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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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Chache  
#1 Posted : Monday, August 3, 2020 12:21:57 PM(UTC)
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I was approved for fers disability about 5-6 months ago and kept my fehb now after being denied multiple times i have been approved for ssdi but they are taking money out of my ssdi for medicare part b? I posted this on another board and was sent here
Also will i get any of the money back if i cancel the part b that they already are automatically taking out of my ssdi check?

My question should i drop the fehb plan and just keep medicare or should i keep the fehb and drop the medicare b, i was informed that the medicare a would be free also if it matters im not even close to 65 i think i read somehwere that when your 65 it changes

So now im being deducted both inusrance plans from checks and obviously id like to just keep one, also medicare is stating if i declining b coverage and want it in the future i will have to pay a penalty? I have 15+ years until im age 65 so how much could this penalty be?
I am completely lost with all this?
also does any of this effect taxes if i decline medicare do i get money back since ive paid into it that might offset the penalty if i do need

Thanks for any help

Edited by user Monday, August 3, 2020 1:08:58 PM(UTC)  | Reason: Not specified

Chache  
#2 Posted : Monday, August 3, 2020 12:53:56 PM(UTC)
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I have the blue cross blue shield basic right now if that matters

Thanks
smithandjones  
#3 Posted : Monday, August 3, 2020 1:26:03 PM(UTC)

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Tough to answer without knowing medical details and how often you receive care/prescriptions etc..... I’d consider keeping both but make sure I had the most cost effective FEHB plan for my situation - a cheaper plan may be very beneficial as Medicare does not cover everything and you will find that doctors hate Medicare and many many refuse it. With combined benefits you often will pay nothing.

Also, are any family members covered now or possible in the future? Not sure, but I think you could still add to FEHB in the future but not Medicare.

TheRealOrange  
#4 Posted : Tuesday, August 4, 2020 2:55:15 AM(UTC)
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Originally Posted by: smithandjones Go to Quoted Post
Not sure, but I think you could still add to FEHB in the future but not Medicare.

If a retiree cancels FEHB, they aren’t be able to re-enroll unless they are reemployed by the federal government in a position that’s covered by the FEHB program. According to OPM, there are also some circumstances under which a retiree can suspend coverage: "As an annuitant you can suspend your Federal Employees Health Benefits (FEHB) enrollment to enroll in a Medicare Advantage plan, TRICARE, CHAMPVA, Medicaid or a similar State-sponsored program of medical assistance for the needy, or use Peace Corps health insurance coverage." Then later, if the annuitant loses the other coverage, they are able to re-enroll in an FEHB plan effective the date coverage was lost. If they don't lose their other coverage but want to re-enroll in an FEHB plan, they are able to do so during an Open Season. Again, they must meet the suspension requirements and they suspend, not cancel, their coverage. If they cancel their coverage, it is gone for good unless they are re-employed and qualify for FEHB as an employee. Then they will need to meet the usual requirements for taking FEHB coverage into retirement.

Chache, since you have BCBS Basic, you are entitled to an annual $800 reimbursement for paying Medicare Part B premiums. Each eligible active or retired member on a contract, including covered spouses, can get their own $800 reimbursement. That should be factored into the equation about your ability to keep both the BCBS Basic and Medicare Part B. Here is a link to a great article at checkbook.org about the issue of the value of keeping both FEHB and Medicare Part B:

https://www.checkbook.or...care-part-b-after-age-65
smithandjones  
#5 Posted : Tuesday, August 4, 2020 5:07:29 AM(UTC)

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Originally Posted by: TheRealOrange Go to Quoted Post
Originally Posted by: smithandjones Go to Quoted Post
Not sure, but I think you could still add to FEHB in the future but not Medicare.

If a retiree cancels FEHB, they aren’t be able to re-enroll unless they are reemployed by the federal government in a position that’s covered by the FEHB program.


Right. But what I actually said in context was you can ADD (and subtract) a family member to FEHB in the future. That could be a huge benefit down the line to consider.
OUtside  
#6 Posted : Tuesday, August 4, 2020 5:36:43 AM(UTC)

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About the penalty, once you turn 65, the clock starts all over, so you would be able to enroll in Part B with no penalty then (just as you can now). If you don't enroll now, then the penalty later would be 10% increase per year for every 12 months you delayed enrolling (until age 65, when the clock re-starts).

As far as dropping FEHB for Medicare alone, it's probably not the best way to go, although suspending FEHB and taking a Medicare Advantage (Part C) is an economical way to go if you find a Part C plan you like. You will have to compare side by side all the types of coverages including prescription drugs. With some Medicare plans you will need a separate prescription drug (Part D enrollment) and pay a separate premium, and the coverage may not be as good as your Blue Cross prescription coverage.

You're eligible for Medicare now bc of disability but otherwise you're facing the situation the rest of us feds face at age 65 with respect to Medicare and how it works with FEHB. There are a ton on particular discussion threads on this forum about that which could give you background to read for info, just to realize all of them are in the same boat but had to wait to age 65 to land in it.

GoHuskers  
#7 Posted : Tuesday, August 4, 2020 8:44:05 AM(UTC)

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Chache - Read the correspondence from SSA again. It should have given you a time limit for requesting cancellation of the Part B. If you do it within that time, which I believe is 2 full months, the premiums previously deducted will be refunded. If you wait too long to make the request, the Part B will be terminated effective as of the end of the calendar month after the calendar month in which the request is filed, and you would be liable for the premiums until then.

Chache  
#8 Posted : Wednesday, August 5, 2020 12:16:26 AM(UTC)
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Appreciate the help and i also looked at other posts in the forum they have been helpful, so many options while im grateful after 3 years of nothing and denials i finally was approved for both i thought process would be easier between figuring out taxes for the back pay also the offset with fers and ssdi it just all hit at once

As for insurance main thing is prescription coverage at this point that is a must for me and i cant do some mail order because certain prescriptions i require certain brands over generics which was and issue with mail order before as for the insurance also only i willl be using it no children or significant other on the policy

Thanks
HoosierDaddy  
#9 Posted : Wednesday, August 5, 2020 11:49:04 AM(UTC)

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Originally Posted by: Chache Go to Quoted Post
Appreciate the help and i also looked at other posts in the forum they have been helpful, so many options while im grateful after 3 years of nothing and denials i finally was approved for both i thought process would be easier between figuring out taxes for the back pay also the offset with fers and ssdi it just all hit at once

As for insurance main thing is prescription coverage at this point that is a must for me and i cant do some mail order because certain prescriptions i require certain brands over generics which was and issue with mail order before as for the insurance also only i willl be using it no children or significant other on the policy

Thanks


You should read how BCBS basic works when Medicare part b is your primary insurance. When I retired I got part b for my wife who gets SSDI.

We usually hit the catastrophic limit of $5500 by March or April mainly because my wife takes some expensive name brand drugs. So far this year her out of pocket is $0 for doctor and hospital visits and $725 all for RX copays, with part b as primary she can now use the mail order pharmacy and instead of paying $900 a month for 1 Tier 3 Rx she now pays $125 for a 3 month supply.

Also with BCBS basic you can get reimbursed up to $800 a year of your part b premiums.
You can't fix stupid, but you can vote it out. https://www.youtube.com/watch?v=DG29PVMtAWE
OUtside  
#10 Posted : Wednesday, August 5, 2020 1:45:04 PM(UTC)

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Regarding your brand name prescriptions, here is a link raised from last year's open season discussions: https://www.fedsmith.com...-fehb-plan-choices-2019/

In it, the author of the Checkbook Guide makes the point that few FEHB retirees enroll in Medicare Part D (prescription drugs) and this 'is often a serious mistake.'

Checkbook is the authority in these matters, so I think this is a very important development not previously covered in the hundreds of Medicare discussions previously at this web site, and well worth exploring further.

But I don't think the Checkbook publication for last year is so clear on it, maybe that is about to change. If there is a 'serious mistake' in not taking Part D, how $erious is it?

The only way to know would be for Checkbook to publish some cost estimates on it (which they have not done so far) or perhaps to start a thread here asking readers to report their experiences and whether it has been worth it to them. I had in mind starting a thread for next open season, but haven't gotten around to it.
OUtside  
#11 Posted : Wednesday, August 5, 2020 1:49:27 PM(UTC)

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Here is the Soup thread from last year that I mentioned above, it is entitled 'Has the cost of Medicare Part B been worth it to you?'.

It closes with me asking for additional information.

https://forum.federalsou...s&t=84681#post936550

Edited by user Friday, August 14, 2020 2:17:17 PM(UTC)  | Reason: Not specified

GSBS  
#12 Posted : Friday, August 14, 2020 12:14:19 PM(UTC)
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Originally Posted by: OUtside Go to Quoted Post
Here is the Soup thread from last year that I mentioned above, it is entitled 'Has the cost of Medicare Part B been worth it to you?'.

It closes with me asking for additional information.
I guess we get no link to your thread? I tried our search box.

I found this very helpful
https://www.opm.gov/heal...stfacts/fehbmedicare.pdf

OUtside  
#13 Posted : Friday, August 14, 2020 2:18:27 PM(UTC)

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You're right, I added the link to my last post.

BTW, the link you posted says feds would likely not benefit from a Part D enrollment (!).

Edited by user Friday, August 14, 2020 2:20:57 PM(UTC)  | Reason: Not specified

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