Ask The Experts: Retirement

By Reg Jones

Medicare Part B vs. FEHB

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Q. If I choose not to take Medicare B, and remain with just my Federal Employees Health Benefits plan, what does the FEHB plan pay? Does it pay as it did when I was working (with annual deductibles, co-pays, etc.) or does the FEHB plan reduce all payments to only the amounts that Medicare pays? I cannot afford to continue paying both Medicare B and FEHB premiums, but have to recognize that fewer doctors will accept Medicare patients. If I get out of Medicare B and use just my FEHB plan, will that FEHB plan automatically reduce payments to Medicare B levels?

A. If you are enrolled In Medicare Part B, you have the advantage of coordination of benefits between Medicare and your FEHB plan, reducing your out-of-pocket costs, and your FEHB plan may waive its co-payments, co-insurance, and deductibles for Part B services. Further, some services covered under Part B might not be covered or only partially covered by your plan, such as orthopedic and prosthetic devices, durable medical equipment, home health care and medical supplies.

For a better idea of what your Blue Cross/Blue Shield plan will cover if you aren’t enrolled in Part B, go to www.opm.gov/healthcare-insurance/healthcare/plan-information/plan-codes/2013/brochure.pdf, beginning on Page 134.

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