Ask The Experts: Retirement

By Reg Jones

FEHB, Medicare and Tricare for Life

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Q. Can FEHB suspension be done only in retirement? How can suspension be done working as an active federal employee with Medicare and Tricare for Life? One may want to keep working for the government but not have to pay FEHB fees and use Medicare Part A with its fees along with Medicare Part B free and TFL benefits included due to being a military retire. Why would one want to have such overkill in health care benefits and costs? Could you explain the process in a scenario such as this, and could either a continuing active employee or a retiree reclaim their FEHB in the event the Medicare or TFL benefit degrades or goes away?

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‘Quitting’ FEHB and re-enrolling

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Q. Can a retired employee quit his Federal Employees Health Benefits in retirement for, say, Tricare for Life and Medicare if retired military, and later opt to switch back to FEHB?

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FEHB and Tricare for Life

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Q. On Jan. 18, there was question about which is primary between these two programs, and the answer ended with “whether you keep both [Federal Employees Health Benefits] and Tricare is something you’ll have to decide.” How do you decide? Where can I find a clear, side-by-side comparison of my FEHB (BC/BS standard in my case) and Tricare for Life — one that is not comparing apples to oranges? I have been told I don’t really need FEHB because TFL is “very comprehensive,” but how can I find out exactly what, if anything, FEHB would cover that TFL wouldn’t. P.S. I’m in excellent health and am also covered by Medicare Parts A and B.

A. Unfortunately, no one has made such a comparison, nor is it likely that anyone will. While Tricare and Medicare A and B are monolithic, with their benefits spelled out in detail, there are around 200 plans in the FEHB program. And what they cover varies, not only in the services covered but in the level of reimbursement, co-payments and deductibles. If you want to make such a comparison, you can do so by carefully reviewing what your own FEHB plan provides with what Tricare does.

In closing, you mentioned that others have told you that you don’t need the FEHB coverage because Tricare is very comprehensive. While I don’t know if that’s true, I’ve been told the same by other former members of the military who made the decision to suspend their FEHB coverage and were happy with the decision. Whether you’d be happy if you did the same is something I can’t predict.

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Health insurance

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Q. I am enrolled in Medicare Part A and B. I also have Tricare for Life and Federal Employees Health Benefits (Blue Cross/Blue Shield). My doctor has opted out of Medicare and wants $5,000 for a hip replacement. Will FEHB pay his fee?

A. The only way to find out how much of your doctor’s fee your FEHB plan will pay is to ask them.

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FEHB and Tricare

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Q. My husband and I are both military retirees and have had Tricare for over 38 years. When my husband turned 65, he had to sign up for Medicare and take Part B to retain Tricare for Life. He also dropped off of the Federal Employees Health Benefits plan and then retired from his civilian federal government job and I changed to single coverage on FEHB under me (I am still working as a civilian federal employee).

I am considering retiring this year and want to know if I need to add him to my FEHB for him to have access to FEHB in the future if we need that. Do I need to put him on my FEHB next open season to retain this benefit in the future?

A. To retain FEHB coverage, he would need to be covered under your FEHB enrollment when you died. Since you can’t predict when that will happen, it would be wise to change your coverage from self-only to self and family while you are still healthy.

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Survivor annuity vs. FEHB

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Q. I am a federal employee and have had Federal Employees Health Benefits for myself and my husband for 20+ years. My husband is retired military with Tricare for Life. I plan to retire on FERS and keep our FEHB for myself and my husband. If I choose to not have survivor benefits and I die before my husband, will he be allowed to keep the FEHB coverage since he receives a military retirement pension and has always had Tricare for Life through the military? In other words, can he keep FEHB and have the premiums taken out of his military retirement pension since he will not be receiving a survivor annuity?

A. No, he can’t.

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Spouse’s insurance after prospective retiree’s death

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Q. I am a FERS employee and plan to retire at age 60 with more than 20 years’ service. I will have been enrolled in FEHB for more than five years and want to know: If I elect to not have a survivor on my annuity, will my spouse, who receives a monthly military retirement from the U.S. Navy and has Tricare for Life, be able to keep the FEHB after my death?

A. No. Your spouse has to be both covered under the self and family option of your FEHB plan and receiving a survivor annuity. As a FERS employee, you have the option of electing a full survivor annuity (50 percent) or half (25 percent). You can elect the lesser amount (or none at all) only if your spouse agrees to that in writing.

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FEHB

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Q. I am approaching age 65 and have some questions concerning Tricare for Life, Medicare, and FEHB. For background, I am a retired reservist and current FERS GS employee with Blue Cross Blue Shield FEHB and Tricare Standard for my wife and me.  I am currently 63 and my wife is a few months older. She is not eligible for Social Security as she is a school teacher and the state of Louisiana opted out.

I plan on working a few years past my 65th birthday but need some guidance on the best course of action when I become Medicare-eligible. We have enjoyed BCBS for many years and are very comfortable with it.  It was a bonus when I reached age 60 and picked up Tricare Standard as our secondary health insurance.  We want to ensure we use the combinations available to use for the best (medically /economical) coverage.

It appears when I turn 65 I need to sign up for Medicare, purchase Part B (for TFL coverage) and no longer participate in the FEHB program.  What about Part C and or Part D?

A. With Tricare for Life and Medicare Parts A & B, you could safely suspend your FEHB coverage, unless there is some specific benefit that would make it worth your continuing that enrollment. Both OPM and the National Association of Current and Retired Employees recommend against enrolling in Medicare Part C, since it provides nothing that wouldn’t already be paid for by your other coverage. They also say that Medicare Part D would only be necessary if you had unusual prescription needs that were not paid for by your other coverage.

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Switching to FEHB

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Q. I am a 59-year-old with 26 years with the federal government. I am a 20/20/20 former spouse also (not remarried). I have not been enrolled in a Federal Employees Health Benefits plan because I am covered under Tricare. I planning on retiring in December 2012 at age 61, with 27 years in federal service. I would like to enroll in an FEHB plan this year during open season. I would like to have the option to use Tricare until I am 65 and then be able to use my FEHB plan rather than use Tricare for Life.

When I renew my military spouse ID card, I have to sign a statement that I am not enrolled in an employee-sponsored heath care plan. Can I enroll in the FEHB plan and choose not to use it until a later date?

I also understand that if you have Tricare, you don’t have to have the FEHB plan for five years before you retire and only need to have it for one year.

Please help me find the answers or direct me to the right people. I have talked to Tricare and the Defense Enrollment Eligibility Reporting System, and they don’t seem to have the answer.

A. Coverage under Tricare will count as meeting the five-year requirement to carry FEHB coverage into retirement as long as you are enrolled in an FEHB plan when you retire. You could do that during the next open season. While I’m not aware that your enrollment in the FEHB would alter your entitlement to coverage under Tricare, Tricare is a military program that falls outside the borders of this forum.

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Two single policies?

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Q. My husband retired at 67 in October 2010 with 15 years of service under Federal Employees Retirement Service. He currently has Tricare for Life through his previous 30-year military retirement. It has become apparent that his policy does not cover as much as mine. I am a current employee planning to retire in 2012. I have a single FEHB. Since we have no dependent children to cover, it would seem that two single policies would be a better cost option for us. Could he sign up for a single policy during the next open season or would I have to add him to my policy?

A. Because he is retired, he cannot enroll in the Federal Employees Health Benefits program. You could, however, add him to your policy by electing the self and family option.

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