Medicare Question from a beginner [federal retiree using FEHB]

[LaurenRose]

In 2025, I will begin using Medicare for the first time, but I am currently trying to learn as much as I can about it, to see whether it informs any decisions I make now for the 2024 season with my current healthcare provider.

So I have been reading various sources and many of them echo each other - the advice is to not sign up for a Medicare Advantage plan....I am just learning what that is - but it would't exist if it didn't serve some population?

Are there any circumstances under which it could be a good idea to purchase a Medicare Advantage plan? Thank you.

[Note: There is another similar thread on this same topic at viewtopic.php?t=443294. But the OPs may have different circumstances to consider for their personal choice. Moderator Pops1860]

[mhalley]

If you have very limited income and the part b plus drug plan would put a strain on your budget, now or in the future.

[nisiprius]

Even though I belong firmly in the "traditional Medicare, not Medicare Advantage" camp myself, I wouldn't be quite as categorical about it as some Bogleheads are. However, I would say this: keep in mind that you can switch from traditional Medicare to Medicare Advantage any time you like, while the full story on switching back, OR switching plans if years down the road you don't like the one you are on, is complicated and varies from state to state.

So there's very little risk in starting out with traditional Medicare.

My situation is very typical and is quite likely to be what you will end up doing. Part A is automatic. Part B is almost automatic but you do have to arrange how you are going to pay the premium, which is currently about $175/month. I have it taken out of my monthly Social Security payment. You "need" a Medicare part D prescription drug plan, because even if you only take a few cheap drugs you could afford without insurance, you need the coverage, particularly the catastrophic coverage, in case you are unexpectedly prescribed expensive drugs. It is my current belief that, because of the new $2,000 "out of pocket" limit, it is not actually hugely important which plan you buy, as long as all your drugs are covered (which they probably will be), and as long as your regular pharmacy is a "preferred provider." So you can probably get buy with a plan that has a low monthly premium.

Medicare part A is for hospital bills, which are typically very expensive... ballpark $5,000 a day or more. Medicare part B is for doctors' bills and outpatient surgery, but it only pays 80% of the bill. If you don't do anything else, you have to pay that. It may not be as crippling as hospital bills, but it can easily run to thousands a year and there's no limit or cap. Most people "should" buy an optional "Medicap" or "supplemental" policy, which is a private insurance policy that pays the 20% that Medicare doesn't pay.

So, to parts A and B, you add part D (prescription drugs) and a Medigap policy.

That may sound complicated but it's easy compared to shopping Medicare Advantage.

[Jack FFR1846]

You will want to do a lot of research. I learned a lot watching videos from the channel Medicare on Video. Keith is a Medicare expert and broker and I ended up using his team to choose my best choices for my individual needs. I am on traditional Medicare with a part B and D and what Massachusetts calls 1A which is similar to G but Mass requires more from the insurance companies.

Each Advantage plan can be different and you really need to understand the restrictions your state puts on the plans and the restrictions the plans put on you. Some look very much like an HMO. Some to the point where you MUST go to their facility and see their in house doctor/PA/NP. How long are the waits for appointments? Is this a facility you already go to and like? Do you have to drive an hour to get there?

I will note that my mom is on Advantage because part of the municipal retirement benefit pays for it. Her doctor left the facility near her to go maybe 15 miles away but into a non-attached network to what her Advantage plan requires. She was unable to see her old doctor unless she paid 100% out of pocket. The old network place doesn't have a new doctor for her because they're short staffed so the best she can do is a PA. Several times, she'd ended up in the ER because the PA was not able to diagnose and they had nobody who could see her. For my traditional Medicare plan, I can see any doctor who accepts Medicare which is virtually all of them.

Part of the part D prescription plan can require some extra legwork to avoid overpayment. I do have several class 3 meds and such. This past year, at my preferred pharmacy (preferred by the drug plan), the med was $49 for 90 days. At the in network but not preferred, $39. Up at Wegmans, where they do not have my Medicare info and I use GoodRx and get retail, it's $12. So looking around is worth it. For Jardiance (note the fat people dancing on their tV commercial), 25 mg, 90 days with the deductible is about $478 until the $590 deductible is paid, then $89. With a Canadian pharmacy, I pay $350 shipped. So this takes some thinking because if I hit $2000 in total drug costs, the cost goes to zero. I'm close to that number. There's also the Mark Cuban drug store and Amazon pharmacy. I've not done better with Jardiance as these and Amazon would not give me a price until I had the prescription sent to them.

Not that all plans are linked to zip codes. Plans I have, you won' t have access to. Plans I've never heard of might be the best for your zip code. So if your Aunt, 1000 miles away thinks her plan is both the best and cheapest in existence, great. You may have no access. Think Kaiser for the east coast. A big "Nope" for us.

[adamthesmythe]

You will want to do a lot of research.

If you don't WANT to do a lot of research, and if you can afford the cost, sign up for Medigap G or GHD and see how it goes.

[123]

Health care is surprisingly localized in many communities. What works well in one area doesn't work at all elsewhere. It depends on the doctors you use. While Medigap plans have advantages and can be very flexible Medicare Advantage plans have their own niche. A lot depends on the type of health care plan you're used to prior to Medicare. If you had a Blue Cross/Blue Shield type plan you'll likely want a Medigap plan because they're generally similar. If you're comfortable with a managed care option, particularly if its an HMO like Kaiser, you can likely find the same type of plan available in a Medicare Advantage form.

[nisiprius]

You will want to do a lot of research.

If you don't WANT to do a lot of research, and if you can afford the cost, sign up for Medigap G or GHD and see how it goes.

Indeed, let me be very prescriptive.

For a first cut: sign up for traditional Medicare (parts A and B), then go to the MEDICARE.GOV Plan Finder and find and sign up for a Medigap "G" plan.

Then, for part D, list your prescription drugs and the pharmacy or pharmacies you want to use, to go to the MEDICARE.GOV Plan Finder. Find the plan with the cheapest total cost for which a) your pharmacies are "preferred providers," and b) all your current drugs are covered.

This will get you decent coverage at a decent price. How much you can cut your costs, and still get coverage acceptable to you, can be left for later. Most strategies for cutting costs involve cutting coverage in some way as well.

The reasons I put MEDICARE.GOV in capital letters is that there are a slew of non-government websites that are trying to trick and distract you into using them instead, and Google is listing them ahead of medicare.gov.

[CenTexan]

Just to clarify your situation - you are not eligible for any Group Benefit Plan from an employer, correct?

The MA plans offered through GBPs are different than what you see advertised on TV and flooding your mailbox.

[LaurenRose]

Just to clarify your situation - you are not eligible for any Group Benefit Plan from an employer, correct?

Not correct. I currently have health insurance coverage as a federal retiree, using FEHB.

I have a HDHP, but considering to switch to a traditional plan between now and the middle of next year, when I sign up for Medicare.

[LaurenRose]

What's a GBP?

[Watty]

Are there any circumstances under which it could be a good idea to purchase a Medicare Advantage plan?

Most Medicare Advantage plans are very local so if you expect to do something like spend the winters in Florid or move to a different part of the country in a few years they would not be a good choice for you.

Something to consider is if you are in a state which has special rules which allow you to enroll in a Medicare supplement with medical underwriting either on your birthday or during an open enrollment period. That will make it more possible to switch back to traditional Medicare if you are unhappy with a Medicare Advantage plan.

Another special circumstance is if Kaiser Permanente is in your area and your region has a good reputation. Kaiser has about a half a dozen regions and some regions have a better reputation than others.

Something I did not like when I looked at other Medicare Advantage plans was that way to tell what it would be like in 10 or 20 years, or if it would even still be around. With Kaiser I felt pretty comfortable that it would still be around in a few decades and more or less like it is today.

I would not have considered any other Medicare Advantage plan other than with Kaiser just because I did not trust the other ones to be the same in the future.

I used Kaiser for a few years between I retired and when I started Medicare because the traditional Affordable Care Act plans did not seem to have very good networks of doctors. When using Kaiser for an ACA plan I was happy with them but while I saw some specialists I did not have any major health problems so that might not mean a lot.

In researching Kaiser one thing I read is that a lot of doctors like working for Kaiser because while Kaiser no doubt has it's own frustrations they did not need to deal with 20 different insurance companies and the schedules are more desirable. From what I read it sounded like it was often hard for a doctor to be hired by Kaiser, in most specialties, because they usually have multiple doctors apply when they have an opening. Kaiser also has a lot of incentive to not have bad doctor on their staff.

The best doctors in the city may not be at Kaiser but my impression is that the worst doctors are also unlikely to to be at Kaiser.

I have had some experiences with mediocre doctors so at least for me having a high likelihood of getting a strong average doctor and avoiding more questionable doctors is important. We have also had experiences where we have found a highly recommended top doctor only to find out that you cannot get an appointment with them for six months if they are taking new patients at all.

At least for me if Kaiser was not in my area then traditional medicare with a supplement would have been an easy choice because I could easily afford the supplement and any out of pocket expenses.

[CenTexan]

What's a GBP?

GBP = Group Benefit Plan

I can't speak for Fed, but I have a state-sponsored benefit plan for retirees. I was given option of traditional Medicare and a "free" Medigap plan (paid by the state) or selecting the MA plan negotiated by the state with UHC. With the GBP, I can switch at will between the two plans - even monthly.

Sorry - I can't help with Fed plans.

[Vinny_in_NJ]

Be aware that either way you pay, sometimes you may pay more for traditional Medicare + Supplement + Part D and sometimes you may pay more for the Advantage Plan based on whatever medical procedures you have during the year. You pay upfront with the traditional Medicare route and you pay back end with Advantage. Either way you have to pay the part B premium which for 2025 will be $185/month.

A great resource to watch on YouTube is "The Retirement Nerds". The host, Eric, goes through both sides pretty well and does not bash either way. https://www.youtube.com/@Theretirementnerds He goes through a few scenarios of traditional Medicare with Plan N or G vs Advantage plan.

Unfortunately a lot of people have a huge opinion on which way you should go. We went the traditional Medicare route because it was right for us. We thought about our healthcare now and in the future and we can afford it, at least for now. My wife's SIL was on just traditional Medicare only for a few months and finally spoke to Medicare for whatever reason and they convinced her to get on an Advantage plan.

[ResearchMed]

Just to clarify your situation - you are not eligible for any Group Benefit Plan from an employer, correct?

Not correct. I currently have health insurance coverage as a federal retiree, using FEHB.

I have a HDHP, but considering to switch to a traditional plan between now and the middle of next year, when I sign up for Medicare.

I have no familiarity with any Federal plans.
However, think very carefully before cancelling that IF you can't get back on it.
In many cases, the separate plans from Employers/ex-Employers can be better than what is available to the general public, for a variety of reasons.
"CAN BE" better. Not "WILL be" better.
So do check.

But any type of group plan can negotiate for different (preferably better) terms of coverage.
Also, in some cases, membership in a group (e.g., and Employer plan) is likely to mean that the insureds are at least somewhat healthier (on average), so the health care costs may be lower.

And especially keep in mind what was said above about later changing Medicare (Advantage OR Medigap) plans. That can be a one-way street in most states, so don't lowball it just because you are healthy *now*. This is for life... pun intended.

RM

[nisiprius]

...The best doctors in the city may not be at Kaiser but my impression is that the worst doctors are also unlikely to to be at Kaiser...

The problem comes when, (God forbid), your doctor says to you "Dr. X up on the fifth floor can do it... but I'd really rather you had it done by a high-volume surgeon like Dr. Y at the Mayo clinic...

[lereh]

Is FEHB an EGWP (Employer Group Waiver Plan)?

If so, anything you hear about Advantage plans may be wrong. Many EGWP plans are NOT HMOs, but PPOs, or even open access.

If you’ve seen one Advantage Plan, you’ve seen one Advantage Plan, lol.

Undortunately, you have to do the detail research to decide what’s best.

[Big Dog]

some Advantage plans are excellent. (Kaiser in California, for example.). Not all Advantage Plan sare HMOs, so you can find a PPO Advantage plan that allows you to go out of network.

[lereh]

Also, as another poster said, exiting an EGWP is a one way trip. There is no going back, usually.

[talzara]

I have no familiarity with any Federal plans.
However, think very carefully before cancelling that IF you can't get back on it.

Also, as another poster said, exiting an EGWP is a one way trip. There is no going back, usually.

Federal retirees can re-enroll in FEHB during open season.

FEHB is not an EGWP. FEHB plans act as Medigap coverage if you keep them after enrolling in Medicare.

If You Want to Reactivate Suspended Coverage
You may voluntarily reenroll in the FEHB Program during an annual open season. We will send you an open season announcement each year. If you don’t want to reenroll, disregard your open season material.

https://www.opm.gov/retirement-center/p ... ri79-2.pdf

[ResearchMed]

Federal retirees can re-enroll in FEHB during open season.

Good! This is so important to know.

Keep in mind that the change apparently can only be during the open season, not "now" and not even "at the start of next month". But it's also not like there is "no coverage" until any change is made.

It would be completely different if one could *never* get better coverage, for the rest of your life, if it turned out that would be much better.
However, that is not the situation, fortunately.

RM

[K2Retire]

Generic "Medicare Advantage" advice is probably worthwhile for non-Federal retirees, but the FEHB flavors of Medicare Advantage are completely different, and generally regarded as superior offerings.

Good intro article that explains how MA plans work specifically for Federal retirees at https://help.checkbook.org/article/71-e ... -advantage

They also publish a guidebook every year that you can purchase that lets you do a deep dive into all the plans offered in your ZIP Code.

https://www.checkbook.org/newhig2/hig.cfm

[delamer]

As a retiring Federal employee, you should get a copy of the Consumers’ Checkbook guide to FEHB (as noted in prior post).

It’s very good at laying out your options.

Be careful with advice above from people who aren’t familiar with FEHB. The FEHB world is different. Those who don’t have access to FEHB have more limited choices.

[furiouschads]

Delamer is correct. Buy the Washington Checkbook analysis. I am a Fed. I went through the same thing you are going through right now when I retired in 2022.

"What is this Medicare Advantage thing? Do I have to do something different now that I am retiring? What is this IRMAA thing?" Etc.

My bottom line was: keep my Kaiser Mid-Atlantic Standard plan and register for Medicare Part A. I wouldn't benefit from Medicare Parts B, C, D, E, F, G,...Z. No need for Advantage or MediGap.

No need to worry about IRMAA!

The FEHB is a different beastie. General purpose advice does not apply to those of us who chose the Federal path.

[LaurenRose]

I just purchased the Consumer Checkbook subscription. Thank you for the suggestion.

I am planning to dig into it over the weekend.

Hopefully it covers the case of someone who's transitioning to Medicare in the middle of an existing health plan year.

[vested1]

One thing I didn't see mentioned. If a person doesn't have an employer sponsored health and prescription plan that are at least as good as Medicare and that extends past age 65, it is important to sign up for Part B and Part D as soon as possible, if you chose not to go with an Advantage plan as soon as possible, or permanent penalties will be levied, and they're not cheap.

The penalty for signing up late for Part B is a 10% increase in the premium for every year you are late signing up, so 2 years late would be a 20% penalty on premiums on a permanent basis for instance. If you are subject to IRMAA the increase may be even more significant.

The penalty for signing up late for Part D is calculated as 1% of the "national base beneficiary premium" multiplied by the number of months you went without creditable prescription drug coverage, added to your monthly premium, permanently. So if you delayed signing up for Part D for two years the penalty would be a 24% higher premium based on that same national base beneficiary premium.

If you have an employer provided plan that extends past age 65 you have to prove it is as good or better than Medicare every year that you are on it by submitting a form that your employer is required to provide to you, stating that fact.

Welcome to Medicare, where it helps to be a rocket scientist.

[mbres60]

I just purchased the Consumer Checkbook subscription. Thank you for the suggestion.

I am planning to dig into it over the weekend.

Hopefully it covers the case of someone who's transitioning to Medicare in the middle of an existing health plan year.

My spouse is a Fed retiree. Most of the comments on this thread are for people NOT in FEHB. Be careful. Consumer Checkbook is great. Also, someone above said if you go the Advantage route you can get back into FEHB during open season. Not true UNLESS you suspended FEHB as opposed to canceling it. Right now there is really no need because FEHB offers some Advantage plans which is all part of FEHB so one can easily change plans next open season. Where you will be starting Medicare in the middle of the year please look carefully. I THINK you have a one time opportunity(when it is not open season) to change your FEHB plan when you start Medicare . We have Aetna Direct and Part B medicare and like it. We can go to any doctor as long as they accept medicare and also willing to bill Aetna. No problems for the several years we have had it.

There are many threads on here about FEHB and medicare.

[Hedgehog51]

To echo an earlier post, some of the responses you received are from people not familiar with FEHB plans, so PLEASE be careful. That’s comparing apples and oranges, so some of their comments, though well-intentioned, simply aren’t at all correct in your case. Some FEHB plans have additional benefits that make Part D or Medigap unnecessary, and FEHB MA plans are totally different than the MA plans advertised on TV.

We are in the same boat - my spouse will be eligible for Medicare in mid 2025. We’ve been doing a lot of research and much of what we find is only regarding commercial MA plans, so is not relevant to us. We have found some helpful posts on Bogleheads regarding FEHB and Medicare specifically, and we also watched a good video on NITP‘s free webinar library which I would encourage you to check out - their resources are specific to feds and fed retirees (nitpinc.com).

While I can’t give you a definitive answer, I can tell you what we eventually decided for his first year on Medicare - he’ll sign up for parts A and B, and will decline the “automatic no-cost addition of Part D” that his FEHB plan offers. While it does look like the FEHB MA plans are much better than commercial MA plans, and would save us about $1200, I worry about whether doctors would accept it, or worse - might suddenly stop accepting it mid-way through the year - leaving him in the lurch. Or what if he had a serious health issue and we wanted to take him to Mayo, or the MA plan required a lot of pre-authorizations? I just don’t want to deal with that uncertainty while we’re still getting used to how the FEHB plan plus Medicare works. During that first year with Parts A and B, I intend to tell each of his doctors we’re considering that specific FEHB MA plan for the next year, and ask if they would have accepted it and if there would be additional pre-authorizations required. Then we could always choose to sign up for it in a year or two if we think we would receive the same benefits and it would save us a little money.

Hope this helps - good luck, it is definitely a challenge to make sense of it all!

[delamer]

One thing I didn't see mentioned. If a person doesn't have an employer sponsored health and prescription plan that are at least as good as Medicare and that extends past age 65, it is important to sign up for Part B and Part D as soon as possible, if you chose not to go with an Advantage plan as soon as possible, or permanent penalties will be levied, and they're not cheap.

The penalty for signing up late for Part B is a 10% increase in the premium for every year you are late signing up, so 2 years late would be a 20% penalty on premiums on a permanent basis for instance. If you are subject to IRMAA the increase may be even more significant.

The penalty for signing up late for Part D is calculated as 1% of the "national base beneficiary premium" multiplied by the number of months you went without creditable prescription drug coverage, added to your monthly premium, permanently. So if you delayed signing up for Part D for two years the penalty would be a 24% higher premium based on that same national base beneficiary premium.

If you have an employer provided plan that extends past age 65 you have to prove it is as good or better than Medicare every year that you are on it by submitting a form that your employer is required to provide to you, stating that fact.

Welcome to Medicare, where it helps to be a rocket scientist.

Yes, the penalties for late sign-ups are relevant to retiring Feds. But FEHB plans are compliant with the Medicare standard.

Reinforcing furiouschads’ comment above — unless you are specifically knowledgeable about the ins-and-outs of FEHB coverage in retirement, please don’t post any further comments. Without that knowledge, you are at best confusing the OP or at worst giving her bad information.

[K2Retire]

I just purchased the Consumer Checkbook subscription. Thank you for the suggestion.

I am planning to dig into it over the weekend.

Hopefully it covers the case of someone who's transitioning to Medicare in the middle of an existing health plan year.

Retirement is not a qualifying life event to change your FEHB insurance mid-year, but turning 65 is a one-time exception because you became eligible for Medicare. https://www.opm.gov/healthcare-insuranc ... urning-65/

You can keep your regular heath plan during this open season to cover you until you turn 65, and then you can use the QLE to change to a medicare-related plan.

[gtd98765]

I have no familiarity with any Federal plans.
However, think very carefully before cancelling that IF you can't get back on it.

Also, as another poster said, exiting an EGWP is a one way trip. There is no going back, usually.

Federal retirees can re-enroll in FEHB during open season.

FEHB is not an EGWP. FEHB plans act as Medigap coverage if you keep them after enrolling in Medicare.

If You Want to Reactivate Suspended Coverage
You may voluntarily reenroll in the FEHB Program during an annual open season. We will send you an open season announcement each year. If you don’t want to reenroll, disregard your open season material.

https://www.opm.gov/retirement-center/p ... ri79-2.pdf

Caution!! FEHB enrollees can re-enroll in FEHB during Open Season ONLY if they have SUSPENDED enrollment, NOT if they have CANCELLED enrollment! Once you cancel your FEHB enrollment you are out for good. Cancelling FEHB enrollment is almost always a mistake.

[cashmoney]

Is FEHB an EGWP (Employer Group Waiver Plan)?

If so, anything you hear about Advantage plans may be wrong. Many EGWP plans are NOT HMOs, but PPOs, or even open access.

If you’ve seen one Advantage Plan, you’ve seen one Advantage Plan, lol.

Undortunately, you have to do the detail research to decide what’s best.

Besides having to be a retiree of corp, government ,schoolboard's etc ,EGWP MA plans differ from individual MA plans in two key ways.First enrollees in a EGWP plan can live anywhere in the country and be eligible to enroll ( that's why they are almost always ppo) whereas enrollment eligibility in an individual MA enrollment is based on living within either the "local service area" or the "regional service area" of the MA plan and EGWP also allows auto enrollment in to plan whereas with an individual MA plan the enrollee must choose to enroll in a specific plan within certain enrollment periods .There are exceptions where people with medicare and medicaid in some states are auto enrolled into integrated MA plans if they don't make a choice.

[talzara]

Caution!! FEHB enrollees can re-enroll in FEHB during Open Season ONLY if they have SUSPENDED enrollment, NOT if they have CANCELLED enrollment! Once you cancel your FEHB enrollment you are out for good. Cancelling FEHB enrollment is almost always a mistake.

Yes, the OP should read the guides carefully. FEHB terms have specific meanings. When it says suspend, it does not mean cancel.

The original title of this thread did not include FEHB. The moderators have added it to the title, but a lot of people posted without realizing that the OP has FEHB. Many posts do not use the correct terminology or do not apply to FEHB members.

[LaurenRose]

I appreciate the feedback and have the Consumer Checkbook and have been reading the OPM website, such as it is.

I need to decide by next Monday if I am going to make a switch in coverage between 1/1/2025 and the middle of 2025....I can still switch again next year, so I now realize the decision is not as critical as i thought it was. I have another six months to do my research for 2025.....which is good. I will need it.

Thanks all.

[LaurenRose]

We have found some helpful posts on Bogleheads regarding FEHB and Medicare specifically, and we also watched a good video on NITP‘s free webinar library which I would encourage you to check out - their resources are specific to feds and fed retirees (nitpinc.com).

Thank you for the reference. I was wondering if there were any Medicare consultants who specialize in advising FEHB annuitants.

[mbcruiser]

OPM has good information for Fed retirees (or soon to be):
https://www.opm.gov/healthcare-insurance
https://www.opm.gov/healthcare-insuranc ... are-plans/
https://www.opm.gov/healthcare-insuranc ... plan-types
I've been pleased with the fee-for-service (with PPO) plan offerings for many years. I don't know if all plans cover some or all of the 20% Medicare Part B doesn't cover (mine does), but coordination of benefits is an important feature with Medicare Part B coverage.

[tallguy3891]

I appreciate the feedback and have the Consumer Checkbook and have been reading the OPM website, such as it is.

I need to decide by next Monday if I am going to make a switch in coverage between 1/1/2025 and the middle of 2025....I can still switch again next year, so I now realize the decision is not as critical as i thought it was. I have another six months to do my research for 2025.....which is good. I will need it.

Thanks all.

I believe it is crucial, if one is going to change FEHB plan in this Open Season for the change to be effective 1/01/2025, in preparation for enrolling in Medicare in 2025 sometime, that a FEHB plan is chosen which will work well WITH Medicare then, but also works well WITHOUT Medicare now through that time. In other words, if I knew I was getting on Medicare in June 2025, I would choose a FEHB plan now which works great on its own until then and thereafter with Medicare too. There are certain FEHB plans I would not use without Medicare.

[LaurenRose]

Hi tallguy, thank you.

So to put it another way, which FEHB plans would you only use along with Medicare?


Although I am still digging away on Checkbook, my first inclination is to switch now from GEHA HDHP to GEHA Standard on January 1,
then consider whether GEHA Standard would be optimal going forward, or whether one of the other FEHB plans might be a better fit.

[cleosdad]

Hi tallguy, thank you.

So to put it another way, which FEHB plans would you only use along with Medicare?


Although I am still digging away on Checkbook, my first inclination is to switch now from GEHA HDHP to GEHA Standard on January 1,
then consider whether GEHA Standard would be optimal going forward, or whether one of the other FEHB plans might be a better fit.

I have had Med A and B AND GEHA Standard for a long time and am very happy.

[tallguy3891]

Hi tallguy, thank you.

So to put it another way, which FEHB plans would you only use along with Medicare?


Although I am still digging away on Checkbook, my first inclination is to switch now from GEHA HDHP to GEHA Standard on January 1,
then consider whether GEHA Standard would be optimal going forward, or whether one of the other FEHB plans might be a better fit.

I believe the answer is going to differ depending on each person's situation, so I can only speak to my own situation. In my search for my own situation, I take into consideration the premium, are all our providers in-network, does it work well with Medicare, the Rx coverage, catastrophic max, Skilled Nursing Facility (SNF) days, any deductible, any Health Reimbursement Account, is it for self+one or self only or self+family, etc.

Having said that, I believe the FEHB plans are all solid plans and there is a great selection to choose from for different scenarios.

But for me, as I've mentioned previously, right now Aetna Direct with Medicare A and B fits what I need. Other choices would be GEHA Standard because of the great premium and SNF days; MHBP Standard--although it offers currently no extra SNF days for one on Medicare, it has in my opinion an excellent Rx plan; BCBS Focus--outstanding premium at this time, although currently no SNF days and it does have a deductible. These would probably be my top picks currently for my situation of self+one WITH Parts A and B Medicare for self and spouse.

As far as WITHOUT Part B (I would always have Part A and spouse too), for my situation I would probably go with GEHA Standard due to the SNF days, or MHBP Standard due to the Rx and the current 10% coinsurance. If it had SNF for those on Medicare it would probably be my choice without Part B.

Again, I repeated several times this is for my self+one situation. I can't say what is best for anyone else. If I was self only, some of this could change because self only premiums are so much lower usually. In such a case, other plans such as APWU High, GEHA High, BCBS Basic or Standard, etc., could work for me with or without Part B in my opinion.

Also, if the situation was one spouse on Medicare and one not, or one with Part B and the other not, or a child on the plan, these things could totally change the equation and my choices.