Federal Retiree Health Care with/Medicare

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Blues
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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Sun Nov 12, 2017 11:03 am

Info_Hound wrote:
Sun Nov 12, 2017 10:56 am
Blues

Excellent! I have downloaded the OPM document and it does seem like I might be able to suspend and retain eligibility once my daughter is off of the insurance plan.

Thank you for pointing to something new that I can use. :D
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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Mon Dec 04, 2017 10:50 am

For those of us considering Aetna Direct....CVS is buying Aetna? :shock:

https://www.npr.org/sections/thetwo-way ... 69-billion

This does not make me feel all warm and cozy.

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dm200
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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Mon Dec 04, 2017 11:07 am

retiredjg wrote:
Mon Dec 04, 2017 10:50 am
For those of us considering Aetna Direct....CVS is buying Aetna? :shock:
https://www.npr.org/sections/thetwo-way ... 69-billion
This does not make me feel all warm and cozy.
No matter who or what "owns" an insurance provider, insurance is highly regulated both (primarily) state and federal (as part of federal retiree healthcare).

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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Mon Dec 04, 2017 11:17 am

dm200 wrote:
Mon Dec 04, 2017 11:07 am
retiredjg wrote:
Mon Dec 04, 2017 10:50 am
For those of us considering Aetna Direct....CVS is buying Aetna? :shock:
https://www.npr.org/sections/thetwo-way ... 69-billion
This does not make me feel all warm and cozy.
No matter who or what "owns" an insurance provider, insurance is highly regulated both (primarily) state and federal (as part of federal retiree healthcare).
I admit I'm being alarmist and it probably does not matter. But I've had poor experiences with them and just want to stay away. It is becoming more difficult every year.

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Blues
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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Mon Dec 04, 2017 11:22 am

retiredjg wrote:
Mon Dec 04, 2017 11:17 am
I admit I'm being alarmist and it probably does not matter. But I've had poor experiences with them and just want to stay away. It is becoming more difficult every year.
Two suggestions...

1. Don't get sick

2. Don't take prescription drugs.

Bonus: Don't watch the cable news networks, all they do is advertise drugs to make you feel like you're on your last legs. On the plus side, the remedy sounds worse than the ailment for the most part.

:wink:
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Re: Federal Retiree Health Care with/Medicare

Post by Tucker50 » Tue Dec 05, 2017 7:35 pm

One thing I'm having a hard time factoring in is the change in how and where care is provided. So much surgery has now gone to outpatient facilities making non Part A insurance even more important. :confused

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Re: Federal Retiree Health Care with/Medicare

Post by ColoRetiredGirl » Tue Dec 05, 2017 8:56 pm

Swansea wrote:
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.
The above is correct. The question I have is how many years of service do you have and what is your age? There are people retiring at age 55 or 56 with 30 years of service and kept their health care.

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Re: Federal Retiree Health Care with/Medicare

Post by 4nwestsaylng » Tue Dec 05, 2017 10:36 pm

ChrisC wrote:
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.
A correction on the GEHA HD employer contribution. If you have the HDHP and are retiring from federal service, you can continue on the HDHP, and GEHA no longer contributes $750 to an HSA, because the law does not permit you to continue funding your HSA (but you still have your HSA funds from up to retirement). Instead, GEHA contributes the $750 to a Health Reimbursement Account they set up for you, and that goes to your deductible. They control the HRA , not you.

So in my case, my $1500 annual deductible with the GEHA HDHP now becomes effectively a $750 annual deductible. Copays are 5 percent, premium is $122 a month. I don't think there is an annual "catastrophic" limit on copay amounts but not sure. Anybody know that?

However if I sign up for Medicare B, I cannot continue with the HDHP, would have to switch to GEHA standard or high option. GEHA standard deductible is $350, copay is higher at 35% of Medicare allowable, and there is an annual "catastrophic" maximum expense of $7500 for 2018, premium is $119 a month.

My income the year prior to retiring was $96K, so I would be in the first higher bracket for Medicare B briefly, but when I submit the 2017 tax return (retired half way through), income dropped to $45K, and there is a form to apply as a Qualifying Life Event (retirement), which then if approved would drop me back into the basic Part B premium.I checked with the Social Security local office, was told that if approved, it is retroactive to the beginning of the approval year, so there is some recovery of higher premium.

I have gone back and forth on this, as I am currently in good health, but we are talking retirement and aging, so my leaning is to sign up for Medicare
B, pay the temporary higher income premium, and have GEHA Standard as my secondary. There are other companies such as Aetna,etc., but I have been very happy with GEHA. If they don't cover part of my Medicare premium I will just pay it out of my HSA funds or my SS when I claim it at age 70.

My gut feeling is that I would do fine with just keeping the HDHP plan and not signing up for part B, but I think I want the piece of mind, even if it gives the FEHB a break on not having to be the primary.

I have found this discussion very helpful. The decision is complex as it deals with the future. I think it was ascribed to Yogi Berra that : "some things are really difficult to predict, especially the future".

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Re: Federal Retiree Health Care with/Medicare

Post by grabiner » Wed Dec 06, 2017 12:24 am

4nwestsaylng wrote:
Tue Dec 05, 2017 10:36 pm
A correction on the GEHA HD employer contribution. If you have the HDHP and are retiring from federal service, you can continue on the HDHP, and GEHA no longer contributes $750 to an HSA, because the law does not permit you to continue funding your HSA (but you still have your HSA funds from up to retirement). Instead, GEHA contributes the $750 to a Health Reimbursement Account they set up for you, and that goes to your deductible. They control the HRA , not you.
The issue is not whether you are retired from federal service, but whether you have non-HDHP coverage. Even if you are still with the federal government, you cannot contribute to the HSA once you start Medicare. And if you have retired but don't have Medicare, you can still enroll in a HDHP and contribute to your HSA.
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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Wed Dec 06, 2017 2:08 am

grabiner wrote:
Wed Dec 06, 2017 12:24 am
4nwestsaylng wrote:
Tue Dec 05, 2017 10:36 pm
A correction on the GEHA HD employer contribution. If you have the HDHP and are retiring from federal service, you can continue on the HDHP, and GEHA no longer contributes $750 to an HSA, because the law does not permit you to continue funding your HSA (but you still have your HSA funds from up to retirement). Instead, GEHA contributes the $750 to a Health Reimbursement Account they set up for you, and that goes to your deductible. They control the HRA , not you.
The issue is not whether you are retired from federal service, but whether you have non-HDHP coverage. Even if you are still with the federal government, you cannot contribute to the HSA once you start Medicare. And if you have retired but don't have Medicare, you can still enroll in a HDHP and contribute to your HSA.
Yep, you're correct about that. I've been retired since 2013 and been with Aetna and GEHA HDHPs, and have made family contributions (and my own catch-up contribution) to my HSA while my spouse has made $1000 catch-up contributions to her HSA. Last year she went on Medicare and we prorated her catch-up contribution, and I continued to make family and catch-up contribution to my HSA. This year with her on Medicare we no longer make catch-up contributions to her HSA. I will once again be enrolled in the GEHA HDHP self plus one plan for 2018 (won't be Medicare eligible until 12/2018 when I reach 65) and I'll make a family contribution plus my own catch-up to my HSA; my wife will be covered under my GEHA HDHP as well as Medicare Parts A and B but is not eligible to make a catch-up contribution.

In all cases since I've been retired, Aetna and later GEHA has made the employer contribution to my HSA of $1500.

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Re: Federal Retiree Health Care with/Medicare

Post by Richard8655 » Mon Jan 29, 2018 12:10 pm

We decided to take Part B after initially rejecting it as we just turned 65. I was able to enroll during the next Medicare open enrollment (Jan-Mar) and still not be penalized. (By the way, if you miss your initial Medicare enrollment during your birthday period, you almost always can enroll in the next open enrollment and not be hit with a penalty as 12 full months without Medicare hadn’t passed yet.)

The reason for our change of heart in favor of Part B is there are some huge potential expenses without it, as I found out from BC/BS. With Part B, physical therapies are completely covered at no cost. Pacemakers as needed at no cost. No per doctor surgery copayments. That’s in addition to no general or specialist doctor visit copayments, and a much more genrerous and cheaper drug mail order program when you also take Part B.

But what cinched it was the new 2018 $600 per person reimbursement to help cover the $134/mo per person Part B premium. This is huge, and brings down the annual Part B premium payment for a couple to about $2000. At this point, we decided Part B was worth it for the extra coverage

As we get older, all these may begin to add up and one may regret all these copayments without this extra coverage. Of course, changing your mind later will cost you the lifetime penalty too.

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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Mon Jan 29, 2018 12:23 pm

Richard8655 wrote:
Mon Jan 29, 2018 12:10 pm
We decided to take Part B after initially rejecting it as we just turned 65. I was able to enroll during the next Medicare open enrollment (Jan-Mar) and still not be penalized. (By the way, if you miss your initial Medicare enrollment during your birthday period, you almost always can enroll in the next open enrollment and not be hit with a penalty as 12 full months without Medicare hadn’t passed yet.)
The reason for our change of heart in favor of Part B is there are some huge potential expenses without it, as I found out from BC/BS. With Part B, physical therapies are completely covered at no cost. Pacemakers as needed at no cost. No per doctor surgery copayments. That’s in addition to no general or specialist doctor visit copayments, and a much more genrerous and cheaper drug mail order program when you also take Part B.
But what cinched it was the new 2018 $600 per person reimbursement to help cover the $134/mo per person Part B premium. This is huge, and brings down the annual Part B premium payment for a couple to about $2000. At this point, we decided Part B was worth it for the extra coverage
As we get older, all these may begin to add up and one may regret all these copayments without this extra coverage. Of course, changing your mind later will cost you the lifetime penalty too.
Not a federal employee or retiree - but know a lot of such.

Note that if your income is above a certain amount, your Part B premium may be more than the $134 per month.

I know some who have chosen Part B (as you have) and others who have not. One longtime friend and his wife have chosen to skip Part B. He is a longtime federal employee, now retired. He always does very extensive research and analysis and he reached the conclusion that, for him and his wife, skipping Part B made the most financial sense. He has some health issues and his wife has many, many more.

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Re: Federal Retiree Health Care with/Medicare

Post by DrGoogle2017 » Mon Jan 29, 2018 12:37 pm

I view it as peace of mind, not always dollar and sense.

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Re: Federal Retiree Health Care with/Medicare

Post by Richard8655 » Mon Jan 29, 2018 12:40 pm

dm200 wrote:
Mon Jan 29, 2018 12:23 pm

Not a federal employee or retiree - but know a lot of such.

Note that if your income is above a certain amount, your Part B premium may be more than the $134 per month.

I know some who have chosen Part B (as you have) and others who have not. One longtime friend and his wife have chosen to skip Part B. He is a longtime federal employee, now retired. He always does very extensive research and analysis and he reached the conclusion that, for him and his wife, skipping Part B made the most financial sense. He has some health issues and his wife has many, many more.
Yes, good points. I also did and do a lot of research on this. I would say, though, your friend may have been correct then when he made his decision, but things have and continue to change with health care costs. I’m sure at that time, the $600 reimbursement benefit per person from FEPBLUE wasn’t offered. There’s also a good chance that this amount will be increased in future years as other insurance companies are subsidizing the full Part B premium.

In addition, BC/BS changes their copayment and coinsurance amounts every year, almost always higher. It seems like an easy decision for forgo Part B at the start of retirement when relatively healthy. But 5-10 years from now things could drastically and suddenly change.

So I’d say your friend was probably correct then and I would have agreed also, but circumstances have and continue to change.

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Re: Federal Retiree Health Care with/Medicare

Post by HIinvestor » Mon Jan 29, 2018 12:48 pm

We also view having Medicare A&B and FEHB as peace of mind. No one knows if and when the FEHB may be changed for retired federal employees and don’t want to get socked with big lifetime penalty for buying B later when there are any changes to FEHB retiree coverage and annuitant charge of premium.

Also medical is one of the biggest potential expenses so why not protect against it? The peace of mind is invaluable to us. We are paying more than the $134/month premiums for the part B coverage, but happily have the funds to do so.

Our CPA is risk adverse and also chooses to have A+B+FEHB.

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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Mon Jan 29, 2018 1:03 pm

dm200 wrote:
Mon Jan 29, 2018 12:23 pm
I know some who have chosen Part B (as you have) and others who have not. One longtime friend and his wife have chosen to skip Part B. He is a longtime federal employee, now retired. He always does very extensive research and analysis and he reached the conclusion that, for him and his wife, skipping Part B made the most financial sense...
We have decided the same after much research and consideration.

(The decision was not based upon the additional premium(s) presenting a hardship.)
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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Mon Jan 29, 2018 3:50 pm

as other insurance companies are subsidizing the full Part B premium.


What other insurance companies are doing this? What I see is companies backing off benefits to employees or retirees who are on Medicare.

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Re: Federal Retiree Health Care with/Medicare

Post by nclion » Mon Jan 29, 2018 4:08 pm

mrc wrote:
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.
I had never really considered not taking medicare part B as well as continuing our FEHB. Are you sure that as you both age and possible require more medical treatments that having Medicare Part B won't be cost effective? I like peace of mind that my health cost are pretty much fixed every year regardless of how much care we may need.

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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Mon Jan 29, 2018 4:36 pm

Blues wrote:
Mon Jan 29, 2018 1:03 pm
dm200 wrote:
Mon Jan 29, 2018 12:23 pm
I know some who have chosen Part B (as you have) and others who have not. One longtime friend and his wife have chosen to skip Part B. He is a longtime federal employee, now retired. He always does very extensive research and analysis and he reached the conclusion that, for him and his wife, skipping Part B made the most financial sense...
We have decided the same after much research and consideration.

(The decision was not based upon the additional premium(s) presenting a hardship.)
I've been doing research as well and we're now in IRMMA tier 2, which would be an additional $3,192 in Part B premium payments beyond the basic $3,216 premium payment for both of us. Our tentative decision has been to include my wife under Part B, as the non-Federal employee spouse when she became Medicare eligible in August 2016, and for me not enroll in Part B when my time comes up this December for Mediare eligibility. Moreover, if we do greater levels of Roth conversions we could end up in Part B tiers 3 or 4. Somehow, the Part B premium subsidies from BC-BS ($600 per covered participants) or from Aetna Direct ($900 per covered partticipant) don't strike me as compensating enough for the high IRMMA payments both of us would be paying.

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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Mon Jan 29, 2018 5:26 pm

Yeah, I'm not much for jumping through lots of hoops. I aim to keep things as simple as possible (but no simpler).

I prefer to limit the level of government intrusion into how I decide my affairs, whether for medical insurance or other matters.
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Re: Federal Retiree Health Care with/Medicare

Post by Richard8655 » Mon Jan 29, 2018 5:32 pm

dm200 wrote:
Mon Jan 29, 2018 3:50 pm

What other insurance companies are doing this? What I see is companies backing off benefits to employees or retirees who are on Medicare.
I take that back. Aetna Direct is subsidizing more than FEPBLUE, at $900 per year. I thought I saw someone mention full subsidy from another, but I’m unable to locate that post again.

By the way with the FEPBLUE reimbursement account, Part B premiums do NOT get paid out of this account. All you have to do is show proof you paid Part B premiums separately. Fairly easy. They must have dropped that requirement.

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Re: Federal Retiree Health Care with/Medicare

Post by nclion » Mon Jan 29, 2018 6:38 pm

HoneyBee wrote:
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?
https://www.fedsmith.com/2016/10/20/sim ... -and-fehb/

This article seems to support a lot of the arguments that you make.

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Re: Federal Retiree Health Care with/Medicare

Post by TimeRunner » Mon Jan 29, 2018 7:10 pm

Or, both Medicare and younger (mostly healthier) employees are subsidizing FEHB insurance for retirees and spouses, including those not enrolled in Medicare Part B. :idea:
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Re: Federal Retiree Health Care with/Medicare

Post by alisa4804 » Mon Jan 29, 2018 8:36 pm

Maybe this has already been mentioned, but Medicare B premiums can be paid with your HSA account savings, if you have one. That can help a retiree’s cash flow.

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Re: Federal Retiree Health Care with/Medicare

Post by LadyGeek » Mon Jan 29, 2018 10:07 pm

I removed an off-topic interchange which derailed the thread. As a reminder, see: General Etiquette
We expect this forum to be a place where people can feel comfortable asking questions and where debates and discussions are conducted in civil tones.

...At all times we must conduct ourselves in a respectful manner to other posters. Attacks on individuals, insults, name calling, trolling, baiting or other attempts to sow dissension are not acceptable.
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Re: Federal Retiree Health Care with/Medicare

Post by Richard8655 » Tue Jan 30, 2018 1:25 pm

alisa4804 wrote:
Mon Jan 29, 2018 8:36 pm
Maybe this has already been mentioned, but Medicare B premiums can be paid with your HSA account savings, if you have one. That can help a retiree’s cash flow.
I think this is an excellent approach in further limiting the cost of Part B.

To be honest, I think you can’t go wrong either way. We have to count ourselves lucky to have FEHB and the choice of Part B or not. Almost all companies with retiree health plans require Medicare at 65 with their plans becoming the supplement. They don’t allow a choice.

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Re: Federal Retiree Health Care with/Medicare

Post by retirednps » Fri Feb 02, 2018 7:15 pm

If you changed FEHB plans effective January 1, (or enrolled in Medicare for the first time) and have Medicare as primary coverage and your FEHB plan as secondary, be sure you notify your FEHB plan that you do have Medicare as primary - and make sure Medicare knows about your current secondary coverage. Otherwise, claims will likely not process correctly.

Simply giving your updated insurance information to the doctor, hospital, etc. will not close the loop on claims for your secondary coverage. I discovered this week that when Medicare processes a claim, they notify your secondary carrier so that carrier can process any benefits paid by your secondary policy. If Medicare does not have the correct information on that policy, there will be lots of unnecessary work for you, the provider, and the insurance companies to clean up the confusion.

You can call the Medicare "Benefits Coordination and Recovery Center" at 800-633-4227 and ask them to update your secondary coverage in the Medicare system, but your secondary coverage carrier also has to make that request direct to Medicare.

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Re: Federal Retiree Health Care with/Medicare

Post by kalrocmk » Tue Feb 13, 2018 9:40 am

I am in a similar situation as the OP. I plan on retiring next year at age 62 with an immediate annuity. I had a few questions and hope that other folks here may be able to answer. My wife is also a federal employee but will not be retiring from the federal government. She plans on quitting her job at age 55 (she is 7 years younger). We will have FEHB health insurance in our retirement.
- If I pass away before her, will she be able to continue to get FEHB benefits?
- I understand that I need to sign up for Medicare Part A. What about Medicare Part B? Will I need to sign up for that also? What happens if Congress takes away the FEHB retiree benefit? Will I be eligible to sign up for Medicare part B without a penalty at that point?
- I like the simplicity of Medicare Advantage Plans, where everything is covered. IS there a way to replicate that with FEHB retiree plans?
Just trying to make a living

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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Tue Feb 13, 2018 10:15 am

kalrocmk wrote:
Tue Feb 13, 2018 9:40 am
I am in a similar situation as the OP. I plan on retiring next year at age 62 with an immediate annuity. I had a few questions and hope that other folks here may be able to answer. My wife is also a federal employee but will not be retiring from the federal government. She plans on quitting her job at age 55 (she is 7 years younger). We will have FEHB health insurance in our retirement.
- If I pass away before her, will she be able to continue to get FEHB benefits?
- I understand that I need to sign up for Medicare Part A. What about Medicare Part B? Will I need to sign up for that also? What happens if Congress takes away the FEHB retiree benefit? Will I be eligible to sign up for Medicare part B without a penalty at that point?
- I like the simplicity of Medicare Advantage Plans, where everything is covered. IS there a way to replicate that with FEHB retiree plans?
In what area do you live? If this is the Washington DC area, I recommend evaluating Kaiser Permanente - both before Medicare eligibility and after. While most Kaiser medicare plans around the country are Medicare Advantage plans, the one in the Washington DC area is a "Medicare Cost" plan currently - much like a MA plan but a few differences (mostly good, I believe). With Kaiser, as long as you get services from Kaiser - there cannot be fights between the provider and the insurance company - they are the same.

When you are on Medicare, in this area, a very significant number of Primary Care Physicians will not accept new medicare patients - although if you are already a patient they will continue to see you.

delamer
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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Tue Feb 13, 2018 11:13 am

kalrocmk wrote:
Tue Feb 13, 2018 9:40 am
I am in a similar situation as the OP. I plan on retiring next year at age 62 with an immediate annuity. I had a few questions and hope that other folks here may be able to answer. My wife is also a federal employee but will not be retiring from the federal government. She plans on quitting her job at age 55 (she is 7 years younger). We will have FEHB health insurance in our retirement.
- If I pass away before her, will she be able to continue to get FEHB benefits?
- I understand that I need to sign up for Medicare Part A. What about Medicare Part B? Will I need to sign up for that also? What happens if Congress takes away the FEHB retiree benefit? Will I be eligible to sign up for Medicare part B without a penalty at that point?
- I like the simplicity of Medicare Advantage Plans, where everything is covered. IS there a way to replicate that with FEHB retiree plans?
You must elect a survivor annuity for your wife to be able to continue with FEHB if you die first.

You are not eligible for Medicare until you turn 65. At that time, you should sign up for Part A which has no premium. You will have the option of signing up for Part B, which does have a premium. There have been several threads here on “Part B or no.” Get the Consumers Checkbook on FEHB coverage for an excellent analysis.

Nobody knows what will happen and whether Part B will be available without penalty if FEHB retiree benefits disappear.

I believe the Consumer Checkbook discusses Medicare Advantage.

Obviously, you need to take into account that your wife will not be eligible for Medicare until long after you. You might need to take one type of coverage until she is Medicare eligible and then switch at that point.

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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Tue Feb 13, 2018 12:03 pm

Obviously, you need to take into account that your wife will not be eligible for Medicare until long after you. You might need to take one type of coverage until she is Medicare eligible and then switch at that point.
I thought the wife was a federal employee now and would retire as a federal employee.

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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Tue Feb 13, 2018 3:36 pm

dm200 wrote:
Tue Feb 13, 2018 12:03 pm
Obviously, you need to take into account that your wife will not be eligible for Medicare until long after you. You might need to take one type of coverage until she is Medicare eligible and then switch at that point.
I thought the wife was a federal employee now and would retire as a federal employee.
No, he said his wife is currently a federal employee but “will not be retiring from the federal government.”

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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Tue Feb 13, 2018 4:36 pm

delamer wrote:
Tue Feb 13, 2018 3:36 pm
dm200 wrote:
Tue Feb 13, 2018 12:03 pm
Obviously, you need to take into account that your wife will not be eligible for Medicare until long after you. You might need to take one type of coverage until she is Medicare eligible and then switch at that point.
I thought the wife was a federal employee now and would retire as a federal employee.
No, he said his wife is currently a federal employee but “will not be retiring from the federal government.”
OK - sorry about that missed the 'not'.

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Re: Federal Retiree Health Care with/Medicare

Post by bsteiner » Tue Feb 13, 2018 4:59 pm

ChrisC wrote:
Tue Jun 27, 2017 6:18 pm
...
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.
...
How does Medicare B plus Aetna Direct or BCBS-Basic compare to a rich FEHB plan but no Medicare B for a couple in the highest Medicare B bracket?

What does Medicare B plus a low-cost FEHB plan cover that a rich FEHB plan doesn't cover?

What are the richer FEHB plans?

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Re: Federal Retiree Health Care with/Medicare

Post by TimeRunner » Tue Feb 13, 2018 5:29 pm

Not answering Bsteiner's great questions directly, but here's an article I found helpful: https://www.checkbook.org/newHig2/year1 ... ter-age-65 . One quote from article: "Part B provides more generous benefits than most FEHB plans in a few categories, such as physical therapy and home health care, and it covers more of the costs of some injected specialty drugs, prostheses and durable medical equipment than many. Still, Medicare Part B rarely reduces overall costs enough to pay for the extra premium." (I have not researched this statement in any depth as I've fortunately had no need to do that.)
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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Tue Feb 13, 2018 6:14 pm

bsteiner wrote:
Tue Feb 13, 2018 4:59 pm
ChrisC wrote:
Tue Jun 27, 2017 6:18 pm
...
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.
...
How does Medicare B plus Aetna Direct or BCBS-Basic compare to a rich FEHB plan but no Medicare B for a couple in the highest Medicare B bracket?

What does Medicare B plus a low-cost FEHB plan cover that a rich FEHB plan doesn't cover?

What are the richer FEHB plans?
I think the poster Blues in this thread provided some information from Consumers Checkbook that attempts to frame and provide guidance on these questions. Both Aetna Direct, BCBC-Basic, and some other plans, reimburse some of the premiums you would pay for Medicare Part B so some of the financial burden with Part B coverage is lessened.

If you're a married couple in the highest levels of Medicare Part B IRMAA premium payments, I'd find it difficult to financially justify taking on Medicare Part B when you have good FEHB coverage like GEHA standard. But I think I read somewhere that 75 percent of Federal retirees take Part B, not sure how many of those do that because it's the default position, or it's the most medically desirable or it's the most financially savvy for them.

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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Tue Feb 13, 2018 6:28 pm

ChrisC wrote:
Tue Feb 13, 2018 6:14 pm
But I think I read somewhere that 75 percent of Federal retirees take Part B, not sure how many of those do that because it's the default position, or it's the most medically desirable or it's the most financially savvy for them.
That sounds high but I threw out the recent NARFE magazine that mentioned something about the percentage of federal retirees that elect Part B, and further reported that the trend has been going steadily down for a period of years. Perhaps someone still has access to the info.

In any case, it's a multi-faceted decision making process, of that there is little doubt.
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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Tue Feb 13, 2018 6:37 pm

ChrisC wrote:
Tue Feb 13, 2018 6:14 pm
bsteiner wrote:
Tue Feb 13, 2018 4:59 pm
ChrisC wrote:
Tue Jun 27, 2017 6:18 pm
...
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.
...
How does Medicare B plus Aetna Direct or BCBS-Basic compare to a rich FEHB plan but no Medicare B for a couple in the highest Medicare B bracket?

What does Medicare B plus a low-cost FEHB plan cover that a rich FEHB plan doesn't cover?

What are the richer FEHB plans?
I think the poster Blues in this thread provided some information from Consumers Checkbook that attempts to frame and provide guidance on these questions. Both Aetna Direct, BCBC-Basic, and some other plans, reimburse some of the premiums you would pay for Medicare Part B so some of the financial burden with Part B coverage is lessened.

If you're a married couple in the highest levels of Medicare Part B IRMAA premium payments, I'd find it difficult to financially justify taking on Medicare Part B when you have good FEHB coverage like GEHA standard. But I think I read somewhere that 75 percent of Federal retirees take Part B, not sure how many of those do that because it's the default position, or it's the most medically desirable or it's the most financially savvy for them.
I think your percentage is roughly correct, but I have seen a table showing that the percentage has steadily declined over the years. No surprise as FEHB and Part B premiums have continued to climb.

I have to make the decision next year with an expected first tier premium (and possibly second tier). Consumer Checkbook has in the past recommended against Part B if your premium is above the baseline, which makes sense to me. But my husband is a couple years younger (and with more health issues than me) and I am not sure how that should/will affect my decision.

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Re: Federal Retiree Health Care with/Medicare

Post by Yooper16 » Tue Feb 13, 2018 6:45 pm

We have this same question coming up in a about a year. We have one of the better coverage, lesser cost FEHB policies, through the Rural Letters Carriers Union. Permium for self plus 1 is 325 per month, total deductible 700 and max out of pocket 4000 might be 4500. According to "checkbook" it has the lowest yearly cost if your use is high and in the top few if your yearly cost is average. Some things we like about it is unlimited Chiro and also pays for massage therapy.

I might consider going to the Aetna Direct or GEHA plan that helps pay for the medicare B premium. We've had 37 years with no issues and hubbys parents also had Rural Carriers with part b. The costs for their extreme use in the final few months of life was extremely low.

His sister who handled the bills said that writing the checks was actually a nuisance for such small amounts.

I am quite certain that we will maintain a FEHB policy and go with Medicare B as we will be under the limit for the higher B premium.

We are supposed to be retired with nothing to think about except sun and fun. In our case snow and fun.

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Re: Federal Retiree Health Care with/Medicare

Post by kalrocmk » Tue Feb 13, 2018 10:57 pm

Delamer and dm200 many thanks for the responses. I will check into Kaiser and the checkbook article.
Just trying to make a living

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Re: Federal Retiree Health Care with/Medicare

Post by chemocean » Tue Feb 13, 2018 11:57 pm

The benefits of enrolling or not enrolling in Part B when you become Medicare eligible is entirely dependent of the reduced deductibles, co-pays, and prescriptions that your present FEHB providers offers with their coordination of benefits with Medicare Part B. With my present provider on the standard FEHB, the main benefit of enrolling in Medicare Part B is the elimination of the yearly deductible ($350) for the few medical visits I make a year. So Medicare Part B costs me about $1300/yr ($134 monthly Medicare B X12 - elimination of $350 deductible). On the other hand, at 65, you and your significant other could start shopping around for a new FHEB provider that has better coordination of benefits with Medicare Part B. (We both turned 65 this year, and both like our present provider)

If I live to be 95, that means an extra $37,740 in my lifetime. This is pretty much present value since both the pension and Medicare premium increase at about the same rate. From my understanding of the population of this Forum, this life-time expense is in the noise relative to their concern with the volatility of the market. Like long-term care insurance, you should probably enroll in Medicare Part B if the premiums don't crimp your life style under your present spending plan. I think when I'm 85 and am going to the doctor more often and being treated by doctors in the hospital without being admitted (under Part B), I think I will appreciate having enrolled in Medicare Part B at 65, rather than enrolling then in Medicare Part B at $402 (present value).

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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Wed Feb 14, 2018 7:05 am

bsteiner wrote:
Tue Feb 13, 2018 4:59 pm
How does Medicare B plus Aetna Direct or BCBS-Basic compare to a rich FEHB plan but no Medicare B for a couple in the highest Medicare B bracket?
Once Medicare becomes your primary insurer, with BCBS Basic and Medicare B, there are no medical bills other than Rx co-pays. BCBS pays the annual deductible and all copays for doctors and testing. Starting this year, BCBS Basic pays $600 reimbursement on Medicare Part B premiums. I think Aetna Direct is the same coverage, but pays $900 instead of $600.

I don't know if there is a difference if the BCBS plan is your primary insurer.

What does Medicare B plus a low-cost FEHB plan cover that a rich FEHB plan doesn't cover?
Nothing that I know of, at least as far as BCBS plans go. I found that surprising, but I switched at the recommendation of this forum and saw no difference.

What are the richer FEHB plans?
I don't know, but I don't think there is any benefit from using one once Medicare is your primary insurer.

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Re: Federal Retiree Health Care with/Medicare

Post by bsteiner » Wed Feb 14, 2018 8:37 am

retiredjg wrote:
Wed Feb 14, 2018 7:05 am
bsteiner wrote:
Tue Feb 13, 2018 4:59 pm
...
What are the richer FEHB plans?
I don't know, but I don't think there is any benefit from using one once Medicare is your primary insurer.
Medicare won't be the primary insurer if you don't take Medicare B. The issue for a high income couple who would pay the top Medicare B premium is comparing (i) Medicare B and a skimpy FEHB plan, to (ii) a rich FEHB plan but no Medicare B.

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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Wed Feb 14, 2018 8:57 am

bsteiner wrote:
Wed Feb 14, 2018 8:37 am
Medicare won't be the primary insurer if you don't take Medicare B.
:oops:

I guess I was thinking high end FEHB vs low end FEHB in addition to Part B rather than what you were thinking (no Part B).

The issue for a high income couple who would pay the top Medicare B premium is comparing (i) Medicare B and a skimpy FEHB plan, to (ii) a rich FEHB plan but no Medicare B.
if I didn't have the comfort and backup of Medicare Part B, I would definitely pay for the high end FEHB product for more coverage.

In my own experience many years ago, I tried low end BCBS one year and it cost me a lot in co-pays after an injury. After that I switched back to high end BCBS and stayed there until I got on Medicare Part B.

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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Wed Feb 14, 2018 10:54 am

chemocean wrote:
Tue Feb 13, 2018 11:57 pm
The benefits of enrolling or not enrolling in Part B when you become Medicare eligible is entirely dependent of the reduced deductibles, co-pays, and prescriptions that your present FEHB providers offers with their coordination of benefits with Medicare Part B. With my present provider on the standard FEHB, the main benefit of enrolling in Medicare Part B is the elimination of the yearly deductible ($350) for the few medical visits I make a year. So Medicare Part B costs me about $1300/yr ($134 monthly Medicare B X12 - elimination of $350 deductible). On the other hand, at 65, you and your significant other could start shopping around for a new FHEB provider that has better coordination of benefits with Medicare Part B. (We both turned 65 this year, and both like our present provider)

If I live to be 95, that means an extra $37,740 in my lifetime. This is pretty much present value since both the pension and Medicare premium increase at about the same rate. From my understanding of the population of this Forum, this life-time expense is in the noise relative to their concern with the volatility of the market. Like long-term care insurance, you should probably enroll in Medicare Part B if the premiums don't crimp your life style under your present spending plan. I think when I'm 85 and am going to the doctor more often and being treated by doctors in the hospital without being admitted (under Part B), I think I will appreciate having enrolled in Medicare Part B at 65, rather than enrolling then in Medicare Part B at $402 (present value).
This is all well and good. But Bsteiner's question, which prompted another round of discussion here, was about a couple at the highest levels of Medicare Part B premium land, which would be a monthly premium payment of $428.60 x 2. I don't see how the numbers work for anyone at the highest levels of Part B premiums. I'm in Part B tier 1 now, with modest Roth conversions, with my wife taking Part B, with her delaying Social Security, and with no RMDs for the next 5 years. But with my CSRS pension and our 2 comma retirement accounts and her taking Social Security in 4 years, we could land in Part B tier 3 and if one of us is not around and becomes single, the survivor lands in tier 4!

For us, there are several other factors to consider, for example, we also want to upgrade our levels of Roth conversions with the new tax brackets; and we have decent funds in HSAs, which could be used to pay FEHB and Medicare Part B premiums.

Perhaps, as your post suggests, that it might be an easy question to address for people who will always be paying baseline Part B premiums and who also have a low cost, decent FEHB plan, especially one that partially reimburses Part B premium payments. But it can get complicated for others who trip higher Part B premium payments.

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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Wed Feb 14, 2018 10:56 am

kalrocmk wrote:
Tue Feb 13, 2018 10:57 pm
Delamer and dm200 many thanks for the responses. I will check into Kaiser and the checkbook article.
As a federal employee, you can choose Kaiser for healthcare at the annual enrollment period. Then , you can see if Kaiser meets your needs. You can always change back the next year.

I went back to Kaiser when I went on Medicare, but my wife (younger) went back to Kaiser as an individual, then on Obamacare - then to medicare. From her experience and what I observe, the transition on Kaiser to Medicare is "seamless". Costs change - mostly lower in our experience - BUT you keep the same medical record number, same doctors, etc. With Kaiser, you will need to switch to Kaiser Physicians/providers - but there are a lot of choices, especially primary care, of Physicians - and if you don't like one Primary care physician - you can go online and pick another in about 30 seconds - no questions asked.

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Re: Federal Retiree Health Care with/Medicare

Post by kalrocmk » Thu Feb 15, 2018 10:46 am

I am with Aetna Open Access HMO currently and am quite happy with it. All our doctors are through Aetna. I have thought about switching to Kaiser. The other option I am thinking about is Aetna Direct. Does anyone have experience with that? How would it work with my spouse not on Medicare?
Just trying to make a living

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Re: Federal Retiree Health Care with/Medicare

Post by retirednps » Thu Feb 15, 2018 9:28 pm

The other option I am thinking about is Aetna Direct. Does anyone have experience with that? How would it work with my spouse not on Medicare?
We switched to Aetna Direct effective Jan. 1st, and so far, so good. Both my wife and I have Medicare Part A and B, and Aetna Direct will work as lower cost "Medicare Supplement" that other FEHB plans we looked at. As long as Medicare pays for a procedure or provider, Aetna Direct is supposed to cover any remaining costs. Net result, our only out-of-pocket costs will be prescription drug copays, and those are paid out of a $900 Aetna "account" for each of us ($1800 total). Anything left in that account can be used to help offset our Medicare Part B premiums at the end of the year. However, my impression is if your spouse is NOT on Medicare, this would probably not be a good choice for your spouse - the copays and deductible would be pretty high.

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Re: Federal Retiree Health Care with/Medicare

Post by Loon11 » Thu Feb 15, 2018 11:50 pm

just retired from fed service Dec. 31 and it is my understanding that I have 8 months to decide to take medicare B without a penalty. Spouse is on my policy and we both have A. Since he is on my policy, he never took Medicare B either. He gets SS but I have suspended mine til 70. After reading all these posts, I am concerned whether my spouse will have to pay a penalty if we decide to take B within the 8 month period. He is nearly 69, I am close to 68 (March). I had assumed the 8 month period also pertained to him as dependent on my policy but now not so sure. Also, there has been expressed concern about future changes, ie, requiring B to keep FEHB or even taking away govt paying the portion of FEHB. Right now, we are under the tier and would pay $134 each for the foreseeable future, not sure after RMD, We have the lower cost BCBS.
So had decided to not take but now the above question concerns me. Its true that we are very healthy for now, but no doubt problems will arise as we age, they always do. appreciate anyone who might shed light.
One more question: If we took medicare b within the 8 months (gives me til August 2018) - does it have to be in a specific enrollment period

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Re: Federal Retiree Health Care with/Medicare

Post by mbres60 » Fri Feb 16, 2018 10:05 am

kalrocmk wrote:
Thu Feb 15, 2018 10:46 am
I am with Aetna Open Access HMO currently and am quite happy with it. All our doctors are through Aetna. I have thought about switching to Kaiser. The other option I am thinking about is Aetna Direct. Does anyone have experience with that? How would it work with my spouse not on Medicare?
We too had the HMO. My dh is a little older than me so went on Medicare before me. He paid Part B with no benefit from Aetna HMO. When I went on Medicare we switched to Aetna Direct and I took Part B. So far we have had no problems and can go to any doctor we want. The disadvantages are that if a person is not on Medicare the copays are high (I think 40%) so I would wait for this plan til both are on Part B. The other issue is that I don't think their prescription drug plan is as good as some others if you need to take more expensive prescriptions. However, their out of pocket maximums appeared to be lower than some other plans.

Loon11- I believe that the window for picking up Part B is individual. Your spouse had a certain window. Made no difference that YOU were working if your spouse was NOT. Most likely the 10% penalty / year would apply. Check out medicare.gov

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