what type of medicare for the spouse of a retired fed employee

Full Answer

Can a retired federal employee spouse enroll in Medicare Part B?

The retired federal employee spouse may enroll in Medicare Part B, without paying a late enrollment penalty if the retired federal employee spouse enrolls within eight months from the time the working federal employee spouse retires or leaves federal service.

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.

How does retiree coverage work with Medicare Part A and B?

Retiree coverage might not pay your medical costs during any period in which you were eligible for Medicare but didn't sign up for it. When you become eligible for Medicare, you will need to enroll in both Medicare Part A and Part B to get full benefits from your retiree coverage. How does your retiree coverage work with Medicare?

Who is eligible for Medicare Part A?

You are eligible for Medicare if you are age 65 or over. Also, certain disabled persons and persons with permanent kidney failure (or End Stage Renal Disease) are eligible. You are entitled to Part A without having to pay premiums if you or your spouse worked for at least 10 years in Medicare-covered employment.

Can my wife go on Medicare when I retire?

Yes! If you worked and paid Medicare taxes through payroll deductions for at least 10 years, then you and your spouse will both for premium-free Medicare Part A at age 65.

Will my wife be covered under my Medicare?

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.

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).

Can my wife get Medicare at 60?

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.

How do I apply for spousal Medicare benefits?

Form SSA-2 | Information You Need to Apply for Spouse's or Divorced Spouse's Benefits. You can apply: Online, if you are within 3 months of age 62 or older, or. By calling our national toll-free service at 1-800-772-1213 (TTY 1-800-325-0778) or visiting your local Social Security office.

How do I put my husband on my Medicare card?

Medicare online account help - Add someone to your Medicare cardStep 1: sign in.Step 2: before you start.Step 3: tell us who you're inviting.Step 4: confirm or update your address.Step 5: confirm or update your bank details.Step 6: review and submit.Step 7: you've created an invite code.Step 8: sign out.

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.

Do federal retirees have to go on Medicare?

Most Federal employees do not need to enroll in the Medicare drug program, since all Federal Employees Health Benefits Program plans will have prescription drug benefits that are at least equal to the standard Medicare prescription drug coverage.

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.

Is my spouse eligible for Medicare when I turn 65?

Your spouse is eligible for Medicare when he or she turns 65. Your eligibility for Medicare has no impact on the date that your spouse is eligible for Medicare. Continue reading for more answers to your questions about Medicare, individual health insurance, and coverage options for your spouse after you enroll.

When can a spouse claim spousal benefits?

You must have been married at least 10 years. You must have been divorced from the spouse for at least two consecutive years. You are unmarried. Your ex-spouse must be entitled to Social Security retirement or disability benefits.

What is Medicare Select?

The purpose of Medigap or Medicare SELECT policies is to pay any medical expenses not paid for by Medicare. Those expenses include deductibles, co-payments, or those expenses not covered at all by Medicare.

When will Alice be eligible for Medicare Part B?

Since Alice’s Medicare Part B becomes effective within one year of her becoming eligible to enroll in Part B (July 1, 2020), Alice will not be subject to a 10 percent late enrollment penalty on her Medicare Part B premium. Federal employees can delay enrollment in Medicare Part B at age 65 because they are either: ...

How long does it take for Medicare to go up?

If an individual waits 12 months or more after first becoming eligible for Medicare Part B to enroll, the individual’s Medicare Part B premiums will go up 10 percent for each 12 months that the individual could have had Part B but did not take it.

How long is the Medicare enrollment period?

The initial enrollment period is a seven-month period starting on the first day of the third month preceding the annuitant’s birthday month and ending on the last day of the third month after the annuitant’s birthday month. To enroll in Medicare, an individual should go online to : www.socialsecurity.gov/medicareonly.

When will Medicare pay 10 percent?

The individual will pay the extra 10 percent for as long as the individual has Part B. The following example illustrates. From the above, Alice forgets to enroll in Medicare Part B as of January 31, 2021. But she enrolls in Part B during the Medicare special enrollment period between Jan. 1, 2021 and March 31, 2021 with coverage becoming effective ...

When does Alice's Medicare end?

Alice’s Medicare initial enrollment period started on July 1, 2020 and will end on January 31, 2021. A federal employee who works past age 65 in federal service and who is enrolled in the FEHB program need not enroll in Medicare Part B as long as he or she continues working in federal service.

Will Carl be in Medicare Part B?

Most importantly when Carl becomes age 65 in April 2021, he will not have to enroll in Medicare Part B because his health insurance coverage is through Amanda who is still working. Carl is encouraged to enroll in Medicare Part A when he becomes age 65 in April 2021 because there is no premium cost. If he has to go to the hospital, his FEHB health insurance plan coverage through Amanda, will be considered primary coverage and Medicare Part A will be secondary coverage. Carl is not required to enroll in Medicare Part B, without paying a late enrollment penalty, until eight months following Amanda’s retirement from federal service.

Why is Melinda so young to enroll in Medicare?

Melinda is too young to enroll in Medicare because she is age 63. When she becomes age 65, she will have her IEP in which she will enroll in Medicare Parts A and B. Melinda is eligible to retain her FEHB health insurance coverage for both herself and for David throughout her retirement.

When to switch FEHB insurance?

The switch of FEHB insurance plans may be performed outside of an FEHB open season as enrolling in Medicare is considered to be a “life event.” The switch of FEHB insurance should be performed within 30 days of Melinda’s enrolling in Medicare.

What insurance does Harold have to go to?

In the event Harold has to go to the hospital or to a skilled nursing facility, the FEHB insurance that is under Claudia’s name will be “primary” insurance and Medicare Part A will be “secondary” insurance.

Is David in Medicare Part A?

Until now, David has been enrolled in Medicare Part A only. Now that Melinda has retired from federal service, David has his “special enrollment period (SEP) to enroll in Part B without being subject to a late enrollment penalty. The SEP is an eight-month period, starting the day after Melinda retires and ends eight months later. Melinda has to download form CMS L564 (Request for Employment Information), Melinda fills out Section A of Form CMS L564 and then gives it to her Personnel Office.

Is FEHB considered secondary coverage?

The reason for the switch is that once Melinda has enrolled in Medicare Part A and Part B, Medicare will be considered “primary” coverage for both she and David and FEHB will be “secondary” coverage. There is no need for them to be enrolled in a more comprehensive FEHB insurance plan when FEHB insurance is considered secondary coverage. In so doing, Melinda will likely be saving in her FEHB plan monthly premiums deducted from her FERS annuity check.

What is Medicare for people 65 and older?

Medicare. Medicare is the federal health insurance program for: People who are 65 or older. Certain younger people with disabilities. People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD) and. group health plan.

What is a group health plan?

group health plan. In general, a health plan offered by an employer or employee organization that provides health coverage to employees and their families. (retiree) coverage from a former employer, generally Medicare pays first for your health care bills, and your. group health plan. In general, a health plan offered by an employer ...

Does retirement insurance include extra benefits?

and deductibles. Sometimes retiree coverage includes extra benefits, like coverage for extra days in the hospital.

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.

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 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.

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.

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 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.

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 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, ...

Is Medicare the primary payer when you retire?

This means you’ll have an extra layer of coverage without needing to pay any additional premium. When you have Medicare and FEHBs, Medicare is the primary payer once you retire. While you’re still working, your FEHB plan will be your primary payer, and Medicare will kick in as a secondary.

Can you use FEHB and Medicare together?

FEHBs and Medicare can be used together to cover medical services. If you’re a federal employee looking toward retirement, you might be wondering how to make the best use of your federal health benefits once you become eligible for Medicare. The Federal Employee Health Benefit (FEHB) program includes over 276 health insurance choices ...

What is Medicare for retired federal employees?

Medicare for Retired Federal Employees. Medicare is a federal government-sponsored health insurance program covering: (1) people 65 years of age and older; (2) some people with disabilities under 65 years of age; and (3) people with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant).

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 is part A insurance?

Part A coverage includes: hospitalization. post-hospital skilled nursing facility care. home health care. hospice care, and. blood. Part A does not cover 100% of these expenses. A graduated payment schedule is applied based on the number of days that care is required. You would be responsible for the remainder.

Do you have to enroll in Part B if you are eligible for Part A?

X-rays. You are automatically eligible to enroll in Part B when you are eligible for Part A. However, Part B has a monthly premium which changes each January. If you fail to enroll in Part B at your first opportunity, there is a 10% penalty applied for each year following the year in which you become eligible.

Do federal employees have to enroll in Medicare?

Part D (Medicare Prescription Drug Coverage). There is a monthly premium for Part D coverage. Most federal employees do not need to enroll in the Medicare drug program, since all Federal Employees Health Benefits program plans will have prescription drug benefits that are at least equal to the standard Medicare prescription drug coverage.

Can you go to a doctor with Medicare?

These are health care choices (like HMOs) in some areas of the country. In most Medicare managed care plans, you can only go to doctors, specialists, or hospitals that are part of the plan. Some Medicare Advantage plans cover extra items, such as prescription drugs.

Does FEHB cover Medicare?

The Federal Employees Health Benefits (FEHB) plan will cover some of the expenses, but you should ensure that you understand what is and isn’t paid for by Medicare and/or FEHB, by checking with local Medicare representatives and consulting your FEHB plan brochure or carrier representative. There is no premium for Part A coverage, which is paid ...

What are the other Medicare plans?

Other Medicare plans include Medicare Cost Plans, demonstration/pilot programs, and PACE (Programs of All-inclusive Care for the Elderly).

What is Medicare fee for service?

Medicare Private Fee-for-Service Plans – In these plans, you may go to any Medicare-approved primary care doctor, specialist, or hospital that will accept the terms of the private plan's payment.

What is a FEHB brochure?

Your FEHB plan brochure provides specific information on how its benefits are coordinated with Medicare. Some HMOs participating in the FEHB are structured to provide more comprehensive coverage if you enroll in both their HMO and their Medicare Advantage plan.

How long after a Medicare plan is suspended can you reenroll?

In this case, you may reenroll from 31 days before to 60 days after you lose the Medicare Advantage plan coverage, and your reenrollment in FEHB will be effective the day after the Medicare Advantage plan coverage ends (or ended).

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.

How old do you have to be to get Medicare?

You are eligible for Medicare if you are age 65 or over. Also, certain disabled persons and persons with permanent kidney failure (or End Stage Renal Disease) are eligible. You are entitled to Part A without having to pay premiums if you or your spouse worked for at least 10 years in Medicare-covered employment. (You automatically qualify if you were a Federal employee on January 1, 1983.) If you donï't automatically qualify for Part A, and you are age 65 or older, you may be able to buy it; contact the Social Security Administration. You must pay premiums for Part B coverage, which are withheld from your monthly Social Security payment or your annuity. You must be enrolled in both Medicare Parts A and B before you can enroll in Part C. You must be enrolled in either Part A or Part B before you can enroll in Part D. The cost of any additional premium will vary depending on the Part C or Part D plan that you select.

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.

Medicare vs. FEHB Coverage

See more on medicarefaq.com

Suspending FEHB For Medicare Plus Supplemental Coverage

Mail Handlers Insurance and Medicare