Medicare and Health Care

My father got really sick last year and my sister ended up taking FMLA and then retiring on February 2nd. She is 70 and paperwork has never been her forte and with everything she's been through in the past 10 months she can't focus on anything. My father passed away earlier this month. I am trying to help her. The problem is my sister has very few health problems but a really high pension after 40 years with the government so her medicare premiums will probably be $300 plus a month, then $245 for BCBS. I'm trying to research if she should even get Medicare part B. She doesn't go to the dr unless she REALLY has to. My question is if she doesn't get part B (I know about the penalty) how does BCBS work. Do they still pay the same amount as if you were working? Any input would be appreciated. She has to sign up within 8 months )by October 2nd)and with everything else we are dealing with I just don't have hours to research and don't know what to do so any input would be appreciated to help me make a decision (I do all the paperwork)

Thank you so much for the detailed post

Why are you forced to enroll in Medicare at age 62?

As far as Fehb with Part B, Checkbook has an analysis plan by plan which suggests which plans would likely result in a cost effective enrollment paired with Part B. The original poster mentioned the situation of a high income retiree, where cost effectiveness would be unlikely, but it may be likely for you in certain plans. You would then have to review those plans to see if they would work for you.

If you are confused about the subject, you could start with page 157 of the BC brochure, or the comparable page if you are not with BC, be sure you understand it, and move on from there.

If hes been on SS disability for two years medicare is mandatory at that point

I'm always interested in learning something new on these subjects, so on this one I would like to see some chapter and verse on it.

My impression formed some time ago while reading the Disability Forum at this web site is that a disability retiree has the opportunity to sign up prior to age 65, but not the requirement to sign up. This would mean that retiree, as a fed retiree, would have to decide on Part B the same as the rest of us but at a younger age.

On this point check out the 2019 Medicare and You booklet, page 15, it says if you are receiving SS benefits, you will be automatically enrolled and if you do nothing, you will have to pay the premium. But you can choose not to keep Part B, in which case I assume you would contact an SS office to unenroll.

If you then unenroll, you would pay a penalty if you later enroll again up until age 65. At age 65, you then have a new opportunity to enroll sans penalty as the clock starts over.

Edited by user Tuesday, July 30, 2019 7:52:44 AM(UTC)  | Reason: Not specified

Here's is a link to the Medicare and You booklet, page 15 refers to this, https://www.medicare.gov/medicare-and-you. Receiving SS benefits, you will be automatically enrolled, so if you want to decline, you will have to take action to notify SS that you want to unenroll. From posts at this web site, people have said they had to meet with a representative for counseling, which am pretty sure means they want to be sure you are not putting yourself in position where you do not have any health insurance; and also that, if you change your mind between the ages of 62 and 65, that there would be the penalty for late enrollment applied to your premium. But at age 65, you then get a new opportunity to enroll without penalty.

I suggest you spend the $10 for a Checkbook subscription https://www.checkbook.org/newhig2/hig.cfm; once you provide them info on your age (say you're 65 because at 62 I don't think you will get the Medicare input from it), zip code, enrollment type, income level, and expected level of health expenses (low, average, or high) they will provide estimates of out of pocket costs (premiums plus copays) fehb plan by plan both with and without Medicare for your evaluation. Then take a serious look at the fehb plans which when paired with Part B result in less costs to you than the fehb plan alone. If they don't work for you, you can also look at the fehb plans one by one vs each other from the same perspective, ie, which would cost less and are highly rated, would they fit your needs and save you money?

The other thing to do would be to look into Medicare Advantage, Medicare Part C. If you are eligible for Medicare, you can enroll in Part B and then suspend (but do not cancel) your fehb plan in order to select a Part C plan. Part C is a very economical way to go but there are some drawbacks such as weaker Rx coverage. Checkbook has a good discussion of Medicare Advantage but as far as I know they do not rate individual plans, so you would have to evaluate individual plans yourself or ask other retirees in your area perhaps. I know a few people who have it and say they really like it.

If you have suspended your fehb plan to take Medicare Advantage and are not happy, you can come back to fehb January following the next open season.

Edited by user Tuesday, July 30, 2019 8:27:13 PM(UTC)  | Reason: Not specified

@OUtside, wouldn't you know it, I click on your Medicare Link and its an error. Wouldn't I be just as covered staying on FEHB from age 62 to 65? As I will need to apply for SS at 62 with my OPM D.R. are you are saying I can opt-out at no penalty if I decide to apply for Medicare @ 65. If there is no requirement by the Government or the FEHB to apply for Medicare, why can't I just stay on it for the rest of my life? There are no Medicare Advantage Plans in my area, we don't even have a Grocery store. Not sure Checkbook can answer my question as I'm almost 61

btw, when you say you're on disability retirement through opm, are you also already on your own SS record as a disabled worker as well? That will change HI/SMI things. You can be on a DIB record until you turn 65, which you will then automatically be converted over to RIB.

No I didn't qualify for SSDI. My Disability retirement is recalculated at age 62 and that is when I thought Medicare comes into play. I am going to read the link provided above and darn if OUtside's link is out of order. If the premium for Part B is about $150, and the FEHB is $250 for better more complete coverage, why would I want or need Medicare if not required?

You can fight until you run out of Work Credits, then the answer is no. I did appeal a few years back but I no longer qualified with Zero credits, and besides the Judge said I could operate a Chair & Desk so I could work anywhere?

Edited by user Wednesday, July 31, 2019 5:20:15 PM(UTC)  | Reason: .