By Reg Jones
Q. My disabled adult child is covered under my Federal Employees Health Benefits. How can I ensure that she will remain covered by FEHB after I pass on?
Q. I am a retiree from Tinker Air Force Base, Okla., with health insurance. Turning 65. What happens about Medicare, and which insurance is primary? Does the health insurance turn to a supplement policy? Do you need Medicare A & B? I have only signed up for Medicare A.
Q. I am a postal employee with self-only coverage. My wife works in private industry and has her own self coverage. Do I need to convert to family coverage and add my wife five years before I retire to keep her on my health insurance? Also, where can I find answers to questions like this?
Q. I am 50, have 20 years under FERS and am thinking of retiring in six years when I reach my MRA of 56. If I do this, will I get health insurance coverage right away? Also, can I retire at 56 but delay retirement payments until 60 (or is it 62?) so I can avoid the 5 percent-per-year reduction in the payout? My main concern is keeping health insurance in place as soon as I retire at 56 — I can afford to delay the payout.
Q. I have a postponed retirement. When I start my annuity at age 62, must I enroll in Federal Employees Health Benefits at startup or may I enroll at a later date?
Q. I will have been a federal employee for five years on Aug. 31. I will be 61 years old. I would like to leave federal service effective on that date. Will I be entitled to a pension? If so, how do I determine the amount. What is the financial impact if I wait to retire until August 2014 when I am 62?
Q. I am 57 and a recent CSRS retiree. My husband is 67 and receives Social Security. He has Medicare Part A and is covered under my Federal Employees Health Benefits insurance plan. He is in the eight-month period after my retirement to enroll without penalty in Medicare Part B. Can he suspend his coverage in the FEHBP to enroll in a Medicare Advantage plan? Then I could change my FEHBP enrollment to self-only, which would reduce our insurance costs. Or is suspension of FEHB only an option for annuitants?
A. He can’t suspend his coverage under the FEHB program. However, during the next open season, you could change from self-and-family coverage to self-only. If, in the future, you would like to switch back to self-and-family coverage, you could do that during an open season.
Q. I am a retired federal employee with Kaiser Permanente standard health coverage. My co-pays are low, as are my prescription drugs. Kaiser offers a Medicare Plus plan I can enroll in, but I have to have Medicare Part B to qualify. My Federal Employees Health Benefits premiums would not increase and they advertise lower deductibles, I assume, because they would be able to bill Medicare for some of the costs of care. It doesn’t seem that enrolling in Medicare Part B when I turn 65 in a few months is worth the extra premium.
At some point in the next few years, I may move to an area where Kaiser is not available. If I have to switch to another FEHB plan like Blue Cross or another HMO, will it be more financially advantageous to have Medicare Part B if their coverage for co-pays and drugs are not as good as Kaiser? I would hate to have to enroll in Medicare Part B a few years down the road and pay the extra premium penalty when I could enroll now at lower cost. What do you think?
Q. I’m a 68-year-old Postal Service employee under FERS. I wanted to retire on or about May 10 because I began my postal career as a regular carrier on May 10, 2009. I purchased the Blue Cross/Blue Shield Basic medical insurance as soon as the open season began in 2009. Now someone tells me that to continue into retirement with the BC/BS medical insurance, I should have signed up for the medical insurance immediately when I became a regular carrier in May 2009. I thought I needed to wait until the open season. Can I still retire on or about May 10, or do I have to wait until 2014 to get in under the five-year rule to continue my BCBS medical insurance?
Q. It seems to me that if I choose to take Medicare Part B with my Blue Cross/Blue Shield standard Federal Employees Health Benefits insurance, my maximum additional out of pocket would be $2,500 Medicare premium plus $5,000 expensive drugs = $7,500. If I decline Medicare Part B, my max out of pocket would be $5,000. Am I missing something?
Q. In 2014, when the Affordable Care Act goes into effect, will federal retirees be forced to change their present medical plan? I have been retired since 2000. I am enrolled in the Kaiser Plan and I want to know whether I will be forced to give it up. If I am allowed to stay enrolled in Kaiser, will I be charged a higher monthly payment to stay in this program? I have established doctors who have been assigned to me for quite a few years and I am concerned that I will lose them.
Q. I am 64 and have worked for the Transportation Security Administration for 2½ years. I would like to retire when I reach 65 next year when Medicare becomes available to me. But my wife is one year younger. Is there a COBRA system so she can be covered for the one year before her Medicare kicks in?
February 27th, 2012 | Coverage after retirement
Q: When do I have to put my wife under my health insurance? She is still working and doesn’t plan to retire for a couple of more years. I plan to retire next year. Do I have to insure her before I retire, while I am still working for the VA, or can I wait till she retires and loses her insurance to put her under my health insurance after I retire?
A: You could change your coverage from self to self and family when she loses her nonfederal coverage. The authority for that is Code 2G under OPM’s Table of Changes to Enrollment.
February 24th, 2012 | Coverage after retirement
Q: My husband and I work for the post office – he will retire soon and I will carry the health insurance and leave with a deferred retirement in a few years – at 45 with 20 years – what happens to the health benefits?
A: Your husband would be able to continue the self and family coverage under Code 1M of the Table of Permissible Changes in Enrollment.
February 17th, 2012 | Coverage after retirement
Q: I have an employee that enrolled in the FEHB plans effective Jan. 2, 2011, and has worked for the government for approximately 30 years. My agency is undergoing a VERA/VSIP announced in September. However, I found out that my agency did not request a preapproved waiver to include the health insurance. Can you tell me if this employee will be eligible to carry her health insurance into retirement?
A: In order for her to continue her FEHB coverage, your agency needed to attach a memorandum to her retirement application stating that she met the requirements for a pre-approved waiver by OPM. That certification had to include the number of the public law granting the agency’s buyout authority and the beginning and ending dates of the agency’s buyout period. If your agency didn’t do that, it will have to correct that error.
February 14th, 2012 | Coverage after retirement
Q: My husband and I are retired federal employees. While we were employed, we did not have separate self-only health insurance plans. My husband was a part of my self-and-family plan. We continue to have a self-and-family plan. Because the combined annual cost of self-and-family coverage is about $900 more than the cost of two self-only policies, we would like to have separtate policies. Can we do this? If the answer is yes, is there an OPM or FEHB reference I can share with my husband. He is concerned about making changes and insists he was told at pre-retirement seminars that the self-only coverage is possible only if he had the self-only coverage while employed by the government.
A: To make a change to two self-only emrollments, call OPM’s Retirement Information Office at 888-767-6738 (202-6-6-0500 in the D.C. Metro area).
February 13th, 2012 | Coverage after retirement
Q: My wife and I are federal employees. I’m under CSRS and will probably retire in 2012 with 40+ years of service at age 62. She is under FERS and not eligible to retire until 2017. We’re enrolled in a family FEHBP under my name. Does it make sense for us to swap during this Open Season so that we are covered by a family plan under her name and paid for by her pre-tax dollars? Are there procedural risks of me dropping coverage and her new election not going through, which would jeopardize me meeting the five-year rule for carrying coverage into retirement?
A: There are no risks in switching during Open Season because you only need to be enrolled or covered by the FEHB program for the five consecutive years before retirement to carry that coverage into retirement.
Q. I plan to retire in a few years. I am currently 67 years old, participate in the Federal Employees Health Benefit Plan with Blue Cross Blue Shield and am enrolled in Medicare Part A, which is free and required at 65. I do not wish to participate in Medicare Part B because, from the way I see it, I would be paying for two primary insurers even when I retire. Am I entitled to continue with my FEHB as my primary coverage, and would I be entitled to the same choices as though I were still working for the government? I feel that Blue Cross is the better of the two coverages and Medicare Part B and my portion of my Basic Plan with BCBS is about the same cost to me and Blue Cross is readily accepted by all doctors.
A. Once you retire, Medicare Part A will be primary and your FEHB plan secondary. If you don’t enroll in Medicare Part B, your FEHB plan will be your only coverage, but it won’t pay benefits in the same way it did when you were employed. How that is done is explained on pages 24 and 25 of your 2011 Blue Cross and Blue Shield Service Benefit Plan brochure.
Q. I am 62, and will be retiring from the Postal Service within three months, rather unexpectedly. We will be continuing with my current Blue Cross Blue Shield plan for annuitants. My wife is 65, and declined Medicare Part B since I was still working. Will it be necessary for her to sign up for Part B, or will the continued Federal Employees Health Benefit plan suffice?
A. She doesn’t have to sign up for Medicare Part B. However, before she makes up her mind, the two of you need to weigh the potential costs and benefits of that decision. If you conclude that what is covered by your Blue Cross Blue Shield plan will be sufficient over time, she can decide not to elect Part B. On the other hand, if Part B offers complementary benefits and/or different ones that fill important gaps and reduce your out-of-pocket cost, even when considering the monthly premiums, then she can elect Part B.
Q. I am a Civil Service Retirement System retiree approaching age 65. My wife and I have been covered by Blue Cross/Blue Shield Standard Option FEHB since retiring in 2002. My wife will not be eligible for Medicare until 2013, and she has never been employed by the federal government. Do I maintain my Federal Employees Health Benefit plan for both of us in order for her to be covered? Or is there some provision that will permit me to pay a Medicare Part B premium for my portion of the health care coverage out of my annuity while maintaining her FEHB full health insurance premium?
A. The only way she can continue to be covered by your FEHB plan is for you to continue being enrolled in the self-and-family option. If you additionally elect to be covered by Medicare Part B, those premiums can be deducted from your annuity.