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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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sport  
#1 Posted : Wednesday, April 8, 2020 3:50:59 PM(UTC)

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30 days away from 65. Retired from Feds in 2011. Kept FEBP with BCBS Basic. So...should I sign up for Part B and keep FEBP, or not get Part B since I have FEBP. Or drop FEBP and get Part B. Has anyone analyzed this? Pros cons? Thanks.
HoosierDaddy  
#2 Posted : Wednesday, April 8, 2020 6:33:53 PM(UTC)

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If I was in your situation I would keep FEHB and get part b. With Medicare as your primary insurance and BCBS basic secondary and you stay in network your only out of pocket costs would be RX co-pays and you can lower those because you would have access to the mail order pharmacy. Also with BCBS basic you can sign up for a medicare reimbursement account and get reimbursed for $800 a year of your part b premiums. Also I believe that if you don't sign up for part b when you are first eligible you pay a penalty if you decide sign up later.
You can't fix stupid, but you can vote it out.
sport  
#3 Posted : Thursday, April 9, 2020 7:55:27 AM(UTC)

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Thanks much.
teeeeej  
#4 Posted : Tuesday, May 26, 2020 8:31:05 PM(UTC)
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My understanding is that Aetna Direct is the most lucrative FEHB option to have with Medicare.

The HalfBreed  
#5 Posted : Monday, August 31, 2020 9:14:39 AM(UTC)

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Please take note that HoosierDaddy said "BCBS BASIC". I kept the BCBS Standard for my own personal reasons.

I just applied for Medicare and took pt B. There's a 7 month window to apply. Your birth month, Plus or Minus 3 months.
If you're still working at that time, you'd have to ask medicare folks. 1-800-MEDICARE (1-800-633-4227) I don't think you'll be required, but double check.
For every 12 months you delay pt B if you can get it at age 65, there's a PERMANENT 10% penalty that will never go away. 24 months = 20%, etc.
Currently, pt B is ~ $144/month but there's IRMAA which forces higher paid retirees to pay more. I was pushed up to $202.40 per month, and I'm single.

I'd keep BCBS, or whatever you chose. It's technically not a "Supplement" (think AARP plan) like many many being sold on the secondary market, but it's more like Secondary Ins.
If Medicare does not pay for XYZ services, you're BCBS will pay for it as they have during your working career as I'm told. You also get the benefit of prescription drugs.
You'd have to sign up for pt D and pay for it if you want prescription drug insurance.

There are others who use AETNA, etc that also get the reimbursement from pt B, according to them.
Also note that, there are certain pitfalls to be aware of, in that BCBS Basic may not cover you're Dr if they're not in the BCBS type listing.
Some have also said it's not usable outside of the USA, but I don't know about that personally.

Edited by user Monday, August 31, 2020 9:17:01 AM(UTC)  | Reason: IRMAA info

RETIRED CSRS 12/19/2012 @ age 57 w/39 years.
Good Bye Tension...Hello Pension !
GSBS  
#6 Posted : Wednesday, September 2, 2020 2:25:57 PM(UTC)
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Originally Posted by: HoosierDaddy Go to Quoted Post
If I was in your situation I would keep FEHB and get part b. With Medicare as your primary insurance and BCBS basic secondary and you stay in network your only out of pocket costs would be RX co-pays and you can lower those because you would have access to the mail order pharmacy. Also with BCBS basic you can sign up for a medicare reimbursement account and get reimbursed for $800 a year of your part b premiums. Also I believe that if you don't sign up for part b when you are first eligible you pay a penalty if you decide sign up later.


I see much lower Prescription prices at a Retail store then I would by mail? Why do I maintain the 'Cadillac' of BCBS Plans, why would I want duplicate coverage at a higher overall price? BCBS suggests everyone to take Medicare when eligible to keep Plan costs low, lower for whom? I've read the FEHB plan can be worth it's weight in Gold in retirement. Reg Jones, former OPM Benefits Director says this if I'm reading it correctly:

"So, what are you to do? The consensus of opinion among the experts is that most Medicare-eligible federal retirees only need their FEHB enrollment and premium-free Part A. That’s because this combination of coverage will give them the greatest protection for the least amount of money. Only those with specific needs covered by Part B need to enroll in that. And even fewer need Part D."

https://www.fedweek.com/...need-fehb-in-retirement/



https://www.opm.gov/heal...stfacts/fehbmedicare.pdf

Edited by user Wednesday, September 2, 2020 2:28:39 PM(UTC)  | Reason: .

OUtside  
#7 Posted : Thursday, September 3, 2020 8:51:56 PM(UTC)

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Plan costs kept low when fehb retiree has Part B, why? The answer is Medicare pays about 80% of medical care for Part B services, leaving the plan to pay only 20%. Without Part B, the Plan likely pays much higher than 20% for the same services (bc Medicare is not paying anything).

In the recent thread which asked has the cost of Part B been worth it to you?, Walt Francis is quoted saying having both insurances overall is extra costly (to the entire healthcare system) as likely having to cover 'unnecessary care.' I think the point here is, if the retiree is not required to pay a copay, he/she is more apt to obtain services, so the person possibly consumes more. If, on occasion, services aren't required or are counterproductive, for example, if mistakes occur, the services are yet more expensive (for the entire healthcare system). If memory services, the amount of extra cost was estimated to be 2 billion a year or so, in that thread.

Edited by user Friday, September 4, 2020 4:29:37 PM(UTC)  | Reason: Clarification

ex-military  
#8 Posted : Wednesday, September 9, 2020 4:24:53 AM(UTC)
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Originally Posted by: GSBS Go to Quoted Post
Originally Posted by: HoosierDaddy Go to Quoted Post
If I was in your situation I would keep FEHB and get part b. With Medicare as your primary insurance and BCBS basic secondary and you stay in network your only out of pocket costs would be RX co-pays and you can lower those because you would have access to the mail order pharmacy. Also with BCBS basic you can sign up for a medicare reimbursement account and get reimbursed for $800 a year of your part b premiums. Also I believe that if you don't sign up for part b when you are first eligible you pay a penalty if you decide sign up later.


I see much lower Prescription prices at a Retail store then I would by mail? Why do I maintain the 'Cadillac' of BCBS Plans, why would I want duplicate coverage at a higher overall price? BCBS suggests everyone to take Medicare when eligible to keep Plan costs low, lower for whom? I've read the FEHB plan can be worth it's weight in Gold in retirement. Reg Jones, former OPM Benefits Director says this if I'm reading it correctly:


Those drug prices are entirely dependent on WHAT you are taking. My wife and I take numerous RXs daily. Some are a better deal to go retail. Others are leaps and bounds cheaper to go Mail Order. One RX in particular would set me back over $70 for a 30 day supply at the Retail , but I can get it through the Mail Pharmacy for $15 for 90 day supply. Not a tough choice.
Guts  
#9 Posted : Friday, October 16, 2020 1:07:28 PM(UTC)

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Also, if you are military retiree Tricare eligible, Tricare for Life (TFL), starting at 65, requires part B. There is no premium for TFL, and is a full benefit medical and pharmacy plan. FEHB can even be 'SUSPENDED', to use/tryout the medicare A&B + TFL combination. TFL also covers all eligible under 65 family members as under regular Tricare Select. You can always go back to FEHB during Open Season.
Grammar: the difference between knowing your **** and knowing you're ****
Guts  
#10 Posted : Friday, October 16, 2020 1:09:41 PM(UTC)

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Originally Posted by: OUtside Go to Quoted Post
Plan costs kept low when fehb retiree has Part B, why? The answer is Medicare pays about 80% of medical care for Part B services, leaving the plan to pay only 20%. Without Part B, the Plan likely pays much higher than 20% for the same services (bc Medicare is not paying anything).

In the recent thread which asked has the cost of Part B been worth it to you?, Walt Francis is quoted saying having both insurances overall is extra costly (to the entire healthcare system) as likely having to cover 'unnecessary care.' I think the point here is, if the retiree is not required to pay a copay, he/she is more apt to obtain services, so the person possibly consumes more. If, on occasion, services aren't required or are counterproductive, for example, if mistakes occur, the services are yet more expensive (for the entire healthcare system). If memory services, the amount of extra cost was estimated to be 2 billion a year or so, in that thread.


Is there a future FEHB Medicare Advantage Plan in the works?
Grammar: the difference between knowing your **** and knowing you're ****
kgkistari  
#11 Posted : Sunday, October 18, 2020 4:20:14 PM(UTC)
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We have Medicare A & B along with Blue Cross Blue Shield Basic. We've had zero out of pocket expenses except for medication copays. Considering both my husband and I have had unexpected medical situations come up, I'm very happy with them. Not to mention, the $800 rebate we each received.
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