Federal Retiree Health Care with/Medicare

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LuigiLikesPizza
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Federal Retiree Health Care with/Medicare

Post by LuigiLikesPizza » Sat Apr 29, 2017 6:37 pm

Although I could retire now, I have been convinced by several that I should stick it out for the time when I am eligible to take my federal retiree health care with me. So, I'll pay the premium when I retire and one day, I will reach the age for Medicare eligibility.

How do federal employees with their own federal health insurance fare with Medicare compared to retirees with their own private health insurance plans? Is there any benefit to having federal retiree health insurance when it comes time to also sign up for Medicare?

glennpost
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Re: Federal Retiree Health Care with/Medicare

Post by glennpost » Sun Apr 30, 2017 7:23 am

There often can be depending on your circumstances and the specifics of the plan you choose. If you take Medicare Part B (outpatient care), most FEHB plans coordinate benefits such that you basically don't have to pay deductibles, co-insurance or pretty much anything aside from the premium. Also, given that FEHB plans cover prescription drugs, you won't need to sign up for Medicare Part D.

dbr
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Re: Federal Retiree Health Care with/Medicare

Post by dbr » Sun Apr 30, 2017 7:42 am

FEHB is used in place of Medigap to cover what Medicare A and B do not. It can replace Medicare D. Based on the experience of a relative it is one of the best deals going. FEHB is not relevant to Medicare per se other than that Medicare would be primary and FEHB or Medigap is secondary.

PS I don't understand what you mean by "How does one fare?"

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dm200
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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Sun Apr 30, 2017 7:55 am

LuigiLikesPizza wrote:Although I could retire now, I have been convinced by several that I should stick it out for the time when I am eligible to take my federal retiree health care with me. So, I'll pay the premium when I retire and one day, I will reach the age for Medicare eligibility.
How do federal employees with their own federal health insurance fare with Medicare compared to retirees with their own private health insurance plans? Is there any benefit to having federal retiree health insurance when it comes time to also sign up for Medicare?
I am not a federal employee or retiree. but I know quite a few. One friend chose Medicare Part A only and did not choose Part B. Others have chosen Part B.

One factor to evaluate is the Medicare is for an individual only, while the federal retiree ben3efit can be for dependent(s) as well.

Not sure, but it might make a difference if you choose a Medicare advantage plan.

LuigiLikesPizza
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Re: Federal Retiree Health Care with/Medicare

Post by LuigiLikesPizza » Sun Apr 30, 2017 8:09 am

PS I don't understand what you mean by "How does one fare?"
I mean that it has been strongly recommended here on the forum that I continue working, even if I don't need the extra money... just to be eligible for federal retiree health care coverage.

At that time, there will be approximately 7 years until Medicare eligibility, so the trade off is working for another year or so, just for the sole purpose of access to 7 +/- years of health insurance.

My question is whether there is any additional benefit to being a federal retiree with healthcare than regular Joe Citizen with private healthcare when it comes time for Medicare...in other words, I am nearly completely ignorant about Medicare and get lost in the terminology. I have heard that federal retiree healthcare is more comprehensive than other plans, i,e. - it fills the gaps of Medicare, but I have no way to know that for sure because i have never had private insurance nor the use yet of Medicare services and I have not yet studied Medicare - of course we know the plan terms may change...who knows - the whole issue of Soc Sec and Medicare is thorny.

Sorry if that is a long winded explanation. lol

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dm200
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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Sun Apr 30, 2017 8:17 am

My question is whether there is any additional benefit to being a federal retiree with healthcare than regular Joe Citizen with private healthcare when it comes time for Medicare...in other words, I am nearly completely ignorant about Medicare and get lost in the terminology. I have heard that federal retiree healthcare is more comprehensive than other plans, i,e. - it fills the gaps of Medicare, but I have no way to know that for sure because i have never had private insurance nor the use yet of Medicare services and I have not yet studied Medicare - of course we know the plan terms may change...who knows - the whole issue of Soc Sec and Medicare is thorny.
Yes, you are better having retiree health insurance when on Medicare than what most folks on Medicare (like me) get which is nothong extra. Federal retiree health insurance benefits are, I believe, quite solid for the future.

As I understand, a lot of research can halp you understand what is best or optimum for you and your situation. When you have dependent(s) can make a big difference. Some choose Part B and some do not (federal retirees). I think (not sure) that you may not want/need a supplement if you have Medicare and federal retiree benefits.

While I do not know your details, I am near certain having the federal retiree health benefits is a very significant financial benefit to you, as well as some possible healthcare benefits as well.

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mrc
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Re: Federal Retiree Health Care with/Medicare

Post by mrc » Sun Apr 30, 2017 8:37 am

DW is a fed, still working, and medicare eligible. I am a dependent on her FEHB plan now (I stopped working earlier this year and am well under medicare eligibility age). DW elected part A only for now (because she is still working, she can postpone B). However, we'll continue on FEHB and neither of us will elect Medicare B. Essentially, we'll have the same insurance in retirement as we have now while DW is working, plus she will have Medicare part A coverage. The part B premiums are not cost effective for us: having both FEHB + Medicare B isn't belt and suspenders, but more like concrete trousers!

If you have not yet met the 5-year eligibility to retain FEHB for you and spouse in retirement, I suggest you keep working until you do. Lifetime coverage at your current premiums for you and a mate are very hard to beat -- especially if you are not yet Medicare eligible. If I had to obtain health insurance via ACA at my age and our income, I would not have been able to stop working.
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dm200
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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Sun Apr 30, 2017 9:06 am

Although this situation has become much less common, I know someone (federal employee/retiree) who was burned by making this mistake.

While federal employees have, in my opinion, excellent health insurance benefits, they pay for a part of the coverage. There are still a few private employers that pay more (or all) health insurance benefits. This federal employee's wife had better benefits, so he waived the federal employee benefits. Then, when he retired - he did not get the federal benefits.

I think federal employees must be on the health insurance benefits for five years prior to retirement.

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Re: Federal Retiree Health Care with/Medicare

Post by Swansea » Sun Apr 30, 2017 9:42 am

5 years is the general rule to be covered under FEHB into retirement. There is one exception to the 5 year rule, pls see in the info below from the OPM site.

Retirees and Survivor Annuitants
Federal retirees and their surviving spouses retain their eligibility for FEHB health coverage at the same cost as current employees. In order to carry your FEHB coverage into retirement, you must be entitled to retire on an immediate annuity under a retirement system for civilian employees (including the Federal Employees Retirement System (FERS) Minimum Retirement Age (MRA) + 10 retirement) and must have been continuously enrolled (or covered as a family member) in any FEHB plan(s) for the 5 years of service immediately before the date your annuity starts, or for the full period(s) of service since your first opportunity to enroll (if less than 5 years). The 5 year requirement period can include the following: the time you are covered as a family member under another person's FEHB enrollment; or the time you are covered under the Uniformed Services Health Benefits Program (also known as TRICARE) as long as you were covered under an FEHB enrollment at the time of your retirement.

delamer
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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Sun Apr 30, 2017 1:01 pm

LuigiLikesPizza wrote:
PS I don't understand what you mean by "How does one fare?"
I mean that it has been strongly recommended here on the forum that I continue working, even if I don't need the extra money... just to be eligible for federal retiree health care coverage.

At that time, there will be approximately 7 years until Medicare eligibility, so the trade off is working for another year or so, just for the sole purpose of access to 7 +/- years of health insurance.

My question is whether there is any additional benefit to being a federal retiree with healthcare than regular Joe Citizen with private healthcare when it comes time for Medicare...in other words, I am nearly completely ignorant about Medicare and get lost in the terminology. I have heard that federal retiree healthcare is more comprehensive than other plans, i,e. - it fills the gaps of Medicare, but I have no way to know that for sure because i have never had private insurance nor the use yet of Medicare services and I have not yet studied Medicare - of course we know the plan terms may change...who knows - the whole issue of Soc Sec and Medicare is thorny.

Sorry if that is a long winded explanation. lol
I am not sure what you mean that you've "never had private insurance." The FEHB program isn't government insurance like Medicare; it is employer-provided insurance comparable to what private sector workers get from their jobs.

FEHB for Medicare-eligible retirees is more comprehensive than Medigap plans that many people enroll in.

But your main issue is that you won't be eligible for Medicare for 7 years after you retire.

Frankly, you'd be crazy to not work another year if it would make you eligible to carry FEHB into retirement. You'll pay a lot more if you buy insurance on your own (since FEHB subsidizes retiree coverage) and the coverage won't be as good. I am a pre-Medicare retired fed and pay about $230/month for family coverage, which is an amazing deal -- probably as valuable to me as my pension (which is on the low side because I worked part-time for about half of my service).

heerekj1
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Re: Federal Retiree Health Care with/Medicare

Post by heerekj1 » Sun Apr 30, 2017 1:28 pm

My experience: I became eligible for Medicare in December of 2015 and initially signed up for parts A and B. My was retired from the U.S. Senate and we had health insurance through FEHB. We used BCBS of Michigan. Because there was no COLA on Social Security that year, new enrollees to Medicare part B had to cover the cost increases to Medicare Part B for everyone. In addition I had sold some stocks and incurred capital gains which made my part B coverage cost approximately $300/mo. When my wife became eligible for Medicare 6 months later it was going to cost an additional $300/mo. My reading indicated that eventually the cost would go back to $300/mo for both.

In addition BCBS does not reduce its premium when you take Medicare. We would end up paying slightly more than what we were paying for BCBS for coverage that only saved me from paying the deductible. I decided to pass on part B

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dm200
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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Sun Apr 30, 2017 1:41 pm

Because there was no COLA on Social Security that year, new enrollees to Medicare part B had to cover the cost increases to Medicare Part B for everyone.
Not exactly. The initial hit would have done this, but Congressional legislation softened the full hot. New enrolees (such as my wife) paid more that year (about $122 vs about $105 for me), but over time it will all adjust to be the same.

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dm200
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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Sun Apr 30, 2017 1:42 pm

In addition BCBS does not reduce its premium when you take Medicare. We would end up paying slightly more than what we were paying for BCBS for coverage that only saved me from paying the deductible. I decided to pass on part B
Yes, that is a frequent decision of such retirees, although I have spoken with some who have concluded that they are better off by choosing Part B.

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mrc
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Re: Federal Retiree Health Care with/Medicare

Post by mrc » Sun Apr 30, 2017 1:58 pm

dm200 wrote:
In addition BCBS does not reduce its premium when you take Medicare. We would end up paying slightly more than what we were paying for BCBS for coverage that only saved me from paying the deductible. I decided to pass on part B
Yes, that is a frequent decision of such retirees, although I have spoken with some who have concluded that they are better off by choosing Part B.
I sure would like to know the circumstances of how a couple with FEHB were better off with part B than without.
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Re: Federal Retiree Health Care with/Medicare

Post by bsteiner » Sun Apr 30, 2017 2:21 pm

dm200 wrote:
In addition BCBS does not reduce its premium when you take Medicare. We would end up paying slightly more than what we were paying for BCBS for coverage that only saved me from paying the deductible. I decided to pass on part B
Yes, that is a frequent decision of such retirees, although I have spoken with some who have concluded that they are better off by choosing Part B.
If you keep the Federal health insurance and don't take Medicare Part B, you have the same as what you had while you were working.

The question is whether adding Medicare Part B provides enough of a benefit to warrant its cost, especially for someone in a high Medicare Part B premium bracket.

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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Sun Apr 30, 2017 2:36 pm

LuigiLikesPizza wrote:
PS I don't understand what you mean by "How does one fare?"
I mean that it has been strongly recommended here on the forum that I continue working, even if I don't need the extra money... just to be eligible for federal retiree health care coverage.

At that time, there will be approximately 7 years until Medicare eligibility, so the trade off is working for another year or so, just for the sole purpose of access to 7 +/- years of health insurance.
This may be what you are missing. Not only do you get the good and relatively low cost insurance for that 7 years, you get to keep it while you are actually on Medicare and you get to keep it at the same relatively low cost. If you do not have it, you'll need to find some other coverage to supplement Medicare and you may also need to pay for prescription coverage.

The problem with "other" coverage to supplement Medicare is that it can be very costly and it is certainly unpredictable at this point in time and that is likely to continue. It may be another 20 or 50 years before the government gets health care figured out and stabilized. I am grateful every day that I don't have to worry about all that is going on with health care.

I pay for my portion of a low cost FEHB plan (government still pays the rest) and I pay for Medicare Part B. That's it. So far, I have paid no medical bills at all other than my co-pay on prescriptions. There has been no major health issue that has required surgery or hospitalization so I still don't know how that will go, but I'm pretty sure my bills will be low for that as well.

heerekj1
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Re: Federal Retiree Health Care with/Medicare

Post by heerekj1 » Mon May 01, 2017 10:05 am

My wife is happy with BCBS. We travel a lot, both US and non-US. My wife has had multiple joint surgeries and BCBS has covered most of it. So I don't think finding a cheaper health insurance is an option. We are indeed in a higher income bracket (because of Roth rollovers) and will remain there once SS and RMDs kick in. Our current deductible from BCBS is, I believe, $1,800 for the two of us. Medicare part B would cost the two of us at least twice that.

Currently I save what I would have spent on part B in a separate savings account. Under BCBS I am not eligible for an HSA.

retiredjg
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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Mon May 01, 2017 1:02 pm

That does bring up another issue - coverage while abroad. Medicare doesn't pay when you are out of the country so if you travel, you definitely want top notch medical coverage. I'm not sure I'd trust that to the "market place" or to private insurance if I had the opportunity to keep FEHB.

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dm200
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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Mon May 01, 2017 2:08 pm

One possible factor for such federal retirees whether to take (and pay for) Part B or not might be whether they pay the standard/minimum for Part B or whether their income requires (or will require) a higher monthly payment for part B.

autolycus
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Re: Federal Retiree Health Care with/Medicare

Post by autolycus » Mon May 01, 2017 2:59 pm

retiredjg wrote:That does bring up another issue - coverage while abroad. Medicare doesn't pay when you are out of the country so if you travel, you definitely want top notch medical coverage. I'm not sure I'd trust that to the "market place" or to private insurance if I had the opportunity to keep FEHB.
For frequent travel within the US it is very helpful to have a plan with either a robust national network or good out of network coverage. However, Medicare theoretically alleviates most of that concern since most normal medical providers will take it. For travel outside the US, it may be worth looking at pricing for travel medical insurance just to get an idea of whether it's affordable enough for your circumstances to be worth paying for a trip at a time. It might not be. I've only looked at the cost of such plans for <40 year olds, and they're not bad. 65+ might be substantially more expensive though.

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Re: Federal Retiree Health Care with/Medicare

Post by Swansea » Mon May 01, 2017 3:32 pm

Some Feds elect to go into a lower cost FEHB plan when they take Medicare Part B. For instance, they move to BCBS Basic instead of standard.
It's tough to crunch the numbers, but my guess was for 2016, Medicare B cost me only a few hundred more than what I received in benefits. However, I did have many PT visits. My RMD next year will affect the Part B cost, so I may find it too expensive then.

delamer
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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Mon May 01, 2017 3:39 pm

I recommend the Checkbook Guide to better understand all the options: https://www.checkbook.org/newhig2/hig.cfm

As indicated, your agency may make it available online for free.

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Re: Federal Retiree Health Care with/Medicare

Post by HoneyBee » Sun Jun 25, 2017 8:56 pm

I am a 62 year old government lawyer who is starting to think about retirement. I have done research into this issue and my question is: why are the FEHB insurance companies allowed to charge the same premium for a federal retiree who has elected to pay for both Medicare Part A and Part B? This is an incredible windfall for the health insurers because Medicare is primary and pays most of the cost of hospitalization, physician fees or labs, etc. All the FEHB insurer is paying is the deductible or coinsurance and pharmacy costs.

If both my husband and I pay Medicare Part B premiums, this is a lot of money. It just seems ridiculous that we would be required to pay the same premium post retirement that I am paying now. As one writer noted, FEHB health policies are not that cheap anymore. I pay about the same as I paid in private practice and a lot more than my son pays at his employer.

I heard that it is best to select the lowest FEHB policy you can find, but I think the better answer is to pressure the FEHB and the OPM to make the insurers offer a policy that is priced fairly and takes into account the fact that the federal government/CMS-Medicare is already footing the lions share of the health costs. The federal government would save money because they continue to pay a portion of the policy during retirement.

I know there are quite a few federal workers/retirees on this blog. Is anyone else with me for a letter writing campaign?

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Re: Federal Retiree Health Care with/Medicare

Post by grabiner » Sun Jun 25, 2017 9:04 pm

HoneyBee wrote:I am a 62 year old government lawyer who is starting to think about retirement. I have done research into this issue and my question is: why are the FEHB insurance companies allowed to charge the same premium for a federal retiree who has elected to pay for both Medicare Part A and Part B? This is an incredible windfall for the health insurers because Medicare is primary and pays most of the cost of hospitalization, physician fees or labs, etc. All the FEHB insurer is paying is the deductible or coinsurance and pharmacy costs.
As with most employee health insurance, FEHB insurers must charge everyone the same premium. It is not allowed to charge less to young workers than to retirees who have declined Part B, nor to people over 65 who are still working (or covered by a working spouse) and thus for whom the FEHB coverage is primary.
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dodecahedron
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Re: Federal Retiree Health Care with/Medicare

Post by dodecahedron » Sun Jun 25, 2017 9:10 pm

Interesting question, HoneyBee. By contrast, NYS retirees and their spouses who are covered by the state health employee insurance plan (NYSHIP) and also sign up for Medicare get their Part B premiums *reimbursed in full* by New York State (including any IRMAA and/or late enrollment additional charges!) You may want to raise this question to your union representatives and see if they can secure a better deal.

So (addressing the issue David raised) everyone pays the same premium (retiree or active employee, regardless of age) but those who sign up for Medicare get their premiums reimbursed by the state government in recognition of the money their Medicare coverage saves the state plan.

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mrc
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Re: Federal Retiree Health Care with/Medicare

Post by mrc » Mon Jun 26, 2017 5:44 am

HoneyBee wrote:If both my husband and I pay Medicare Part B premiums, this is a lot of money. It just seems ridiculous that we would be required to pay the same premium post retirement that I am paying now. As one writer noted, FEHB health policies are not that cheap anymore. I pay about the same as I paid in private practice and a lot more than my son pays at his employer.
Since you have great coverage now with the FEHB, and can keep that coverage in retirement, have you though about simply declining Medicare B? You'll pay the same (subsidized) FEHB premiums in retirement as you do now, for the same coverage that you have now. Do you need Medicare B? Why pay for coverage that goes beyond what you have now, at a steep premium (especially if you are subject to IRMAA)?
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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Mon Jun 26, 2017 7:01 am

HoneyBee wrote:I am a 62 year old government lawyer who is starting to think about retirement. I have done research into this issue and my question is: why are the FEHB insurance companies allowed to charge the same premium for a federal retiree who has elected to pay for both Medicare Part A and Part B? This is an incredible windfall for the health insurers because Medicare is primary and pays most of the cost of hospitalization, physician fees or labs, etc. All the FEHB insurer is paying is the deductible or coinsurance and pharmacy costs.

If both my husband and I pay Medicare Part B premiums, this is a lot of money. It just seems ridiculous that we would be required to pay the same premium post retirement that I am paying now. As one writer noted, FEHB health policies are not that cheap anymore. I pay about the same as I paid in private practice and a lot more than my son pays at his employer.

I heard that it is best to select the lowest FEHB policy you can find, but I think the better answer is to pressure the FEHB and the OPM to make the insurers offer a policy that is priced fairly and takes into account the fact that the federal government/CMS-Medicare is already footing the lions share of the health costs. The federal government would save money because they continue to pay a portion of the policy during retirement.

I know there are quite a few federal workers/retirees on this blog. Is anyone else with me for a letter writing campaign?
So, you want us to begin a letter writing campaign to convince OPM, which is part of the Federal Government, to get Congress and the Administration to change a statutorily required coordination of benefits between the FEHB and Medicare programs, that in the long run reduces the cost of retiree health care insurance paid by the Federal Government for Federal retirees because (1) retirees are paying both FEHB and Medicare premiums and (2) Medicare is primary and FEHB is secondary? Good luck with that, especially if you can pressure Congress and the Administration to negotiate lower cost health insurance just for annuitants. If you were in the Government long enough, you would really appreciate how long it would take to accomplish such an endeavor -- Federal vision and dental care and Self plus one health coverage took years to get. If you succeed with that I'd encourage you to take on WEP and GPO for us CSRS or CSRS-Offset retirees -- that also seems superficially unfair as well to many of us. And since you're a lawyer like me and my wife, and it's now the season for paying bar dues, maybe you can get the State Bars, like Virginia, not to charge us bar dues for our inactive or retired status, like the District of Columbia does. These fees are burning a hole in our pockets too. (Sarcasm intended here. :sharebeer )

As others have mentioned, I think the answer is just don't enroll in Medicare B and avoid the Medicare B premiums especially if you're in IRMAA land like me. But be careful there. If your spouse, like mine, is not a Federal retiree, he or she might want to enroll in Medicare Part B because if your spouse divorces you, your ex-spouse may not be able to receive FEHB health insurance. My spouse is enrolled in Part B but I won't likely enroll in Part B when I become eligible next year. I do think you're on to something in cutting costs and handling the situation: enroll in a low cost FEHB plan (like BCBS Basic) and Medicare Part B -- I know many retirees who do this -- even though it might not be the most cost efficient approach (not enrolling in Medicare Part B might be the most efficient) -- because it's the most convenient way of dealing with medical bills and expenses in retirement.

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Re: Federal Retiree Health Care with/Medicare

Post by Barefootgirl » Mon Jun 26, 2017 11:02 am

Whenever the talk turns to abolishing or scaling back on Medicare benefits, isn't it possible to view the FEHB program for retirees as a good cushion for handling the fall?
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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Mon Jun 26, 2017 11:36 am

Everybody's mileage may vary but I only intend to elect Part A when I apply in the next few months.

I'll remain with my current FEHB provider.

(If my decision changes somewhere down the road, so be it.)
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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Mon Jun 26, 2017 2:45 pm

ChrisC wrote:
HoneyBee wrote:I am a 62 year old government lawyer who is starting to think about retirement. I have done research into this issue and my question is: why are the FEHB insurance companies allowed to charge the same premium for a federal retiree who has elected to pay for both Medicare Part A and Part B? This is an incredible windfall for the health insurers because Medicare is primary and pays most of the cost of hospitalization, physician fees or labs, etc. All the FEHB insurer is paying is the deductible or coinsurance and pharmacy costs.

If both my husband and I pay Medicare Part B premiums, this is a lot of money. It just seems ridiculous that we would be required to pay the same premium post retirement that I am paying now. As one writer noted, FEHB health policies are not that cheap anymore. I pay about the same as I paid in private practice and a lot more than my son pays at his employer.

I heard that it is best to select the lowest FEHB policy you can find, but I think the better answer is to pressure the FEHB and the OPM to make the insurers offer a policy that is priced fairly and takes into account the fact that the federal government/CMS-Medicare is already footing the lions share of the health costs. The federal government would save money because they continue to pay a portion of the policy during retirement.

I know there are quite a few federal workers/retirees on this blog. Is anyone else with me for a letter writing campaign?
So, you want us to begin a letter writing campaign to convince OPM, which is part of the Federal Government, to get Congress and the Administration to change a statutorily required coordination of benefits between the FEHB and Medicare programs, that in the long run reduces the cost of retiree health care insurance paid by the Federal Government for Federal retirees because (1) retirees are paying both FEHB and Medicare premiums and (2) Medicare is primary and FEHB is secondary? Good luck with that, especially if you can pressure Congress and the Administration to negotiate lower cost health insurance just for annuitants. If you were in the Government long enough, you would really appreciate how long it would take to accomplish such an endeavor -- Federal vision and dental care and Self plus one health coverage took years to get. If you succeed with that I'd encourage you to take on WEP and GPO for us CSRS or CSRS-Offset retirees -- that also seems superficially unfair as well to many of us. And since you're a lawyer like me and my wife, and it's now the season for paying bar dues, maybe you can get the State Bars, like Virginia, not to charge us bar dues for our inactive or retired status, like the District of Columbia does. These fees are burning a hole in our pockets too. (Sarcasm intended here. :sharebeer )

As others have mentioned, I think the answer is just don't enroll in Medicare B and avoid the Medicare B premiums especially if you're in IRMAA land like me. But be careful there. If your spouse, like mine, is not a Federal retiree, he or she might want to enroll in Medicare Part B because if your spouse divorces you, your ex-spouse may not be able to receive FEHB health insurance. My spouse is enrolled in Part B but I won't likely enroll in Part B when I become eligible next year. I do think you're on to something in cutting costs and handling the situation: enroll in a low cost FEHB plan (like BCBS Basic) and Medicare Part B -- I know many retirees who do this -- even though it might not be the most cost efficient approach (not enrolling in Medicare Part B might be the most efficient) -- because it's the most convenient way of dealing with medical bills and expenses in retirement.
No letter writing campaign for me either, for the reasons cited above. We have always used a lower cost plan FEHB plan and will probably continue it when we become Medicare eligible, and probably without Part B. The difference in premiums between the higher and lower cost premium is $3500/year. That covers a lot of healthcare.

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VictoriaF
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Re: Federal Retiree Health Care with/Medicare

Post by VictoriaF » Mon Jun 26, 2017 3:05 pm

When I become eligible for Medicare, I will pay for both Medicare Part B and FEHB. Even with the coverage overlap, Federal retirees get a good value comparing to other Americans.

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Re: Federal Retiree Health Care with/Medicare

Post by Tucker50 » Mon Jun 26, 2017 6:36 pm

I'm 67, retiring at the end of the year, and struggling with the question of Medicare Part B. I enrolled in Part A at 65. I'm trying to decide whether it is worth it to take Part B. If I don't take Part B when I retire and decide later to enroll in Part B, I will have to pay a 10% penalty for every year I was eligible but didn't enroll. There is something reassuring in having both insurances - having everything covered, not having to argue with insurance company about what they didn't pay, or dealing with creditors who don't like the speed at which your insurance is paying. On the other hand the Part B premium is dependent on income and I plan on spending $ my first 10 years of retirement making Part B expensive. One problem is I can't figure out what Part B might pay for that FEHB won't. Has anyone figured that out? If I break my hip and need rehab services in nursing home, will FEHB cover it? What will Medicare pay for that FEHB won't? Has anyone found any good explanations?

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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Mon Jun 26, 2017 7:20 pm

Tucker50 wrote:I'm 67, retiring at the end of the year, and struggling with the question of Medicare Part B. I enrolled in Part A at 65. I'm trying to decide whether it is worth it to take Part B. If I don't take Part B when I retire and decide later to enroll in Part B, I will have to pay a 10% penalty for every year I was eligible but didn't enroll. There is something reassuring in having both insurances - having everything covered, not having to argue with insurance company about what they didn't pay, or dealing with creditors who don't like the speed at which your insurance is paying. On the other hand the Part B premium is dependent on income and I plan on spending $ my first 10 years of retirement making Part B expensive. One problem is I can't figure out what Part B might pay for that FEHB won't. Has anyone figured that out? If I break my hip and need rehab services in nursing home, will FEHB cover it? What will Medicare pay for that FEHB won't? Has anyone found any good explanations?
Read the Consumer Checkbook report on FEHB for retirees; there is lots of good information there on the FEHB/Part B decision.

The advantage of havng both, as I understand it, is that the FEHB plan will pick up the deductibles and coinsurance under Medicare. I don't know that Medicare covers anything that FEHB won't. People with a serious illness with coverage under both can end up paying virtually nothing out-of-pocket. But, of course, the tradeoff is possibly years of premiums for both which people tend to forget about. For my husband and I, the Part B premium will be about twice the cost of FEHB when we are both retired. I am not convinced that I am willing to pay that much for peace of mind.

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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Mon Jun 26, 2017 8:05 pm

delamer wrote:
Tucker50 wrote:I'm 67, retiring at the end of the year, and struggling with the question of Medicare Part B. I enrolled in Part A at 65. I'm trying to decide whether it is worth it to take Part B. If I don't take Part B when I retire and decide later to enroll in Part B, I will have to pay a 10% penalty for every year I was eligible but didn't enroll. There is something reassuring in having both insurances - having everything covered, not having to argue with insurance company about what they didn't pay, or dealing with creditors who don't like the speed at which your insurance is paying. On the other hand the Part B premium is dependent on income and I plan on spending $ my first 10 years of retirement making Part B expensive. One problem is I can't figure out what Part B might pay for that FEHB won't. Has anyone figured that out? If I break my hip and need rehab services in nursing home, will FEHB cover it? What will Medicare pay for that FEHB won't? Has anyone found any good explanations?
Read the Consumer Checkbook report on FEHB for retirees; there is lots of good information there on the FEHB/Part B decision.

The advantage of havng both, as I understand it, is that the FEHB plan will pick up the deductibles and coinsurance under Medicare. I don't know that Medicare covers anything that FEHB won't. People with a serious illness with coverage under both can end up paying virtually nothing out-of-pocket. But, of course, the tradeoff is possibly years of premiums for both which people tend to forget about. For my husband and I, the Part B premium will be about twice the cost of FEHB when we are both retired. I am not convinced that I am willing to pay that much for peace of mind.
For those of us who have HDHPs there is another wrinkle to this issue. Of course, when you enroll in Medicare (even if it's only Part A) you lose your eligibility to continue on an HDHP/HSA plan, but your spouse, like mine, may still enroll in Medicare Part A and B and still be covered by my family HDHP -- my wife just loses her ability to make catch-up HSA contributions. But unlike a traditional FEHB plan, HDHPs don't waive Medicare deductibles and copays for other family members covered by Medicare even though Medicare is still primary and my HDHP family coverage is secondary for my wife; we still have to meet the HDHP family deductible for her to be covered by my plan's traditional insurance coverage. For a number of reasons, it made sense for my wife to enroll in Medicare Part A and B, even though we're in IRMAA land.

We're now the primary financial planners for my MIL and BIL, both of whom are retired Federal employees. They each have some very serious illnesses and long term care needs. For their serious illnesses and emergencies, their traditional FEHB plans (high and low option plans) covers everything. My BIL has MS and his infusion therapy is at a ridiculous level. My MIL has had a series of medical emergencies over the past 2 years as well. I'm so glad they have Medicare and FEHB and for them, the added cost of Part B is well worth it.

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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Mon Jun 26, 2017 8:27 pm

ChrisC wrote:
delamer wrote:
Tucker50 wrote:I'm 67, retiring at the end of the year, and struggling with the question of Medicare Part B. I enrolled in Part A at 65. I'm trying to decide whether it is worth it to take Part B. If I don't take Part B when I retire and decide later to enroll in Part B, I will have to pay a 10% penalty for every year I was eligible but didn't enroll. There is something reassuring in having both insurances - having everything covered, not having to argue with insurance company about what they didn't pay, or dealing with creditors who don't like the speed at which your insurance is paying. On the other hand the Part B premium is dependent on income and I plan on spending $ my first 10 years of retirement making Part B expensive. One problem is I can't figure out what Part B might pay for that FEHB won't. Has anyone figured that out? If I break my hip and need rehab services in nursing home, will FEHB cover it? What will Medicare pay for that FEHB won't? Has anyone found any good explanations?
Read the Consumer Checkbook report on FEHB for retirees; there is lots of good information there on the FEHB/Part B decision.

The advantage of havng both, as I understand it, is that the FEHB plan will pick up the deductibles and coinsurance under Medicare. I don't know that Medicare covers anything that FEHB won't. People with a serious illness with coverage under both can end up paying virtually nothing out-of-pocket. But, of course, the tradeoff is possibly years of premiums for both which people tend to forget about. For my husband and I, the Part B premium will be about twice the cost of FEHB when we are both retired. I am not convinced that I am willing to pay that much for peace of mind.
For those of us who have HDHPs there is another wrinkle to this issue. Of course, when you enroll in Medicare (even if it's only Part A) you lose your eligibility to continue on an HDHP/HSA plan, but your spouse, like mine, may still enroll in Medicare Part A and B and still be covered by my family HDHP -- my wife just loses her ability to make catch-up HSA contributions. But unlike a traditional FEHB plan, HDHPs don't waive Medicare deductibles and copays for other family members covered by Medicare even though Medicare is still primary and my HDHP family coverage is secondary for my wife; we still have to meet the HDHP family deductible for her to be covered by my plan's traditional insurance coverage. For a number of reasons, it made sense for my wife to enroll in Medicare Part A and B, even though we're in IRMAA land.

We're now the primary financial planners for my MIL and BIL, both of whom are retired Federal employees. They each have some very serious illnesses and long term care needs. For their serious illnesses and emergencies, their traditional FEHB plans (high and low option plans) covers everything. My BIL has MS and his infusion therapy is at a ridiculous level. My MIL has had a series of medical emergencies over the past 2 years as well. I'm so glad they have Medicare and FEHB and for them, the added cost of Part B is well worth it.
Sorry to hear about your in-laws' health. Anyone hitting Medicare eligibility age with a serious chronic condition like MS would be foolish to not take Part B and FEHB to control out-of-pocket costs.

In my family, long-term care expenses, due to dementia, have been a much more common occurence than high medical care expenses for chronic conditions or high-cost conditions like cancer. So, for me, a dollar spent on health insurance is a dollar that I can't save for long-term care which is where I see a big risk.

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Re: Federal Retiree Health Care with/Medicare

Post by trueblueky » Mon Jun 26, 2017 8:31 pm

It's not for my family yet, but the Aetna policy that is meant for federal retirees is worth investigation.

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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Mon Jun 26, 2017 9:01 pm

trueblueky wrote:It's not for my family yet, but the Aetna policy that is meant for federal retirees is worth investigation.

Yes. Right now that premium is a bit higher than our plan, but our plan doesn't offer the $1800 toward the Part B premium.

But how reliable will that $1800 be over the years? Probably no more or less so than anything else related to healthcare :shock:

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Re: Federal Retiree Health Care with/Medicare

Post by HoneyBee » Mon Jun 26, 2017 9:53 pm

I think some folks are missing the point of my post. It is that behemoth insurance companies are getting unjustly enriched by the FEHB program when federal retirees qualify for Medicare. And since the federal government continues to pay a significant portion of the premium in retirement, it increases federal costs.

Insurance rates are supposed to be based on risk. When federal retirees pay for Part B Medicare (and Medicare is primary coverage for eligible federal retirees), the insurance company's risk (amount they have to pay out) is substantially reduced, especially because most retirees also qualify for Part A. Yet, the insurance companies are not adjusting their premiums commiserate with their reduced risk of payout.

I am not advocating that folks should waive Part B or drop out of FEHB. That depends on your individual health, the health and needs of your spouse or other covered individuals. Personally, I'd like to take Part B and keep my FEHB, but pay a premium that is appropriately risk adjusted.

The standard Part B premium in 2017 is $134 per person per month. So if you and your spouse both elect Part B, you are paying at least $268. If your joint income is above $170,000 ($85,000 if single), part B premiums are more.

When my mother retired from teaching public school, if she elected Part B Medicare, her health insurance premium was reduced from almost $350/month to about $85/month. Her state policy covered RX and almost all the Medicare deductibles/copays.

I understand the if one elects Tricare for Life after age 65, Tricare requires them to pay for Medicare part B and the Tricare premium is very small. But that information is from someone in my office who was in the military and has kept his Tricare coverage so you should verify.

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Re: Federal Retiree Health Care with/Medicare

Post by bsteiner » Mon Jun 26, 2017 10:04 pm

From everyone's posts, it appears that the choice is between a rich FEHB plan without Part B (which puts the person in the same position as he/she was before age 65) or a skinny FEHB plan with Part B (which would pick up the co-pays). How should someone choose? What if the person is in one of the higher Part B premium brackets?

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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Mon Jun 26, 2017 10:42 pm

HoneyBee wrote:I think some folks are missing the point of my post. It is that behemoth insurance companies are getting unjustly enriched by the FEHB program when federal retirees qualify for Medicare. And since the federal government continues to pay a significant portion of the premium in retirement, it increases federal costs.

Insurance rates are supposed to be based on risk. When federal retirees pay for Part B Medicare (and Medicare is primary coverage for eligible federal retirees), the insurance company's risk (amount they have to pay out) is substantially reduced, especially because most retirees also qualify for Part A. Yet, the insurance companies are not adjusting their premiums commiserate with their reduced risk of payout.

I am not advocating that folks should waive Part B or drop out of FEHB. That depends on your individual health, the health and needs of your spouse or other covered individuals. Personally, I'd like to take Part B and keep my FEHB, but pay a premium that is appropriately risk adjusted.

The standard Part B premium in 2017 is $134 per person per month. So if you and your spouse both elect Part B, you are paying at least $268. If your joint income is above $170,000 ($85,000 if single), part B premiums are more.

When my mother retired from teaching public school, if she elected Part B Medicare, her health insurance premium was reduced from almost $350/month to about $85/month. Her state policy covered RX and almost all the Medicare deductibles/copays.

I understand the if one elects Tricare for Life after age 65, Tricare requires them to pay for Medicare part B and the Tricare premium is very small. But that information is from someone in my office who was in the military and has kept his Tricare coverage so you should verify.
In your mother's case and with Tricare, the plan has decided to have a different premium for those enrollees with Medicare versus enrollees without Medicare. So the risk assessment is for two distinct groups with coverage in the plan, and the two premiums differ accordingly. With FEHB, the decision is to have one premium for all enrollees so the risk assessment is done across all employees and the one premium is based on that assessment.

When you retire with Medicare and FEHB, you'll pay more because of the "one premium for all" choice but while you were an active employee with just FEHB you paid less. With your mother's plan, the reverse would have been true.

Note that I am not an actuary nor an expert on health insurance, but It is incorrect to say that the FEHB plans don't adjust their rates to reflect that a portion of their enrollees have Medicare coverage. It is just that the adjustment applies across the whole population, not only the retirees.

This is from the Consumer Checkbook guide on FEHB plans, specifically from the section on why premiums differ across plans, but it makes the point:

"... variations in the proportion of enrollees with Medicare Parts A and B has a big effect on plan premiums, since Medicare is “primary” (pays first) for retirees, and covers over four-fifths of hospital and doctor costs. Most HMO benefits are so good that retired enrollees often do not sign up for Part B, which puts these plans at a major disadvantage in keeping premiums low."

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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Tue Jun 27, 2017 6:32 am

delamer wrote:
trueblueky wrote:It's not for my family yet, but the Aetna policy that is meant for federal retirees is worth investigation.

Yes. Right now that premium is a bit higher than our plan, but our plan doesn't offer the $1800 toward the Part B premium.

But how reliable will that $1800 be over the years? Probably no more or less so than anything else related to healthcare :shock:


I wouldn't worry that much about the reliability of the Aetna Direct HRA payment. These Consumer Driven Health Plans will likely get better as the Government shifts more financial responsibility for health care to consumers. I don't worry about the HSA payment of $1500 I've been receiving first from Aetna and now from GEHA for the last 9 years.

The Aetna Direct plan is a plan worth considering if you're going to enroll in Medicare Part B.

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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Tue Jun 27, 2017 8:38 am

HoneyBee wrote:I think some folks are missing the point of my post. It is that behemoth insurance companies are getting unjustly enriched by the FEHB program when federal retirees qualify for Medicare. And since the federal government continues to pay a significant portion of the premium in retirement, it increases federal costs.

Insurance rates are supposed to be based on risk. When federal retirees pay for Part B Medicare (and Medicare is primary coverage for eligible federal retirees), the insurance company's risk (amount they have to pay out) is substantially reduced, especially because most retirees also qualify for Part A. Yet, the insurance companies are not adjusting their premiums commiserate with their reduced risk of payout.
I seriously doubt, given the negotiating leverage OPM has with FEHB insurance carriers and the way insurance is structured for the Federal workforce and retirees, that "behemoth insurance companies" are making out like fat cats. The underwriting conditions imposed by the Government alter the notion for risk-based premiums for employees or retirees. Even before Obamacare, pre-existing conditions couldn't be carved out for FEHB participants: and there's always been uniformity in rates for all employees and retirees. FEGLI life insurance is also a good example of how the underwriting is not solely risk-driven: no age and gender distinctions (which would normally be taken into account), no medical underwriting; and no distinctions between employees and retirees.

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Re: Federal Retiree Health Care with/Medicare

Post by TimeRunner » Tue Jun 27, 2017 8:52 am

Another way to look at it is that all federal employees' and retirees' FEHB premiums are being partially subsidized by Medicare.
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Re: Federal Retiree Health Care with/Medicare

Post by InMyDreams » Tue Jun 27, 2017 9:11 am

LuigiLikesPizza wrote:I mean that it has been strongly recommended here on the forum that I continue working, even if I don't need the extra money... just to be eligible for federal retiree health care coverage.
I would love to retire with Federal retiree health care coverage. It is not just one of the MediGap plans (supplements). It is a secondary insurance.

I'm not sure that it is still true, but the benefit that I've seen in the past (before the ACA): the Fed plan (at least one flavor of it) covers home IV therapy. Otherwise, if you need daily (or twice daily) IV therapy, you have to trudge in to a clinic for each dose, or go into a skilled nursing facility to receive it with coverage.

Who knows what else is covered, but that one alone is enough to make me drool.

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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Tue Jun 27, 2017 9:19 am

bsteiner wrote:From everyone's posts, it appears that the choice is between a rich FEHB plan without Part B (which puts the person in the same position as he/she was before age 65) or a skinny FEHB plan with Part B (which would pick up the co-pays). How should someone choose? What if the person is in one of the higher Part B premium brackets?
Yep, those are the enlightened options. I've known folks in the highest Part B brackets who nonetheless enroll in Part B and the richest FEHB plan -- they are indifferent to costs. Realistically, however, if you know you have serious medical conditions going into retirement, you should take Medicare Part B and be completely covered. You can just take the highest, enriched FEHB plan, not enroll in Part B, and rely on catastrophic limits in the FEHB plan as a stop-gap measure to cap exposure to health costs, but I think that's risky if you have known problem conditions. Medicare does not have limits. If you're healthy and think you'll continue to be healthy, then you might forego Medicare Part B and pick up a good FEHB plan for coverage.

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Re: Federal Retiree Health Care with/Medicare

Post by VictoriaF » Tue Jun 27, 2017 3:35 pm

ChrisC wrote:
bsteiner wrote:From everyone's posts, it appears that the choice is between a rich FEHB plan without Part B (which puts the person in the same position as he/she was before age 65) or a skinny FEHB plan with Part B (which would pick up the co-pays). How should someone choose? What if the person is in one of the higher Part B premium brackets?
Yep, those are the enlightened options. I've known folks in the highest Part B brackets who nonetheless enroll in Part B and the richest FEHB plan -- they are indifferent to costs. Realistically, however, if you know you have serious medical conditions going into retirement, you should take Medicare Part B and be completely covered. You can just take the highest, enriched FEHB plan, not enroll in Part B, and rely on catastrophic limits in the FEHB plan as a stop-gap measure to cap exposure to health costs, but I think that's risky if you have known problem conditions. Medicare does not have limits. If you're healthy and think you'll continue to be healthy, then you might forego Medicare Part B and pick up a good FEHB plan for coverage.
When the time comes, I am planning to get Medicare Part B and keep FEHB. My current FEHB plan is high-deductible GEHA which is very inexpensive. I will probably keep it. If I develop adverse health conditions I will consider other options.

Victoria
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Re: Federal Retiree Health Care with/Medicare

Post by winski58 » Tue Jun 27, 2017 5:08 pm

DW and I have been enrolled with BCBS Basic for more than 25 years and are enrolled with Aetna Direct and added Part B, effective July 1,2017.

Premiums
DW $1608 (Part B premium)
ME $2251 (Part B premium - penalty for late enrollment at age 69)
Aetna Direct $3158
Subtotal $7,017
Aetna Reimb. $1,800 (Reimbursement for Medicare Part B premiums)
Total $5217
BCBS Basic $4,284

Rational: Subtract all the deductibles and copays plus the services not fully covered by BCBS Basic and the additional cost of $933 for Part B with Aetna Direct justifies the switch for our situation. Not to mention the piece of mind for full coverage of major outpatient procedures and inpatient stays. (Keep in mind that with the advancement of healthcare technology, many outpatient procedures have replaced what used to be done as an inpatient.)

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Re: Federal Retiree Health Care with/Medicare

Post by trueblueky » Tue Jun 27, 2017 5:33 pm

ChrisC wrote:FEGLI life insurance is also a good example of how the underwriting is not solely risk-driven: no age and gender distinctions (which would normally be taken into account), no medical underwriting; and no distinctions between employees and retirees.
FEGLI costs more as you age. Some of the increases are about double the previous age. See 64 to 65 and 69 to 70.

Retirees can stop paying into basic life at 65 and maintain a life insurance policy that gradually declines to about 1/4 of final pay.

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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Tue Jun 27, 2017 6:18 pm

VictoriaF wrote:
ChrisC wrote:
bsteiner wrote:From everyone's posts, it appears that the choice is between a rich FEHB plan without Part B (which puts the person in the same position as he/she was before age 65) or a skinny FEHB plan with Part B (which would pick up the co-pays). How should someone choose? What if the person is in one of the higher Part B premium brackets?
Yep, those are the enlightened options. I've known folks in the highest Part B brackets who nonetheless enroll in Part B and the richest FEHB plan -- they are indifferent to costs. Realistically, however, if you know you have serious medical conditions going into retirement, you should take Medicare Part B and be completely covered. You can just take the highest, enriched FEHB plan, not enroll in Part B, and rely on catastrophic limits in the FEHB plan as a stop-gap measure to cap exposure to health costs, but I think that's risky if you have known problem conditions. Medicare does not have limits. If you're healthy and think you'll continue to be healthy, then you might forego Medicare Part B and pick up a good FEHB plan for coverage.
When the time comes, I am planning to get Medicare Part B and keep FEHB. My current FEHB plan is high-deductible GEHA which is very inexpensive. I will probably keep it. If I develop adverse health conditions I will consider other options.

Victoria
I think you'd be better off financially with Aetna Direct or BCBS-Basic. I have GEHA-HDHP, family plan, and wife is covered with my plan and separately she has Medicare Part B. Aetna Direct and BCBS-Basic are very inexpensive plans, perhaps, as cheap as GEHA-HDHP, more importantly, they waive all deductibles and co-pays with Medicare A and B. GEHA-HDHP does not waive the Medicare deductibles or co-pays: Part A has a deductible of $1330 and Part B has a deductible of $183 plus a 20 percent co-pay.

One hospital stay and any savings from the inexpensive GEHA-HDHP is gone, as compared to Aetna Direct or BCBS-Basic.

Also, Aetna-Direct has a $900 HRA type reimbursement for self only plans (operates like an HSA payment) that you can use to pay Medicare Part B premiums; once on Medicare you lose the ability to make HSA contributions so the GEHA employer contribution of $750 and employee/retiree contributions to an HSA are unavailable.

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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Tue Jun 27, 2017 6:23 pm

trueblueky wrote:
ChrisC wrote:FEGLI life insurance is also a good example of how the underwriting is not solely risk-driven: no age and gender distinctions (which would normally be taken into account), no medical underwriting; and no distinctions between employees and retirees.
FEGLI costs more as you age. Some of the increases are about double the previous age. See 64 to 65 and 69 to 70.

Retirees can stop paying into basic life at 65 and maintain a life insurance policy that gradually declines to about 1/4 of final pay.
Thanks. I stand corrected. I use to have FEGLI but no longer have it. I was checking out my BIL's basic life coverage under FEGLI and his premiums did not appear to vary one year to the next since his retirement.

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