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Advantages Of Having FEHB & Medicare Coverage In Retirement

FFEBA Contributor

September 13, 2024

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As a federal employee, if you have coverage under the Federal Employee Health Benefits Program (FEHB) in retirement, you don’t have to enroll in Medicare when you become eligible at age 65. However, there are some advantages you may want to consider before making a final decision.

Medicare Part A May Limit Out-Of-Pocket Costs

Combined with FEHB coverage, Medicare Part A may limit your out-of-pocket costs for expenses like hospital or skilled nursing facility stays. Since Part A is “premium-free,” it’s something to consider.

However, when you enroll in Part A, you can no longer contribute to a Health Savings Account (HSA). If your FEHB coverage is HSA-qualified, and you want to continue making contributions, you can delay enrolling in Medicare Part A. Once you start receiving your Social Security benefit, your Part A coverage starts automatically.

Medicare Part B May Fill In Some Insurance Gaps  

Medicare Part B may provide additional benefits for orthopedic and prosthetic devices, certain types of medical equipment, home healthcare during recovery from an illness, medical supplies, chiropractic care, and treatment for chronic conditions that your FEHB plan doesn’t fully cover.

If you decide to enroll in Medicare Part B in addition to FEHB, you’ll have to pay a monthly premium. In 2024, the Medicare Part B premium is $174.70 and the annual deductible is $240. If your adjusted gross income is above a certain amount, you may pay a higher Income Related Monthly Adjustment Amount (IRMAA) for Part B premiums.

Medicare May Enable You To Switch To A Less Expensive FEHB Plan

Since some FEHB insurers waive deductibles, co-pays, and coinsurance when you have Medicare Parts A and B, you may want to consider switching to a less expensive FEHB plan. Contact your FEHB insurer to see if they waive this type of cost-sharing for federal workers enrolled in Medicare. Also keep in mind that if you’re enrolled in an FEHB HMO, you can go outside your HMO network for Medicare services and receive reimbursement.

Medicare Offers Free Services

When you enroll in Medicare Part B, you’re entitled to a free, one-time “Welcome To Medicare” visit within the first 12 months. When you’ve been enrolled in Medicare Part B for 12 months or more, you can receive a free annual visit to update your personalized healthcare plan. Even better – some of the free preventative care services covered under Medicare Part B may save you out-of-pocket deductibles and co-pays.

For more details, visit: Coordination of Medicare and FEHB Benefits on the OPM.gov website.

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