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Medicare and Health Care


*This is a non-medical board. This site shall not be used to seek professional, medical or legal consultation.

Medicare is health insurance for people age 65 or older, under age 65 with certain disabilities, and any age person with End-Stage Renal Disease (ESRD). There are many different parts to Medicare; with all of these options, it can be confusing.

This forum will allow members to share their experience with medicare and seek advice* on certain medicare-related situations.

To read today's top news stories on federal employee pay, benefits, retirement, job rights and other workplace issues visit FederalDaily.com.

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sarmikreb  
#1 Posted : Sunday, November 11, 2012 3:17:17 AM(UTC)
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What are peoples thoughts about the best FEHB insurance to have as a secondary health insurance program to carry in addition to Medicare when you turn 65 years old?
freeageless  
#2 Posted : Sunday, November 11, 2012 3:30:40 AM(UTC)
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For me the best secondary insurance to have is one that covers items that Medicare does not cover. For example Medicare does not cover illness and injury incurred while overseas and certain vaccines. So you want a secondary insurance that covers those. Obviously, in addition I want one that waives the deductibles and co-payments. Some of the plans that do that that I have had are Blue Cross Standard, Foreign Service Benefit Plan, Compass Rose. I just signed up for GEHA standard for next year, and they told me that they do that as well.
dhacker56  
#3 Posted : Sunday, November 11, 2012 7:20:11 AM(UTC)
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It also depends on whether you are on maintenance RXs. If not then BCBS basic is great assuming your doctors are signatory. If you have a lot of meds then NALC is a great plan.
Frank1938  
#4 Posted : Tuesday, November 13, 2012 10:20:13 PM(UTC)
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I have had NALC as secondary for 5 years or more & for the most part I am pleased with it.
A minus for me is they have instructed Caremark to force everyone on Generics even if the doctor has marked no substitute. I just went though this mess after they forced me on generic Avapro after the doctor detailed why he stated no substitute.
I did finally get the approval to stay on Avapro after some long phone conversations, but was told that NALC is the one that makes the rules & it is difficult to go against their directives.
Fed1969  
#5 Posted : Wednesday, November 14, 2012 8:03:20 AM(UTC)
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I like BCBS Standard. I know others who prefer NALC. I recommend them both.
freeageless  
#6 Posted : Wednesday, November 14, 2012 9:50:27 AM(UTC)
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Fed1969 wrote:
I like BCBS Standard. I know others who prefer NALC. I recommend them both.


Fed1969, any reason or reasons why you like them over GEHA standard. I notice that the premiums for one person with GEHA are way less than BCBS Standard-and considerably less than NALC.
gmaof21  
#7 Posted : Friday, November 16, 2012 4:52:50 AM(UTC)
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I am considering GEHA Standard too. 2nd choice would NALC but would save over $100 per month on GEHA Standard. Am concerned about coverage for Cancer meds if that were to happen to us, and can't find any posts about Cancer meds. I wonder if they are usually Name brand or Generic drugs? I guess you take a chance if you want to save money upfront, huh? I have really researched, read most of the plans brochures and just wanted to know if I am overlooking something?
martyb  
#8 Posted : Friday, November 16, 2012 8:51:13 AM(UTC)
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If you don't currently have a need for cancer meds, why would you worry about it now? Since you can switch carriers every year, even if you happen to come down with some illness you don't have now, you will only have to wait a short time before you can switch to a more appropriate & probably more expensive policy. Just sayin.....
Forum trolls to 0%
gmaof21  
#9 Posted : Friday, November 16, 2012 10:29:26 AM(UTC)
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So would you recommend NALC or GEHA?
Fed1969  
#10 Posted : Friday, November 16, 2012 10:47:33 AM(UTC)
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I had GEHA for many years but switched to BCBS.

GEHA would also be a good choice, but limited as compared BCBS.

The reason I prefer BCBS over GEHA is more options.
dhacker56  
#11 Posted : Friday, November 16, 2012 10:57:35 AM(UTC)
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If you are wanting options why would you pick BCBS over NALC? Just to spend $100 more per month?
Fed1969  
#12 Posted : Friday, November 16, 2012 11:35:43 AM(UTC)
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I guess I need to compare these plans. It may be worth the $100, but maybe not.

Thanks for pointing this out.
martyb  
#13 Posted : Friday, November 16, 2012 11:47:27 AM(UTC)
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Fed1969 is not and was not a fed. He's a ridiculous troll. Go back and read his many posts that say nothing.
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sarmikreb  
#14 Posted : Tuesday, November 20, 2012 11:00:34 AM(UTC)
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Thank you all for the helpful information!
sueva1  
#15 Posted : Tuesday, February 12, 2013 6:47:21 PM(UTC)
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In 2013 MHBP will pay Original Medicare's part B Premium. Has anyone tried this?   I wish more plans would offer something like this for
retirees. After all there liability goes to 20% from 80, 90, 100% when it's used as a Medicare supplement.
freeageless  
#16 Posted : Tuesday, February 12, 2013 10:36:16 PM(UTC)
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sueva1 wrote:
In 2013 MHBP will pay Original Medicare's part B Premium. Has anyone tried this?   I wish more plans would offer something like this for
retirees. After all there liability goes to 20% from 80, 90, 100% when it's used as a Medicare supplement.


I have had MHBP in the past. I did not like them. As far as MHBP paying the Medicare premium, that is no big deal. They just add that to the cost of their premium. For example I note that the approximate monthly cost for a single person for MHBP is $200 per month. You can get other federal health plans for about half of that-like Foreign Service Benefit Plan, GEHA etc. Sueval, believe you me-MHBP ain't giving no free lunch.
edalder  
#17 Posted : Wednesday, February 13, 2013 1:41:21 AM(UTC)
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It has been awhile, but when I had GEHA standard, I found that the copay for non-generic drugs could be rather high and often a tad unpredictible (although the variation between refills was never more than a few dollars. (It was a percentage of some kind of price that always seemed to be a moving target.) If you take medications that do not have a generic equivalents or your doctor has said, no substitutes, you may be unpleasantly surprised at your out-of-pocket drug co-pays.

Also, in some areas, the GEHA network of physicians can be a little skimpy. However, I think if you have Medicare Part B, you can go out of network without penalty. (Best to read the current plan brochure and make sure of that one.) This one could be a real issue if you are retired but not quite old enough for Medicare.

Becoming eligible for Medicare is a qualifying event that allows you to make a change in your FEHB plan outside of open season. So, you do not have to make this switch during an open season period in anticipation of becoming eligible for Medicare at some point during the following year. You can wait until you have that Medicare card and then make the switch, probably within 30 to 60 days of becoming eligible for Medicare.

BC-BS and NALC (Cigna network) seem to have more physicians from which to choose. Not everyone would be eligible for Compass Rose or the Foreign Service Benefit plan. But, if you are, check those plans as well.
Kivi
OUtside  
#18 Posted : Wednesday, February 13, 2013 5:21:44 AM(UTC)
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About sueva1’s question, the brochure on page 87 says retiree pays the plans deductibles, co-pays, and coinsurance in addition to the Medicare deductibles (none are waived).
The page also says if retiree is subject to penalty for late enrollment in Part B, to inform Medicare of creditable fehb coverage in order to have the penalty waived. This seems to be something new which has not been discussed on this forum previously, to my knowledge.
Also, sueval’s comment about Part B enrollee’s coverage by fehb going to 20% from 80% etc, doesn’t take into account that elderly tend to need much higher and costly care than younger fehb age groups, meaning the coverage going to 20% from a much higher percentage is not as stark as it seems. For example, if elderly retiree goes to doctor four times as often as younger employee, 4 x 20% = 80%.
freeageless  
#19 Posted : Wednesday, February 13, 2013 7:03:10 AM(UTC)
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OUtside wrote:
About sueva1’s question, the brochure on page 87 says retiree pays the plans deductibles, co-pays, and coinsurance in addition to the Medicare deductibles (none are waived).
The page also says if retiree is subject to penalty for late enrollment in Part B, to inform Medicare of creditable fehb coverage in order to have the penalty waived. This seems to be something new which has not been discussed on this forum previously, to my knowledge.
Also, sueval’s comment about Part B enrollee’s coverage by fehb going to 20% from 80% etc, doesn’t take into account that elderly tend to need much higher and costly care than younger fehb age groups, meaning the coverage going to 20% from a much higher percentage is not as stark as it seems. For example, if elderly retiree goes to doctor four times as often as younger employee, 4 x 20% = 80%.


OUtside, has excellent points. I would also add that if you have Medicare Part B with Blue Cross, Foreign Service, GEHA, Compass Rose and most federal employee plans that are not HMO's you in almost all cases will have no deductibles, co-pays, and coinsurance. I would definitely stay away from Mail Handler's.

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