By Reg Jones
August 30th, 2012 | Uncategorized
Q. My wife and I are federal employees under FERS. I will be retiring with 25-plus years of service as a federal law enforcement officer this year. I have been enrolled in self and family coverage under the FEHBP during my entire career, and my wife has been covered under my benefit plan during this period. My wife has been employed with the government for a little more than a year in a non-LEO position and plans to remain in her job at least until she reaches MRA, which will give her right at 10 years of service. I do not intend to take a survivor annuity when I retire because we made other arrangements long ago with life insurance and personal IRAs.
Based on this scenario, I have a few questions about our options during the next FEHBP open season:
1. Since I will be retired when the next FEHBP open season occurs, will my long-term eligibility for FEHBP be harmed if I drop my self and family coverage plan during open season and my wife enrolls in a self and family plan to cover us both?
2. If my wife passes away before I do and after she retires, would I be able to re-enroll in the FEHBP even though I dropped my enrollment after retiring for coverage under my wife’s plan?
3. If my wife retires at the MRA and defers her annuity, would she still be eligible to be enrolled in the FEHBP between her retirement date and when she begins drawing her annuity? If not, would I be eligible to pick up self and family coverage for both of us during this time?
4. Overall, would it be better (or easier) for me to remain enrolled in the FEHBP after I retire and continue to carry my wife on my policy? What would be the advantages and disadvantages of doing this?
5. Finally, although we are confident that I do need to take a survivor annuity because of the arrangements we have made, would we be forgoing anything important by not taking it? I know the main issue for many people is the ability of the spouse to maintain health insurance in retirement, but since my wife is a federal employee, does it really matter?
A. While I could answer each of your questions in turn, I won’t. That’s because there’s nothing to be gained by you and your wife engaging in enrollment hopping. The only sensible thing for you to is to be continuously enrolled in the self and family option of your plan. That way all contingencies are covered.
November 23rd, 2011 | Uncategorized
Q. I am regular full-time Civil Service CSRS employee with insurance coverage (Blue Cross/ Blue Shield) for my wife and myself. My wife is retired military with Tricare. My insurance costs me about $400 a month and I understand Tricare would cost me only about $500 a year. I want to retire next year. I’m 60 years old. Would you suggest dropping BCBS and going over to Tricare?
A. I’m old enough and wise enough not to give advice. What I can tell you is that if you drop your FEHB coverage, you won’t be able to re-enroll if you later lose Tricare coverage. To avoid that outcome, you could instead either chose a lower- cost FEHB plan and option or suspend (rather than drop) your coverage.
August 24th, 2011 | Uncategorized
Q. My son is about to turn 22 and his dental coverage is ending. We are with United Concordia. Can you tell me if any other federal dental programs are available that will cover a full-time college student after the age of 22? Thank you.
A. The Federal Employee Dental and Vision Benefits program only provides coverage for unmarried dependent children under age 22. However, if your son is covered under your Federal Employees Health Benefits Program enrollment, the more limited dental services available there would continue to age 26.
July 14th, 2011 | Uncategorized
Q. I will retire soon and will chose a lifetime annuity not to include my husband with survivor benefits. Can I still carry him on my FEHB coverage?
A. You can continue to include him under the self and family option of your FEHB plan. However, if you were to change to self only or die, he would lose that coverage unless he is a federal employee or retiree who would be eligible to continue that coverage on his own.
Q: I am on disability retirement through the U.S. Postal Service. I am 48 years old and am under the Federal Employees Retirement System. I have been retired since 2009. I am also receiving Social Security disability. I just received information from Social Security stating that I am required to receive Medicare Part B. It says I may opt out, but if I decide to join later, I may end up paying penalties.
Can I keep my health insurance through the Federal Employees Health Benefits Plan? If I do keep it and decide to keep Medicare Part B, is Medicare Part B the supplementary insurance or the primary? If I decide I do not want Medicare Part B, will I be penalized when I do want it? What if I don’t want it until I reach the legal age? Will I still need to pay back penalties?
A: Enrolling in Medicare Part B is voluntary; however, as you were told, if you later elect to enroll in Part B, you will have to pay the penalty for late enrollment. That penalty is 10 percent for each 12-month period you could have been enrolled but weren’t. Because you aren’t employed, Medicare is your primary payer and the FEHBP your secondary payer.
June 1st, 2011 | Eligibility
Q: I’m in CSRS and I’m 55 with 27-and-a-half years service. I’m considering getting married and would like to know if my future spouse can be covered under my FEHB enrollment if I get married and retire within two years of retirement or, if I wait to get married until after I retire would he eligible for FEHBP? Also, he is a FERS employee but he isn’t eligible for FEHB if he retires early with me.
A: I’m not sure I understand the scenarios you presented. Fortunately, that doesn’t matter. If you get married, you can switch your enrollment from self only to self and family within 60 days of that event. Also, once married, you can make that switch during any open season, whether you are employed or retired.
Q: My spouse and I are both under the Federal Employees Retirement System and our service computation dates are within weeks of each other. We would both like to retire under the minimum retirement age plus-10 provision. My spouse wants to retire in 2011 at age 58, with 26 1/2 years of continuous service, the entire time enrolled in a Federal Employees Health Benefits individual plan. The earliest I would retire is 2012 at age 57, with 27 1/2 years of continuous service, all in an FEHB individual plan.
Here is our plan: During this open season, I should enroll my spouse and myself in an FEHB family plan. She could then retire in 2011 and elect a postponed annuity. She would have health benefits under my family plan, while her annuity entitlement increases 5 percent for each year she postpones receipt of her annuity. When she elects to receive her annuity at age 59 or 60, she can then re-enroll in an FEHB family plan. At that time, I could retire (also with a postponed annuity) and receive health benefits under my wife’s plan. Again, when I start receiving my postponed annuity several years later, I can re-enroll in an individual FEHB plan, and she could change her family coverage to an individual plan during open season. This way, we have two individual FEHB plans and we won’t have to worry about electing FERS survivor benefits that would otherwise reduce our annuities. Is this a reasonable plan?
A: Sounds like a reasonable plan. However, because you cannot have dual coverage (i.e., self and family plus self only for one family member, or self and family for both members), you’ll have to time the switch from one covered member to the other. As a rule, this would be easiest to do during the annual open season.
Q: I am retiring at the end of December and have already reached age 65. I have signed up for Social Security benefits starting in January. I also signed up for Medicare Part A coverage but not Part B coverage, as suggested at a retirement seminar. I am carrying over my Federal Employees Health Benefits coverage. I checked with my plan and they said I would not need Medicare Part B. If I decide to switch plans in the future and my new insurer suggests that I need Part B coverage, will I be penalized with the 10 percent per year penalty when I sign up?
A: Yes, you would be penalized.
Q: I am 53 years old and have 36 years of federal service. One catch: I don’t have the five years of coverage under a Federal Employees Health Benefit plan (I’m still four years short). If my office offers early out through downsizing or restructuring, approved by the Office of Personnel Management, can I retire and carry my health benefits into retirement, even though I don’t have five years of coverage?
A: Yes, you would be eligible to carry your coverage into retirement because you would have been enrolled in the program at the time your agency received approval from OPM to offer early retirements. Your agency would attach a memo to your retirement application stating that you meet the requirements for an immediate waiver of the five-year rule.
Q: I am a Civil Service Retirement System annuitant who will turn 65 soon. I have a Federal Employees Health Benefits plan. Must I sign up for Medicare Part B and/or Part D? What are the consequences if I don’t? Will my FEHB plan continue to cover my health care costs if I don’t sign up for Medicare? I have signed up for Part A because I paid for it over my working career.
A: No, you don’t have to sign up for Medicare Part B or Part D. Whether you should is a decision you’ll have to make. Your plan brochure has information about how benefits will be paid. Look for the following headings: “When you are age 65 or over and do not have Medicare,” and “When you have the Original Medicare Plan (Part A, B or both).” As for Part D, very few employees covered by an FEHB plan would have anything to gain by enrolling in it.
Q: My wife and I are both federal employees. We each have had individual coverage under the Federal Employees Health Benefits plan since we began working for the government. We both plan on retiring next year. She will be 61 and have 26 years of service; I will be 58 and have 20 years of service. I will postpone my retirement until age 60 to avoid the penalty. We plan on converting to a family plan this open season (2010) so that I am covered during those two years of my postponement. Is this the correct way to guarantee that I maintain my eligibility under FEHB for the past five years and be able to go back to an individual FEHB plan when I begin collecting my annuity at age 60?
A: Having your wife enroll in the self and family option of her plan will assure that you have health benefits coverage during the period between when you retire and when your annuity begins. You can both revert to self-only coverage during the following open season.
Q: I retired from the U.S. Postal Service in 2000 after being divorced in 1997. I gave my ex-wife 100 percent survivor benefits; she recently turned 55. I remarried in 2004 and sent the proper forms needed to add my current wife to my Federal Employees Health Benefits plan. I now have the American Postal Workers Union (472) plan, and I assumed that if I died, my present wife would be able to keep the plan. After talking with the Office of Personnel Management, I was told that I need to have my present wife named as survivor beneficiary for her to keep it, even though my ex-wife has 100 percent survivor benefits. They said that I had to do that within two years after our marriage. I was never advised of this and have never read anything on the matter. Can you please explain this to me?
A: Under 5 CFR 831.631, a retiree can elect a survivor annuity for a spouse acquired after retirement. That election must be made within two years after the marriage. Although your former spouse has entitlement to the full survivor annuity, if she were to die and you had elected a survivor annuity for your current spouse, your current spouse would be entitled to that survivor annuity. Because your annuity has already been reduced to pay for the original survivor annuity, your election of one for your current spouse wouldn’t cost you anything. Note: Even if you died after electing a survivor annuity for your current spouse, she would only be eligible to continue her FEHB coverage if she was actually receiving a survivor annuity.
Q: I have more than 30 years of employment with the federal government and plan to retire under the Civil Service Retirement System in about three years, at which point I will elect survivor benefits. For the past five years, I’ve elected a family Federal Employees Health Benefits plan to include my wife. My wife has more than three years of employment with the federal government and plans to retire under the Federal Employees Retirement System in about four years. We are both thinking about switching from family coverage to self-only coverage. If my wife retires with self-only coverage after four years of service (not five years), will she be able to carry her self-only FEHB plan into retirement, or will I have to elect a family coverage plan prior to her retirement?
A: As long as she was covered continuously for five years under a combination of your self and family option or her self-only enrollment, she can carry that coverage into retirement.
Q: I intend to retire Dec. 31 from the Department of Health and Human Services. I have had a family health insurance plan (Blue Cross/Blue Shield) for 20-plus years. My wife is a federal government employee. We want to transfer coverage from my agency to her agency (Labor Department) during the open season.
First, how do we make sure that the transfer of payment for coverage and the policy will assure that the five-year required continuous coverage is maintained? Second, if we are able to transfer and maintain continuous coverage, will my wife’s plan be my primary insurance after retirement, with Medicare secondary?
A: As long as you are enrolled in or covered by the Federal Employees Health Benefits Program for five years, you may continue that coverage into retirement. It doesn’t make any difference who is carrying the self and family enrollment. If you are still working when you become eligible for Medicare, your FEHB plan would be primary and Medicare secondary. If you aren’t working, Medicare would be primary and FEHB secondary.
Q: I am a retired federal employee, almost 65 years old, and I have to decide whether to sign up for Medicare Part B. Whether I sign up or not, I will continue with the Federal Employees Health Benefits Plan (currently Government Employees Health Association, which has a maximum annual $5,000 out-of-pocket expense). The Part B decision seems to be one of costs versus benefits. I would pay about $1,400 per year for Part B and would save/eliminate most of my out-of-pocket expenses. I rarely spend more than about $1,000 a year in out-of-pocket expenses.
It’s almost impossible to predict how the future will go on costs for Medicare and the FEHPB or on required future services. But based on my analyses, it appears that it would be easier to select an FEHPB plan that has a low annual out-of-pocket expense, some of which are not significantly different than the cost of carrying GEHA. So, I am not seeing a lot of benefit for federal employees to sign up for Part B. Are there any statistics regarding how many otherwise-Medicare-eligible federal employees decide against signing up for Part B?
A: As far as I know, there aren’t any such statistics. Nor would knowing them be of any value in determining whether you should sign up for Medicare Part B coverage. Decisions like this are personal ones, based on what we know about our health, what we anticipate, and what we fear.
Q: Is there a Federal Employees Health Benefit provider that provides care in case something happens while traveling overseas? What happens to my insurance if I leave federal service for a year and do something else? Can I still pay and keep my health benefits?
A: Every FEHB plan has a section in its brochure that explains what it will cover if you live or travel outside the U.S. and Puerto Rico. As to your other question, if you were to leave government, you would receive a 31-day extension of coverage at no cost to yourself. During that time, you could elect to continue being covered by that plan (or choose another) under the temporary continuation of coverage provision of law. You would be required to pay 100 percent of the premiums for that coverage, which would last for up to 18 months.
Q: I am currently under workers’ comp from the Postal Service. My health insurance is through workers’ comp. My husband is a retired Postal Service employee with MVP family insurance. I would like to disability retire but I need to know that I can be added to my husband’s insurance effective immediately. I have been advised to cancel my workers’ comp health insurance first, then I can be picked up on his. This is very risky. Please advise.
A: If your husband is enrolled in the self and family option of his Federal Employees Health Benefits plan, you are already covered by it even though your medical expenses are currently being paid by OWCP. Once your period of workers’ compensation ends, any medical needs you have will be covered by his plan.
Q: My husband and I are both federal law enforcement officers. The family health plan is under my husband. We both plan to retire this year. He wants me to waive my survivor annuity and he says I will still be covered under our federal Blue Cross/Blue Shield plan because I was covered for the last five years of my employment under the Federal Employees Health Benefits family plan that he carried. He wants a bigger retirement check. My question is, if I sign the survivor annuity waiver and he dies before me, am I still automatically covered under our FEHB plan because I was also a federal retiree and would have been eligible for coverage? I think he is wrong and will not sign any waiver. I told him there is no “federal spouse rule” laid out in the Office of Personnel Management’s guidelines concerning FEHB.
A: Whether you decide to waive your entitlement to a survivor annuity is entirely up to you. However, your husband’s explanation of why you would be able to continue your FEHB coverage if he were to die before you is wrong. As long as you are covered under his FEHB plan enrollment and either employed or receiving an annuity when he dies, you would be able to continue that coverage. As the one carrying the enrollment, it’s your husband who needs to be enrolled for the five consecutive years before he retires, not you.
June 8th, 2010 | FEHBP
Q: I am on regular Medicare and have maintained my BC/BS family coverage through FEHBP for a monthly cost of $510 or so.
Would I not be better off getting a Medicare supplement policy that would not cost anywhere near as much as my FEHBP premium? Do many federal retirees make this choice? I had thought it wise to maintain FEHBP, and will until my wife catches up with me and goes on Medicare, but due to these costs I wonder.
A: If I read you correctly, you are considering dropping FEHB coverage and buying supplemental Medicare coverage before your wife goes on Medicare. If so, I hope that she has health benefit coverage elsewhere, otherwise you’d be leaving her out in the cold. As for whether buying a supplemental policy would be a good option, you can’t rely on cost as the sole measure. You need to compare the coverage it would provide along with out-of-pocket costs. And if, and it’s a big if, you drop your FEHB coverage, you can’t re-enroll as a retiree.
April 7th, 2010 | HEALTH INSURANCE
Q: If a Civil Service Retirement System retiree is currently receiving government health insurance and gets married, can he add his spouse to his health insurance?
A: Anyone covered by the Federal Employees Health Benefits program who has a change in family status, such as marriage, birth or death of a family member, adoption, legal separation or divorce, can change from self only to self and family or vice versa. For employees, the code is 1C in the Table of Permissible Changes; for retirees, it is code 2B.