Federal Retiree Health Care with/Medicare

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VictoriaF
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Re: Federal Retiree Health Care with/Medicare

Post by VictoriaF » Tue Jun 27, 2017 6:26 pm

ChrisC wrote:
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.
Thank you, Chris!

I am not Medicare eligible yet and so for me it's a purely theoretical discussion at this time. I did not know that:
1. not all FEHB plans wave deductibles and co-pays, and
2. there is an HRA possibility for Medicare recipients.

This is very useful information!

Victoria
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trueblueky
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Re: Federal Retiree Health Care with/Medicare

Post by trueblueky » Tue Jun 27, 2017 8:14 pm

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

Retirees can stop paying into basic life at 65 and maintain a life insurance policy that gradually declines to about 1/4 of final pay.
Thanks. I stand corrected. I use to have FEGLI but no longer have it. I was checking out my BIL's basic life coverage under FEGLI and his premiums did not appear to vary one year to the next since his retirement.
Basic is the same for everyone, about fifteen cents per thousand dollars of coverage. Basic covers one time annual salary raised to next thousand plus two thousand. (So, salary of $54,321 has basic FEGLI of $57,000.) However, really young employees (under 30 as I recall) get twice as much coverage, which gradually declines to one time. So, they effectively pay half as much.

Optional insurance, sold in increments of annual pay, and with no contribution by employer, is age based in five-year brackets. The jumps at 60, 65, 70 are big.

RetiredFed
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Re: Federal Retiree Health Care with/Medicare

Post by RetiredFed » Mon Oct 16, 2017 12:16 pm

With the announcement of the FEHB premiums for 2018 and a new FEHB open-season beginning in mid-November, there are likely to be questions about Medicare and FEHB. I have two comments. 1) ConsumerCheckbook's Guide to Federal Employee Health Plans is a must read. Unbiased advice by experts. 2) Take a hard look at Aetna Direct combined with Medicare A and B. Aetna Direct is as close to a medigap-type policy that one find in the world of FEHB plans. FEHB plans cannot limit their eligibility to particular classes of employees or annuitants. Therefore Aetna Direct is available to all active and retired feds, but offers enhanced benefits hospital, medical and prescription drug benefits to feds who have Medicare A and B. Besides waiving deductibles and copays, Aetna Direct provides a spending account ($900 individual/$1800 family&1+1), which can be used to reimburse the Part B Premium. It also includes enhanced benefits for rehab care that coordinates with Medicare Part A benefits.

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macaroon
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Re: Federal Retiree Health Care with/Medicare

Post by macaroon » Tue Oct 17, 2017 7:17 pm

Blue Cross Basic is going to have a Medicare premium reimbursement account in 2018 but it's only $600 -- less than Aetna Direct.
https://fepblue.org/en/news/2017/09 ... fits-rates

Medicare Updates
As part of our Medicare benefits, Basic Option members with Medicare Part A and B can receive up to a $600 Medicare reimbursement account. You must use the account to pay your Medicare Part B premium."

retiredjg
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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Wed Oct 18, 2017 6:26 am

It sounds like you both are saying that the insurance company gives the insured money to pay or reimburse Medicare premiums???? :shock:

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macaroon
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Re: Federal Retiree Health Care with/Medicare

Post by macaroon » Sat Oct 21, 2017 5:38 pm

That's correct. Here's what the FEPBlue page has to say about it.

Medicare reimbursement account

If you have Basic Option, you can get a $600 Medicare
reimbursement account if you have Medicare Part A and B.
You must use this account to pay your Medicare Part B
premium. Each member on your contract with Medicare
Part A and B is eligible to earn $600.
To earn the money, you’ll need to provide proof that you pay
2018 Medicare Part B premiums.
We’ll accept the following as proof of payment:
• Copies of social security checks
• Bank statements
• COLA statements
• Canceled checks or copies of canceled checks
Learn more at fepblue.org/mra.

retiredjg
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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Sat Oct 21, 2017 8:50 pm

Well, that's worth looking at. :happy

HIinvestor
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Re: Federal Retiree Health Care with/Medicare

Post by HIinvestor » Sat Oct 21, 2017 9:26 pm

H is a retired federal employee. Some chronic health issues run in his family. He has Medicare A & B as well. He also has FEHB family plan which covers him, me and our dependent.

Having both high BCBS FEHB and Medicare B has eliminated all copays and deductibles, which have been helpful for H’s PT and MD visits and outpatient surgery.

It is possible we could have saved more by not electing part B and just going with FEHB but so far we have no regrets. We may revisit in 5 years when I become Medicare-eligible.

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mrc
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Re: Federal Retiree Health Care with/Medicare

Post by mrc » Sun Oct 22, 2017 5:17 am

retiredjg wrote:
Sat Oct 21, 2017 8:50 pm
Well, that's worth looking at. :happy
Indeed it is. But I have a question about providers ... If we keep BCBS, and decline Part B, we continue to function as we do now. Same rules, same providers, payments, etc. But if we elect Part B, and Medicare becomes primary, are we then not subject to completely different terms? For example, do we then have to find providers that participate in Medicare and that will "accept assignment?"

That $600 makes the decision a much closer call from a money standpoint. But not if we have trouble finding providers that accept Medicare. And we are then subject to the Medicare paper mill.

I would love to hear from folks that have lived with Medicare + FEHB for a while to learn about what changes.
A great challenge of life: Knowing enough to think you're doing it right, but not enough to know you're doing it wrong. — Neil deGrasse Tyson

retiredjg
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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Sun Oct 22, 2017 5:39 am

HIinvestor wrote:
Sat Oct 21, 2017 9:26 pm
Having both high BCBS FEHB and Medicare B has eliminated all copays and deductibles, which have been helpful for H’s PT and MD visits and outpatient surgery.
I found that all copays and deductibles were also paid when I moved from high BCBS to low BCBS this last year. In fact, the coverage seems just the same. Have not had a surgery on either coverage, but MD visits didn't change and PT is covered up to a certain number of visits - 40 if I remember right.

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Info_Hound
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Re: Federal Retiree Health Care with/Medicare

Post by Info_Hound » Sun Oct 22, 2017 11:00 am

LuigiLikesPizza wrote:
Sat Apr 29, 2017 6:37 pm
Although I could retire now, I have been convinced by several that I should stick it out for the time when I am eligible to take my federal retiree health care with me. So, I'll pay the premium when I retire and one day, I will reach the age for Medicare eligibility.

How do federal employees with their own federal health insurance fare with Medicare compared to retirees with their own private health insurance plans? Is there any benefit to having federal retiree health insurance when it comes time to also sign up for Medicare?
Addressing the OP's original question -
1) I have Federal retiree health insurance - BCBS basic -plus 1 plan (24 yr old child also covered). Widowed
2) I am retired, 65 rolling on to 66 shortly and did sign up for Med. Part A & B at 65. I retired at age 60.
3) In good health, no current issues or known long term medical needs.
4) I do not live in an area with a large federal work force presence, so finding doctors who accept the range of offered FEH plans is difficult to near impossible. Something to think about when choosing a plan.

Your thoughts were my thoughts prior to making a decision. Having BCBS coverage prior to becoming Medicare eligible was worth it's weight in gold. With (currently) 70% of the cost covered by the government and only 30% of the cost coming out of my pocket made a huge difference in addressing one of the more expensive aspects of retirement prior to Medicare. If you want to see what you might pay for insurance coverage in your 'gap' years, price out a policy on the ACA exchange that most closely matches your current FEH plan and compare what you are currently paying/deductibles/availability to an ACA plan. It's unlikely you will beat the FEH plan with an ACA plan. Carrying a private policy is usually more expensive than most of the FEH plans.

I did a mega ROTH conversion at age 63 which would put my Part B payments through the roof if I signed on at age 65. I considered delaying by a year, signing up and taking the 10% penalty. Did a cost analysis and decided to sign up and take the pain of 1 year of large Part B premiums, because in the long run it would be cheaper than carrying the 10% penalty over a lifetime. I plan to live an average life span (for planning purposes).

I have been to the doctor for wellness visits and minor issues. What I have seen is I no longer pay copays at the doctor's or for prescriptions. Things that BCBS basic does not cover, Medicare Part B has. The only change that occurred when I signed up for A & B was Medicare gets to pay first, then BCBS next. My BCBS coverage did not change at all.

I am paying premiums for both Part B and BCBS coverage. The Part D options were more expensive than continuing with the better and more comprehensive FEH coverage. Seeing that this year BCBS is offering an $600 reimbursement option for Part B payments, I will be looking into this for 2018. If I choose to leave the FEH plan system all together (likely do to raging cost), I know I can never come back.

Having both FEH and Part B gives me options - 1) Belt and suspenders - SWAN. 2) If for some reason the FEH plan cost coverage changes, say the government only pays 30% and I am expected to pay 70% of the premium, I have not saddled myself with the 10% per year Part B penalty because I did not sign up at 65. 3) As a widow of a Fed, my husband gave me a precious gift - a way to buy health coverage at affordable rates even after he was no longer with me. I think of it as his 'I Love You' plan after he passed.

The way I read your question was as a 2 part question - 1) Is it worth it to stick it out to get FEH coverage for the rest of my/our life. Only you know what that is worth to you and your wife. This can be calculated as mentioned above. 2) Is it worth it to continue working until I meet the lifetime FEH plan requirement. That is more easily calculated as it is a near term event, but it does mean when you decide on an answer to question 2, you automatically have resolved question #1.

Good luck!

delamer
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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Sun Oct 22, 2017 1:26 pm

retiredjg wrote:
Sun Oct 22, 2017 5:39 am
HIinvestor wrote:
Sat Oct 21, 2017 9:26 pm
Having both high BCBS FEHB and Medicare B has eliminated all copays and deductibles, which have been helpful for H’s PT and MD visits and outpatient surgery.
I found that all copays and deductibles were also paid when I moved from high BCBS to low BCBS this last year. In fact, the coverage seems just the same. Have not had a surgery on either coverage, but MD visits didn't change and PT is covered up to a certain number of visits - 40 if I remember right.
The aforementioned Consumer Checkbook -- at least in my past readings -- suggests that taking high option plans with Medicare Part B is unnecessarily expensive.

HIinvestor is not yet Medicare-eligible, so that is obviously a factor in their decision since it is family coverage.

Not to derail, but does anyone know if it is possible under FEHB for one spouse to elect Part B while the other one does not (under family or self+1 coverage)? My spouse has a lot more health issues than I do, and it has occurred to me that might make financial sense in our case.

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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Sun Oct 22, 2017 3:32 pm

Info_Hound wrote:
Sun Oct 22, 2017 11:00 am
What I have seen is I no longer pay copays at the doctor's or for prescriptions. Things that BCBS basic does not cover, Medicare Part B has. The only change that occurred when I signed up for A & B was Medicare gets to pay first, then BCBS next. My BCBS coverage did not change at all.
Really? I have BCBS Basic and Medicare is my primary coverage. I don't pay co-pays or deductibles, but I do have a co-pay for prescriptions. It was the same when I was on BCBS Standard and Medicare.

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Re: Federal Retiree Health Care with/Medicare

Post by bsteiner » Sun Oct 22, 2017 5:00 pm

It seems like it's a choice between a high end FEHB plan and no Part B or a low end FEHB plan together with Part B.

Of course, the high end FEHB plan has some co-pays.

From a quick look, a high end FEHB plan for a couple or family is about $7,000 a year.

From a quick look, a low end FEHB plan for a couple or family is about $4,000 a year and Part B is about $2,500 a year for a low income couple but $8,000 or perhaps $10,000 a year for a high income couple.

So the low income couple would probably take a low end FEHN plan and Part B.

What about the high income couple? A low end FEHB plan and Part B appears to be $5,000 to $7,000 more than a high end FEHB plan.

What would the high income couple get for the additional $5,000 to $7,000 a year other than not having co-pays?

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HueyLD
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Re: Federal Retiree Health Care with/Medicare

Post by HueyLD » Sun Oct 22, 2017 5:50 pm

I think people who are subject to the IRMAA may be better off going with FEHB without Medicare unless they are heavy users of medical services. But....

Let's use BCBS as an example. The high option (standard option) is a PPO and it also covers out of network providers and facilities at lower rates. So, one can still be covered even when a preferred provider is not available.

However, the low option (basic option) is an EPO and one is only covered if one goes to a preferred provider or a preferred facility. So, if you live in an area where few providers are in the preferred network, you are about as bad as uninsured.

Moreover, if you cancel the FEHB in retirement, you cannot rejoin at a later date unless you you previously joined a Medicare Advantage plan and the MA plan was subsequently cancelled. Since the FEHB is such a fantastic benefit and people have to work many years to earn the right to keep such an insurance, I think it is unwise to give it up, even for those subject to the IRMAA.

And those subject to the IRMAA can afford to pay a few thousand extra in insurance.

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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Sun Oct 22, 2017 6:04 pm

HueyLD wrote:
Sun Oct 22, 2017 5:50 pm
I think people who are subject to the IRMAA may be better off going with FEHB without Medicare unless they are heavy users of medical services. But....

Let's use BCBS as an example. The high option (standard option) is a PPO and it also covers out of network providers and facilities at lower rates. So, one can still be covered even when a preferred provider is not available.

However, the low option (basic option) is an EPO and one is only covered if one goes to a preferred provider or a preferred facility. So, if you live in an area where few providers are in the preferred network, you are about as bad as uninsured.

Moreover, if you cancel the FEHB in retirement, you cannot rejoin at a later date unless you you previously joined a Medicare Advantage plan and the MA plan was subsequently cancelled. Since the FEHB is such a fantastic benefit and people have to work many years to earn the right to keep such an insurance, I think it is unwise to give it up, even for those subject to the IRMAA.

And those subject to the IRMAA can afford to pay a few thousand extra in insurance.
Consumer Checkbook has recommended -- at least it was true a couple years ago -- that people subject to IRMMA skip Part B and just take FEHB.

HIinvestor
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Re: Federal Retiree Health Care with/Medicare

Post by HIinvestor » Sun Oct 22, 2017 6:17 pm

IRMAA amounts are on a sliding scale. At the lower end, they’re not much higher than basic part B and go up from there.

https://medicare.gov/your-medicare- ... costs.html

For just one person on Part B, it’s not that much extra to pay for more security. My understanding is that sometimes Part B may cover some things FEHB doesn’t and vice versa. Our CPA says he and his W have both B and FEHB as well.

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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Sun Oct 22, 2017 6:23 pm

bsteiner wrote:
Sun Oct 22, 2017 5:00 pm
It seems like it's a choice between a high end FEHB plan and no Part B or a low end FEHB plan together with Part B.

Of course, the high end FEHB plan has some co-pays.

From a quick look, a high end FEHB plan for a couple or family is about $7,000 a year.

From a quick look, a low end FEHB plan for a couple or family is about $4,000 a year and Part B is about $2,500 a year for a low income couple but $8,000 or perhaps $10,000 a year for a high income couple.

So the low income couple would probably take a low end FEHN plan and Part B.

What about the high income couple? A low end FEHB plan and Part B appears to be $5,000 to $7,000 more than a high end FEHB plan.

What would the high income couple get for the additional $5,000 to $7,000 a year other than not having co-pays?
Soome people are really enamored of not having any out-of-pocket expenses or getting bills in the mail -- it almost as if they don't realize how much they paying in premiums for that convenience.

I have not made a final decision on Part B yet; I still have a year or so to make a decision. But we would have to pay the higher Part B premium and so Part B makes no sense to me (see my reference to Consumer Checkbook above). EDIT: It would cost us over $6,000/year.

We have the less expensive GEHA plan. GEHA has said that unless you use expensive prescriptions or expect to be hospitalized, then standard makes sense than high. Of course, hospitalization isn't predictable. But you can always switch to high option at open season if your circumstances change.

HIinvestor
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Re: Federal Retiree Health Care with/Medicare

Post by HIinvestor » Sun Oct 22, 2017 6:26 pm

While one can switch FEHB and Medicare supplemental plans during open season, can’t really “time” it re an emergency hospitalization that occurs with little or no notice.

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Blues
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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Sun Oct 22, 2017 6:37 pm

delamer wrote:
Sun Oct 22, 2017 6:23 pm

Some people are really enamored of not having any out-of-pocket expenses or getting bills in the mail -- it almost as if they don't realize how much they paying in premiums for that convenience.

I have not made a final decision on Part B yet; I still have a year or so to make a decision. But we would have to pay the higher Part B premium and so Part B makes no sense to me (see my reference to Consumer Checkbook above). EDIT: It would cost us over $6,000/year.

We have the less expensive GEHA plan. GEHA has said that unless you use expensive prescriptions or expect to be hospitalized, then standard makes sense than high. Of course, hospitalization isn't predictable. But you can always switch to high option at open season if your circumstances change.
I just turned 65, the missus is a few years younger. I filed for Part A three months prior and declined to enroll in any other coverage via Medicare.

Like you, we are also enrolled in GEHA's standard (not high option) plan and it has served us well (along with the optional dental) for several years now after transferring from BC/BS. We are not on prescription medications nor receiving any ongoing therapy.
Last edited by Blues on Sun Oct 22, 2017 6:40 pm, edited 1 time in total.
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delamer
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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Sun Oct 22, 2017 6:39 pm

HIinvestor wrote:
Sun Oct 22, 2017 6:26 pm
While one can switch FEHB and Medicare supplemental plans during open season, can’t really “time” it re an emergency hospitalization that occurs with little or no notice.

True. But 1) this isn't a question of coverage versus no coverage; it is a question of less expensive, less generous coverage versus more expensive, more generous coverage and 2) for my family, the difference in cost could be nearly $10,000 per year; that covers a lot of co-pays.

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TimeRunner
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Re: Federal Retiree Health Care with/Medicare

Post by TimeRunner » Sun Oct 22, 2017 7:00 pm

I'm in the same boat as delamer and will need to decide starting in January 2019 whether to take Part B or not. Currently I'm on GEHA standard (after having been in HDHP for five years or so), but I'll be looking around and using Checkbook Guide this Open Season to see what plan to be on during my last year prior to Medicare. We will be subject to IRMAA. OTOH, without getting into politics, there is real RISK that FEHB could be substantially trimmed, or gov contributions substantially reduced, or many other potential impacts to the current FEHB system. While Medicare has risks as well, the affected pool (of voters), should Medicare changes be sought, is much larger. The Checkbook Guide is not available for the current open season until Nov 13, see: https://checkbook.org/newhig2/year1 ... ype=online . Having looked at a few brochures, the SAMBA standard option plan (in our case self+one) looks like a nice balance of cost vs benefit for our health situation and location, slightly more favorable than GEHA or BCBS.
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Re: Federal Retiree Health Care with/Medicare

Post by bartbill » Sun Oct 22, 2017 7:09 pm

Retired fed here. Both age 68. We have part A and B along with BCBS. We have significant medical expenses and expensive medications due to my wife's ongoing medical issues.
Her medical problems nearly bankrupted us. It the reason I went back to work for the federal government. You can't appreciate what a relief it is to know all the cost are taken care of (other than prescription copays) until you've been down that road.

delamer
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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Sun Oct 22, 2017 7:10 pm

TimeRunner wrote:
Sun Oct 22, 2017 7:00 pm
I'm in the same boat as delamer and will need to decide starting in January 2019 whether to take Part B or not. Currently I'm on GEHA standard (after having been in HDHP for five years or so), but I'll be looking around and using Checkbook Guide this Open Season to see what plan to be on during my last year prior to Medicare. I will be subject to IRMA. OTOH, without getting into politics, there is real RISK that FEHB could be substantially trimmed, or gov contributions substantially reduced, or many other potential impacts to the current FEHB system. While Medicare has risks as well, the affected pool (of voters), should Medicare changes be sought, is much larger. The Checkbook Guide is not available for the current open season until Nov 13, see: https://checkbook.org/newhig2/year1 ... ype=online . Having looked at a few brochures, the SAMBA standard option plan (in our case self+one) looks like a nice balance of cost vs benefit for our health situation and location, slightly more favorable than GEHA or BCBS.
One "known unknown" is if there are changes to FEHB for retirees such that we are required to take Part B, will those who did not enroll in Part B at 65 be penalized at the rate of 10%/year or will that penalty be waived due to the new requirement?

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Blues
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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Sun Oct 22, 2017 7:14 pm

I doubt the penalty will be waived...I don't think they'll be looking to do any favors for feds or former feds in the current legislative environment.
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mrc
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Re: Federal Retiree Health Care with/Medicare

Post by mrc » Mon Oct 23, 2017 4:28 am

We have BCBS Basic, and there are many feds in our area. I'm still wondering what happens if we elect Part B: Must we choose providers that participate in Medicare? In other words, is there a difference in provider choices between having BCBS+Part B and having ONLY Medicare? That will likely be our decision point. In our area many providers accept BCBS, but far fewer accept new Medicare patients.
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Swansea
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Re: Federal Retiree Health Care with/Medicare

Post by Swansea » Mon Oct 23, 2017 5:03 am

delamer wrote:
Sun Oct 22, 2017 7:10 pm
TimeRunner wrote:
Sun Oct 22, 2017 7:00 pm
I'm in the same boat as delamer and will need to decide starting in January 2019 whether to take Part B or not. Currently I'm on GEHA standard (after having been in HDHP for five years or so), but I'll be looking around and using Checkbook Guide this Open Season to see what plan to be on during my last year prior to Medicare. I will be subject to IRMA. OTOH, without getting into politics, there is real RISK that FEHB could be substantially trimmed, or gov contributions substantially reduced, or many other potential impacts to the current FEHB system. While Medicare has risks as well, the affected pool (of voters), should Medicare changes be sought, is much larger. The Checkbook Guide is not available for the current open season until Nov 13, see: https://checkbook.org/newhig2/year1 ... ype=online . Having looked at a few brochures, the SAMBA standard option plan (in our case self+one) looks like a nice balance of cost vs benefit for our health situation and location, slightly more favorable than GEHA or BCBS.
One "known unknown" is if there are changes to FEHB for retirees such that we are required to take Part B, will those who did not enroll in Part B at 65 be penalized at the rate of 10%/year or will that penalty be waived due to the new requirement?
Being required to take Part B would be a similar route as taken for military personnel who are now required to take Part B if they are covered by TriCare.

ester
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Re: Federal Retiree Health Care with/Medicare

Post by ester » Mon Oct 23, 2017 11:49 am

My understanding is that at age 65 FEHB w/o Part B Medicare will only pay Medicare rates, rather than what they paid prior to you turning 65, and you will be responsible for the difference.

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Re: Federal Retiree Health Care with/Medicare

Post by delamer » Mon Oct 23, 2017 3:20 pm

ester wrote:
Mon Oct 23, 2017 11:49 am
My understanding is that at age 65 FEHB w/o Part B Medicare will only pay Medicare rates, rather than what they paid prior to you turning 65, and you will be responsible for the difference.
Do you have a source for that? That is not my understanding.

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Blues
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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Mon Oct 23, 2017 3:24 pm

delamer wrote:
Mon Oct 23, 2017 3:20 pm
ester wrote:
Mon Oct 23, 2017 11:49 am
My understanding is that at age 65 FEHB w/o Part B Medicare will only pay Medicare rates, rather than what they paid prior to you turning 65, and you will be responsible for the difference.
Do you have a source for that? That is not my understanding.
Mine either.
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TimeRunner
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Re: Federal Retiree Health Care with/Medicare

Post by TimeRunner » Mon Oct 23, 2017 3:53 pm

From what I've read, it's this: "When you are age 65 or over and do not have Medicare -
Under the FEHB law, we must limit our payments for inpatient hospital care and physician care to those payments you would be entitled to if you had Medicare. Your physician and hospital must follow Medicare rules and cannot bill you for more than they could bill you if you had Medicare. You and the FEHB benefit from these payment limits. Outpatient hospital care and non-physician based care are not covered by this law; regular Plan benefits apply." Brochures for FEHB plans go into much more detail, for example GEHA Standard and Hi Option Plan 2018 brochure discusses this on page 109. (It's obviously different than ester's understanding.) Please read the brochure for the FEHB plan you have and/or are considering....
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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Mon Oct 23, 2017 4:19 pm

TimeRunner wrote:
Mon Oct 23, 2017 3:53 pm
From what I've read, it's this: "When you are age 65 or over and do not have Medicare -
Under the FEHB law, we must limit our payments for inpatient hospital care and physician care to those payments you would be entitled to if you had Medicare. Your physician and hospital must follow Medicare rules and cannot bill you for more than they could bill you if you had Medicare. You and the FEHB benefit from these payment limits. Outpatient hospital care and non-physician based care are not covered by this law; regular Plan benefits apply." Brochures for FEHB plans go into much more detail, for example GEHA Standard and Hi Option Plan 2018 brochure discusses this on page 109. (It's obviously different than ester's understanding.) Please read the brochure for the FEHB plan you have and/or are considering....
I'm not sure Ester's understanding, which squares with what I've been told by GEHA-HDHP customer service representatives, is entirely or obviously, different from the guidance you posted here from OPM. In fact, I've been told that the scope of that guidance applies to FEHB dependent spouses on FEHB plans who are Medicare eligible (though they might not even have signed up for Part B, in my wife's case). Similar reports are found here at post # 11: http://early-retirement.org/forums/ ... 88848.html

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Re: Federal Retiree Health Care with/Medicare

Post by Swansea » Mon Oct 23, 2017 4:39 pm

TimeRunner wrote:
Mon Oct 23, 2017 3:53 pm
From what I've read, it's this: "When you are age 65 or over and do not have Medicare -
Under the FEHB law, we must limit our payments for inpatient hospital care and physician care to those payments you would be entitled to if you had Medicare. Your physician and hospital must follow Medicare rules and cannot bill you for more than they could bill you if you had Medicare. You and the FEHB benefit from these payment limits. Outpatient hospital care and non-physician based care are not covered by this law; regular Plan benefits apply." Brochures for FEHB plans go into much more detail, for example GEHA Standard and Hi Option Plan 2018 brochure discusses this on page 109. (It's obviously different than ester's understanding.) Please read the brochure for the FEHB plan you have and/or are considering....
The above is my understanding, also.

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Re: Federal Retiree Health Care with/Medicare

Post by trueblueky » Mon Oct 23, 2017 5:09 pm

bartbill wrote:
Sun Oct 22, 2017 7:09 pm
Retired fed here. Both age 68. We have part A and B along with BCBS. We have significant medical expenses and expensive medications due to my wife's ongoing medical issues.
Her medical problems nearly bankrupted us. It the reason I went back to work for the federal government. You can't appreciate what a relief it is to know all the cost are taken care of (other than prescription copays) until you've been down that road.
Retired fed. DW is younger and not yet eligible for Medicare. Once she's on Medicare, we'll go to Aetna which seems to be most seamless with Medicare.

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Re: Federal Retiree Health Care with/Medicare

Post by TimeRunner » Mon Oct 23, 2017 5:10 pm

ChrisC wrote:
Mon Oct 23, 2017 4:19 pm
I'm not sure Ester's understanding, which squares with what I've been told by GEHA-HDHP customer service representatives, is entirely or obviously, different from the guidance you posted here from OPM....
I'm not sure either, but one key missing piece is that what one is being charged is now capped by Medicare rules for services applicable to these rules (again, not all are). One is not necessarily being charged the same amount as one was prior to Medicare eligibility, which was likely a negotiated amount between one's provider and one's FEHB insurer. The page I referenced (page 109, GEHA 2018 Standard/High brochure) would be worth reading, or similar page(s) from your current FEHB provider or whomever you are considering for 2018. I am obviously trying to not explain it here, but to refer people to authoritative explanation from their current or potential FEHB provider.
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Re: Federal Retiree Health Care with/Medicare

Post by mrc » Tue Oct 24, 2017 4:37 am

Swansea wrote:
Mon Oct 23, 2017 4:39 pm
TimeRunner wrote:
Mon Oct 23, 2017 3:53 pm
From what I've read, it's this: "When you are age 65 or over and do not have Medicare -
Under the FEHB law, we must limit our payments for inpatient hospital care and physician care to those payments you would be entitled to if you had Medicare. Your physician and hospital must follow Medicare rules and cannot bill you for more than they could bill you if you had Medicare. You and the FEHB benefit from these payment limits. Outpatient hospital care and non-physician based care are not covered by this law; regular Plan benefits apply." Brochures for FEHB plans go into much more detail, for example GEHA Standard and Hi Option Plan 2018 brochure discusses this on page 109. (It's obviously different than ester's understanding.) Please read the brochure for the FEHB plan you have and/or are considering....
The above is my understanding, also.
This changes everything for us. We were planning to keep FEHB (BCBS basic) and elect only Part A. I looked forward to not having to find Medicare providers, and manage a double set of insurance paperwork. But later in the "Coordinating benefits with Medicare and other coverage" section reads:
It is generally to your financial advantage to use a physician who participates with Medicare. Such physicians are permitted to collect only up to the Medicare approved amount.
I am having second thoughts that I know enough to make this decision, and have the ability always to stick to the terms. For example, what kind of money are we talking about here?
If your physician does not participate with Medicare and is in our network: you are responsible for your copayments and coinsurance, and any balance up to 115% of the Medicare approved amount.
How likely is it for annual part B premiums to consistently be less than all the 115% charges one will incur?
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Re: Federal Retiree Health Care with/Medicare

Post by retirednps » Mon Oct 30, 2017 7:53 pm

re: "I would love to hear from folks that have lived with Medicare + FEHB for a while to learn about what changes."

I'm in my early 70s, I've been retired and on Medicare Part A and B for 7 years, and have continued my BCBS FEHB coverage. My wife is on Medicare A & B and my FEHB "member + 1" plan. Yes, I've paid some extra premiums as a result, but have had no out-of-pocket expenses other than some prescription med co-pays. I was healthy when I retired, but have since have 3 surgeries - one a very expensive one, and some expensive diagnostic tests - so in my case I'm glad to have this "full coverage." I've had only one minor claims question, arising when my wife had an ER visit out-of-state, and it bounced around the BCBS system for a while. Otherwise the coordination of benefits between Medicare (primary) and BCBS (secondary) has been seamless. This coming open season I'm looking seriously at the Atena Direct plan, due to lower overall costs, and the fact that the only major hospital in my area and BCBS have parted ways, so my use of that facility would be '"out of network" for BCBS. I've had no problem finding physicians in our area that accept both Medicare assignment and my FEHB policy for payment, and there aren't many federal retirees in this area. In retrospect, I should have looked more closely at going to a less expensive FEHB plan once I was enrolled in Medicare, but given my recent medical history, I don't think I've paid a big financial penalty for having"maximum coverage" so far.

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Re: Federal Retiree Health Care with/Medicare

Post by mrc » Tue Oct 31, 2017 3:32 am

retirednps wrote:
Mon Oct 30, 2017 7:53 pm
re: "I would love to hear from folks that have lived with Medicare + FEHB for a while to learn about what changes."

I'm in my early 70s, I've been retired and on Medicare Part A and B for 7 years, and have continued my BCBS FEHB coverage. My wife is on Medicare A & B and my FEHB "member + 1" plan. Yes, I've paid some extra premiums as a result, but have had no out-of-pocket expenses other than some prescription med co-pays. I was healthy when I retired, but have since have 3 surgeries - one a very expensive one, and some expensive diagnostic tests - so in my case I'm glad to have this "full coverage." I've had only one minor claims question, arising when my wife had an ER visit out-of-state, and it bounced around the BCBS system for a while. Otherwise the coordination of benefits between Medicare (primary) and BCBS (secondary) has been seamless. This coming open season I'm looking seriously at the Atena Direct plan, due to lower overall costs, and the fact that the only major hospital in my area and BCBS have parted ways, so my use of that facility would be '"out of network" for BCBS. I've had no problem finding physicians in our area that accept both Medicare assignment and my FEHB policy for payment, and there aren't many federal retirees in this area. In retrospect, I should have looked more closely at going to a less expensive FEHB plan once I was enrolled in Medicare, but given my recent medical history, I don't think I've paid a big financial penalty for having"maximum coverage" so far.
Fantastic information, makes me feel better. Welcome to BH too!
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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Tue Oct 31, 2017 6:36 am

retirednps wrote:
Mon Oct 30, 2017 7:53 pm
This coming open season I'm looking seriously at the Atena Direct plan, due to lower overall costs, and the fact that the only major hospital in my area and BCBS have parted ways, so my use of that facility would be '"out of network" for BCBS.
Welcome to the forum. :happy My experience with Medicare and BCBS has been similar.

I am in the same situation - the largest medical provider in my area has left BCBS. But I'm under the impression that once Medicare becomes the primary provider, that in network and out of network does not matter.

Something to look at as I'd like to stay with BCBS.

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Re: Federal Retiree Health Care with/Medicare

Post by retirednps » Tue Oct 31, 2017 8:59 am

re: "I'm under the impression that once Medicare becomes the primary provider, that in network and out of network does not matter. "

That's a key point. My FEHB (Blue Cross/Blue Shield) is my secondary coverage, and has paid the full balance after medicare since I've only used "in network" providers. My understanding is that if I use an OUT-of-network provider, BCBS will not pay the full amount due after Medicare. I called BCBS to try to clarify that, and got a very confusing explanation. I do know I'd have to pay the provider for the full amount due after Medicare, file a claim with BCBS for that amount, and then be reimbursed by BCBS for my payment. Unfortunately, I could not get a clear explanation about even a general rule of thumb about how much of that balance BCBS would reimburse to me (All of it, most of it, a percentage . . . ?)

Perhaps someone else on this site can clarify that for me. I suspect others have the same question.

That uncertainty, plus the higher cost of BCBS, will likely cause me to switch to Aetna Direct for 2018. All of my current providers, plus the area's major hospital, will be in-network next year for the Aetna plan; that won't be the case for BCBS.

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Re: Federal Retiree Health Care with/Medicare

Post by bartbill » Tue Oct 31, 2017 9:20 am

How did you learn that the hospitals in you area will no longer participate with BCBS. This could be a big deal for us. I would never have thought to ask.

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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Tue Oct 31, 2017 9:38 am

bartbill wrote:
Tue Oct 31, 2017 9:20 am
How did you learn that the hospitals in you area will no longer participate with BCBS. This could be a big deal for us. I would never have thought to ask.
In the counties surrounding where I live, it was announced in the newspapers and TV news. Also I got a letter from BCBS saying they were getting out (even before the end of the year).

I don't think this is something you need to worry about if you have not heard anything.

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Re: Federal Retiree Health Care with/Medicare

Post by retiredjg » Tue Oct 31, 2017 9:41 am

My understanding is that if I use an OUT-of-network provider, BCBS will not pay the full amount due after Medicare
.
That would be a problem. More research is due on this. There is a convenient SHIP person in a nearby town - I'll ask him too.

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Re: Federal Retiree Health Care with/Medicare

Post by mrc » Tue Oct 31, 2017 9:47 am

retirednps wrote:
Tue Oct 31, 2017 8:59 am
re: "I'm under the impression that once Medicare becomes the primary provider, that in network and out of network does not matter. "

That's a key point. My FEHB (Blue Cross/Blue Shield) is my secondary coverage, and has paid the full balance after medicare since I've only used "in network" providers. My understanding is that if I use an OUT-of-network provider, BCBS will not pay the full amount due after Medicare. I called BCBS to try to clarify that, and got a very confusing explanation. I do know I'd have to pay the provider for the full amount due after Medicare, file a claim with BCBS for that amount, and then be reimbursed by BCBS for my payment. Unfortunately, I could not get a clear explanation about even a general rule of thumb about how much of that balance BCBS would reimburse to me (All of it, most of it, a percentage . . . ?)

Perhaps someone else on this site can clarify that for me. I suspect others have the same question.

That uncertainty, plus the higher cost of BCBS, will likely cause me to switch to Aetna Direct for 2018. All of my current providers, plus the area's major hospital, will be in-network next year for the Aetna plan; that won't be the case for BCBS.
A lot depends on whether you elect Standard or Basic. Here's the BCBS FEP physician charges table for 2018. This is exactly the kind of thing I hoped to avoid dealing with in retirement. Notice that last line: It is generally to your financial advantage to use a physician who participates with Medicare.

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Re: Federal Retiree Health Care with/Medicare

Post by Blues » Tue Oct 31, 2017 10:11 am

retiredjg wrote:
Tue Oct 31, 2017 9:38 am
In the counties surrounding where I live, it was announced in the newspapers and TV news. Also I got a letter from BCBS saying they were getting out (even before the end of the year).

I don't think this is something you need to worry about if you have not heard anything.
I don't know if you ultimately ended up settling in the general area where we reside, but they announced the same thing regarding the relationship between the hospitals and BC / BS over the past year.

We switched from BC / BS to GEHA Standard several years ago and it's been more than adequate for our needs thus far...enough so that I've only elected Part A when I recently became eligible for old people's insurance. Sigh. (The missus has a few more years before she's eligible.)
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Re: Federal Retiree Health Care with/Medicare

Post by dm200 » Tue Oct 31, 2017 10:17 am

bartbill wrote:
Tue Oct 31, 2017 9:20 am
How did you learn that the hospitals in you area will no longer participate with BCBS. This could be a big deal for us. I would never have thought to ask.
No knowledge of BCBS and hospitals, but in this area (Washington DC, Maryland and Virginia suburbs) there seems to be a trend that plans focus on certain hospitals or only work with certain ones (with the exception of emergency rooms). Depending on your plan, you may need to use a particular hospital. Our plan, for example, dropped to largest hospital in Northern Virginia. The good news, for us, is that the one they retained is the closest one to our home.

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Re: Federal Retiree Health Care with/Medicare

Post by ChrisC » Tue Oct 31, 2017 10:23 am

retirednps wrote:
Tue Oct 31, 2017 8:59 am
re: "I'm under the impression that once Medicare becomes the primary provider, that in network and out of network does not matter. "

That's a key point. My FEHB (Blue Cross/Blue Shield) is my secondary coverage, and has paid the full balance after medicare since I've only used "in network" providers. My understanding is that if I use an OUT-of-network provider, BCBS will not pay the full amount due after Medicare. I called BCBS to try to clarify that, and got a very confusing explanation. I do know I'd have to pay the provider for the full amount due after Medicare, file a claim with BCBS for that amount, and then be reimbursed by BCBS for my payment. Unfortunately, I could not get a clear explanation about even a general rule of thumb about how much of that balance BCBS would reimburse to me (All of it, most of it, a percentage . . . ?)

Perhaps someone else on this site can clarify that for me. I suspect others have the same question.

That uncertainty, plus the higher cost of BCBS, will likely cause me to switch to Aetna Direct for 2018. All of my current providers, plus the area's major hospital, will be in-network next year for the Aetna plan; that won't be the case for BCBS.
Well, you must have BCBS-Basic, which only covers medical care provided by in-network providers. Just to give you a sense of how benefits might be coordinated, let me give you my family's situation. My wife and I have GEHA-HDHP (self plus 1) but wife has Medicare A and B. Under my FEHB plan, Medicare deductibles or co-pays aren't waived for care incurred by my wife, so we pay out-of-pocket expenses with Medicare as primary until we meet the GEHA deductible of $3000 then all deductibles and co-pays would be covered by GEHA as secondary coverage. I'm paying very low GEHA premiums but that's balanced against paying Medicare Part B, IRMAA premiums, for coverage for my wife.

I manage my BIL's financial situation, including his medical expenses and payments. He's retired Federal LEO, with BCBS-Basic and Medicare Part A & B. (He was automatically enrolled in Medicare when he became disabled with MS four years into his Federal retirement and covered by SS Disability.) He has very expensive medical care, with 2 knee replacements this past year, and on-going MS infusion therapies that occur monthly. All of his care has been in-network with BCBS with few exceptions. In those excepted cases for care that occurred at a SNF which had some providers out of networ for BCBS -- so we paid the 20% Medicare Part B co-payment.

On the other hand, we also managed my MIL's financial and medical care for the last 9 months of her life -- she passed at 98 this past July (and it was unexpectedly to us). She was also a retired Federal worker, with APWU-high option and Medicare Part A & B. Except for one emergency ambulance trip, between Medicare and APWU, all of her medical care was fully covered. The high option plan with APWU worked for her the last 9 months as we moved her from Virginia to North Carolina and APWU didn't appear to have in-network restrictions on her medical providers.

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Re: Federal Retiree Health Care with/Medicare

Post by DrGoogle2017 » Tue Oct 31, 2017 10:58 am

It helps my family tremendously, in fact this is one reason why we didn’t retire sooner. Without the retiree health insurance my husband and I could NOT retire before Medicare age, plus the insurance covers my two kids. And not just health insurance, you can buy decent dental insurance. My oldest daughter is no longer in the plan and she has health insurance but no dental. The dental insurance plans on the market are not worth paying for. So she pays $180 to see our dentist twice a year.

Plus when we travel overseas, we don’t worry about medical insurance. I think the cheapest BCBS covers when we travel overseas also.

My husband originally didn’t want to pay for Medicare Part B, but 3 months after he turned 65, his doctor was no longer taking BCBS, but he would take Medicare. So my husband signed up just in time before he had to pay penalty. He is now paying $128 for Medicare part B plus about $360 for BCBS from the federal. We maybe overinsuring now because we rarely see our doctors but I think the peace of mind will come in later when we are much older. Right now I don’t have the headache of dealing with the receptionist regarding the copay amount. In the past they kept insisting the copay is higher than it should be.

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Re: Federal Retiree Health Care with/Medicare

Post by DrGoogle2017 » Tue Oct 31, 2017 1:02 pm

macaroon wrote:
Tue Oct 17, 2017 7:17 pm
Blue Cross Basic is going to have a Medicare premium reimbursement account in 2018 but it's only $600 -- less than Aetna Direct.
https://fepblue.org/en/news/2017/09 ... fits-rates

Medicare Updates
As part of our Medicare benefits, Basic Option members with Medicare Part A and B can receive up to a $600 Medicare reimbursement account. You must use the account to pay your Medicare Part B premium."
I see Skilled Nursing Facility for Standard Option, is that helpful for LTC in later years.

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Re: Federal Retiree Health Care with/Medicare

Post by Nearing_Destination » Wed Nov 08, 2017 1:30 pm

Info_Hound wrote:
Sun Oct 22, 2017 11:00 am
LuigiLikesPizza wrote:
Sat Apr 29, 2017 6:37 pm
Although I could retire now, I have been convinced by several that I should stick it out for the time when I am eligible to take my federal retiree health care with me. So, I'll pay the premium when I retire and one day, I will reach the age for Medicare eligibility.

How do federal employees with their own federal health insurance fare with Medicare compared to retirees with their own private health insurance plans? Is there any benefit to having federal retiree health insurance when it comes time to also sign up for Medicare?
Addressing the OP's original question -
1) I have Federal retiree health insurance - BCBS basic -plus 1 plan (24 yr old child also covered). Widowed
2) I am retired, 65 rolling on to 66 shortly and did sign up for Med. Part A & B at 65. I retired at age 60.
3) In good health, no current issues or known long term medical needs.
4) I do not live in an area with a large federal work force presence, so finding doctors who accept the range of offered FEH plans is difficult to near impossible. Something to think about when choosing a plan.

Your thoughts were my thoughts prior to making a decision. Having BCBS coverage prior to becoming Medicare eligible was worth it's weight in gold. With (currently) 70% of the cost covered by the government and only 30% of the cost coming out of my pocket made a huge difference in addressing one of the more expensive aspects of retirement prior to Medicare. If you want to see what you might pay for insurance coverage in your 'gap' years, price out a policy on the ACA exchange that most closely matches your current FEH plan and compare what you are currently paying/deductibles/availability to an ACA plan. It's unlikely you will beat the FEH plan with an ACA plan. Carrying a private policy is usually more expensive than most of the FEH plans.

I did a mega ROTH conversion at age 63 which would put my Part B payments through the roof if I signed on at age 65. I considered delaying by a year, signing up and taking the 10% penalty. Did a cost analysis and decided to sign up and take the pain of 1 year of large Part B premiums, because in the long run it would be cheaper than carrying the 10% penalty over a lifetime. I plan to live an average life span (for planning purposes).

I have been to the doctor for wellness visits and minor issues. What I have seen is I no longer pay copays at the doctor's or for prescriptions. Things that BCBS basic does not cover, Medicare Part B has. The only change that occurred when I signed up for A & B was Medicare gets to pay first, then BCBS next. My BCBS coverage did not change at all.

I am paying premiums for both Part B and BCBS coverage. The Part D options were more expensive than continuing with the better and more comprehensive FEH coverage. Seeing that this year BCBS is offering an $600 reimbursement option for Part B payments, I will be looking into this for 2018. If I choose to leave the FEH plan system all together (likely do to raging cost), I know I can never come back.

Having both FEH and Part B gives me options - 1) Belt and suspenders - SWAN. 2) If for some reason the FEH plan cost coverage changes, say the government only pays 30% and I am expected to pay 70% of the premium, I have not saddled myself with the 10% per year Part B penalty because I did not sign up at 65. 3) As a widow of a Fed, my husband gave me a precious gift - a way to buy health coverage at affordable rates even after he was no longer with me. I think of it as his 'I Love You' plan after he passed.

The way I read your question was as a 2 part question - 1) Is it worth it to stick it out to get FEH coverage for the rest of my/our life. Only you know what that is worth to you and your wife. This can be calculated as mentioned above. 2) Is it worth it to continue working until I meet the lifetime FEH plan requirement. That is more easily calculated as it is a near term event, but it does mean when you decide on an answer to question 2, you automatically have resolved question #1.

Good luck!
INFO-HOUND

You can “ suspend “ —**not cancel** — your FEHB benefits and return to using them later.
Canceling results in your no longer being eligible; suspending means you CAN restart at some later open season


Re: hospitals dropping BC/BS — are the hospitals dropping or is BC/BS dropping the hospitals?
In speaking to dr office, the BC/BS standard is the best option for those of us not yet eligible for Medicare, and fewer dr are accepting Medicare patients (that weren’t already existing patients) don’t know if BC/BS basic would fare as well with our current health conditions for both of us (recent surgery for spouse mostly covered with small co-pay)

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