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• 91358
  

  Number Cruncher: Just to be clear about your statement that fehb premiums 'are based on Medicare being primary so you will likely have significant co-pays', it is NOT correct to imply that if you do not take Part B you will pay more in co-pays as if being penalized.

  For example, if you had $500 in fehb co-pays for an illness during your working years, you would have the same $500 in co-pays for that illness if you are of Medicare age but have not enrolled in Part B. In fact, the co-pays could be less if any are based on a %; the reason is that Medicare will set the rate once you are 65 and it will usually be lower. Therefore, the same percent of a lower number would result in a lower co-pay.

  This is another instance of the privilege to take fehb into retirement, ie, there is no penalty for not taking Part B that would drive up the individual amount of any co-pay beyond what it would have been during retiree's working years.

  Retired Posted November 5, 2009 7:38 PM
• 91223
  

  tammy's column refers to "1960, when FEHBP was created." it never before occurred to me that the FEHBP was created so late. if tammy knows, i'ld be very interested in hearing a bit about what there was for feds in the way of health insurance prior to 1960.

  mirah Posted November 4, 2009 3:22 PM
• 91110
  

  It is my understanding that you do not have to terminate your Federal Health Benefits but can instead suspend them indefinitely. If you choose this option and Medicare B does not work out, you can always go back to your Federal Benefits.

  Anette Posted November 3, 2009 1:48 PM
• 90983
  

  Gary, your logic is ok but your facts are not ok. Medicare is optional for the retired fed, not required. This means that he does not have to enroll in Part B and pay the premium if he does not find it cost effective (that's another discussion entirely) or if he cannot afford to enroll. As for Part A, the withholding during working years is to cover Part A. If the retiree had that withholding, Part A is free. Most fehb plans waive their hospital co-pay if the retiree has Part A, I'll leave to you to try to figure out if the retiree will recover those premiums after he retires, it depends on how many times he is inpatient in a hospital and the number of days, which fehb plan he has, etc.

  Rich's HR folks are correct that it is a privilege to be able to take fehb into retirement regardless of whether the retiree enrolls in Medicare. Anyone who thinks otherwise should make a comparison of expenses between having fehb and terminating fehb for Medicare-only enrollments. The subject can be complicated and there are ways to misunderstand then make a poor decision such as to terminate fehb. Beware.

  Retired Posted November 2, 2009 5:36 PM
• 90953
  

  Non Fed: I realize it seems otherwise, but your Medicare individual enrollment is not 100% funded by you as there is an implied subsidy that you do not see. This has been discussed in the media recently with respect to the health care reform debate. I can't cite the equivalent amount per month of subsidy offhand for a Part B enrollment but it is not small. Note that the simple idea of Medicare on an unsustainable trajectory of expenses describes the overall idea that premiums being received by the government are not enough to cover expenses, therefore, the shortage must be made up somehow.

  Retired Posted November 2, 2009 11:44 AM
• 90950
  

  This is to Gary. Medicare A is what everyone pays into and gets at 65 without having to pay premiums. It basically only covers hospitalization. Again FEHB premiums are based on this knowledge. Medicare B is the one that you have to pay the premium for at 65 IF YOU WANT IT. It is not required. It is for doctor visits and other out of hospital costs. You can just keep your FEHB after 65 but again the premiums are based on Medicare being primary so you will likely have significant co-pays.

  Number Cruncher Posted November 2, 2009 11:30 AM
• 90947
  

  To 'Non Fed'

  Whining aside, 67% of nothing is still nothing. We can't afford 67% of our current premium or any FEHB premiums once we retire. And, lets face it, we know that premium co-pay is only going up. What I would like is for our HR folk to stop telling me what a wonderful thing FEHB is to take into retirement as secondary coverage with no reduction in premiums. Maybe if you're a GS 15 with 30 years. Until OPM starts using some actual clout representing several million employees, in 'negotiating' with insurance carriers the situation is only going to get worse.

  Rich Posted November 2, 2009 11:19 AM
• 90926
  

  To "Former Benefits Manager" - you need to look at what the discussion is about. This is about medical insurance during retirment (not while employed). Most of us non-feds have no insurance besides Medicare in retirement unless we purchase this ourselves. Thus my statement that this coverage is 100% funded by the individual is accurate.

  Non Fed Posted November 2, 2009 9:52 AM
• 90889
  

  Rich has a valid point. And why should federal retirees be forced to use Medicare (or even forced to contribute to it at all) if we already have health care insurance (such as GEHA or BC/BS) and do not want or need Medicare? This would be like forcing us to pay for government auto insurance (even though we have private insurance), then at age 65 we can no longer use our private insurance as primary and must use the government insurance. Doesn't make sense to me. And if we didn't want to use Medicare, seems like that would save the government money (they get 1.45% of our salary for x years, but we don't draw anything out).

  Gary Posted November 2, 2009 2:22 AM
• 90884
  

  I agree with "Numbers Cruncher" that the rates take into account that younger workers pay as much as older workers and they don't normally need the full range of benefits for which they are covered. I for one had close to 2000 accumulated hours of sick leave, and at age 55 (last year) was diagnosed with stage 4 cancer. It had not metasticized and was treated aggressively with chemo, radiation, and surgery. I am sure the bills came to about 1/4 Million Dollars. All bills were paid without question by Blue Cross. I always have been, and still am a very healthy person except for this one exception. So when open season rolls around, I will not give too much thought to switching to be penny wise and pound foolish. All my doctors were Blue Cross preferred providers with benefits paid at the max. I am not sure that I would be able to keep my doctors if I went to another plan (not sure if each and every one of them is a participating provider). Lessons learned. When I married, I was in an HMO, and my wife had chronic back pain. The general practice doctor with the HMO ordered an ex-ray, and the verdict was "there is nothing we can do." So what options do you have in such a case? appeal or switch plans, which I did, to have freedom of choice and ability to get second opinions without leaving the network and have it covered. The cheapest plan may not be the best plan so all factors must be taken into consideration.

  PitbullDad Posted November 1, 2009 1:24 PM
• 90869
  

  Rich, here, in my opinion, is the 'reasonable answer' you are looking for.

  You're letting the primary-secondary payer thing confuse the issue. In effect, it doesn't matter who is which so long as your bills are paid and you have no co-pays to worry about.

  And that's the deal, you will have no out of pocket expenses in the form of co-pays for medical expenses. If you do not like the deal, you do not have to enroll in Medicare Part B if you don't want to, you just continue to pay your fehb co-pays which are generally very reasonable.

  Do you really think the younger workers you referred to will relish their fehb premiums going up so yours can go down just because you have enrolled in another insurance plan which is primary? And if you explain that your co-pays are now waived but they will continue to pay theirs, will they be more agreeable?

  And re: your worry about affording fehb in retirement, try looking at a Medicare alone package consisting of Parts A, B, D, and Medigap--- the premiums will be more expensive and the benefits probably not as good.

  As far as I know, no one in fehb falls in a donut hole.

  Retired Posted October 31, 2009 4:28 PM
• 90842
  

  In response to: "for all of us Non-Feds - we have to pay the entire cost of any insurance we have -"

  NOT TRUE-major private sector employers pay on average about 75-80% of the cost of medical insrance for their employees. I know, I was a benefits manager in the commercial world prior to entering federal service. You may have had employee pay all coverage at a very small company, but that is not comparable to working for the Federal government, which is the nation's largest employer. I was shocked when I entered the Feds at how little was contributed by the employer, and that was without dental, vision, and disability insurance!

  You might want to check the accuracy of your statements before paiting with such a broad brush.

  Former Benefits Manager Posted October 30, 2009 7:07 PM
• 90816
  

  Rich,

  You state that the Fed share is 67% - think about this - for all of us Non-Feds - we have to pay the entire cost of any insurance we have - my taxpayer dollars are paying the 67% you get - AND I am paying my entire bill. Stop whining and be thankful

  Non Fed Posted October 30, 2009 11:38 AM
• 90812
  

  This is to Rich. You do realize that "younger" employees are why the FEHB rates are as low as they are. I have 30 years in and over that time I have very rarely "used" my health insurance for which I am extremely grateful. However, as I get older I am using more and more but I still pay the same rate as a 25 year old would.

  Also, if you are paying $14,600 for your share in premiums, that is QUITE a lot of money since the "average" family plan costs a TOTAL of about $525 biweekly making the maximum government payment about $375 biweekly. Have you checked to see if another plan would meet your needs for less money? Especially after you are Medicare eligible you should not need the most expensive plan. Personally my plan (single not family) in 2010 will cost me $720 a year in premiums and the government portion is $2,150. The family version would be $1,700 and $5,100.

  Number Cruncher Posted October 30, 2009 10:50 AM
• 90804
  

  Rich, Your premiums have not increased or decreased as you aged in the federal job you had before retirement because you paid into a large pool of people that operate within a system that agrees to keep rates at an average level steady premium for all active employees and retirees. Even though you were more risk to the FEHB system at 50 then at 30 your rate stayed the same. The same reasoning goes to why your premium stayed the same at 65 years old when you qualified for Medicare. If the system was setup the way you wish then you would have paid lots more in premiums throughout your career to reflect your risk increasing. You enjoyed years of rates that were actually lower than you would have been charged if your age and risk factors had been considered into the premium. If you did not argue then about not paying your fair share for the coverage you were getting then you don't have an arguement now. The system is designed this way ... thankfully

  chuck Posted October 30, 2009 10:04 AM
• 90792
  

  I wonder how many younger federal retirees are aware that when they turn 65 and apply for Medicare, with Medicare then becoming their primary provider, and FEHB becoming a secondary provider, their FEHB premiums are not reduced by once cent. My wife and I currently are covered by FEHB to the tune of $14,600 (in 2010). The premiums go up and the Fed share goes down (67% in 2010). At this rate we won't be able to continue FEHB into retirement. Yet when I try to get any kind of reasonable answer as to why I and US taxpayers will have to pay these exhoribant premiums for a secondary provider I'm told this is what OPM 'negotiated.'

  Rich Posted October 30, 2009 9:04 AM