Why should FEHB members buy Medicare Part B?

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JohnS33031
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Re: Why should FEHB members buy Medicare Part B?

Post by JohnS33031 » Tue Apr 23, 2019 12:03 pm

We opted to take Part B and use Federal plan as supplemental . Never had a problem seeing any specialist or primary doc in Pennsylvania. Now we are moving to NYC and are having issues about the many docs who will not take Medicare patients.
If fees charged to medicare eligible pts with or without part B are limited anyway (is that correct?)why are these docs refusing medicare patients ? If we dropped B and used Federal as primary would this issue be solved?

mrc
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Re: Why should FEHB members buy Medicare Part B?

Post by mrc » Tue Apr 23, 2019 12:18 pm

JohnS33031 wrote:
Tue Apr 23, 2019 12:03 pm
We opted to take Part B and use Federal plan as supplemental . Never had a problem seeing any specialist or primary doc in Pennsylvania. Now we are moving to NYC and are having issues about the many docs who will not take Medicare patients.
If fees charged to medicare eligible pts with or without part B are limited anyway (is that correct?)why are these docs refusing medicare patients ? If we dropped B and used Federal as primary would this issue be solved?
It may depend on the particular FEHB plan you choose. For us, BCBS Basic, without Medicare coverage we must be very careful seeing a provider that does not participate in Medicare and/or is not a preferred provider. Read your plan's "Coordinating Benefits with Medicare or Other Coverage" (section 9 in our plan brochure) with great care.
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dm200
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Re: Why should FEHB members buy Medicare Part B?

Post by dm200 » Tue Apr 23, 2019 3:04 pm

No firsthand knowledge or research, but a longtime friend and federal retiree (under CSRS) researches everything - to the ultimate. You ask him what time it is - and he will tell you how to make a watch!

His very extensive research led him to NOT get (and pay for) Medicare Part B. He told me that one important factor for him was that his wife used and depended upon his health/medical insurance. His wife has also chosen to NOT get )and pay for) Medicare part B either. They, especially his wife, probably have above average use of medical services - for their ages.

JohnS33031
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Re: Why should FEHB members buy Medicare Part B?

Post by JohnS33031 » Tue Apr 23, 2019 9:24 pm

mrc, you mentioned you have basic bc/bs without medicare coverage? If that is case , why would one need to find out if doc takes medicare? I was hoping if we drop part b. And just have federal as primary CIGNA plan, let's say, then could go to anyone on CIGNA panel ?

mrc
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Re: Why should FEHB members buy Medicare Part B?

Post by mrc » Wed Apr 24, 2019 5:16 am

JohnS33031 wrote:
Tue Apr 23, 2019 9:24 pm
mrc, you mentioned you have basic bc/bs without medicare coverage? If that is case , why would one need to find out if doc takes medicare? I was hoping if we drop part b. And just have federal as primary CIGNA plan, let's say, then could go to anyone on CIGNA panel ?
I'm sorry, my phrasing was poor. We have BCBS Basic, and DW elected Medicare Part B (I'm not eligible yet). For folks in that plan WITHOUT Medicare part B, you must be careful who you see. You can be on the hook for balance billing amounts if your provider doesn't accept Medicare, or the entire amount, if your provider doesn't participate with BCBS.

We were all set to forego Medicare and stick with the same FEHB/BCBS Basic insurance we'd had all along (and avoid the hassle of finding docs that accept Medicare). That was, until we read the fine print on the retiree coverage limit rules. FEHB will only pay Medicare rates, and so choosing a doctor that doesn't accept Medicare subjects us to possible high OOP costs. Because we really should use providers that participate in Medicare (and for sure accept BCBS), DW elected Part B. And so will I when it's time.

When reading the plan brochure, remember you are an annuitant (not an active employee). See section 9 for an explanation of the FEHB law:
When you are age 65 or over and do not have Medicare
Under the FEHB law , we must limit our payments for inpatient hospital care and physician care to those payments you would be entitled to if you had Medicare. Y our physician and hospital must follow Medicare rules and cannot bill you for more than they could bill you if you had Medicare. Y ou and the FEHB benefit from these payment limits. Outpatient hospital care and non-physician-based care are not covered by this law; regular Plan benefits apply. The following chart has more information about the limits.
Then review the details of your payment responsibility in the table that follows this explanation.

I know nothing about the other plans, but I do know the Medicare rate cap is FEHB-based and not BCBS-specific.
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rosemary11
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Re: Why should FEHB members buy Medicare Part B?

Post by rosemary11 » Wed Apr 24, 2019 5:58 am

I am planning on getting medicareB and FEHB.
FEHB would be Blue cross basic or GEHA standard.
I appreciate any final thoughts.

retiredjg
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Re: Why should FEHB members buy Medicare Part B?

Post by retiredjg » Wed Apr 24, 2019 7:10 am

rosemary11 wrote:
Wed Apr 24, 2019 5:58 am
I am planning on getting medicareB and FEHB.
FEHB would be Blue cross basic or GEHA standard.
I appreciate any final thoughts.
This is what I do and I'm very happy with it. I am single and do not pay any extra due to IRMAA.

A couple with large IRMAA payments might not be as happy with this plan.

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Re: Why should FEHB members buy Medicare Part B?

Post by MnD » Wed Apr 24, 2019 7:19 am

I expect by the time I'm up to make this decision in 9 years or so, it won't be a choice to opt of Part B out if you want to continue FEHB.
Which would be fine with me.
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Blues
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Re: Why should FEHB members buy Medicare Part B?

Post by Blues » Wed Apr 24, 2019 7:49 am

I am on Medicare Part A and FEHB. The missus is not yet of age. (Another couple of years.)

I have done the research and am satisfied that opting out of Part B was the right decision for me. No doubt it's not the right answer for everyone.
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Re: Why should FEHB members buy Medicare Part B?

Post by Beatle Boots » Wed Apr 24, 2019 9:44 am

Disabled retired lady friend has both Medicare Part B and GEHA Standard. Medicare Part B is her primary with GEHA secondary. She justifies keeping both (apparent duplications) due to her unique medical illness and Med Part B loop hole. She has Osteoporosis and the generic front line drugs are ineffective. Her Dr prescribed the non-generic (expensive) drug Prolia. Part B provides a "loop hole" if the patient meets certain criteria (mainly can't administer drug in home). Lady does not have Med Part D. Here is the Medicare carve out:

https://www.medicare.gov/coverage/osteoporosis-drugs

(Not sure how many similar "loop holes" there are and certainly YMMV depending on reader's medical situation.)

Bottom line:

Without insurance, 2 injections of this drug cost about $1,650 (excluding office charges).

(support: google keyword search term: Prolia Cost)

Not sure how much GEHA would charge for this drug but the lady claims to have done the Cost benefit Analysis and says the "loop hole" justifies having both FEHB and Medicare Part B.

DrGoogle2017
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Re: Why should FEHB members buy Medicare Part B?

Post by DrGoogle2017 » Wed Apr 24, 2019 10:05 am

They reimburse $50 per month if you have Medicare part B, so it’s about $85 for my husband. Honestly, one reason why we feel our retirement planning is so good is because we pay up front on payment so it can simplify our live. So far it has been excellent. Very limited out of pocket payment. We are not even sick yet, but my husband is approaching 70, so he is most likely will need more Medicare so I’m not going to worry about $85 per month.
Last edited by DrGoogle2017 on Wed Apr 24, 2019 11:33 am, edited 1 time in total.

retiredjg
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Re: Why should FEHB members buy Medicare Part B?

Post by retiredjg » Wed Apr 24, 2019 10:21 am

DrGoogle2017 wrote:
Wed Apr 24, 2019 10:05 am
They reimburse $50 per month if you have Medicare part B, so it’s about $85 for my husband. Honestly, one reason why we feel our retirement planning is so good is because we pay up front on payment so it can simplify our live. So far it has been excellent. Very limited out of pocket payment. We are not even sick yet, but my husband is approaching 70, sohe most likely will need more Medicare so I’m not going to worry about $85 per month.
This is a good point. FEHB BCBS Basic reimburses you $600 a year for Medicare Part B premiums. Makes it pretty darn cheap!

delamer
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Re: Why should FEHB members buy Medicare Part B?

Post by delamer » Wed Apr 24, 2019 10:33 am

retiredjg wrote:
Wed Apr 24, 2019 10:21 am
DrGoogle2017 wrote:
Wed Apr 24, 2019 10:05 am
They reimburse $50 per month if you have Medicare part B, so it’s about $85 for my husband. Honestly, one reason why we feel our retirement planning is so good is because we pay up front on payment so it can simplify our live. So far it has been excellent. Very limited out of pocket payment. We are not even sick yet, but my husband is approaching 70, sohe most likely will need more Medicare so I’m not going to worry about $85 per month.
This is a good point. FEHB BCBS Basic reimburses you $600 a year for Medicare Part B premiums. Makes it pretty darn cheap!
That would only cover 3 months of Part B for me. It depends on individual circumstances.

DrGoogle2017
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Re: Why should FEHB members buy Medicare Part B?

Post by DrGoogle2017 » Wed Apr 24, 2019 11:36 am

delamer wrote:
Wed Apr 24, 2019 10:33 am
retiredjg wrote:
Wed Apr 24, 2019 10:21 am
DrGoogle2017 wrote:
Wed Apr 24, 2019 10:05 am
They reimburse $50 per month if you have Medicare part B, so it’s about $85 for my husband. Honestly, one reason why we feel our retirement planning is so good is because we pay up front on payment so it can simplify our live. So far it has been excellent. Very limited out of pocket payment. We are not even sick yet, but my husband is approaching 70, sohe most likely will need more Medicare so I’m not going to worry about $85 per month.
This is a good point. FEHB BCBS Basic reimburses you $600 a year for Medicare Part B premiums. Makes it pretty darn cheap!
That would only cover 3 months of Part B for me. It depends on individual circumstances.
It’s not meant to cover everything. I thought about not buying Medicare part B at one point, but now I’m glad I have both. Actually my husband, I don’t have Medicare yet.

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dm200
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Re: Why should FEHB members buy Medicare Part B?

Post by dm200 » Wed Apr 24, 2019 11:43 am

While the benefits of having Medicare Part B are the same for different folks with the same other overages, the costs to different folks might be quite different due to IRMAA - and, perhaps, spousal factors.

delamer
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Re: Why should FEHB members buy Medicare Part B?

Post by delamer » Wed Apr 24, 2019 11:51 am

DrGoogle2017 wrote:
Wed Apr 24, 2019 11:36 am
delamer wrote:
Wed Apr 24, 2019 10:33 am
retiredjg wrote:
Wed Apr 24, 2019 10:21 am
DrGoogle2017 wrote:
Wed Apr 24, 2019 10:05 am
They reimburse $50 per month if you have Medicare part B, so it’s about $85 for my husband. Honestly, one reason why we feel our retirement planning is so good is because we pay up front on payment so it can simplify our live. So far it has been excellent. Very limited out of pocket payment. We are not even sick yet, but my husband is approaching 70, sohe most likely will need more Medicare so I’m not going to worry about $85 per month.
This is a good point. FEHB BCBS Basic reimburses you $600 a year for Medicare Part B premiums. Makes it pretty darn cheap!
That would only cover 3 months of Part B for me. It depends on individual circumstances.
It’s not meant to cover everything. I thought about not buying Medicare part B at one point, but now I’m glad I have both. Actually my husband, I don’t have Medicare yet.
Yes, I understand that. But for those of us subject to IRMAA, the savings are small relative to the total Medicare B outlay. For me, this year, my Part B premiums would still be $2700 after the reimbursement.

DrGoogle2017
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Re: Why should FEHB members buy Medicare Part B?

Post by DrGoogle2017 » Wed Apr 24, 2019 12:11 pm

delamer wrote:
Wed Apr 24, 2019 11:51 am
DrGoogle2017 wrote:
Wed Apr 24, 2019 11:36 am
delamer wrote:
Wed Apr 24, 2019 10:33 am
retiredjg wrote:
Wed Apr 24, 2019 10:21 am
DrGoogle2017 wrote:
Wed Apr 24, 2019 10:05 am
They reimburse $50 per month if you have Medicare part B, so it’s about $85 for my husband. Honestly, one reason why we feel our retirement planning is so good is because we pay up front on payment so it can simplify our live. So far it has been excellent. Very limited out of pocket payment. We are not even sick yet, but my husband is approaching 70, sohe most likely will need more Medicare so I’m not going to worry about $85 per month.
This is a good point. FEHB BCBS Basic reimburses you $600 a year for Medicare Part B premiums. Makes it pretty darn cheap!
That would only cover 3 months of Part B for me. It depends on individual circumstances.
It’s not meant to cover everything. I thought about not buying Medicare part B at one point, but now I’m glad I have both. Actually my husband, I don’t have Medicare yet.
Yes, I understand that. But for those of us subject to IRMAA, the savings are small relative to the total Medicare B outlay. For me, this year, my Part B premiums would still be $2700 after the reimbursement.
Ouch, I don’t know what I would do if I were in your situation. But I have to admit the FEHB service has been outstanding, I’m not sure because it’s the FEHB or regular BCBS. But we’re very satisfied customer.

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dm200
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Re: Why should FEHB members buy Medicare Part B?

Post by dm200 » Wed Apr 24, 2019 12:19 pm

One potential risk of either decision would be if the rules about those so eligible change in the future.

I thing such risks are very low for federal retirees vs. retirees from other employers.

For those with other employers, these risks will be higher, in my opinion.

rosemary11
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Re: Why should FEHB members buy Medicare Part B?

Post by rosemary11 » Wed Apr 24, 2019 12:29 pm

Is Standard GEHA OR BASIC BCBS better as a supplement to Medicare part B?

DrGoogle2017
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Re: Why should FEHB members buy Medicare Part B?

Post by DrGoogle2017 » Wed Apr 24, 2019 12:36 pm

rosemary11 wrote:
Wed Apr 24, 2019 12:29 pm
Is Standard GEHA OR BASIC BCBS better as a supplement to Medicare part B?
You have to look up a website that comparing both plans. But in the past when we switched to GEHA dental plan, we heard it was good or better than Delta Dental. It wasn’t.

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Re: Why should FEHB members buy Medicare Part B?

Post by tj » Wed Apr 24, 2019 6:34 pm

rosemary11 wrote:
Wed Apr 24, 2019 12:29 pm
Is Standard GEHA OR BASIC BCBS better as a supplement to Medicare part B?
Aetna direct is the one people mention a lot for Medicare. Not sure why it's not in this thread.

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Re: Why should FEHB members buy Medicare Part B?

Post by jerryk68 » Thu Apr 25, 2019 7:29 am

dm200 wrote:
Tue Apr 23, 2019 3:04 pm
No firsthand knowledge or research, but a longtime friend and federal retiree (under CSRS) researches everything - to the ultimate. You ask him what time it is - and he will tell you how to make a watch!

His very extensive research led him to NOT get (and pay for) Medicare Part B. He told me that one important factor for him was that his wife used and depended upon his health/medical insurance. His wife has also chosen to NOT get )and pay for) Medicare part B either. They, especially his wife, probably have above average use of medical services - for their ages.
My "guy" at the office who has since retired decided to take Part B. I don't know about his watch capability but he read every brochure like he was reading a novel. When asked he would counsel his coworker's on the pro's and con's of each plan. His theory on Part B was he was eventually going to die in retirement and wanted full coverage not only for himself but for his wife. He didn't want treatment cost to be a factor in the decision making process. Beside, he said BC/BS Basic reimbursed $600 of the cost and provided mail order services for Part B participants saving an additional $50 a quarter ($200) for each of his tier 2 drug.

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Re: Why should FEHB members buy Medicare Part B?

Post by Yooper16 » Thu Apr 25, 2019 8:15 am

tj wrote:
Wed Apr 24, 2019 6:34 pm
rosemary11 wrote:
Wed Apr 24, 2019 12:29 pm
Is Standard GEHA OR BASIC BCBS better as a supplement to Medicare part B?
Aetna direct is the one people mention a lot for Medicare. Not sure why it's not in this thread.


We are intending to switch to it in May/June after I turn 65, as it is not recommended for use (Aetna customer support) other than in conjunction with Part B. Without checking, it is a higher premium than Basic and a couple of others approx 300/mo for self plus one, vs 250ish for the others. It does come with an 900 each person reimbursement account that we intend to apply towards part B premiums.

tj
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Re: Why should FEHB members buy Medicare Part B?

Post by tj » Thu Aug 01, 2019 10:05 pm

Yooper16 wrote:
Thu Apr 25, 2019 8:15 am
tj wrote:
Wed Apr 24, 2019 6:34 pm
rosemary11 wrote:
Wed Apr 24, 2019 12:29 pm
Is Standard GEHA OR BASIC BCBS better as a supplement to Medicare part B?
Aetna direct is the one people mention a lot for Medicare. Not sure why it's not in this thread.


We are intending to switch to it in May/June after I turn 65, as it is not recommended for use (Aetna customer support) other than in conjunction with Part B. Without checking, it is a higher premium than Basic and a couple of others approx 300/mo for self plus one, vs 250ish for the others. It does come with an 900 each person reimbursement account that we intend to apply towards part B premiums.
Maybe take a look at MHBP Consumer option as well, it appears to offer $1,200/year each person, waives medicare copays, coinsurance and deductibles, and has a smaller premium than Aetna Direct? You have to join the Mail Handlers Union though.

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Re: Why should FEHB members buy Medicare Part B?

Post by mrc » Fri Aug 02, 2019 11:25 am

tj wrote:
Thu Aug 01, 2019 10:05 pm
Maybe take a look at MHBP Consumer option as well, it appears to offer $1,200/year each person, waives medicare copays, coinsurance and deductibles, and has a smaller premium than Aetna Direct? You have to join the Mail Handlers Union though.
The reviews here for that plan are abysmal, which underscores the importance of doing thorough research every year. Oh, and being able to see into the future is always helpful.
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MichDad
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Re: Why should FEHB members buy Medicare Part B?

Post by MichDad » Wed Dec 18, 2019 2:13 pm

I’ll reach the Medicare Part B decision point (age 65) in 2020. My current thinking remains that I should not pay for it. I’d like to provide my reasoning and welcome others’ comments. But first, some basic facts. My wife, who’s three years younger than I, is also covered by my FEHB plan. In 2020, we’ll be in the GEHA standard plan, self plus one. Also, if it’s relevant, we have about $30,000 in total in our HSA accounts. Since we’re no longer in GEHA’s HDHP, we’re no longer contributing to those accounts.

1. We’re in the process of making large Roth conversions (about $200,000 per year). I also have my FERS pension and rental income. As a result, I figure our Medicare Part B premiums, including surcharges, would be $376 per month, or $4,512 per year, per person. If my wife was also Medicare Part B eligible, that would be $752 per month or $9,024 per year for the two of us. We’ll likely be making such large Roth conversions until I’m at least age 70 and will begin to collect maximum Social Security benefits. After I turn 70, we’ll probably continue to make Roth conversions but at a lower dollar figure, perhaps around $100,000 per year.

2. Beginning around the time I turn 72, it’s my hope that our Required Minimum Distributions will be low enough that they, in addition to my FERS pension and our combined Social Security benefits, will not subject us to significant taxes. Were it not for the ten percent per year penalties for delaying enrollment into Medicare Part B, I think we might qualify for the lowest Medicare Part B payments around age 74. In other words, we’ll be in the high Medicare Part B surcharge zone until approximately when I’ll turn 74, ten years from now. [Remember, the Medicare Part B premiums for any given year are based on the taxpayer’s Modified Adjusted Gross Income from two years prior.]

3. We live in Europe six months each year and will continue to do so as long as we’re healthy. During the other six months, we’re outside the USA for about one to two additional months. Medicare doesn’t cover any of our medical expenses while we’re outside the USA. On a related note, we have a private evacuation insurance policy in the event we need to return to the USA for medical care.

4. While outside the USA, GEHA covers our medical expenses as if all our care is given by in-network preferred providers. We need to pay the full price abroad and then submit the invoices to GEHA for reimbursement. So far, that’s not been a problem. I visited a doctor in a European capital’s emergency room a few years ago. The total bill (not my co-pay) from that hospital was . . . drum roll please . . . 20€. I haven’t omitted any zeros from that sum. If I had been a citizen of that country, there would have been no out-of-pocket cost for that visit. GEHA later reimbursed me in full for that visit. I think this helps explain why GEHA is willing to treat all medical expenses incurred outside the USA as if they were given by preferred providers.

5. As noted above, my wife is three years younger than I. Thus, we’ll revisit the Medicare Part B issue for her in 2023. If things are working out for me, we may forego Medicare Part B for her as well.

Thank you in advance for your comments.

MichDad

mrc
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Re: Why should FEHB members buy Medicare Part B?

Post by mrc » Wed Dec 18, 2019 2:46 pm

MichDad,

We planned to skip electing Medicare B thinking the FEHB BCBS Basic we had pre-Medicare was good enough, and it wouldn't matter whether our providers accepted Medicare. However, BCBS (and other FEHB plans) pay no more than the Medicare allowance. It is possible to be on the hook for the difference if one's provider doesn't accept/participate in Medicare. So DW elected part B as will I when the time comes. So far this year, we have had no OOP expenses as BCBS covers any Medicare co-payments. The premiums are not bad. We are not subject to IRMAA, nor do we spend any time out of the country, both of which would have made this decision more difficult. Just be sure you'll be covered adequately by your GEHA plan in light of the Medicare rate limit.
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Trapper
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Re: Why should FEHB members buy Medicare Part B?

Post by Trapper » Wed Dec 18, 2019 2:54 pm

I will be looking at the same situation in about five years.
My thoughts are to skip Medicare B.
What I am unclear about is how will FEHB (in your situation GEHA) reimburse providers? At the Medicare reimbursement schedule? At the GEHA contract rate? Do you know which/how, and if it will impact providers willing to accept and treat you as a patient?

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Re: Why should FEHB members buy Medicare Part B?

Post by VictoriaF » Tue Dec 24, 2019 8:40 am

MichDad wrote:
Wed Dec 18, 2019 2:13 pm
I’ll reach the Medicare Part B decision point (age 65) in 2020. My current thinking remains that I should not pay for it. I’d like to provide my reasoning and welcome others’ comments.

MichDad
MichDad,

I am a strong proponent of having both FEHB and Medicare Part B, but your high Part B payments give me a pause. Here are some isolated thoughts:
1. The SECURE Act makes it even more prudent to do Roth conversions.
2. You will still have Medicare Part A.
3. If FEHB were merged in the future with Medicare, it might be a qualifying event for not paying Medicare penalties.
4. Check out GEHA-High.

It's a gamble. My sincere wishes are for you winning it,

Victoria
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MichDad
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Re: Why should FEHB members buy Medicare Part B?

Post by MichDad » Fri Dec 27, 2019 10:46 am

VictoriaF wrote:
Tue Dec 24, 2019 8:40 am
MichDad wrote:
Wed Dec 18, 2019 2:13 pm
I’ll reach the Medicare Part B decision point (age 65) in 2020. My current thinking remains that I should not pay for it. I’d like to provide my reasoning and welcome others’ comments.

MichDad
MichDad,

I am a strong proponent of having both FEHB and Medicare Part B, but your high Part B payments give me a pause. Here are some isolated thoughts:
1. The SECURE Act makes it even more prudent to do Roth conversions.
2. You will still have Medicare Part A.
3. If FEHB were merged in the future with Medicare, it might be a qualifying event for not paying Medicare penalties.
4. Check out GEHA-High.

It's a gamble. My sincere wishes are for you winning it,

Victoria
Thank you, Victoria.

I've just completed my final Roth conversion for 2019. By not having to worry about Medicare Part B surcharges, I was able to convert a very large sum and remain in the 24 percent tax bracket. If I do this for the next six to eight years, I'll put a huge dent in our RMDs beginning at age 72. I'm paying the increased federal and state taxes out of my FERS pension, rental income, and taxable accounts.

And you're correct that if our health care needs increase significantly in coming years, I can move from GEHA-Standard to GEHA-High (or something similar). The increased health insurance premiums are probably less than the Medicare Part B surcharges. But, while we're living outside the USA, I don't see any need to pay for the better health insurance plan.

MichDad

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