[Bill14564]

Originally Posted by GATORBILL66

Yes, I am a retired postal employee, you need to sign up for Part B within 8 months of retiring. Medicare will pay the first 80% and your government plan will cover the other 20%. I have GEHA standard option and don't pay any medical expenses. You have to sign up for Part B through Social Security. Don't be late or you will have to pay an extra 10% per year the rest of your life.

Originally Posted by BlueStarAirlines

This is not true for all Federal employees....only for Postal employees. There are efforts to make it applicable to all employees, but no traction on this effort so I don't expect to see this anytime soon.

When I was looking into this I saw no mention of special Part B rules for postal employees. Please check to make sure of the rules for your specific situation. From what I was able to find, Gatorbill's statement also applies to me, a non-postal federal retiree.

The two rules I saw were:
- If you are currently retired and less than 65 then you must enroll in Part B within the window around your 65th birthday
- if you turn 65 before you retire then you have an eight month eligibility window once you retire

Miss the window that applies to you and you may need to pay a lifetime late-enrollment penalty.

[jump4]

Originally Posted by Bill14564

Where did you get the idea that BC/BS was one of the most expensive plans? According to the plan comparison chart, BC/BS falls in the middle price-wise.

Comparing benefits, provider availability, benefits when you travel out of your area, and benefits when also covered under medicare is possibly more important than choosing by price alone.

I agree 100% you should not shop for any type of insurance on premium price alone! But if you take a close look at the FEHB plans, you will find several with benefits comparable to BC/BS (especially when paired with medicare) and much lower premium price. The best comparison tool is at Guide to Health Plans For Federal Employees, 2023 FEHB Open Season

[jump4]

Originally Posted by bsloan1960

I'll soon be a Federal Retiree. The Fed Gov allows me to take my BC/BS plan into retirement- So I'll have private insurance

My BC/BS plan will reimburse me $800 in Part B premiums per year if I take Part B

I'm aware Part A is mandatory- but Part B is elective.

I go to the doctor quite a lot- regular doctor and specialists. What does Part B cover/pay for?... do they cover cover co-pays for doctor visits and urgent care visits?

I will be paying about $40 for all office visits. If Part B covers these it will be worth it.

Bottom line- I'm hoping to find out what Part B pays for and if people here who have private insurance find Part B worth the expense of premiums.

Thanks!

If you're willing to do some research, the following resources should be helpful:

myfederalretirement.com

FEHB and Medicare Coverage - FEDweek

Medicare and FEHB Coordination | Federal News Network

Excellent comparison tool Guide to Health Plans For Federal Employees, 2023 FEHB Open Season

[retiredguy123]

Originally Posted by Bill14564

When I was looking into this I saw no mention of special Part B rules for postal employees. Please check to make sure of the rules for your specific situation. From what I was able to find, Gatorbill's statement also applies to me, a non-postal federal retiree.

The two rules I saw were:
- If you are currently retired and less than 65 then you must enroll in Part B within the window around your 65th birthday
- if you turn 65 before you retire then you have an eight month eligibility window once you retire

Miss the window that applies to you and you may need to pay a lifetime late-enrollment penalty.

There is a penalty for delaying enrollment into Medicare. I think it is 10 percent for every year that you delay the enrollment, but it only applies to the basic, $164.90 per month amount, not to the IRMAA amount, if that applies. But, it sounded like Gatorbill was saying that you were required to sign up for Medicare Part B. That is not true. Enrollment in Medicare is optional for Federal retirees. You are not required to have Medicare Part B at all.

[Hardlyworking]

Medicare part B is optional for everyone.

[retiredguy123]

Originally Posted by Hardlyworking

Medicare part B is optional for everyone.

Yes and no. If you are a retiree or an over-65 employee with some companies or organizations, and they allow you to continue to use their health insurance, they may require you to sign up for Medicare or they will cancel your insurance. But, for Federal retirees, that is not the case.

[Hardlyworking]

Originally Posted by retiredguy123

Yes and no. If you are a retiree or an over-65 employee with some companies or organizations, and they allow you to continue to use their health insurance, they may require you to sign up for Medicare or they will cancel your insurance. But, for Federal retirees, that is not the case.

That is true but that is not a Medicare requirement.

[jump4]

Originally Posted by jump4

BC/BS is one of the most expensive plan. If you are going to have both medicare and FEHB, there are much less expensive FEHB plans that will give you the wave medicare wrap-around.

Sorry, I meant "waive" not "wave". Here are some additional resources you can check out:

Checkbook's advice re: Medicare FEHB & Medicare - Guide to Health Plans for Federal Employees including:
• FEHB's MA option Everything You Need to Know About Medicare Part C - Medicare Advantage - Guide to Health Plans for Federal Employees
• IRMAA IRMAA - Income Related Monthly Adjustment Amounts - Guide to Health Plans for Federal Employees

Good article by Tammy Flanagan Open Questions About Open Season - Government Executive mentions:
• Many FEHB plans will waive their cost sharing when Medicare is the primary payer.
• Some FEHB plans will provide some reimbursement if you are enrolled in Parts A and B.
• For 2023, there are many FEHB plans that offer incentives to enrolling in Medicare A and B, but some provide these benefits only if you join the Medicare Advantage option of the FEHB plan. Unlike the Medicare Advantage plans available commercially, these plans maintain the underlying FEHB coverage, which means you may not need to stay within the plan network, get referrals to see a specialist or pay out of pocket costs for most of your health care. Enrolling in the FEHB Medicare Advantage option requires a second step after you make your open season election. Details about step can be found on the plan website, or you will receive a mailing once you are enrolled.

I just listened to the following podcast The Consumers’ CHECKBOOK Guide and FEHBP Open Season with Walton Francis | Federal News Network
• skip to 23:00 minute mark for good information for annuitants (e.g., IRMAA, new Federal employee Medicare Advantage (MA) option for several FEHB plans). These MA options rebate $100-150 of medicare premium per month and adds benefits on top of the regular FEHB plan. "And especially with Aetna and United Healthcare Choice plans $0 out of pocket for approved health care services if you go to a Medicare provider, and you only are left with paying out of pocket for prescription drugs. And so that is one of the categories where you really have to focus in to see how these Medicare Advantage plans will handle your prescription drugs. But there’s tremendous savings 1000s of dollars compared to popular Blue Cross plans"

Somewhere I heard that if you add the MA option and don't like it you can remove it (do not have to wait for the next FEHB open season).

Questions I sent to the checkbook people and their response:
1. How is the prescription coverage of an FEHB plan affected when I start Medicare part B (original or the new MA option within FEHB)? “Sometimes, depending on the plan, it might lead to lower out-of-pocket costs. For example, with BCBS Basic you gain mail order prescription drug coverage when you have Part B”. [Checkbook/Kevin Moss 12/2022]

2. Does adding the MA option to FEHB plans such as United Choice Primary + United Retiree Advantage trigger both part B IRMAA and Part D IRMAA surcharges? “YES” [Checkbook/Kevin Moss 12/2022]

3. Do the FEHB MA plans suffer from the same drawbacks or concerns as for commercial MA plans (e.g. limited networks and prior authorization)? See https://www.medpagetoday.com/special...lusives/102143 and https://wapo.st/3VLutTf. “The FEHB Medicare Advantage plans go through a quality scoring system and all are either 4 or 5 stars. You have access to any provider that accepts Medicare with these plans. Are there exceptions to that? Yes, I found out this week that Aetna Advantage doesn't have a contract with the Mayo Clinic and therefore those providers wouldn't be accepted. My advice, if you're considering one of these plans is to check their existing provider network to make sure your current providers will be covered. Prescription drugs are an area of focus and the only out-of-pocket cost you'll face. You should check carefully that any prescription drugs you currently take will be covered.” [Checkbook/Kevin Moss 12/2022]

The online Checkbook FEHB guide at https://www.checkbook.org/newhig2/hig.cfm is a terrific resource where you enter your age, zip code, etc. and get a personalized analysis of all FEHB plans available to you, listing estimated total cost, maximum out-of-pocket, and summary of benefits for each plan. I think you have to pay about 10 bucks if you enter promo code FEDSMITH or FEDNEWS at checkout.

[bsloan1960]

Thank you so much for your detailed answer. I'll investigate the links you provided

Originally Posted by jump4

Sorry, I meant "waive" not "wave". Here are some additional resources you can check out:

Checkbook's advice re: Medicare FEHB & Medicare - Guide to Health Plans for Federal Employees including:
• FEHB's MA option Everything You Need to Know About Medicare Part C - Medicare Advantage - Guide to Health Plans for Federal Employees
• IRMAA IRMAA - Income Related Monthly Adjustment Amounts - Guide to Health Plans for Federal Employees

Good article by Tammy Flanagan Open Questions About Open Season - Government Executive mentions:
• Many FEHB plans will waive their cost sharing when Medicare is the primary payer.
• Some FEHB plans will provide some reimbursement if you are enrolled in Parts A and B.
• For 2023, there are many FEHB plans that offer incentives to enrolling in Medicare A and B, but some provide these benefits only if you join the Medicare Advantage option of the FEHB plan. Unlike the Medicare Advantage plans available commercially, these plans maintain the underlying FEHB coverage, which means you may not need to stay within the plan network, get referrals to see a specialist or pay out of pocket costs for most of your health care. Enrolling in the FEHB Medicare Advantage option requires a second step after you make your open season election. Details about step can be found on the plan website, or you will receive a mailing once you are enrolled.

I just listened to the following podcast The Consumers’ CHECKBOOK Guide and FEHBP Open Season with Walton Francis | Federal News Network
• skip to 23:00 minute mark for good information for annuitants (e.g., IRMAA, new Federal employee Medicare Advantage (MA) option for several FEHB plans). These MA options rebate $100-150 of medicare premium per month and adds benefits on top of the regular FEHB plan. "And especially with Aetna and United Healthcare Choice plans $0 out of pocket for approved health care services if you go to a Medicare provider, and you only are left with paying out of pocket for prescription drugs. And so that is one of the categories where you really have to focus in to see how these Medicare Advantage plans will handle your prescription drugs. But there’s tremendous savings 1000s of dollars compared to popular Blue Cross plans"

Somewhere I heard that if you add the MA option and don't like it you can remove it (do not have to wait for the next FEHB open season).

Questions I sent to the checkbook people and their response:
1. How is the prescription coverage of an FEHB plan affected when I start Medicare part B (original or the new MA option within FEHB)? “Sometimes, depending on the plan, it might lead to lower out-of-pocket costs. For example, with BCBS Basic you gain mail order prescription drug coverage when you have Part B”. [Checkbook/Kevin Moss 12/2022]

2. Does adding the MA option to FEHB plans such as United Choice Primary + United Retiree Advantage trigger both part B IRMAA and Part D IRMAA surcharges? “YES” [Checkbook/Kevin Moss 12/2022]

3. Do the FEHB MA plans suffer from the same drawbacks or concerns as for commercial MA plans (e.g. limited networks and prior authorization)? See https://www.medpagetoday.com/special...lusives/102143 and https://wapo.st/3VLutTf. “The FEHB Medicare Advantage plans go through a quality scoring system and all are either 4 or 5 stars. You have access to any provider that accepts Medicare with these plans. Are there exceptions to that? Yes, I found out this week that Aetna Advantage doesn't have a contract with the Mayo Clinic and therefore those providers wouldn't be accepted. My advice, if you're considering one of these plans is to check their existing provider network to make sure your current providers will be covered. Prescription drugs are an area of focus and the only out-of-pocket cost you'll face. You should check carefully that any prescription drugs you currently take will be covered.” [Checkbook/Kevin Moss 12/2022]

The online Checkbook FEHB guide at https://www.checkbook.org/newhig2/hig.cfm is a terrific resource where you enter your age, zip code, etc. and get a personalized analysis of all FEHB plans available to you, listing estimated total cost, maximum out-of-pocket, and summary of benefits for each plan. I think you have to pay about 10 bucks if you enter promo code FEDSMITH or FEDNEWS at checkout.