[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]

Originally Posted by 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.

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]

Originally Posted by naneiben

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]

Originally Posted by MikeV

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]

Originally Posted by 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.

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]

Originally Posted by 784caroline

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]

Originally Posted by Sable99

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]

Originally Posted by 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.

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]

Originally Posted by 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.

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.