Should I enroll in Medicare if I have FEHB?
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 Medicare could reduce your out-of-pocket costs, because many FEHB plans waive cost sharing for enrollees who have Medicare.
Do I have to pay a premium for FEHB coverage?
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. 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.
How do I retain my FEHB benefits After retiring?
Retaining your FEHB coverage after retiring is relatively easy. All you need to do is have retained coverage for at least 5 years prior to retirement and leave your place of work under an immediate annuity. OPM should automatically carry your health benefits over. To sign up for Medicare, first determine which Parts of Medicare you’d like.
What happens to my FEHB plan if I return to work?
Medicare would no longer be your primary insurer if you return to work for the federal government, however, and in that case your FEHB plan would pay first, with Medicare paying at least some of your remaining costs.
Can you have Medicare and FEHB at the same time?
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. The federal employee plans often include prescription drug benefits, although drug coverage may vary.
How does Medicare work with FEHB plans?
Does My FEHB Plan or Medicare Pay Benefits First? 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.
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 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. You can find more information about this here. Should I Enroll in Medicare Part B as a Federal Employee?
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).
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 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.
Do I automatically get Medicare when I turn 65?
You automatically get Medicare when you turn 65 Part A covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home health care.
What is the most popular FEHB plan?
The rankings were released as part of the 2020 FEHB Plan Performance Assessment, which rates 83 health plans across the country in the areas of quality and customer satisfaction. “I could not be any more proud that CDPHP has been named the preeminent health plan in the country for federal employee health benefits.
Should I keep FEHB when I retire?
Keeping FEHB in Retirement is Very Important Being able to continue FEHB into retirement allows you more flexibility in your retirement planning. You get to keep better coverage for a lower cost, and the government will continue to pay for the lion's share of your premium costs.
What percentage of Medicare pays for FEHB?
Medicare Part B pays 80 percent for covered services. When you use Part B along with an FEHB plan, your FEHB plan may cover the 20 percent you’d be responsible for with Part B alone.
What is FEHB insurance?
The Federal Employee Health Benefit (FEHB) program provides health insurance to federal employees and their dependents. Federal employers are eligible to keep FEHB after retirement. FEHBs can cover spouses and children up to age 26 even during retirement. FEHBs and Medicare can be used together to cover medical services.
How long do you have to be in FEHB to retire?
The second requirement is that you’ll need to have been enrolled in your current FEHB plan for at least 5 years or the entire period of time since you were first eligible to sign up. So, if you don’t start a federal job until later in your career, you can retire sooner than 5 years and still keep your FEHB plan.
How much is the Part B premium for 2021?
In 2021, the standard Part B premium is $148.50. Your premium will be higher if your income is over $88,000. You’ll pay this premium in addition to the premium of your FEHB plan if you use both together. Even though you’ll be paying two premiums, using FEHBs and Part B together is often a good choice.
What is Medicare Part A?
Medicare Part A is hospital coverage. It provides coverage for stays in the hospital or at long-term care facilities. As long as you’ve worked for at least 10 years and earned enough Social Security work credits, Part A will be premium-free. This means you’ll have an extra layer of coverage without needing to pay any additional premium.
How many health insurance options are there for federal employees?
The Federal Employee Health Benefit (FEHB) program includes over 276 health insurance choices for federal employees. While some plans are only available for employees in certain roles, such as the military, most federal employees will have multiple options to choose from. You also may be able to use both your Federal Employee Health Benefits ...
Does Medicare Advantage cover vision?
Medicare Advantage plans cover all the services of original Medicare and often add coverage for medications, vision care, dental care, and more. You might not need your FEHB plan if you choose to enroll in a Medicare Advantage plan. Since a Medicare Advantage plan takes the place of original Medicare and has more coverage, ...
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.
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.
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.