Thread: FEHB and Medicare ?

Originally Posted by Stoplight

Tony,

So I hit the magical age 65 next year ! That raises the issue of Medicare for me. Google gives me all kinds of links to contradicting advice !

Do you have a definitive answer to (or link to the definitive answer to !) the question(s) :

Do I :
1. Drop FEHB and buy Part B and Part D or an Advantage Plan ?
2. Do I keep FEHB (currently BC/BC Basic Option, Self) and not take Part B ? (Is that even an option ?)
3. Do I keep FEHB and pay for Part B also ? (I know you DON'T take Part D if you keep FEHB)

I've seen this discussed many times, in bits and pieces, all over this board, but I'm looking for a clear, concise discussion of the pros and cons...

FWIW : I'm a regular FERS retiree ; collecting SS since age 62 ; no outside income and reductions to worry about (I'm pretty darn lazy !) ; no VA or TRICARE or anything like that ; Wife has her own healthcare coverage through her Teacher retirement

Any comments or links appreciated !


Stoplight...

OK, I will try...seeings how I just went thru this 6 months ago.
I am 65, retired FERS, signed up for Medicare.

Re. #1: Part B cost is a sliding scale, so if you are taking out traditional TSP, I believe you have to pay more for part B. At least that is why I did not opt for part B. On the other hand, if you don’t get part B up front, you have to pay more if you decide to get it later.

Re. #2:Yes, this is an option. I kept FEHB and did not take part B (or D). Keep in mind that the gov pays for 75% of your actual FEHB.

Re.#3: Part B with FEHB is basically getting 2 insurance policies. This should enable you to forego any co-payments. But see #1. It may not be worth the extra cost to get rid of co-payments.

Bottom line (what I did), was sign up for Medicare Part A (hospital), which becomes primary for hospital care. Kept my FEHB for me and my wife for Dr visits and Rx.

Stop, we selected option #3 with BCBS Standard Self Plus One and have been generally pleased except for the premium increases. There are basically no doctor copays and lots of reductions in prescription copays. We have tons of prescriptions and take full advantage of the mail order prescription benefits. I understand that there are FEHB plans that pay the Part B premiums for you. Have been thinking of looking into that option since it is pretty pricy to have both BCBS and Medicare Part B. Good luck with your planning!

Don't drop FEHB!!!!! The government pays 70% of the premium for life. My wife and I selected #3. We have GEHA High Deductible Self+1 ($3314.40 yearly premium) with a $3000 deductible ($1500 per person) as secondary and Medicare A and B as primary. Because it is high deductible, GEHA reimburses an $1800 HRA of the $3000, which rolls over each year, and accrues. We pay $3228 per year for Medicare A&B. Beginning 2020 GEHA High Deductible will reimburse $600 in Medicare premiums also. So we'll end up with about $4742.40 annually for 2 people. A little less than $200 a month for each of us. We have zero co-pays and spent $0 so far in 2019 for medical expenses. The GEHA Plan also includes 2 dental exams and cleanings annually for each person also. Kind of depends how comfortable you feel about your health situation.

As usual, my TSP Talk Friends come through, with real life examples of what they've done, and why !!! THANKS, y'all !!!

Here's the thing that irks me : My Wife's health care premium price dropped when she hit Medicare, which makes total sense ! The company is no longer the "primary" payer ! ...But do the FEHB premiums change ? Nope (unless I missed something...) !!! What's wrong with this picture ? The FEHB company is paying less out of their funds, yet still charge me (and the Government !) the same ?

Yeah, the "system" IS broken...


Stoplight...

I use BCBS [Basic] and Medicare, Basic is much cheaper than Standard, works for us.

OK, This looks like a good place to ask this question:


Is our FEHB coverage the same before retirement and afterwards with Medicare?


In particular, if I do not take Part B will my FEHB cover me as they did before I retired?


The reason I ask is because I heard that when Medicare becomes primary, FEHB only pays up to 20%. So if I don't take Part B am I stuck paying the 80% for outpatient care? That doesn't sound right to me -- paying the same amount for insurance and getting less coverage.

Originally Posted by Stoplight

As usual, my TSP Talk Friends come through, with real life examples of what they've done, and why !!! THANKS, y'all !!!

Here's the thing that irks me : My Wife's health care premium price dropped when she hit Medicare, which makes total sense ! The company is no longer the "primary" payer ! ...But do the FEHB premiums change ? Nope (unless I missed something...) !!! What's wrong with this picture ? The FEHB company is paying less out of their funds, yet still charge me (and the Government !) the same ?

Yeah, the "system" IS broken...


Stoplight...

Here is what you missed:

The premium is NOT set based on what the plan paid out for YOUR benefit.

The premium is set based on what the plan pays out FOR ALL THE PLAN MEMBERS, from infants, until the deceased's final bills. The total sum of ALL the expenses of the entire pool, PLUS the costs of the CEO's third and fourth Yacht, plus the returns to the shareholders (in the case of the private sector for profit plans), plus any miscellaneous expenses.

You simply are one small cog in the wheel, And while the plan's expenses for YOU might be slightly less now, they will, in fact, likely rise later on, when you get sick and need hospitalization, and /or specialty treatment or drugs that aren't covered by Medicare.

The CEO of Blue Cross/Blue Sheild, Scott Seorta, made $5.2 million in salary, and $1.9 in deferred compensation last year. And he's been CEO since 2001.
Think about how that adds up.

https://www.crainsdetroit.com/articl...east-1-million

Just saying.

It's not about you.

It's about the fourth yacht.

Originally Posted by Cactus

OK, This looks like a good place to ask this question:


Is our FEHB coverage the same before retirement and afterwards with Medicare?


In particular, if I do not take Part B will my FEHB cover me as they did before I retired?


The reason I ask is because I heard that when Medicare becomes primary, FEHB only pays up to 20%. So if I don't take Part B am I stuck paying the 80% for outpatient care? That doesn't sound right to me -- paying the same amount for insurance and getting less coverage.

I think you may have mis-heard the Medicare/FEHB facts. Your interpretation (or rather, what you heard) is a bit jumbled up.

Upon turning 65, you MUST take Medicare part A. That is part of being able to continue your FEHB. Part A becomes your primary carrier, but Part A is for hospital care only. So FEHB stays the same cost and payouts for the rest, and for Hospital stays FEHB becomes secondary. As secondary, FEHB will cover whatever Medicare does not (usually the co-pay).

If you also take Part B, that also then becomes primary. And again, as secondary, FEHB covers whatever Part B does not cover (again, usually the co-pay). Rx would stay the same as regular FEHB, unless you also take Part D.

I think this info should answer your questions. And should ‘sound right’ to you.

One last thing that I alluded to in my earlier post.
Part B starts at $135 per person, per month. But it is a sliding scale, based on your annual income. Since I am taking a lot of traditional TSP out in retirement, my ‘income’ is still rather high. My estimate for Part B was $435 per person, per month, instead of the $135. Way too high. That is why I opted for Part A only. The cost of double insurance was just too high to cover my co-pays.

There may be one other thing to consider in looking at Medicare Part B premiums depending on what you carry for FEHB. Blue Cross standard and basic both pay you $600 a year to take Medicare Part B, since it lowers their costs as they become secondary. So whatever you figure for monthly Part B premiums, you can reduce by $50 a month for that benefit. Not all FEHB policies have this benefit though.

Originally Posted by James48843

Here is what you missed:

The premium is NOT set based on what the plan paid out for YOUR benefit.

The premium is set based on what the plan pays out FOR ALL THE PLAN MEMBERS, from infants, until the deceased's final bills. The total sum of ALL the expenses of the entire pool, PLUS the costs of the CEO's third and fourth Yacht, plus the returns to the shareholders (in the case of the private sector for profit plans), plus any miscellaneous expenses.

You simply are one small cog in the wheel, And while the plan's expenses for YOU might be slightly less now, they will, in fact, likely rise later on, when you get sick and need hospitalization, and /or specialty treatment or drugs that aren't covered by Medicare.

The CEO of Blue Cross/Blue Sheild, Scott Seorta, made $5.2 million in salary, and $1.9 in deferred compensation last year. And he's been CEO since 2001.
Think about how that adds up.

https://www.crainsdetroit.com/articl...east-1-million

Just saying.

It's not about you.

It's about the fourth yacht.

LOL !!! ....and I thought I was a cynic...

What you say does make sense, though...


Stoplight...

Originally Posted by kportra

There may be one other thing to consider in looking at Medicare Part B premiums depending on what you carry for FEHB. Blue Cross standard and basic both pay you $600 a year to take Medicare Part B, since it lowers their costs as they become secondary. So whatever you figure for monthly Part B premiums, you can reduce by $50 a month for that benefit. Not all FEHB policies have this benefit though.

Kportra,

Thanks for weighing in !

This is something I have never heard of before...can you steer us to a link to support how this works ????


Stoplight...