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-   -   Federal Retiree w/ BC/BS Should I Get Medicare Part B? (https://www.talkofthevillages.com/forums/medical-health-discussion-94/federal-retiree-w-bc-bs-should-i-get-medicare-part-b-336695/)

bsloan1960 11-14-2022 11:27 AM

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!

retiredguy123 11-14-2022 12:33 PM

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 11-14-2022 01:03 PM

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 11-14-2022 01:08 PM

Quote:

Originally Posted by Byte1 (Post 2157539)
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 11-14-2022 01:14 PM

Quote:

Originally Posted by bsloan1960 (Post 2157541)
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 11-14-2022 01:21 PM

Quote:

Originally Posted by Hardlyworking (Post 2157543)
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 11-14-2022 01:41 PM

Quote:

Originally Posted by bsloan1960 (Post 2157541)
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 11-14-2022 03:25 PM

Quote:

Originally Posted by bsloan1960 (Post 2157546)
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 11-14-2022 03:46 PM

Quote:

Originally Posted by Hardlyworking (Post 2157570)
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 11-14-2022 04:27 PM

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 11-14-2022 06:37 PM

Quote:

Originally Posted by Toymeister (Post 2157581)
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 11-14-2022 06:52 PM

Quote:

Originally Posted by bsloan1960 (Post 2157603)
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 11-14-2022 07:50 PM

Quote:

Originally Posted by bsloan1960 (Post 2157571)
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 11-14-2022 09:03 PM

Quote:

Originally Posted by retiredguy123 (Post 2157605)
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 11-14-2022 09:49 PM

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.


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