FatCamera/Getty

A 4-Step Guide to Solving the Medicare-FEHB Puzzle

Piecing together the best solution for you.

Although health insurance open season is still five months away, if you’re retiring and older than 65, or are already retired and turning 65 this year, it’s not too early to start thinking about one of the biggest decisions you’ll face: choosing the best Federal Employees Health Benefit plan to coordinate with Medicare.

This can be a difficult decision for a number of reasons, including cost (the standard Medicare Part B premium for 2023 is $164.90 per month), your own potential resistance to changing plans and an abundance of choices. FEHB plans can’t require enrollment in Medicare Part B. You will continue to be covered regardless of your decision to enroll in Medicare.

To add to this dilemma, when you are part of a married couple in which one spouse is younger than 65 and the other is eligible for Medicare, then a decision has to be made to benefit both spouses. Fortunately, there are many federal plans that work well for retirees with and without Medicare coverage. 

Choosing the best health plan to coordinate with Medicare Parts A and B is like putting together a complex puzzle. To do it, just follow the steps to solving any puzzle.

Step 1: Eliminate the pieces that aren’t even a part of the puzzle. Use the Office of Personnel Management’s Plan Information Map to locate the plans available where you live. This is an important step for all who are eligible for FEHB, whether you are working or retired and regardless of your age. 

Step 2: Fill in the outside edges first. Eliminate the plans that you don’t want to consider. Maybe you prefer a fee-for-service plan rather than a health maintenance organization. Or maybe you like the HMO that you’ve been enrolled in, but wonder if it’s time to switch from standard to high option or value to standard. If you don’t want to change health care providers, check the plan website or contact your providers to see which networks they participate in. 

Step 3: Find the colors and patterns that match. Once you’ve narrowed your choices to five or six plans, it’s time for some comparison shopping. One way to do this is to create a chart with potential plans listed in the left hand column. Across the top row, add the following headings:

  • Premium.
  • Deductible for inpatient and outpatient care.
  • Copayments for office visits with your primary care physician, a specialist, and labs or other medical services. Include in-network and out-of-network costs.
  • Coinsurance you are responsible to pay for diagnostic and treatment services.
  • Catastrophic protection limit on out of pocket expenses. Include in-network and out-of-network, along with expenses not included in the limit that may be important to you and your covered family members.
  • Whether the plan waives its own deductibles, copayments and coinsurance when Medicare A and B are your primary payers.
  • Availability of a health fund, health reimbursement arrangement, health savings account, or Medicare Part B reimbursement.
  • Coverage for specific needs, such hearing aids, chiropractic care, and dental and vision coverage.

Step 4: Finish putting the puzzle together. Now you’re ready to make your final selection. At this point, you can get extra help from plan comparison tools such as the Consumers’ Checkbook Guide to Health Plans for Federal Employees or the OPM Plan Comparison Guide.

Retirees enrolled in Medicare A and B also have the option to try out an FEHB plan offering Medicare Advantage. These plans seem like an attractive option, but they’re new. Some of them offer additional benefits such as gym memberships, meal delivery programs and non-emergency transportation benefits. But they have different prescription drug formularies than non-advantage plans.

If you take the time to choose wisely, you could find yourself with more comprehensive coverage with an overall lower cost to carry you through your Medicare years. Remember, at 65, you may still have two, three or four decades ahead of you.

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.