By Reg Jones
Two forms of health insurance
February 17th, 2012 | FEHBP and Medicare
Q: I am 68 and a CSRS retiree. What are the advantages of enrolling in Medicare Part A when I am already covered under the FEHB?
A: You want some advantages? First, it’s free. You already paid for it through payroll deductions while you were working. Second, the combination of Medicare Part A and your FEHB plan will reduce or eliminate most of the deductibles and out-of-pocket charges for hospital care. Third, because the two programs don’t always cover the same things or in the same way, they tend to complement each other, giving you better coverage at lower cost.
Tags: CSRS, HEALTH INSURANCE
Figuring out primary, secondary coverage
January 31st, 2012 | Coverage after retirement FEHBP and Medicare HEALTH INSURANCE Medicare 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.
Part B decision depends on costs, benefits
January 31st, 2012 | Coverage after retirement FEHBP and Medicare HEALTH INSURANCE Medicare RETIREMENT
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.
Primary insurance depends on employment status
January 25th, 2012 | Creditable service: CSRS FEHBP and Medicare HEALTH INSURANCE Medicare RETIREMENT
Q. I have been receiving workers’ comp benefits since 1981. I have no Civil Service Retirement System benefits available, as I withdrew my contributions when I was separated from service. I am now 65 years old and have applied for Medicare. I have maintained my Blue Cross/Blue Shield insurance through the Office of Workers’ Compensation Programs. There is now a dispute as to whether that insurance is primary or Medicare is primary. The question seems to revolve around the following question: Am I “retired” or am I still employed? Do you know the answer?
A: Workers’ compensation is an income replacement program that is designed to continue until an injured employee recovers or dies, whichever comes first. If someone on workers’ comp recovers, he goes back on the agency rolls or, if he is eligible and wants to do so, retires. This tells me that you aren’t retired, a conclusion that is bolstered by the fact that you are not on OPM’s annuity roll and, therefore, not receiving an annuity. If I am right, then your Federal Employees Health Benefit plan carrier would continue to be the primary payer and Medicare secondary.
Fed health plan is secondary; should premium drop?
January 20th, 2012 | FEHBP and Medicare HEALTH INSURANCE RETIREMENT
Q. I am covered under my wife’s Blue Cross/Blue Shield federal plan, even though we both retired from the Postal Service. I am now on Medicare, and Medicare is my primary health coverage (I have plans A and B), with BCBS being secondary. My wife is 62. My question is: Should my wife’s (our) BCBS coverage premium be reduced since BCBS is now secondary and not covering me like it did before I went on Medicare?
A. No. There isn’t any provision in law that would permit that.
Will FEHB plan cover wife?
January 17th, 2012 | Coverage after retirement FEHBP and Medicare HEALTH INSURANCE Medicare
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.
Compare Part B, FEHBP to decide which is appropriate
January 17th, 2012 | FEHBP and Medicare HEALTH INSURANCE Medicare
Q. I am a federal annuitant and have Federal Employees Health Benefit Plan 105 for myself and my spouse. We also subscribe to Medicare Part B. Since there are overlaps between Medicare Part B and FEHBP, I am considering stopping Medicare Part B. How do I do a cost-benefit analysis of retaining vs. stopping Medicare Part B? Also, please let me know about which state and federal help agents I can approach.
A. To the best of my knowledge, there isn’t any publication or software that will allow you to do a cost-benefit analysis. There are simply too many variables. You’re going to have to make a decision based on your own comparison of the coverage offered by the two and their relative cost. Just remember that what you need in the way of coverage today may not be the same as what you need later on. Further, if you drop your Medicare Part B coverage and later realize that you need it, when you re-enroll you will be penalized for every year you could have been enrolled and weren’t. Note: While there is no source of information that will meet all your needs, OPM has a pamphlet called called “The Federal Employees Health Benefits Program and Medicare” that you might find helpful. You’ll find it at http://www.opm.gov/insure/archive/health/medicare/75-12-FINAL.pdf.
Insurance for spouse
December 16th, 2011 | FEHBP and Medicare
Q: My husband is retired from civil service. We were not married at the time of his retirement. It has been three years since we married and I wanted to know if I was able to get coverage on his health insurance. We had attempted to get some help locally when we first got married but we were told no.
A: He could have done that from 31 days before you married through 60 days after the event. Since he didn’t, he can still change from self-only to self-and-family coverage during the upcoming FEHB open season.
Tags: HEALTH INSURANCE, RETIREMENT
Medicare schedule
December 15th, 2011 | FEHBP and Medicare
Q: I understand that FEHB, by law, may not pay the provider more than Medicare schedule after retirement. Is that correct?
A: No. To find out what FEHB plans pay, read the section in your plan brochure titled “When you have the Original Medicare Plan (Part A, Part B, or both).”
Tags: FEHB, Medicare, RETIREMENT
Medicare enrollment
September 21st, 2011 | FEHBP and Medicare
Q: I am a 60-year-old CSRS retiree enrolled in an FEHB family plan. My wife is several years younger than me. If I enroll in Medicare at age 65, what happens to my wife’s FEHB coverage? Do I need to continue my FEHB plan even after I enroll in Medicare to insure she is covered? Would I be better off forgoing Medicare and just relying on my FEHB plan?
A: In order for your wife to continue her coverage, you’ll need to maintain your FEHB enrollment in the self and family option. While you will be eligible for Medicare Part A coverage at no cost to you when you reach age 65, you’ll need to decide whether to enroll in Part B, for which you’d have to pay the premiums. Before making up your mind about the latter, consult your FEHB plan brochure to learn the pluses and minuses of enrolling in Part B.