicare or FEHB?
With regard to Medicare, the decision is yours. 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.
Why do I need Medicare Part B if I have FEHB?
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.
Do federal retirees with FEHB need 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.
How do CSRS retirees pay for Medicare?
Those who chose to remain in CSRS are still not covered under Social Security and are not eligible for SS retirement benefits. But they do qualify for Medicare through taxes paid on federal earnings.
Do I need Medicare Part D if I have FEHB?
Healthcare & Insurance Healthcare OPM has determined that the prescription drug coverage offered by plans participating in the FEHBP is, on average, comparable to Medicare Part D prescription drug coverage, thus you do not need to enroll in Medicare Part D and pay extra for prescription drug benefits.
Is FEHB better than Medicare Part B?
Individuals that travel may consider purchasing non-emergency coverage while out of town. Part B will cover these costs, whereas FEHB generally includes emergency care when traveling outside the U.S. – plus dental and vision benefits. For some, paying the Part B premium is worth the benefits.
Can federal employees have both FEHB and Medicare?
Your FEHB Plan must pay benefits first when you are an active Federal employee or reemployed annuitant and either you or your covered spouse has Medicare. (There is an exception if your reemployment position is excluded from FEHB coverage or you are enrolled in Medicare Part B only.)
Do most federal retirees take 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.
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.
Are federal retirees automatically enrolled in Medicare?
Signing Up for Medicare If you are retired and receiving Social Security you will automatically be enrolled in Part A and B and should receive your Medicare card three months before your 65th birthday.
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.
How does Medicare Part D work with FEHB?
If you enroll in both Part D and FEHB drug coverage, Part D is typically the primary payer for your prescription drugs. Note: FEHB drug coverage cannot be suspended separately from FEHB health coverage. If you want to keep your FEHB health coverage, you must keep drug coverage, even if you enroll in Part D.
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 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 cov...
Are Medicare rules different if I have FEHB coverage?
Most people who have retiree coverage must enroll in Medicare Part A and Part B when first eligible. If they don’t enroll, their retiree plan may p...
Will FEHB be my primary coverage? or Medicare?
If you have FEHB and do enroll in Medicare, then Medicare will be your primary coverage and your FEHB plan will pay after Medicare does. Having Med...
If I'm in the FEHB, should I enroll in Part A?
Most people don’t have to pay a premium for Part A. When combined with FEHB coverage, having Part A would limit your out-of-pocket costs for the ex...
Should I enroll in Part B if I have FEHB coverage?
Deciding whether to enroll in Part B is complicated. And unlike Medicare Part A, all enrollees pay a premium for Medicare Part B ($171.10/month in...
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 yo...
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...
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, a...
What happens if I decline FEHB coverage?
If you decline FEHB coverage, you would give up the subsidy the government pays toward it — which is the same for active employees and retirees and...
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 fe...
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.
Am I required to enroll in Medicare in retirement if I have FEHB?
Yes and no. Medicare is comprised of four parts: A, B, C, and D. Part A does not cost you extra when you enroll as you’ve likely had Medicare deductions on your paychecks throughout your career. Part A is your hospital coverage, and you have to enroll in it when eligible.
Why should I consider enrolling in Medicare?
When you turn 65 and are retired, many health insurance carriers assume that you’ll be on Medicare Part B. In turn, many people experience slight changes in their health insurance coverage as time goes on, even with FEHB.
Other considerations
When you plan on making changes to your health coverage, whether it’s within FEHB plans or the FEHB + Medicare combination, it’s important that you talk to the doctors from whom you regularly receive service, before making changes to your health insurance.
About the Author
Thiago Glieger, AIF ®, ChFEBC℠ is a Director and advisor at RMG Advisors, a premier private wealth management firm in the Washington, DC metro area. As fiduciaries, he and his team have served federal employees for over 40 years by helping them grow, manage, and protect their wealth.
What is Medicare Advantage Part C?
Medicare Advantage is the term used to describe the various private health plan choices available to Medicare beneficiaries.
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.
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.
Does Medicare pay for FEHB?
However, if you choose to enroll in Part D, Medicare benefits for drugs will be primary (will pay first) in most cases for FEHB enrollees. (Medicare C plans that include prescription drugs will also be primary to FEHB benefits.)
What to do before retiring from federal health insurance?
Prior to retiring, federal employees should contact the benefits administrator or their FEHB insurer for information about their FEHB prescription coverage before making any changes. It is important to note that FEHB prescription drug coverage is an integral part of a federal employee’s total health benefits package.
When does a FEHB plan pay?
A FEHB plan must pay first when an individual is an active federal employee or rehired annuitant. When an individual is an annuitant and is enrolled in Medicare Parts A and B and in a FEHB plan, then Medicare is primary coverage and the FEHB is secondary coverage or Medicare supplement.
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 his or her 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.
When is Medicare open season?
As long as the individual has FEHB coverage, they may enroll in a Medicare prescription drug plan from during the Medicare Part D “open season” (October 15 to December 7 of each year) at the regular monthly premium rate.
How much is Medicare Part B deductible?
The annual deductible for all Medicare Part B beneficiaries is $185 in 2019, an increase of $2 from the annual deductible $183 in 2018. Since 2007, a beneficiary’s Part B monthly premium is based on his or her MAGI.
How many Medicare beneficiaries will pay less than the full Medicare premium?
An estimated 2 million Medicare beneficiaries will pay less than the full Part B standard monthly premium amount in 2019 due to the statutory “hold harmless provision”, which limits certain beneficiaries’ increase in their Part B premium to be no greater than the increase in their Social Security benefits.
How long do you have to work to qualify for Medicare Part A?
Federal employees are eligible for Part A if they, or their spouse, worked in a Medicare Part A-covered employment for at least 10 years (40 credits), are 65 years or older, and are a citizen or permanent resident of the U.S. If an individual is eligible for Medicare Part A, then the individual and the individual’s spouse is automatically eligible ...
What Is Medicare?
Medicare is a government-sanctioned health insurance program that provides medical benefits to adults over the age of 65, younger people with certain disabilities, and those with End-Stage Renal Disease (ESRD).
Is it Beneficial to Have Both Medicare and FEHB Coverage?
FEHB, or Federal Employee Health Benefits, coverage is something that all government employees are given the option to enroll in. For those who take advantage of it, a small fee is automatically deducted from their paychecks each pay period to cover the premium.
Which is Better, Medicare or FEHB Coverage?
The answer to which program is better isn’t something that comes with a straightforward answer. It largely depends on the lifestyle you plan to lead after retirement and what sort of doctors you expect to be seeing.
How Do I Enroll?
There are different methods for enrolling in the two different types of health insurance. You can read up on them below:
Conclusion
Unfortunately, the question of whether or not to maintain both types of coverage (or simply have one or the other) is not something we can answer in this article. There are several considerations that must be made about your lifestyle, which only you are currently qualified to make.
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.
What happens if you don't enroll in Medicare?
If you don't enroll in Medicare, your FEHB plan will pay benefits in full. Your FEHB premiums will not reduce if you enroll in Medicare. You may change your enrollment to any option of any available plan at any time beginning on the 30th day before you become eligible for Medicare.
Does FEDVIP reduce if you turn 65?
Turning 65 has no bearing on your FEDVIP enrollment or eligibility. If you are turning 65 years old and you are employed, your coverage continues unreduced. For retirees, your coverage may/may not reduce based on your elections you made at retirement for your Basic and Optional coverages.
Can I get Medicare Part B if I don't have Medicare?
The Social Security Administration can provide you with premium and benefit information. Review the information and decide if it makes sense for you to buy the Medicare Part B coverage. If you enroll in Medicare, benefits will be coordinated. If you don't enroll in Medicare, your FEHB plan will pay benefits in full.
What is the 1.45% Medicare deduction?
The 1.45% that was deducted from your paycheck was for Medicare Part A (Hospitalization). There is no cost to you when you enroll in Part A at age 65. However, if you want to enroll in Part B, then you have to pay a monthly premium - - just like any other senior who enrolls in Part B.
What is the penalty for late enrollment in Part B?
Important also is the rule of the penalty for late enrollment in Part B, which provides an increase of 10% per year on the premium for each year retiree delays enrolling after first eligibility (generally age 65 and retired).
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.