Health Insurance for Retired Federal Employees

[Rosalie]

Hi, It's nearly Open Season again and another Fed. Retiree and I have been discussing options---we're hoping there are other Federal retirees who we could brainstorm with as to what Plans might be a good choice. Mail Handler's and BC/BS look good. We haven't received a detailed booklet yet. After we all receive them, we're thinking it would be helpful if some of us could get together at one of the rec centers and help each other with choices. Please let me know if there is any interest.

[Sable99]

Hi, It's nearly Open Season again and another Fed. Retiree and I have been discussing options---we're hoping there are other Federal retirees who we could brainstorm with as to what Plans might be a good choice. Mail Handler's and BC/BS look good. We haven't received a detailed booklet yet. After we all receive them, we're thinking it would be helpful if some of us could get together at one of the rec centers and help each other with choices. Please let me know if there is any interest.

I just got back to Michigan from my whirlwind trip to The Villages. I wish I could be there if you have a Federal retiree insurance meeting.

[mixsonci]

I will retire in December as a Federal Employee. However, I won't be in TV until January. I have the FSBP insurance which I am very happy with and will keep after retirement. I will also enroll in Medicare Part A and B to supplement so I will have virtually no out of pocket expenses. I am also considering on signing up for Dental and perhaps Vision insurance also during this open season. SOrry I can't be there to brainstorm with you. Let me know the outcome and decisions to see if they help me with my decisions please.

[Bizdoc]

Before I retired, I looked very carefully at the various FEHB plans. Since we were planning to travel a great deal, I especially looked at network coverage. While the CIGNA administered plans (Mail handlers, SAMBA, and the like) had lower premiums, their networks (outside of metro areas) were not as good. GEHA seemed to have a lot of geographic holes. The FEP Blue plan basically makes every provider who is a provider for a state/regional plan a preferred provider for FEP Blue. Since we planned to travel, it provided the best coverage including during trips.

In 2012, Betsy's fall resulted in several hundred thousand dollars worth of medical bills. FEP Blue paid all but about $5K.

I'm sticking with FEP Blue. Your mileage may vary. FYI, the companies are no longer sending out brochures unless you request them.

If you travel a fair amount or (more importantly) split your time be sure to look up providers in the places where you will be. As some seasonals have noticed, their insurance company from back home may or may not work here.

Finally, a shameless plug. There is a National Active and Retired Federal Employees chapter here which meets the 2nd Wed of each month at the Golden Corral on 466. National dues are $40 per year. The monthly magazine provides all kinds of info for feds. Friendly bunch of people and excellent guest speakers.

The NARFE NY federation has a number of tools for comparing plans:

NARFE-NY (http://www.narfeny.org)

[Bizdoc]

Also a plan comparison tool at

https://www.plansmartchoice.com/Registration.aspx?nosession=Y

The website is (apparently) run by ADP. However, I have been told it is neutral in its recommendations.

[Bonnevie]

Before I retired, I looked very carefully at the various FEHB plans. Since we were planning to travel a great deal, I especially looked at network coverage. While the CIGNA administered plans (Mail handlers, SAMBA, and the like) had lower premiums, their networks (outside of metro areas) were not as good. GEHA seemed to have a lot of geographic holes. The FEP Blue plan basically makes every provider who is a provider for a state/regional plan a preferred provider for FEP Blue. Since we planned to travel, it provided the best coverage including during trips.

In 2012, Betsy's fall resulted in several hundred thousand dollars worth of medical bills. FEP Blue paid all but about $5K.

I'm sticking with FEP Blue. Your mileage may vary. FYI, the companies are no longer sending out brochures unless you request them.


If you travel a fair amount or (more importantly) split your time be sure to look up providers in the places where you will be. As some seasonals have noticed, their insurance company from back home may or may not work here.

Finally, a shameless plug. There is a National Active and Retired Federal Employees chapter here which meets the 2nd Wed of each month at the Golden Corral on 466. National dues are $40 per year. The monthly magazine provides all kinds of info for feds. Friendly bunch of people and excellent guest speakers.

The NARFE NY federation has a number of tools for comparing plans:

NARFE-NY (http://www.narfeny.org)



wondering what time the meetings are at Golden Corral?

[Bonnevie]

I stick with BCBS.

[KayakerNC]

I stick with BCBS.

Another vote for FedBlue (BCBS). I checked with the insurance/payments people at my family Doctor & Dentist offices. BCBS seemed to be the insurance with the least re-submits and quick payments. And it played well with Medicare.

[Bizdoc]

wondering what time the meetings are at Golden Corral?

Doors open at 11:00 am, meeting starts at 11:15. The down side is that attendees must purchase lunch - $11 including tax and tip and beverage. Note that you don't have to be a NARFE member to attend (tho we hope you will join). Meetings are "off campus", in part, because not all of our members are Villagers.

This month's program is on electric use - speaker from SECO.

[MikeV]

I have FedBlue also. I am keeping it. I also have Medicare Part A. I don't have Part B so FedBlue is my primary for non hospital care. The Villages Health System accepts.

[woodywdmt]

MikeV,
I also don't have Medicare Part B and MDIPA/United Health Care is my primary but I am looking to switch to FedBlue this season. Are we in harms way by not having part B?

[Villageswimmer]

wondering what time the meetings are at Golden Corral?


Somewhere I heard the Golden Corral had closed. Not true?

[Villageswimmer]

I have FedBlue also. I am keeping it. I also have Medicare Part A. I don't have Part B so FedBlue is my primary for non hospital care. The Villages Health System accepts.


My husband and I are also under FEP BCBS. However, when he went on Medicare, we researched it and came to the decision that he should opt for Part B as well.

Since going on Medicare, he has paid zero...no copays, no deductibles, nothing. Been very smooth sailing through several surgeries.

Still, this is not cheap. I keep asking myself if taking Part B in addition to BCBS was a good decision.

Would be interested in hearing any experiences.

also, would love to come to such a meeting as proposed above.

[Villageswimmer]

This thread got me thinking. Another important decision once one has opted to keep FEP BCBS in addition to Part B is: Basic plan or Standard plan? Basic plan is about $140/month less than Standard (S&F).

I called BCBS to try to get help with this decision. They, of course, weren't much help since they can't express an opinion.

Seems like the biggest difference is that Basic won't cover out-of-network providers. But wouldn't the Part B Medicare cover?

Anyone out there have answers or personal experience; I.e., standard vs. Basic. I feel like we're overinsured but am afraid to make a bad decision by changing.

[Sable99]

I am new to Medicare and am so confused!! I travel so I have always had BC/BS Standard and since August I also have Medicare Part A and B. Should I keep BC/BS Standard or should I switch to the Basic plan?

Do I need Medicare Part B?

I was a Federal employee with the Senate and I am asuming our health care plan is the same as other Federal employees.

I wished I lived in TV full time so I could attend the meetings at the Golden Corral. I did call the Department on Aging here in Michigan and they told me to keep what I have.

[784caroline]

Another big distinction between standard and basic FEP BLue Cross is Prescriptions. If you or your significant other take a fair amount of prescriptions and/or you require brand name meds, there can be a big difference in the price you pay between the two plans....but the difference can justify the Basic plan. Basic Prescription coverage is not bad for it is as good as Medicare Part D. Under most circumstances, if you have Medicare Plans A and B most people would only need "Basic" coverage to cover deductibles/copays...uness you need alot of meds as stated above. If you donot have Medicare B then you would want to subscribe to the FEP BCBS Standard (105) plan.

A key determining factor in taking Medicare B should be your household income level and your expected income in the future, since the premiums for Medicare B are graduated based on a Modified Adjusted Gross Income (MAGI) from the previous year. (MAGI is determined by adding your previous years Adjusted Gross Income and all Tax Exempt income.)

Just remember, once you opt out of Medicare Part B it is very expensive to get back in.

[Bizdoc]

I am new to Medicare and am so confused!! I travel so I have always had BC/BS Standard and since August I also have Medicare Part A and B. Should I keep BC/BS Standard or should I switch to the Basic plan?

Do I need Medicare Part B?

I was a Federal employee with the Senate and I am asuming our health care plan is the same as other Federal employees.

I wished I lived in TV full time so I could attend the meetings at the Golden Corral. I did call the Department on Aging here in Michigan and they told me to keep what I have.

My advice is Medicare A and B plus standard FEP Blue. Some years you will pay more than you really needed to with Standard. Then there are the years where you really, really want that extra coverage, especially for meds. This is an area where you can be lose saving money. No one knows what next years will bring - if you need that extra coverage, you can't get a do over in mid-year.

The Dept of Aging advice is sound.

[MikeV]

My husband and I are also under FEP BCBS. However, when he went on Medicare, we researched it and came to the decision that he should opt for Part B as well.



Since going on Medicare, he has paid zero...no copays, no deductibles, nothing. Been very smooth sailing through several surgeries.



Still, this is not cheap. I keep asking myself if taking Part B in addition to BCBS was a good decision.



Would be interested in hearing any experiences.



also, would love to come to such a meeting as proposed above.


I couldn't see any benefit to FEPBLUE and Part B. I sent a copy of my Medicare card to FEPBLUE showing only Part A so FEPBLUE is still my primary provider except for hospitalization where Medicare is primary. I have had my federal health insurance for over 42 years with no problems. I may be paying more than I should since I have the high option but it is what I feel comfortable with. I just don't trust government to administer my healthcare. Paranoid maybe but I can't help it.

[olgreeneyes]

I too am quite confused. I am a retired federal employee but not yet eligible for Medicare. I have Aetna (NJ) high option and I have a few major health issues and take quite a bit of medicine. Comparing plans hasn't helped me decide what to do. I know each person has different circumstances but you can't predict what the future will bring.
Will the higher cost of this plan outweigh the possible higher cost of the medicine? The formularies don't seem to list everything I take.

[laceylady]

FEP Blue is going to have a " self and spouse" option in 2016 in addition the "self and family" premium that we currently pay. This should bring down our costs, right?

[Sable99]

As I said in an erlier post on this thread, I am new to Medicare. In August, I had my yearly exams and had tests done by my doctor and the hospital. They both told me there were some new changes that became effective in July. They told me one of my standing labs would have to be re-written or it wouldn't be covered. They also told me that if Medicare denies a claim that the secondary insurances are now automatically denying the claim.

My question was (and still is) if the secondary insurance is automatically denyig the claims why do we need them? I realize that Medicare is only good in this country.

I currently have BC/BS Standard and Medicare Part A and B. But because of what the doctor and hospital told me in August I am wondering if that is a wise choice.

[784caroline]

I couldn't see any benefit to FEPBLUE and Part B. I sent a copy of my Medicare card to FEPBLUE showing only Part A so FEPBLUE is still my primary provider except for hospitalization where Medicare is primary. I have had my federal health insurance for over 42 years with no problems. I may be paying more than I should since I have the high option but it is what I feel comfortable with. I just don't trust government to administer my healthcare. Paranoid maybe but I can't help it.

Not having Medicare Part B, there is no doubt you should have FEP BCBS Standard (High) Option. As to wether you are paying more or not, each person(family) is different and it all depends upon what your needs are, income levels, and how comfortable you are.

As far as the Government administering your health care, I think it is more likely you will see changes in the FEHB program, including your BCBS high option, than changes to Medicare Part B. You can already see that happening since members of congress and their staff now get their health care through the exchanges. Cannot comment if that is better or worse but it is a change

[784caroline]

As I said in an erlier post on this thread, I am new to Medicare. In August, I had my yearly exams and had tests done by my doctor and the hospital. They both told me there were some new changes that became effective in July. They told me one of my standing labs would have to be re-written or it wouldn't be covered. They also told me that if Medicare denies a claim that the secondary insurances are now automatically denying the claim.

My question was (and still is) if the secondary insurance is automatically denyig the claims why do we need them? I realize that Medicare is only good in this country.

I currently have BC/BS Standard and Medicare Part A and B. But because of what the doctor and hospital told me in August I am wondering if that is a wise choice.

I may be mistaken but I think you have this backwards. If Medicare approves a charge, your secondary most likely will also approve any deductible or copay that needs to cover the entire bill. If Medicare disallows a charge, then your secondary insurance will review it for approval. I have had test or services disallowed by medicare but approved by BCBS at their rate.

[Sable99]

I may be mistaken but I think you have this backwards. If Medicare approves a charge, your secondary most likely will also approve any deductible or copay that needs to cover the entire bill. If Medicare disallows a charge, then your secondary insurance will review it for approval. I have had test or services disallowed by medicare but approved by BCBS at their rate.

That is not what the doctor and the hospital told me in August. They told me ithey are finding that if Medicare denies a claim that the secondary insurances are now automatically denying the claim. Both offices told me they started seeing this in July 2014. In October, I went to a Department on Aging Medicare briefing and she said the same thing.

[Villageswimmer]

That is not what the doctor and the hospital told me in August. They told me ithey are finding that if Medicare denies a claim that the secondary insurances are now automatically denying the claim. Both offices told me they started seeing this in July 2014. In October, I went to a Department on Aging Medicare briefing and she said the same thing.


I, too, am confused.

assuming Medicare approves a claim, dont they pay 80 percent? Your BCBS would then pick up the remaining 20 percent. Without the Bcbs or some other supplement), you would pay the 20 percent (and all copays, deductibles, etc) out of pocket. Please, someone, correct me if I'm wrong.

[jnieman]

We have had Blue Cross Blue Shield Federal Plan for 6 years. Works great. Have never had a doctor here who doesn't take the plan. We have the high option plan. Hubby also has Medicare and when they work together he has hardly any out of pocket. I'm not old enough for Medicare yet so I do have out of pocket about 15-20% on most procedures (x-rays, mri's, etc.). Definitely a good plan. We also have Aetna for dental. Hard to find a dentist who takes the plan but Dr. Heydari at Aesthetic Dentistry across from Walgreens in Colony does.

[laceylady]

I am very interested in attending any meetings on this subject. We have Fed BCBS. My husband has been very ill this year. He will be 65 y/o in Nov. 2015. Fed BCBS REC'd close to $1 million in bills for him this year. We have not had any co pays since we hit the $6,000 max. in July. Fed BCBS is outstanding coverage. We will definitely keep it but are confused about whether to get Medicare Part B. I would like a clear explanation about how they work together. Reading the BCBS literature just confuses me more. My husband takes MANY medications also.

[mixsonci]

My Opinion, if your husband is very sick and requires a lot of medical services and medications, you should definitely go with both Fed BCBS and Medicare Part B. Without Part B, you will have significant out of pocket expenses. With Part B, you will not have to pay the 15-20% nor any co-pays and if you go to the doctor a lot, these really add up. With Part B, all you will have to pay is your monthly premiums for both

[784caroline]

I am very interested in attending any meetings on this subject. We have Fed BCBS. My husband has been very ill this year. He will be 65 y/o in Nov. 2015. Fed BCBS REC'd close to $1 million in bills for him this year. We have not had any co pays since we hit the $6,000 max. in July. Fed BCBS is outstanding coverage. We will definitely keep it but are confused about whether to get Medicare Part B. I would like a clear explanation about how they work together. Reading the BCBS literature just confuses me more. My husband takes MANY medications also.

With your situation there is no doubt I would take Medicare Part B and stay with BCBS Standard plan (105). The premiums for Medicare Part B will be deducted directly from his Federal pension or Social Security if he is already receiving that. He is eligible for Medicare November 1, 2015 and should sign up for PARTS A and B ... 2-3 months (August 2015) before he turns 65. Medicare Part B will be primary in covering all the medical or doctor bills (Hospital stays are Part A). Once you receive your medicare card, notify your health providers of the new (additional) coverage and start date (November 1, 2015), and they will bill medicare as the Primary provider. Medicare will automatically coordinate with BCBS and any amount not covered by Medicare will be sent to BCBS for consideration. BCBS will cover all your Copays/Deductibles.

The system and coordination actually works fairly well.

[Villageswimmer]

I am very interested in attending any meetings on this subject. We have Fed BCBS. My husband has been very ill this year. He will be 65 y/o in Nov. 2015. Fed BCBS REC'd close to $1 million in bills for him this year. We have not had any co pays since we hit the $6,000 max. in July. Fed BCBS is outstanding coverage. We will definitely keep it but are confused about whether to get Medicare Part B. I would like a clear explanation about how they work together. Reading the BCBS literature just confuses me more. My husband takes MANY medications also.

So sorry to hear of your husband's health problems. The advice given be the last 2 posters seems sound and informed.

just so you are aware, Medicare will mail your husband information a couple of months before his birthday. In it, he will have the option to opt out of Part B. If he does nothing he will automatically be covered under both.

I wrestled with this just recently because of the additional expense involved. Part B will cost on the order of $104/mo.

I'm glad I decided to go for it. Anyone's good health can change on a dime, and it does give peace of mind to know that everything is covered.

I wish you and your husband well and better days ahead.

[klc1923]

I get the part B. But please help me understand why "standard" would be better than "basic". Other than the prescription coverage, wouldn't the deductibles, coinsurance and copays be picked up regardless of the plan you choose?

[Villageswimmer]

I get the part B. But please help me understand why "standard" would be better than "basic". Other than the prescription coverage, wouldn't the deductibles, coinsurance and copays be picked up regardless of the plan you choose?

I had the same question since I keep trying to bring my expenses down so I called BCBS yesterday.

Essentially, Basic is like an HMO. if you want them to cover, you are restricted to specific providers. Basic will not cover out-of-network providers except in an emergency. At all. That can be significant. Another difference is that there is no mail order pharmacy benefit. There may be other differences, but the rep indicated these were the major ones.

Hope this helps.

[784caroline]

Most of our responses were in regard to "Close to $1 million" in medical bills. AT this level you are talking about some serious medical issues. I would get the best I could afford. Standard offers much better prescription coverage than basic and you also have the issue of Dr/facility selection..ie PPO vs non-PPO. Catastrrophic cost limits are also lower under standard.

[Bizdoc]

Yes, we are one of those folks who have had huge medical bills. However, am important part of our story is not the huge bills as much as how unexpected they were. Prior to her fall, my wife had been extremely active. In her 40s and 50s, she had hiked to the bottom of the Grand Canyon and back up. We spend our honeymoon hiking Acadia National Park and spent our first post-retirement trip hiking in Yellowstone.

All of that changed in a heart beat when she fell. She fractured her C-2 vertibrae and was in a coma for 3 weeks.

If you wait to add insurance coverage until a major event occurs, it is too late. (Just as waiting to look at long term care insurance until you are in your 80s and ready for a nursing home.)

[Villageswimmer]

Yes, we are one of those folks who have had huge medical bills. However, am important part of our story is not the huge bills as much as how unexpected they were. Prior to her fall, my wife had been extremely active. In her 40s and 50s, she had hiked to the bottom of the Grand Canyon and back up. We spend our honeymoon hiking Acadia National Park and spent our first post-retirement trip hiking in Yellowstone.

All of that changed in a heart beat when she fell. She fractured her C-2 vertibrae and was in a coma for 3 weeks.

If you wait to add insurance coverage until a major event occurs, it is too late. (Just as waiting to look at long term care insurance until you are in your 80s and ready for a nursing home.)

Bizdoc, so sorry to hear of your wife's accident. My prayers for her recovery and for you and your family. Sometime we forget how uncertain life is.

[dbussone]

Yes, we are one of those folks who have had huge medical bills. However, am important part of our story is not the huge bills as much as how unexpected they were. Prior to her fall, my wife had been extremely active. In her 40s and 50s, she had hiked to the bottom of the Grand Canyon and back up. We spend our honeymoon hiking Acadia National Park and spent our first post-retirement trip hiking in Yellowstone.

All of that changed in a heart beat when she fell. She fractured her C-2 vertibrae and was in a coma for 3 weeks.

If you wait to add insurance coverage until a major event occurs, it is too late. (Just as waiting to look at long term care insurance until you are in your 80s and ready for a nursing home.)

Your advice is oh so true! I hope others pay attention. Has your wife fully recovered?

[Bizdoc]

Thanks for asking about how she is doing. The accident was 2 1/2 years ago. She spent 3 weeks in ICU, a month in a nursing home and had a couple of surgeries plus a lot of physical, occupational and speech therapy. Took 6 months before she could walk without a walker.

She won't ever be back to what she once could do. Since she had to have a spinal fusion, she can't swivel her neck and has limited ability to bend neck up and down. She proved the doctors wrong in the sense that they originally thought she's spend the rest of her life in a nursing home (A C-2 fracture is sometime known as a Christopher Reeves fracture - in her case the bone fragment went out instead of in and thus minimal spinal damage). Hiking over broken ground is out of the question as she (1) can't look up or down and (2) has a permanent, unfixable form of vertigo caused by damage to the nerves from her right side vestibular canals.

How did she make it? *GREAT* doctors at Duke including the (arguably) best neuro surgeon and the best neuro-otoligist in the universe. Lots and lots of painful hard work (as in 4 or 5 hours a therapy a day for the first month after coming out of her coma. An incredible will to live. And lots of hours of me singing "Just Keep Swimming" while she was in the coma and in the weeks that followed (which probably motivated her to get moving so could leave the room when I sang).

And she is one tough bird.

[784caroline]

Good to hear some positive coming from a bad situation!

Best of luck in her recovery.

[DELTADWN]

I have had FedBlue (Standard) for many years before I retired, and have kept it since then. It's been used on numerous occasions and I don't have any complaints. I also participate in the Fed Employees Dental and Vision Insurance Program. No complaints there either.

I am a NARFE member from Clay County, FL so will try to attend The Villages January 2015 meeting.