Medicare and/or government Ins plan

[mixsonci]

I need some advice and guidance from the most knowledgeable people I know.

Some background, I am a Federal Gov employee with excellent health care through the USG with 20plus years of service. I will be retiring at the end of this year (YAY). I will keep my existing health insurance through the USG at the same cost which also includes medications.

My dilemma is, do I also buy into Medicare Part B? If I have both the USG plan and Medicare B, I will be completely covered and will pay virtually nothing out of pocket nor will I have to deal with paper work, like claims forms. However, I will have to pay over $100 per month for Medicare and Medicare will become my primary insurance. If I go to a doctor outside of Medicare, my USG plan will not pick it up, they will only pay what they would have paid with Medicare. If I don't opt for Medicare right away, I will pay a 10 percent penalty for every year I wait after eligibility. I could opt not to take Medicare at all and keep what I have now, which is pretty good, but as I get older, I'm sure I will be needing more medical care than I do at the present time and my personal costs will go up.

How difficult is it to find doctors who take Medicare in TV? I'm asking this because I've read on previous posts about people having trouble finding doctors who will take their insurance provider.

Iwill be a full timer as of January 2015.

Thank you all for your help.

[784caroline]

In your particular situation what most people (that I have talked to ) do, is to switch their FEHP to the lowest level of coverage . For ex if you are BCBS Standard you would switch to Basic. The BIG difference with the basic plan is that you would not be eligible for mail order prescriptions but you do have coverage as good as Part D Medicare. But as you said Medicare would be primary and your basic BCBS should cover the vast majority of deductibles and copays. AS far as enrolling in Part B..thats a tough one but again most people do for the penalty is pretty big if you dont and then for what ever reason need to at a later time. I have no idea of you income level but it becomes more of a question if you are in the penalty income bracket for medicare part B and charged more.

It all comes down to personal choice and what you can afford. Also you may be healtly today but 2-5-10 years down the road....crap shoot.

[Sable99]

Can't OPM help you? I looked at Mom's Medicare book and it said to call them. I haven't called them yet but need to do so.

[Bizdoc]

You will need to do Medicare B as FEHB plans automatically switch to Medicare rates for payment if you don't (so your copays would go up if you don't do Medicare). You should look very carefully at what your plan covers when it becomes second pay to Medicare -- switching to the "lowest cost" plan may not be the best move as some don't pay nearly as much for drugs as others and may not pay for out of network doctors.

If you have FEP Blue Standard (not Basic), you will have virtually everything covered except for a few copay drugs. You also have the freedom of Blue being accepted almost anywhere in the country (unlike many Medicare Advantage or Supplement plans). I cheerfully pay the extra bucks for standard as you never know what the year will bring (2012 saw us with well over 1/2 mill of medical bills after an accident, all paid by BC)

Your servicing personnel office can help with some of your questions as well as OPM. If you are a NARFE member, NARFE's website has lots of resources and your chapter service officer can help.

As to doctors accepting Medicare - that's what the vast majority of people living here have. Most of the comments about not accepting Medicare are for specific Medicare Advantage and Medicare supplement plans. And (other than the blankety blank anesthesiologists at the Villages Hospital), virtually everyone takes Blue Cross.

[mixsonci]

Can't OPM help you? I looked at Mom's Medicare book and it said to call them. I haven't called them yet but need to do so.

I don't have BCBS, I have FSPB (Foreign Service Benefit Plan) which is Coventry Insurance. I am Foreign Service not Civil Service. There are some things where OPM only works with Civil Service and they have nothing to do with Foreign Service side, not sure if that includes health insurance but probably does. Is your Mom FS or CS?

My basic concern is whether or not it is difficult to find doctors in or near TV who take Medicare or will I have any easier time finding doctors who take my government insurance.

Anyway, I will probably keep FSBP and get the Part B.

Thank you all for your responses.

[784caroline]

Alot of Drs here take Medicare (part A and B). What you need to be careful with is the supplemental...Alot DONOT take Medicare HMO plans but will take Medicare supplemental PPO plans. You need to ask very specific questions before you schedule an appointment depending upon your insurance.

[Erijo]

Medicare Part A is free to everyone at 65 ...this covers hospital only which the patient paying a co pay for each admission.
Part B is for doctor visits only. Need secondary or medigap to pay the 20% not covered. I hope I am explaining this properly.

[Erijo]

Part B is the part you pay for out of your social security check. Right now it is about $104 per month

[2BNTV]

Almost all doctors accept Medicare, but it is always wise to ask before making an appoinment. Medicare will always be you primary carrier, with you work insurance plan being secondary.

I would look to see what your work insurance covers, before you even think of taking a lesser plan. Your HR rep should be able to assist you.

Medicare Advantage plans have certain doctors that are not in their plan, and that's why some people have a harder time, finding the right doctor. With medicare, you shouldn't have this problem.

It doesn't sound like you will paying any substantial medical fees with Medicare and your work insurance. I would take medicare at 65, and not delay getting it, because of the penalty fees.

[billethkid]

We have yet to come across any doctors in any field in the state of FL that do not take Medicare. Nor do we know of anybody that has ever run into the problem.

Do your homework on supplements. Do not be lulled by the lowest bidder.

With Traditional Medicare and a top notch supplement (AARP for example) you will rarely ever have to reach in your pocket..........at least for now....who knows what the future of the health insurance circus will bring upon us.

Good luck

[2BNTV]

We have yet to come across any doctors in any field in the state of FL that do not take Medicare. Nor do we know of anybody that has ever run into the problem.

Do your homework on supplements. Do not be lulled by the lowest bidder.

With Traditional Medicare and a top notch supplement (AARP for example) you will rarely ever have to reach in your pocket..........at least for now....who knows what the future of the health insurance circus will bring upon us.

Good luck

I was thinking their plan at work would cover the differences in the amounts owed. Of course, I don't know if they have to pay into their work plan, so maybe they need to do some homework as to what is best for them. I know that's what I would do.

I never try to state anything that is absolute but I agree all doctors take Medicare. At least that's what my brother tells me, as he never asks if they do. :smiley:

[Bizdoc]

According to the OPM website (as well as the FSBP website), FSBP is one of the choices (albiet restricted to FS people) under FEHB program. It isn't unique in being restricted. For example, Special Agent Mutual Benefit Assoc is limited to current and retired federal law enforcement agencies.

Take a close look at providers under your current program in this area. If you are serious about The Villages, you may be much better off with Blue. You can switch at retirement if you wish irrespective of open period (as a life event). While rates among the FEHB plans, they are relatively close and you will probably pay about the same for BC standard as FSB.

[Bizdoc]

One other thing. If you decide to not use a FEHB plan in addition to Medicare, do *not* tell OPM to cancel your coverage. Canceling it is irrevocable and you cannot ever return to FEHB no matter how much you may want to. You would want to tell them to *suspend* your coverage. You can then resume it at some point in the future.

[mixsonci]

Thank you all. YOu have all been most helpful, as usual. I will be getting Medicare Part B and I will also keep my FSBP insurance, I'll be fully covered with no out of pocket expenses and no paperwork. It's a win/win. And, yes BIZDOC, I am serious about TV, I bought my house in Collier last September.