FEHB versus Medicare 2024 Update

Should I take Medicare Part B or keep FEHB? This is a common question as a federal employee, and Thiago Glieger discusses some of the main considerations as you plan your federal retirement.
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[@vanessag6900]

I have seen how FEHB plus Part B have covered all aspects of medical care and a good financial move for my parents.

[@TheFedCorner]

Thanks for sharing that with us.

[@logroller3122]

Excellent review. The part about the Part B cost being per person is something to take note. I asked my wife to watch this and we discussed how all this worked (she made notes) so she knows whats going on so when we turn 65 she'll have a good grasp on the subject. Her mother is a retiree survivor and has Part A, Part B and has FEHB BCBS coverage. It helped her understand her mother's insurance situation better. Her mother is in good health and never pays for anything extra. Also, it pays to call the insurance provider (in this case BCBS) as not everyone knows how it all works. For example she has $0 deductible but the pharmacy said she had a deductible to meet. I encouraged her mother to call BCBS insurance and BCBS cleared that up with the pharmacy and BCBS was extremely helpful with her situation. Thanks so much.

[@TheFedCorner]

Thanks for sharing your experience, and glad you found the video helpful.

[@kenedward4585]

I do not see any reason to buy into Part B if you have FEHB unless you have no financial cushion and/or have bad health. For a married couple, you should just save the $4,000 yearly into an HSA or even a high interest money market/tbills to build up a cash cushion/reserve. I have $75k in an HSA earning a minimum of 5.4% yearly, which is around $4,000 interest + $4,000 medicad savings = $8,000 PAID TO ME YEARLY which cover all my deductibles. I earn money rather than the government.

[@TheFedCorner]

Certainly one way to look at it. Just remember, any account that's invested is never guaranteed to earn positive returns yearly. Arithmetic average returns are one thing and observed from 30K ft. Geometric returns can mean an HSA gets reduced. Right now even cash pays because rates are higher, but they're likely not to remain like this forever.

[@kenedward4585]

@@TheFedCorner My point is that you will earn something on the HSA (2%, 3%, 4%, 5%, 6% CD's Tbills, MM ,etc ), and when combined with SAVING (not spending) the Medicare premium that you would have paid the government, it is possible to build a nice cushion to pay any deductibles, while also having a nice pot of money for multiple purposes depending on your health situation. People just need to open their own free Fidelity account, etc and move their HSA's and IRA's there where they manage their retirement with NO AUM fees, which saves you 1% to 2% yearly right off the bat by eliminating a cfp.

[@b.coxemba6799]

​@@kenedward4585 I just read this today. As a experience financial consultant I can tell you MOST people won't save or invest the difference of Medicare part B. They will end up spending these funds on unobligated expenditures.

[@back4052]

I agree with you 100% I'm retired in good health and see the doctor once a year. If something happens 15 years from now I'll pay the maximum out of pocket for the year and keep the tens of thousands I've saved in the stock market.@@kenedward4585

[@stephendove2850]

@@kenedward4585you are 100 percent right, FEHB wants you to sign up for part B because it makes them the secondary payer, but you are smart to avoid that means tested Medicare mess altogether until you are forced into part A by taking SS at 70.

[@b.coxemba6799]

Medicare Part B is about $170 monthly or $2050.00. For me the veteran affairs covers everything else. So Bluecross blueshield / VAp/Medicare Part A.

[@55stevieray]

Thank you, very educational.

[@TheFedCorner]

Glad you found it so!

[@kenedward4585]

1)The real question is will you save money over the course of your retirement by paying the government $4,000 per year for a married couple? I have seen you run projections for other aspects of retirement, and you should do the same for this calculation to help determine if a person should take Medicare. 2)For instance, my FEHB max out of pocket is $8k to 10k yearly depending on which plan I take, but if I save $4,000 per year for 10 years starting at age 65 I will have $40,000 + interest. Do I really plan on paying out more than $40k in deductibles within 10 years? 3) If I build an HSA account up prior to age 65, then I could have $40k Medicare savings plus the HSA (I have $75k HSA) to cushion any possible deductible.

[@TheFedCorner]

Great questions to consider! Such is the reason(s) why this is such a personalized decision. Thx for tuning in!

[@kenedward4585]

@@TheFedCorner My point is you should be doing better to walk people through the numbers, instead of the high level puff talk.

[@trackguy4038]

Excellent story! Please do an update each year!

[@TheFedCorner]

Will do!

[@gw5309]

My wife will turn 65 in ten months and will pick up Part B in addition to BC Basic. Im coming up on my 2nd year of A&B plus Basic. She had treatments for Non-Hodgkins Lymphoma two years ago and we had over $16k out-of-pocket that BC wouldn't cover. She doesn't need treatments now and says she won't go through it again until her Medicare is primary 😂. (I pray its a lot longer than that, like, never). About ten years ago she had two back surgeries for ruptured disks. A couple of weeks back she started having issues again, and symptoms pointed to another disk issue. That started us down the path of getting our GP to set up an MRI. He told us it's nearly impossible to get Anthem to approve an MRI without 1st attempting physical therapy, pain management, etc. We know this to be true because 1) she went through that ten years ago and 2) our son has Federal Anthem and had to self pay for an MRI because they wouldn't approve it. Turned out he had pieces of a ruptured disk in his back that were pressing against the nerve. The surgeon said had he gone another day he likely would have had permanent damage and might have been in a wheelchair. The infuriating thing is that Anthem is willing to pay more for PT and pain blocks than the MRI would cost. In the end, our GP thought he could get my wife's MRI approved because of her prior back issues and her NHL. This turned out to be the case and we are currently awaiting the results of her MRI. (He also told us that 90% of self-pay MRI's result in surgery...so what does that tell you?) During our discussion with him, I asked him about getting an MRI approved through Medicare when it is primary. He said "MEDICARE IS A PIECE OF CAKE". So, one thing to keep in mind if you are thinking of NOT picking up Part B; Anthem will drag their feet on some approvals. Finally, I read on a forum the story of a gentleman who had A&B and BC Basic and who had a $160k back surgery. He had less than $200 out of pocket.

[@TheFedCorner]

Thanks for sharing this experience, we all appreciate more perspectives!

[@robjus1601]

Great information

[@TheFedCorner]

Glad it was helpful!

[@rosiefeord6600]

Just starting to look at Medicare coverage and, holy cow, rates go up fast for AGI 😮 Are there look backs at income for determining premium rates? Are 2024 rates based on 2022 income tax returns, or if I file early for 2023 and start getting Medicare Part B in May 2024, will it be based on 2023 income tax return? Just a note... there was a lot they didn't tell us about traditional IRAs and 401Ks... like that tax free "advantage" for the year earned, lowered our Social Security Income for life, and now I see will add significantly to our Medicare premiums when we try to take it out!

[@TheFedCorner]

It certainly does, and many more things impact MAGI than people realize. There can be an application for reduction under qualifying life events, such as retirement. There is a form you would file letting them know that you've retired and income may drop. Medicare does a two year look back.

[@healthadvicewithmary5598]

I am on FEHB. I also have A and B medicare with the new plan That's going to emerge in 2025 with F.EH, B, do I have to stay On medicare B and order to keep my Health Insurance. I currently have FEHB Blue Cross Blue Shield. If I decided not to go with plan B medicare Then I could. Be excused from that when the new system f.E HB health care is implemented in 2025

[@donaldpezzino2238]

Elaborate on sale of house for medicare b

[@jporter504]

The best overview on this subject I have seen yet. One question: If I am retired and turn 65 and opt for Pat B coverage but my wife who is under my plan is 61, will Medicare be my primary insurance still?

[@TheFedCorner]

Glad to hear the video was helpful! To your question, Medicare is an individual plan so it's not like FEHB that covers the family. She would not be eligible for Part B on her own.

[@mando7558]

I would rather not take Medicare. I have FEHB (civil service) and Tricare (military). Tricare tries to force people into Medicare at age 65 by changing over to Tricare for Life, which I do not know anything about. I would like to hear your thoughts on my situation.

[@TheFedCorner]

They are both good programs. We have clients in both that are happy. Tricare actually has a great website with good information on how the program works, check it out!

[@negativepositive3933]

What is the rules for federal Law Enforcement retirees? They can retire at age 50 if the meet the service requirment, and get a SSN supplement unitl you can get regular social security...No one covers this...

[@TheFedCorner]

That's right, LEO and other covered under special provisions have eligibility for retirement benefits much sooner than most civ-FERS employees. The pension calculation is slightly different as well. Thanks for bringing this up!

[@mtan7746]

I am a retired Navy Civilian. However I am still working as a full time consultant. I am still under FEHB medical/dental insurances. This year I turned 65. I signed up for Medicare A but am confused if I need to also sign up for B or suffer penalty later. I’m wondering does the fact that I’m still working full time allow me to delay signing up for Medicare B without penalty until I’m fully retired ? Or do I have to make the Medicare B decision as soon as I turn 65? Thank you

[@TheFedCorner]

If a fed is still an active civil service employee under creditable time, then they are eligible under FEHB. If they're on FEHB while an active employee, they can postpone Part B without penalty. Once retired, they have a window of time before penalties begin.

[@JanetVaughn-cm3et]

Under the new PSHB, for postal employees only, the new rules & offer to enroll in Medicare's part B during a SEP are different. Sure, there will be no part B penality under this SEP. But then to consider an additional premium for the offers from PSHB carriers on top of part B, will probably double the monthly expense. I wonder if that is wise just to be almost assured of no out of pocket costs for care. Vs the deductible and co-pay if you don't sign up for part B. Catch 62 if you ask me ! What are your thoughts on that ??

[@TheFedCorner]

This can depend greatly on someone's need for care. Frequent visits can result in high amounts of out-of-pocket with co-pays and co-insurance!

[@JanetVaughn-cm3et]

@TheFedCorner well I don't go to the Dr but once a year. And never had a lot of Oop costs. So I guess comparing those with the cost of the premiums over the year will be my deciding factors. PSHB +MEDICARE PART B is probably overkill for me. To have both just for the price of mind for future medical bills vs my past cost seems to be too much $$,. Guess I'll take my chances without MEDICARE part B & just stick with the PSHB

[@FBone-pj7ov]

The combo will cost a lot of money $$$$

[@TheFedCorner]

Yes, but sometimes necessary to insure against bigger costs.

[@Kep19901]

I'll be required to be on medicare part B when I retire so... 🙃

[@olsailordan]

I’m retired military, so I have Tricare. I’m 62 and plan to retire from federal service. Does me being covered by Tricare mean that I AM enrolled in FEHB? Or are they two different things? And if they are two different things, do I need to really need FEHB?

[@TheFedCorner]

Tricare coverage counts towards FEHB enrollment eligibility, but they are indeed two separate programs.

[@GucciandMia]

If my spouse and I have FEHB health insurance through my federal employer and he is about to turn 65, can he opt out of my health insurance to change to Medicare A n B so he doesn't have to pay both FEHB premiums and Part B and later get back on my insurance (if ge wants to) since i will still be on it (i am younger but retired)?

[@TheFedCorner]

He won’t want to let go of FEHB. Even when taking Part B, FEHB is still used as the supplemental policy. Part B only covers 80%, so everyone needs a supplemental policy.

[@osiumeh6261]

Very excellent and informative video. I am over 65 and retired and in the 8 month window to sign up for Medicare. I currently have my FEHB and am pulling what is left of my hair about Medicare. We file Married Filling Separately and my Social Security and FERS payments has put my income above $120k and I have not even factored in TSP. As it stands now, My Part B premium is $559, since the income limit to trigger IRMAA is $103k. I don't know about tomorrow but as of now, I go to the doctor once a year just for check ups. Any thoughts or advice on how I can proceed? I am really confused. I know that both FEHB and Medicare gives me maximum coverage but the Medicare premium is a tad high. Thanks.

[@TheFedCorner]

Glad you find it helpful. You're right, often times families will find themselves paying substantially more for Medicare Part B due to IRMAA which in part may nullify the additional benefits. Try to look at it objectively first: do the benefits outweigh the additional costs. If you're healthy, no family history of illnesses, and take care of yourself well, you may consider keeping only FEHB. The tough part is knowing what private insurance carriers under FEHB will be willing to cover in the future. Medicare is a wider program (nationally) which makes implementing coverage changes much more difficult. It's also not for profit, unlike regular insurance carriers. Hope this helps -TG

[@osiumeh6261]

@@TheFedCorner Thank you for the quick response. I guess I may have to bite the bullet and sign up for Part B. No one knows what the future will bring. I am healthy now but who knows about tomorrow. Again, thanks and keep up the good work.

[@stephendove2850]

@@TheFedCornerFEHB plans list the coverage, your plan does not change in retirement unless you sign up for a new one. These are scare tactics, because FEHB would love for you to sign up for part B so they can move to secondary payer.

[@appleblows1]

if you have part B and FEHB, should you still need to get part D or C?

[@gw5309]

From what I understand, no. I only have Medicare A & B and Federal BC/BS Basic. Basic covers everything that any other medigap plans would pay.

[@parler8698]

Sir, your handwriting 😢

[@TheFedCorner]

We joke at the office that perhaps Thiago and doctors are all competing for most illegible handwriting!