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

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!

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.

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.

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.

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.

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.

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

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.

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.

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.

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.

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.

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?

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.

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.

FEHB with Medicare
 

FEHB offers several plans that integrate with Medicare, including:

FEHB Plans for Medicare:
• Aetna for retirees AetnaFeds.com

Aetna® Medicare Advantage Welcome Federal Employees | Aetna Medicare Advantage

Aetna Direct Welcome Federal Employees | Aetna Direct

• UnitedHealthcare “Retiree Advantage” Plan Details

• Humana Group Medicare Advantage plan will be a subset plan of the Value Plan (CS2887) Feds

• Blue Cross Preparing for Medicare - Blue Cross and Blue Shield's Federal Employee Program

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

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.

Not if the out-of-network provider has opted out of Medicare entirely. A provider can opt out and charge whatever they want.

Have done the same and I don’t have to pay co-pays.

I have both and feel it's well worth it.
 

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

"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

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:

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.

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.

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.

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.

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

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.

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

Haven't retired yet, and haven't spoken to any Rep yet- Didn't know my employer would offer advice of this type.

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.

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

Medicare
 

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.

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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.