Medicare Blog

when getting medicare should i switch to fep blue basic option

by Vida Denesik Published 3 years ago Updated 2 years ago

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 before you qualify for Medicare. Changes can only be made once during this window.

Full Answer

Can I switch my FEHB plan to Medicare Advantage?

If you have Part A and Part B, you may be able to switch to a less expensive FEHB plan. You may choose to suspend your FEHB coverage to enroll in Medicare Advantage or other eligible coverage.

Should I sign up for Medicare Part D or FEHB?

If you do sign up for Part D, it will usually be your primary insurer. If you’re eligible for Extra Help, you probably do want to use Medicare Part D, because the co-pays for people with Extra Help pay are typically lower than the costs in FEHB plans.

How much does basic option pay for Medicare Part B premiums?

Basic Option members who have Medicare Parts A and B (doesn’t have to be primary) can get reimbursed for paying Medicare Part B premiums. In 2020, we’re increasing the reimbursement amount from $600 to $800!

When can I switch my Medicare coverage?

ENROLLING IN MEDICARE << Previous Next >> fepblue.org 16 FEDERAL BENEFITS OPEN SEASON As long as you remain a member of the FEHB, you’ll have the option of switching your coverage during the annual Federal Benefits Open Season.

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.

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.

Which is better BCBS standard or basic?

Both Standard Option and Basic Option offer some level of dental benefits. Basic Option provides coverage for preventive dental care services only, while Standard Option provides coverage for preventive dental care and some other non-routine services.

Does Fepblue pay Medicare deductible?

Is combining our coverage with Medicare right for you? Even though you pay a premium for Part B and your Service Benefit Plan coverage, when you combine, we wipe out all your other out-of-pocket costs (deductibles, copays and coinsurance) for covered medical services.

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.

Who pays first FEHB or Medicare?

When FEHB and Medicare Coordinate Benefits, Which One Pays Benefits First? Medicare law and regulations determine whether Medicare or FEHB is primary (that is, pays benefits first).

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.

Is FEP the same as FEHB?

The Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Program® (FEP®), has been part of the Federal Employees Health Benefits (FEHB) Program since its inception in 1960.

Do I need to enroll in FEHB each year?

Once you enroll in a health insurance plan, your enrollment automatically continues each year, as long as you remain eligible for the program. You do not have to reenroll each year.

Do most federal retirees enroll in 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.

Is Blue Cross federal primary to Medicare?

Usually if you're retired, Medicare is primary. If you're still actively working, we're your primary coverage.

How do I get my $800 back from Medicare?

All you have to do is provide proof that you pay Medicare Part B premiums. Each eligible active or retired member on a contract with Medicare Part A and Part B, including covered spouses, can get their own $800 reimbursement.

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.*.

Get the details

Want to see detailed benefits for this plan? Download the 2022 Blue Cross and Blue Shield Service Benefit Plan Brochure below. For a convenient summary of our three coverage options, download the 2022 Benefit Summary Book.

2022 Basic Option Rates

Use our National Doctor and Hospital Finder tool to see if your current doctor is in our Preferred provider network or to find a specialist, retail clinic or urgent care center near you.

Not sure which plan is right for you?

Our AskBlue SM FEP Medical Plan Finder tool can help you select the right option for your needs.

Why combine Medicare Part A and B?

Another reason to combine your coverage is to get access to benefits not covered by Medicare.

When can I sign up for Medicare if I don't have a Medicare card?

This is January 1 to March 31 every year. You may be able to sign up for coverage outside of this period if a special circumstance (such as the exception noted above for the late enrollment penalty) applies.

What is Medicare for people over 65?

GET TO KNOW MEDICARE. Medicare is a health insurance program provided by the federal government, available to people: • 65 and older • Under 65 with certain disabilities • With permanent kidney failure who need dialysis treatment or a transplant (End-Stage Renal Disease) .

What is Blue365 discount?

Through the program, you can get discounts on different products and services that can help you live a healthy lifestyle, such as diet and exercise plans, gym shoes and athletic apparel, hearing aids and more. View all the current available deals at

What is Blue365 for Blue Cross?

Blue365 is a discount program exclusively for Blue Cross and Blue Shield members. Through the program, you can get discounts on different products and services that can help you live a healthy lifestyle, such as diet and exercise plans, gym shoes and athletic apparel, hearing aids and more.

How to contact Medicare for service benefits?

or call 1-800-MEDICARE (TTY: 1-877-486-2048) . << Previous Next >>. 3. Combining your Service Benefit Plan coverage with Medicare is a choice. Here are some things to know that can help you decide: Keep your future healthcare needs in mind before making a decision.

What is the penalty for late enrollment in Medicare?

The penalty is a 10% premium increase for each year you choose to delay your enrollment.

Get money back

There are no restrictions on how you can use your $800 reimbursement. Most claims will be reviewed within one to two business days after they have been received. Upon approval, you will receive reimbursement by direct deposit or check, depending on how you set up your account.

Submit your claim

You can submit proof of premium payments through the online portal, EZ Receipts mobile app (available at the App Store® and Google Play™) or by mail or fax. You have until December 31 of the following benefit year to submit your claim for reimbursement.

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.

What is the difference between Medicare PPO and Medicare HMO?

Medicare HMOs You must get your care from primary care doctors, specialists, or hospitals on the HMO's list of network providers, except in an emergency. Medicare PPO Plans – In most plans your share of plan costs is less when you use in-network primary care doctors, specialists and hospitals.

What is Medicare Advantage Part C?

Medicare Advantage is the term used to describe the various private health plan choices available to Medicare beneficiaries.

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.

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 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.

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.

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.

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 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 ...

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.

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