Medicare Blog

is my fehb blue cross blue shield coverage reduced if i don't take medicare part b when i turn 65

by Kadin Dooley Published 3 years ago Updated 2 years ago

If you choose to keep the FEHB coverage along with Medicare Part B, your FEHB premium will not decrease. This is a very common question we receive in our retirement workshops, so we don’t have any confusion here. The age 65 mark is a really important period of time, including that seven-month window around your 65th birthday.

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.

Full Answer

Will my FEHB coverage continue even if I enroll in Medicare?

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.

Should I stay in a high premium FEHB plan for Part B?

What you should generally not do is stay in a high premium FEHB plan to get the Part B wraparound benefit when you can join a less costly FEHB plan with an equally good wraparound benefit. If your medical costs are close to zero in a number of plans, in or out of network, why pay a higher rather than lower premium?

Is Blue Cross and blue shield good for retirees?

together for you. The Blue Cross and Blue Shield Service Benefit Plan is the number one choice of federal retirees in the Federal Employees Health Benefits Program. For 60 years, we’ve been covering federal employees and retirees.

What are my options if I don’t qualify for FEHB?

The first option is to enroll in a Medicare Advantage plan and suspend FEHB enrollment. This is the lowest-cost option for many. Many MA plans have benefits as good as many FEHB plans and charge nothing beyond the regular Part B premium.

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.

Do federal retirees need Medicare Part B FEHB?

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.

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.

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.

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.

How do I keep my FEHB in retirement?

To continue your health benefits enrollment into retirement, you must: (1) have retired on an immediate annuity (that is, an annuity which begins to accrue no later than one month after the date of your final separation); and (2) have been continuously enrolled (or covered as a family member) in any FEHB Program plan ( ...

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.

Is Medicare primary or secondary to FEHB?

primary payerGenerally, if you have Medicare and you (1) are age 65 or older and (2) are not employed in the federal service, Medicare is the primary payer of your health benefits expenses, and your FEHB plan is the secondary payer.

Is FEHB creditable coverage for Medicare Part B?

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 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.

What does Medicare Part B cover that FEHB does not?

Medicare may cover some services and supplies that some FEHB plans may not cover, including but not limited to: • Some orthopedic and prosthetic devices, and durable medical equipment; • home health care; • limited chiropractic supplies.

Do retired federal employees get Medicare?

Retired federal employees are entitled to Medicare under the same rules as all other retirees.

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.

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.

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 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 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 it cost to join Part B?

For those who pay the higher part B income-tested premiums, this is a very considerable cost, at least $700 a year extra, and for some almost $6,000 extra to join Part B, depending on exact income level.

Do Part B plans cost extra?

Some plans cost very little extra for Part B, taking into account both premium and enhanced benefits. These are sometimes the plans that offer the best premium reimbursements, and sometimes not. What Federal Annuitants Need to Know About the FEHB Program and Medicare.

What happens if you stay in FEHB and take Part B?

If you stay enrolled in FEHB and also take Part B: Medicare will be primary. FEHB may cover your Medicare cost-sharing (deductibles, copayments, coinsurances) If you stay enrolled in FEHB and do not enroll in Part B: Your FEHB plan will continue providing the same coverage it did when you were actively employed.

Is FEHB primary or secondary?

Federal Employee Health Benefits (FEHB) plans continue paying primary for retirees who do not enroll in Medicare Part B. FEHB is only secondary if you enroll in Part B. Whether to enroll in Part B or use FEHB as primary coverage is a personal decision, based on your individual circumstances.

Does FEHB have HMO?

Remember, FEHB plans offer HMO and FFS options . FEHB HMO plans have networks of providers and facilities. FFS plans allow you to see any provider, but you may pay higher costs. You should also compare the costs and benefits of your FEHB drug coverage and Part D to decide which best suits your needs.

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 happens when you retire with Medicare?

When you retire and have Medicare, it typically becomes your primary coverage and they pay first. If you decide to combine your Medicare and Service Benefit Plan coverage, we’ll pay for covered services not covered by Medicare. When you receive care, you should show your providers both your Service Benefit Plan member ID card ...

What is the service benefit plan?

When you’re an active federal employee, the Service Benefit Plan is typically your primary coverage, which means we pay for your healthcare services first.

Does Medicare pay for its own network?

Medicare has its own network of Participating providers who accept Medicare’s assignment or payment. When you visit a provider (regardless of if they accept Medicare’s assignment), we’ll pay the difference between what Medicare pays and what you owe the provider.*.

How much is Part B premium?

For you and your husband, a year of Part B premiums adds up to $2,770, meaning that if you wait a year before signing up, your premiums will be $277 a year more than they would have been otherwise. Choice 2. Take both Part B and your FEHB plan.

Do you have to take Part B if you are retired?

You are in a position that many retirees would kill for, but you still have decisions to make. While most retirees must take Part B once they or their spouse are no longer actively employed, such is not the case for federal retirees. You basically have three choices, all with pros and cons.

Is FEHB a Medigap?

This will be more expensive because you will be paying two sets of premiums, but your FEHB plan will now function as a Medigap plan for both your hospital and doctor bills, and cover your drugs as it always did.

How much is the penalty for not enrolling in Part B?

Because there is a 10 percent per year premium penalty for not enrolling in Part B within a few months of the deadline, annuitants are under great pressure to make a decision and about 70 percent decide to enroll. It can be surmised that this is usually an “everybody does it” rather than well-calculated decision.

Does Medicare Part B pay more than the standard premium?

Some of the Medicare Part B rebates will pay slightly more than the standard Part B premium, but none come close to matching the income- tested premium. Every family’s situation is unique, but for those subject to these higher premiums, the case for enrolling in Part B is far weaker under any of the four strategies.

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