Federal Retiree w/ BC/BS Should I Get Medicare Part B?

[bsloan1960]

I'll soon be a Federal Retiree. The Fed Gov allows me to take my BC/BS plan into retirement- So I'll have private insurance

My BC/BS plan will reimburse me $800 in Part B premiums per year if I take Part B

I'm aware Part A is mandatory- but Part B is elective.

I go to the doctor quite a lot- regular doctor and specialists. What does Part B cover/pay for?... do they cover cover co-pays for doctor visits and urgent care visits?

I will be paying about $40 for all office visits. If Part B covers these it will be worth it.

Bottom line- I'm hoping to find out what Part B pays for and if people here who have private insurance find Part B worth the expense of premiums.

Thanks!

[retiredguy123]

I am also a Federal retiree, and I have the Blue Cross Standard plan. I do not have Medicare Part B. Not paying the Medicare premiums has saved me thousands of dollars, and I have had no problem finding providers who accept the Federal plan. The way I look at is that I can afford to pay the Blue Cross catastrophic annual limit of $6,000, if I need to. After that, everything is covered at 100 percent. Do the math. In my case, it is a no brainer because I am subject to IRMAA, which makes my Medicare premium higher than the minimum. Check the IRMAA income limits.

[Byte1]

I have Fed BC/BS and do not have Medicare part B. I would have to pay $170+ for Part B each month, plus my wife would also have to pay that amount each month. $340+ per month when my private insurance pays almost all but the co-payment. Plus I have prescriptions (co-pay) that Part B does not have. Right now, it is a better deal for me to keep my insurance. Money wise, I do not feel that I would be saving anything by dropping my insurance and paying for medicare part B. I would still need to get medicare part D for prescriptions, or something similar.

[bsloan1960]

I have Fed BC/BS and do not have Medicare part B. I would have to pay $170+ for Part B each month, plus my wife would also have to pay that amount each month. $340+ per month when my private insurance pays almost all but the co-payment. Plus I have prescriptions (co-pay) that Part B does not have. Right now, it is a better deal for me to keep my insurance. Money wise, I do not feel that I would be saving anything by dropping my insurance and paying for medicare part B. I would still need to get medicare part D for prescriptions, or something similar.
My BC/BS plan will reimburse each of us $800 per year for part B ($1,600) so about half. I don't intend to give up my BC/BS I'm simply wondering if Part B pays for doctor visit co-pays. If it does it may be worth it in my particular case to get Part B.

[Hardlyworking]

My BC/BS plan will reimburse each of us $800 per year for part B ($1,600) so about half. I don't intend to give up my BC/BS I'm simply wondering if Part B pays for doctor visit co-pays. If it does it may be worth it in my particular case to get Part B.

Part B becomes your primary coverage and BCBS Basic becomes your supplemental plan. My wife is setup that way and pays no copays or deductibles. 2 years ago she had a $16,000 bill at the hospital and paid nothing out of pocket. Even the 2 hour ambulance ride was covered.

[bsloan1960]

Part B becomes your primary coverage and BCBS Basic becomes your supplemental plan. My wife is setup that way and pays no copays or deductibles. 2 years ago she had a $16,000 bill at the hospital and paid nothing out of pocket. Even the 2 hour ambulance ride was covered.
This is the sort of info I'm hoping to get. My wife is covered by my insurance and almost never goes to the doctor- but no telling what the future holds. I'm at one doctor or another constantly- along with MRIs, x-rays, dermatologist, etc.

So I guess you are saying that even though your wife has insurance you have found adding Part B to be worthwhile $$$. Maybe not so much for my wife.

[retiredguy123]

My BC/BS plan will reimburse each of us $800 per year for part B ($1,600) so about half. I don't intend to give up my BC/BS I'm simply wondering if Part B pays for doctor visit co-pays. If it does it may be worth it in my particular case to get Part B.
The minimum Medicare Part B premium for 2023 will be $165 per month, or $1,980 minus the $800 BC credit, equals $1,180. It is possible that the Blue Cross plan will waive some of the normal plan copays if you have Medicare. You should read the plan brochure to see which copays, if any, are waived.

[Hardlyworking]

This is the sort of info I'm hoping to get. My wife is covered by my insurance and almost never goes to the doctor- but no telling what the future holds. I'm at one doctor or another constantly- along with MRIs, x-rays, dermatologist, etc.

So I guess you are saying that even though your wife has insurance you have found adding Part B to be worthwhile $$$. Maybe not so much for my wife.

I’m no longer on her plan. The Self + one is a total joke. I have my own insurance at a much lower cost.

[bsloan1960]

I’m no longer on her plan. The Self + one is a total joke. I have my own insurance at a much lower cost.

I'm wondering what you mean about the Self + 1 being a joke. Will you elaborate? This is the BC/BS plan my wife and I have through the Fed Gov.

[Toymeister]

Not only can the OP take BC/BS into retirement s/he can take ANY Federal employee health plan into retirement. And can change it each and any year!

Think about it, if you do this and plan B you are buying insurance (plan B) FOR your FEHB insurance company. I do not buy insurance to benefit an insurance plan -ever

[bsloan1960]

Not only can the OP take BC/BS into retirement s/he can take ANY Federal employee health plan into retirement. And can change it each and any year!

Think about it, if you do this and plan B you are buying insurance (plan B) FOR your FEHB insurance company. I do not buy insurance to benefit an insurance plan -ever

While I understand that the insurance company benefits from me being on Part B, I don't care- as long as if by having it, along with my insurance I significantly reduce my medical expenses. With this in mind, my question is aimed at determining if by having both I keep more money in my pocket. I'm not saying I'll take Part B if ONLY my insurance will benefit

[retiredguy123]

While I understand that the insurance company benefits from me being on Part B, I don't care- as long as if by having it, along with my insurance I significantly reduce my medical expenses. With this in mind, my question is aimed at determining if by having both I keep more money in my pocket. I'm not saying I'll take Part B if ONLY my insurance will benefit
Most likely, the Blue Cross insurance company will benefit if you sign up for Medicare, and you will lose. That is why they are offering the $800 rebate. It should be a lot higher. But, it really depends on your actual health care expenses, which is unknown. But, so far, I am way ahead of the game.

[Hardlyworking]

I'm wondering what you mean about the Self + 1 being a joke. Will you elaborate? This is the BC/BS plan my wife and I have through the Fed Gov.

The difference in price from self only and self +1 is quite high and going up higher next year. There are some plans where self+1 is higher than self plus family. It makes no sense.

[bsloan1960]

Most likely, the Blue Cross insurance company will benefit if you sign up for Medicare, and you will lose. That is why they are offering the $800 rebate. It should be a lot higher. But, it really depends on your actual health care expenses, which is unknown. But, so far, I am way ahead of the game.

As I mentioned in my initial post I go to a lot of Dr. appts (co-pays) and have frequent tests- so probably a couple of grand in out of pocket each year.

[Jim M]

I have the same questions. My concern has been finding Drs who will accept FEHB BC/BS here. I don’t want to be restricted by Medicare pre approval requirements that I don’t currently have. I had two big issues in the last few years, broken leg and pneumonia only paid $350 deductible for each.

[retiredguy123]

I have the same questions. My concern has been finding Drs who will accept FEHB BC/BS here. I don’t want to be restricted by Medicare pre approval requirements that I don’t currently have. I had two big issues in the last few years, broken leg and pneumonia only paid $350 deductible for each.
So far, I have never been rejected by a provider because I have FEHB and not Medicare. Most providers seem to like it that I have FEHB insirance.

[mfodale]

I am a Federal retiree and I have both Medicare Part B and Aetna (better deal than BCBS, look into it). IMO, you would be a fool NOT to take Part B. You'll never have another deductible, copay or other out of pocket expense as long as you live. And keep in mind, you may be healthy now, but, odds are you won't be, at some point. I had about $15,000 on tests and treatments last year; I paid $0. And, all my prescriptions (6 of them) are at no cost to me. I have a buddy whose wife has been sick, ulcerative colitis. Hundreds of thousands in bills, including hospital stay (which of course is covered by Medicare A) and he paid $0. And, you could decide to delay taking Part B, but in doing so, you will pay a penalty for the remainder of your coverage years in addition to your premium. But, it's your choice. Choose wisely. Medical bills and bad luck can bankrupt you otherwise.

[RICH1]

After Reading the comments I feel blessed to have the Humana Advantage plan PPO and pay no copayment for Drs visits … had my gall bladder removed and payed the hospital my 120 copayment! Traveling around the country at ease knowing I’m covered is a blessing. You seem perplexed but didn’t you discuss this with a Rep before your Exit Interview?

[retiredguy123]

I am a Federal retiree and I have both Medicare Part B and Aetna (better deal than BCBS, look into it). IMO, you would be a fool NOT to take Part B. You'll never have another deductible, copay or other out of pocket expense as long as you live. And keep in mind, you may be healthy now, but, odds are you won't be, at some point. I had about $15,000 on tests and treatments last year; I paid $0. And, all my prescriptions (6 of them) are at no cost to me. I have a buddy whose wife has been sick, ulcerative colitis. Hundreds of thousands in bills, including hospital stay (which of course is covered by Medicare A) and he paid $0. And, you could decide to delay taking Part B, but in doing so, you will pay a penalty for the remainder of your coverage years in addition to your premium. But, it's your choice. Choose wisely. Medical bills and bad luck can bankrupt you otherwise.
You need to do the math and compare the extra cost for the Medicare premiums to the actual cost benefit it provides on an annual basis, especially if you are subject to IRMAA. But, your comment about hundreds of thousands in bills is irrelevant because almost every FEHB plan has an annual catastrophic limit for out-of-pocket expenses. The Blue Cross limit is $6,000. If it were not for the catastrophic limit, I would agree that you should buy Medicare Part B. In my case, I would be throwing money away to buy Medicare. That would be foolish.

[JeanC]

My mom had Medicare A and B as primary and her Federal BCBS as secondary. Now I can’t tell you how much this cost her on a monthly basis but it was no hardship on her. What it did do for her was insure that she never paid a penny for her healthcare. And her later years that was a A LOt. It was always comforting knowing that having these two plans allowed her to go to ANY doctor or facility. And she never had to think twice about having any medical services performed because of Costs.

[jump4]

FEHB offers several plans that integrate with Medicare, including:

FEHB Plans for Medicare:
• Aetna for retirees AetnaFeds.com (http://www.AetnaFeds.com/retireeplans)
Aetna® Medicare Advantage Welcome Federal Employees | Aetna Medicare Advantage (https://www.aetnafeds.com/aetna-medicare-advantage.php)
Aetna Direct Welcome Federal Employees | Aetna Direct (https://www.aetnafeds.com/aetna-direct.php)

• UnitedHealthcare “Retiree Advantage” Plan Details (https://www.uhcfeds.com/medicare-plans/plan-details.advantage)

• Humana Group Medicare Advantage plan will be a subset plan of the Value Plan (CS2887) Feds (https://feds.humana.com/whats-new)

• Blue Cross Preparing for Medicare - Blue Cross and Blue Shield's Federal Employee Program (https://www.fepblue.org/our-plans/Medicare)

[nn0wheremann]

I'll soon be a Federal Retiree. The Fed Gov allows me to take my BC/BS plan into retirement- So I'll have private insurance

My BC/BS plan will reimburse me $800 in Part B premiums per year if I take Part B

I'm aware Part A is mandatory- but Part B is elective.

I go to the doctor quite a lot- regular doctor and specialists. What does Part B cover/pay for?... do they cover cover co-pays for doctor visits and urgent care visits?

I will be paying about $40 for all office visits. If Part B covers these it will be worth it.

Bottom line- I'm hoping to find out what Part B pays for and if people here who have private insurance find Part B worth the expense of premiums.

Thanks!
Yes, do it. Medicare assignment rules protect you from out of network overcharges.

[Byte1]

I have Fed BC/BS basic and Medicare part A only. If I use the VA for my medical needs, I pay no copay other than $8 for a 30 prescription. When I had a $22K surgery, I paid $120 copay using BC/BS. My wife's medicine doesn't exceed a hundred bucks a month so we probably save about $300 a month by NOT having Part B. I am sure that everyone is different and may or may not save money by having part B medicare. I have to admit that Florida Blue has been a pain in the *** to deal with, compared to where I was located before I came to Florida. If I had to pay the total premium for BC, I would not have it and would definitely go Medicare A,B and C or D or F, whatever gives me the prescription plan. There is no way that I would pay the total monthly premium for BC/BS.

[retiredguy123]

Yes, do it. Medicare assignment rules protect you from out of network overcharges.
Not if the out-of-network provider has opted out of Medicare entirely. A provider can opt out and charge whatever they want.

[Artesians]

My BC/BS plan will reimburse each of us $800 per year for part B ($1,600) so about half. I don't intend to give up my BC/BS I'm simply wondering if Part B pays for doctor visit co-pays. If it does it may be worth it in my particular case to get Part B.
Have done the same and I don’t have to pay co-pays.

[SophieP]

I'll soon be a Federal Retiree. The Fed Gov allows me to take my BC/BS plan into retirement- So I'll have private insurance

My BC/BS plan will reimburse me $800 in Part B premiums per year if I take Part B

I'm aware Part A is mandatory- but Part B is elective.

I go to the doctor quite a lot- regular doctor and specialists. What does Part B cover/pay for?... do they cover cover co-pays for doctor visits and urgent care visits?



I will be paying about $40 for all office visits. If Part B covers these it will be worth it.

Bottom line- I'm hoping to find out what Part B pays for and if people here who have private insurance find Part B worth the expense of premiums.

Thanks!

We have had several hundred thousand in charges from hospitals and doctors including urgent care over the years and never a co-pay!

[larcha]

"Federal Retirement" recently presented a series of Medicare columns. Those employees who are within five years of retirement eligibility and current federal retirees are highly encouraged to read each of those columns in order to get a better understanding of how FEHB program health plans coordinate with Medicare. Federal retirees who enroll in Medicare can save thousands of dollars during their retirement by being enrolled in both Medicare and an FEHB health plan considered to be a Medicare supplemental plan. Federal retirees who enroll in Medicare do not have to purchase a private Medicare supplemental plan or a Medigap plan.

myfederalretirement.com (https://www.myfederalretirement.com/questions-choosing-fehb/)

[Samcat13]

Call Pat. 352-348-7148. One of the best Medicare Agents in The Villages. She even makes house calls. She will explain all of your options.:posting:

[Samcat13]

I'll soon be a Federal Retiree. The Fed Gov allows me to take my BC/BS plan into retirement- So I'll have private insurance

My BC/BS plan will reimburse me $800 in Part B premiums per year if I take Part B

I'm aware Part A is mandatory- but Part B is elective.

I go to the doctor quite a lot- regular doctor and specialists. What does Part B cover/pay for?... do they cover cover co-pays for doctor visits and urgent care visits?

I will be paying about $40 for all office visits. If Part B covers these it will be worth it.

Bottom line- I'm hoping to find out what Part B pays for and if people here who have private insurance find Part B worth the expense of premiums.

Thanks!

Call Pat. 352-348-7148. One of the best Medicare Agents in The Villages. She even makes house calls. She will explain all of your options.

[retiredguy123]

"Federal Retirement" recently presented a series of Medicare columns. Those employees who are within five years of retirement eligibility and current federal retirees are highly encouraged to read each of those columns in order to get a better understanding of how FEHB program health plans coordinate with Medicare. Federal retirees who enroll in Medicare can save thousands of dollars during their retirement by being enrolled in both Medicare and an FEHB health plan considered to be a Medicare supplemental plan. Federal retirees who enroll in Medicare do not have to purchase a private Medicare supplemental plan or a Medigap plan.

myfederalretirement.com (https://www.myfederalretirement.com/questions-choosing-fehb/)
Some Federal retirees can save thousands, but most do not.

I would point out that the companies that sell the FEHB insurance plans are in business to make money. They want retirees to sign up for Medicare because it saves them a lot of money in claim payments. In fact, they would like the Federal Government to require retirees to have Medicare, like many private companies do. That is why they offer rebates and other benefits to encourage retirees to have Medicare. But those benefits are calculated to benefit the insurance company, not the retiree. That is why it is important to calculate the cost and benefits for your particular situation.

[garykoca427@gmail.com]

As a retired Federal employee, I say you should definitely have a Medicare supplement plan. I have Blue Cross Basic, not standard. Between Medicare and Blue Cross Basic, that covers the vast majority of my costs, and it is a lot cheaper than standard.

[BlueStarAirlines]

Some Federal retirees can save thousands, but most do not.

I would point out that the companies that sell the FEHB insurance plans are in business to make money. They want retirees to sign up for Medicare because it saves them a lot of money in claim payments. In fact, they would like the Federal Government to require retirees to have Medicare, like many private companies do. That is why they offer rebates and other benefits to encourage retirees to have Medicare. But those benefits are calculated to benefit the insurance company, not the retiree. That is why it is important to calculate the cost and benefits for your particular situation.

RetiredGuy is making a lot of sense to me.

If married, FEHB for BCBS standard self plus one is $627.49 a month plus Medicare is $170.10 each (non-IRMAA) ($340.20 total) for a total of $967.69 a month or $11,612.28 a year for 2022. Thats a lot of money per month just to not have a co-pay or a deductible.

IRMAA will definitely be a factor for me, so I appreciate the discussion! I'm a few years out from having to make a decision, so good food for thought.

[Karmanng]

Go to medicare school.com to get info on the different plans. you learn alot there He also is on UTUBE........


Part B covers 2 types of services
Medically necessary services: Services or supplies that are needed to diagnose or treat your medical condition and that meet accepted standards of medical practice.
Preventive services: Health care to prevent illness (like the flu) or detect it at an early stage, when treatment is most likely to work best.
You pay nothing for most preventive services if you get the services from a health care provider who accepts assignment.

Part B covers things like:
Clinical research
Ambulance services
Durable medical equipment (DME)
Mental health
Inpatient
Outpatient
Partial hospitalization
Limited outpatient prescription drugs

IF Dr accepts regular medicare than this kicks in also and they have to take it no matter what the plan...............IF you want to go to MAYO in Florida with a advantage plan forget it.........They only take regular medicare and supps the letter went out this week also on UTUBE advantage plans can not be that great THOSE are the ones that can deny your knee replacement and make you wait and get injections or theraphy IF thats what they suggest........NO referral needed if on regular MEDICARE OR IF you need that surgery.......Also depending on even what drugs you are using and your health records IF you want to go back to regular medicare you may never ever be able to moving forward.....You may be stuck in the Advantage plan BTW also covered in medicareschool.com or his utube channel..........buyer beware

[GATORBILL66]

Yes, I am a retired postal employee, you need to sign up for Part B within 8 months of retiring. Medicare will pay the first 80% and your government plan will cover the other 20%. I have GEHA standard option and don't pay any medical expenses. You have to sign up for Part B through Social Security. Don't be late or you will have to pay an extra 10% per year the rest of your life.

[LucyP]

Answer is Yes! Take part B. You need A and B. I’m retired Federal Employee . Blue cross With dental and eyes.

[bsloan1960]

After Reading the comments I feel blessed to have the Humana Advantage plan PPO and pay no copayment for Drs visits … had my gall bladder removed and payed the hospital my 120 copayment! Traveling around the country at ease knowing I’m covered is a blessing. You seem perplexed but didn’t you discuss this with a Rep before your Exit Interview?
Haven't retired yet, and haven't spoken to any Rep yet- Didn't know my employer would offer advice of this type.

[jump4]

RetiredGuy is making a lot of sense to me.

If married, FEHB for BCBS standard self plus one is $627.49 a month plus Medicare is $170.10 each (non-IRMAA) ($340.20 total) for a total of $967.69 a month or $11,612.28 a year for 2022. Thats a lot of money per month just to not have a co-pay or a deductible.

IRMAA will definitely be a factor for me, so I appreciate the discussion! I'm a few years out from having to make a decision, so good food for thought.

BC/BS is one of the most expensive plan. If you are going to have both medicare and FEHB, there are much less expensive FEHB plans that will give you the wave medicare wrap-around.

[kkingston57]

I'll soon be a Federal Retiree. The Fed Gov allows me to take my BC/BS plan into retirement- So I'll have private insurance

My BC/BS plan will reimburse me $800 in Part B premiums per year if I take Part B

I'm aware Part A is mandatory- but Part B is elective.

I go to the doctor quite a lot- regular doctor and specialists. What does Part B cover/pay for?... do they cover cover co-pays for doctor visits and urgent care visits?

I will be paying about $40 for all office visits. If Part B covers these it will be worth it.

Bottom line- I'm hoping to find out what Part B pays for and if people here who have private insurance find Part B worth the expense of premiums.

Thanks!

Suggest talking to your BC/BS agent(Florida Blue) They are good and will meet with you in person.

[GCMartin]

You should check with the M Marion County SHINE office. They are extremely helpful. As well, I met a lady who knows the Medicare business Inside and out…Diana Johnson. 352-454-8409.

[

[BlueStarAirlines]

Yes, I am a retired postal employee, you need to sign up for Part B within 8 months of retiring. Don't be late or you will have to pay an extra 10% per year the rest of your life.

This is not true for all Federal employees....only for Postal employees. There are efforts to make it applicable to all employees, but no traction on this effort so I don't expect to see this anytime soon.

[epoch]

I go to the doctor quite a lot- regular doctor and specialists.


I am not yet on medicare, but this suggests you should get top insurance. medicare plus FEHB. compare annual medicare part B premiums to your max out-of-pocket.

if you are unsure, you could try it for a year. see how well it works, then decide to keep part B or not.

[BFISHER54]

If you do an internet search there are a number of sites, such as checkbook, that crunch the numbers. The copays and deductible are not likely to be more than the Part B premiums. I have BSBS Standard and elected not to enroll in Part B. I’ve encountered no problem with doctors accepting BCBS in and around the villages.

[bsloan1960]

BC/BS is one of the most expensive plan. If you are going to have both medicare and FEHB, there are much less expensive FEHB plans that will give you the wave medicare wrap-around.
Which plans offered to Fed Gov employees are less expensive but still are as widely accepted and offer the same or better value for money as BC/BS?

[retiredguy123]

Which plans offered to Fed Gov employees are less expensive but still are as widely accepted and offer the same or better value for money as BC/BS?
A lot of people use GEHA. But I had a very sick friend who had GEHA, and they rejected an expensive drug and she had to switch to Blue Cross to get it covered.

The Blue Cross plan is probably the most popular and widely recognized FEHB plan. It has been that way for many years.

[Bill14564]

BC/BS is one of the most expensive plan. If you are going to have both medicare and FEHB, there are much less expensive FEHB plans that will give you the wave medicare wrap-around.

Where did you get the idea that BC/BS was one of the most expensive plans? According to the plan comparison chart, BC/BS falls in the middle price-wise.

Comparing benefits, provider availability, benefits when you travel out of your area, and benefits when also covered under medicare is possibly more important than choosing by price alone.

[Bill14564]

Yes, I am a retired postal employee, you need to sign up for Part B within 8 months of retiring. Medicare will pay the first 80% and your government plan will cover the other 20%. I have GEHA standard option and don't pay any medical expenses. You have to sign up for Part B through Social Security. Don't be late or you will have to pay an extra 10% per year the rest of your life.

This is not true for all Federal employees....only for Postal employees. There are efforts to make it applicable to all employees, but no traction on this effort so I don't expect to see this anytime soon.

When I was looking into this I saw no mention of special Part B rules for postal employees. Please check to make sure of the rules for your specific situation. From what I was able to find, Gatorbill's statement also applies to me, a non-postal federal retiree.

The two rules I saw were:
- If you are currently retired and less than 65 then you must enroll in Part B within the window around your 65th birthday
- if you turn 65 before you retire then you have an eight month eligibility window once you retire

Miss the window that applies to you and you may need to pay a lifetime late-enrollment penalty.

[jump4]

Where did you get the idea that BC/BS was one of the most expensive plans? According to the plan comparison chart, BC/BS falls in the middle price-wise.

Comparing benefits, provider availability, benefits when you travel out of your area, and benefits when also covered under medicare is possibly more important than choosing by price alone.

I agree 100% you should not shop for any type of insurance on premium price alone! But if you take a close look at the FEHB plans, you will find several with benefits comparable to BC/BS (especially when paired with medicare) and much lower premium price. The best comparison tool is at Guide to Health Plans For Federal Employees, 2023 FEHB Open Season (https://www.checkbook.org/newhig2/hig.cfm)

[jump4]

I'll soon be a Federal Retiree. The Fed Gov allows me to take my BC/BS plan into retirement- So I'll have private insurance

My BC/BS plan will reimburse me $800 in Part B premiums per year if I take Part B

I'm aware Part A is mandatory- but Part B is elective.

I go to the doctor quite a lot- regular doctor and specialists. What does Part B cover/pay for?... do they cover cover co-pays for doctor visits and urgent care visits?

I will be paying about $40 for all office visits. If Part B covers these it will be worth it.

Bottom line- I'm hoping to find out what Part B pays for and if people here who have private insurance find Part B worth the expense of premiums.

Thanks!

If you're willing to do some research, the following resources should be helpful:

myfederalretirement.com (https://www.myfederalretirement.com/how-fehb-medicare-work/)

FEHB and Medicare Coverage - FEDweek (https://www.fedweek.com/ask/medicare/fehb-medicare/)

Medicare and FEHB Coordination | Federal News Network (https://federalnewsnetwork.com/for-your-benefit/2022/01/medicare-and-fehb-coordination/)

Excellent comparison tool Guide to Health Plans For Federal Employees, 2023 FEHB Open Season (https://www.checkbook.org/newhig2/hig.cfm)

[retiredguy123]

When I was looking into this I saw no mention of special Part B rules for postal employees. Please check to make sure of the rules for your specific situation. From what I was able to find, Gatorbill's statement also applies to me, a non-postal federal retiree.

The two rules I saw were:
- If you are currently retired and less than 65 then you must enroll in Part B within the window around your 65th birthday
- if you turn 65 before you retire then you have an eight month eligibility window once you retire

Miss the window that applies to you and you may need to pay a lifetime late-enrollment penalty.
There is a penalty for delaying enrollment into Medicare. I think it is 10 percent for every year that you delay the enrollment, but it only applies to the basic, $164.90 per month amount, not to the IRMAA amount, if that applies. But, it sounded like Gatorbill was saying that you were required to sign up for Medicare Part B. That is not true. Enrollment in Medicare is optional for Federal retirees. You are not required to have Medicare Part B at all.

[Hardlyworking]

Medicare part B is optional for everyone.

[retiredguy123]

Medicare part B is optional for everyone.
Yes and no. If you are a retiree or an over-65 employee with some companies or organizations, and they allow you to continue to use their health insurance, they may require you to sign up for Medicare or they will cancel your insurance. But, for Federal retirees, that is not the case.

[Hardlyworking]

Yes and no. If you are a retiree or an over-65 employee with some companies or organizations, and they allow you to continue to use their health insurance, they may require you to sign up for Medicare or they will cancel your insurance. But, for Federal retirees, that is not the case.

That is true but that is not a Medicare requirement.

[jump4]

BC/BS is one of the most expensive plan. If you are going to have both medicare and FEHB, there are much less expensive FEHB plans that will give you the wave medicare wrap-around.

Sorry, I meant "waive" not "wave". Here are some additional resources you can check out:

Checkbook's advice re: Medicare FEHB & Medicare - Guide to Health Plans for Federal Employees (https://help.checkbook.org/category/66-fehb-medicare) including:
• FEHB's MA option Everything You Need to Know About Medicare Part C - Medicare Advantage - Guide to Health Plans for Federal Employees (https://bit.ly/3VM2PVZ)
• IRMAA IRMAA - Income Related Monthly Adjustment Amounts - Guide to Health Plans for Federal Employees (https://bit.ly/3iRiPYa)

Good article by Tammy Flanagan Open Questions About Open Season - Government Executive (https://www.govexec.com/pay-benefits/2022/12/open-questions-about-open-season/380372/) mentions:
• Many FEHB plans will waive their cost sharing when Medicare is the primary payer.
• Some FEHB plans will provide some reimbursement if you are enrolled in Parts A and B.
• For 2023, there are many FEHB plans that offer incentives to enrolling in Medicare A and B, but some provide these benefits only if you join the Medicare Advantage option of the FEHB plan. Unlike the Medicare Advantage plans available commercially, these plans maintain the underlying FEHB coverage, which means you may not need to stay within the plan network, get referrals to see a specialist or pay out of pocket costs for most of your health care. Enrolling in the FEHB Medicare Advantage option requires a second step after you make your open season election. Details about step can be found on the plan website, or you will receive a mailing once you are enrolled.

I just listened to the following podcast The Consumers’ CHECKBOOK Guide and FEHBP Open Season with Walton Francis | Federal News Network (https://bit.ly/3Butgra)
• skip to 23:00 minute mark for good information for annuitants (e.g., IRMAA, new Federal employee Medicare Advantage (MA) option for several FEHB plans). These MA options rebate $100-150 of medicare premium per month and adds benefits on top of the regular FEHB plan. "And especially with Aetna and United Healthcare Choice plans $0 out of pocket for approved health care services if you go to a Medicare provider, and you only are left with paying out of pocket for prescription drugs. And so that is one of the categories where you really have to focus in to see how these Medicare Advantage plans will handle your prescription drugs. But there’s tremendous savings 1000s of dollars compared to popular Blue Cross plans"

Somewhere I heard that if you add the MA option and don't like it you can remove it (do not have to wait for the next FEHB open season).

Questions I sent to the checkbook people and their response:
1. How is the prescription coverage of an FEHB plan affected when I start Medicare part B (original or the new MA option within FEHB)? “Sometimes, depending on the plan, it might lead to lower out-of-pocket costs. For example, with BCBS Basic you gain mail order prescription drug coverage when you have Part B”. [Checkbook/Kevin Moss 12/2022]

2. Does adding the MA option to FEHB plans such as United Choice Primary + United Retiree Advantage trigger both part B IRMAA and Part D IRMAA surcharges? “YES” [Checkbook/Kevin Moss 12/2022]

3. Do the FEHB MA plans suffer from the same drawbacks or concerns as for commercial MA plans (e.g. limited networks and prior authorization)? See https://www.medpagetoday.com/special-reports/exclusives/102143 and https://wapo.st/3VLutTf. “The FEHB Medicare Advantage plans go through a quality scoring system and all are either 4 or 5 stars. You have access to any provider that accepts Medicare with these plans. Are there exceptions to that? Yes, I found out this week that Aetna Advantage doesn't have a contract with the Mayo Clinic and therefore those providers wouldn't be accepted. My advice, if you're considering one of these plans is to check their existing provider network to make sure your current providers will be covered. Prescription drugs are an area of focus and the only out-of-pocket cost you'll face. You should check carefully that any prescription drugs you currently take will be covered.” [Checkbook/Kevin Moss 12/2022]

The online Checkbook FEHB guide at https://www.checkbook.org/newhig2/hig.cfm is a terrific resource where you enter your age, zip code, etc. and get a personalized analysis of all FEHB plans available to you, listing estimated total cost, maximum out-of-pocket, and summary of benefits for each plan. I think you have to pay about 10 bucks if you enter promo code FEDSMITH or FEDNEWS at checkout.

[bsloan1960]

Thank you so much for your detailed answer. I'll investigate the links you provided

Sorry, I meant "waive" not "wave". Here are some additional resources you can check out:

Checkbook's advice re: Medicare FEHB & Medicare - Guide to Health Plans for Federal Employees (https://help.checkbook.org/category/66-fehb-medicare) including:
• FEHB's MA option Everything You Need to Know About Medicare Part C - Medicare Advantage - Guide to Health Plans for Federal Employees (https://bit.ly/3VM2PVZ)
• IRMAA IRMAA - Income Related Monthly Adjustment Amounts - Guide to Health Plans for Federal Employees (https://bit.ly/3iRiPYa)

Good article by Tammy Flanagan Open Questions About Open Season - Government Executive (https://www.govexec.com/pay-benefits/2022/12/open-questions-about-open-season/380372/) mentions:
• Many FEHB plans will waive their cost sharing when Medicare is the primary payer.
• Some FEHB plans will provide some reimbursement if you are enrolled in Parts A and B.
• For 2023, there are many FEHB plans that offer incentives to enrolling in Medicare A and B, but some provide these benefits only if you join the Medicare Advantage option of the FEHB plan. Unlike the Medicare Advantage plans available commercially, these plans maintain the underlying FEHB coverage, which means you may not need to stay within the plan network, get referrals to see a specialist or pay out of pocket costs for most of your health care. Enrolling in the FEHB Medicare Advantage option requires a second step after you make your open season election. Details about step can be found on the plan website, or you will receive a mailing once you are enrolled.

I just listened to the following podcast The Consumers’ CHECKBOOK Guide and FEHBP Open Season with Walton Francis | Federal News Network (https://bit.ly/3Butgra)
• skip to 23:00 minute mark for good information for annuitants (e.g., IRMAA, new Federal employee Medicare Advantage (MA) option for several FEHB plans). These MA options rebate $100-150 of medicare premium per month and adds benefits on top of the regular FEHB plan. "And especially with Aetna and United Healthcare Choice plans $0 out of pocket for approved health care services if you go to a Medicare provider, and you only are left with paying out of pocket for prescription drugs. And so that is one of the categories where you really have to focus in to see how these Medicare Advantage plans will handle your prescription drugs. But there’s tremendous savings 1000s of dollars compared to popular Blue Cross plans"

Somewhere I heard that if you add the MA option and don't like it you can remove it (do not have to wait for the next FEHB open season).

Questions I sent to the checkbook people and their response:
1. How is the prescription coverage of an FEHB plan affected when I start Medicare part B (original or the new MA option within FEHB)? “Sometimes, depending on the plan, it might lead to lower out-of-pocket costs. For example, with BCBS Basic you gain mail order prescription drug coverage when you have Part B”. [Checkbook/Kevin Moss 12/2022]

2. Does adding the MA option to FEHB plans such as United Choice Primary + United Retiree Advantage trigger both part B IRMAA and Part D IRMAA surcharges? “YES” [Checkbook/Kevin Moss 12/2022]

3. Do the FEHB MA plans suffer from the same drawbacks or concerns as for commercial MA plans (e.g. limited networks and prior authorization)? See https://www.medpagetoday.com/special-reports/exclusives/102143 and https://wapo.st/3VLutTf. “The FEHB Medicare Advantage plans go through a quality scoring system and all are either 4 or 5 stars. You have access to any provider that accepts Medicare with these plans. Are there exceptions to that? Yes, I found out this week that Aetna Advantage doesn't have a contract with the Mayo Clinic and therefore those providers wouldn't be accepted. My advice, if you're considering one of these plans is to check their existing provider network to make sure your current providers will be covered. Prescription drugs are an area of focus and the only out-of-pocket cost you'll face. You should check carefully that any prescription drugs you currently take will be covered.” [Checkbook/Kevin Moss 12/2022]

The online Checkbook FEHB guide at https://www.checkbook.org/newhig2/hig.cfm is a terrific resource where you enter your age, zip code, etc. and get a personalized analysis of all FEHB plans available to you, listing estimated total cost, maximum out-of-pocket, and summary of benefits for each plan. I think you have to pay about 10 bucks if you enter promo code FEDSMITH or FEDNEWS at checkout.