Federal Employees Health Benefits (FEHB) & Medicare: What's the Deal?
Вставка
- Опубліковано 17 бер 2022
- The number one decision federal employees struggle with is whether or not they need to get Medicare when age 65. You don't "have to" but...there are things you need to be aware of if you choose to opt out.
Here are applicable links mentioned in the video. (1) OPM's general information about FEHB and Medicare. www.opm.gov/healthcare-insurance/healthcare/medicare/coordination-of-medicare-and-fehb-benefits/ Remember to ALSO look at your specific FEHB Plan booklet. (2) Coverage at the VA and Medicare. www.va.gov/health-care/about-va-health-benefits/va-health-care-and-other-insurance/ and (3) Tricare for Life and Medicare. www.tricare.mil/medicare
Awesome presentation! Thanks so much for doing this.
Thank you so much for covering this topic and for giving us access in the links to OPM for more info. You explanation of Medicare parts A,B and D were very helpful.
I'm so glad, Lori. Thank you for letting me know.
Deb, this video is VERY CLEAR and STRAIGHTFORWARD. English is my second language and you help me to understand this topic A LOT better than other videos. Thank You for your time in sharing your knowledge of the matter.
Thank YOU so much for your kind words, and for taking the time to let me know this was helpful.
Great job explaining this topic! Hubby is covered under my FEHB and turns 63 tomorrow so no urgent need to sign up for him yet for Medicare. However, I didn't know the part about not having to sign up once I retire. I will utilize the links provided to continue research prior to retiring! Thank You again!
Thank you so much for the feedback. Happy birthday to your husband.
Thank you for the great information! Any advice on FEHB vs. Medigap G?
As always, great informative video!
Thank you so much Mark.
Thanks for the information. I’m a retiree(FEHB) and will be 65 this April. So if I understand u correctly Medicare part A kicks in automatically. And it would be advantageous to enrollment in part B. Parts C and D are not needed.
Your video was very clear and organized. Excellent Job. The only items I remain puzzled on are:
I need to maintain coverage for my spouse who is 2years younger. So when I become 65, if I stop working, and am retired Military I need to sign up for Medicare parts A and B but she would only have Tricare. So I would need to carry both. If I remain working and maintain FEHB’s, for an additional 2 years am I required to sign up for both Part A and Part B simply because of the Tricare requirement.
I am having difficulty with carrying Medicare cost and FEHB because FEHB takes 3rd place for coverage but at an average cost of $6k per year. Thank you for considering my question
Thank you so much. We, individually, reach Medicare eligibility.
When you are 65, Tricare becomes TFL and whether you are working or not they will require you to get Medicare A and B. Your spouse would have Tricare and/or FEHB but not be eligible for Medicare until age 65.
Such good information
This was great!!! SIMPLE, NICE AND CLEAR in explaining the benefits. I've learned a lot and feeling much relieved now!!! Thank you SO very much in taking the time to do this video.
At one time an “expert” told me I was too simplistic. I took it as a negative but then thought about it. My goal is for EVERYONE to understand this stuff. I want it to be simple and clear. Thank you for letting me know I accomplished the goal! I’m glad this was helpful.
I just went to one of her in-person classes and she is so knowlegeble. I think she wrote the manual for Federal Civilian HR.
@@TheJimtanker Awww. Thank you very much!!
Thanks for the information. I have VA benefits & medical. The VA is my primary health care. My questions is when I turn age 65 am I required to get Medicare part B and/or part C?
Very good content
Thank you so much.
Love how you present this important info. Glad I found you. Big changes coming for Postal employees starting in 2025, which I'm a part. Would love to hear your thoughts and or advice on how to make the best decision regarding these changes. Thank You.
Thank you very much for the compliment. I’m adding that topic to my list. It’ll be a few weeks. I live in Lewiston, Maine and need to process a little bit more here before I can “get back to normal”. I’ll tag you when I do.
Glad your back
I appreciate that Wesley!! Thanks.
I would like to know if the USPS Health care plan will pay 71% of the PSHB in retirement as the secondary insurance to the primary Medicare Part A & B.
Thanks for replying.
I chose to keep my Fed Employee BC-BS insurance coverage after retiring at 65 because I wanted to live overseas and Medicare told me they wouldn't cover me outside the USA .
My question, now that I plan to return to the US, I had automatically Medicare Part A, could I switch from BC-BS to Medicare Part B without penalty?
BC-BS is so expensive and hardly covers any of my medical expenses!
It is true that Medicare won't cover you outside of the US. When you return, you can't "switch" from BC-BS to Medicare Part B but you can enroll in Part B; normally in the January - March open season although there are some exceptions. You may find this interesting: www.medicareconsumerguide.com/moving-to-us-and-enrolling-in-medicare
All of this said, unless you opt for Medicare Part C and suspend your FEHB, I don't recommend cancelling your FEHB. That is a permanent decision and you will never be able to come back in. Do know that quite typically when you enroll in Part B and maintain your BC/BS, they cover the Medicare co-pays/deductibles and waive their own so you're paying premiums but not typically anything else. You are also eligible, within 60 days of enrolling in Medicare, to change FEHB plans if you'd like. You may find one that will work very well as a Medicare Supplement, and save yourself so money.
Does FEHB as a secondary cover less than as a Primary? For example, do I get less physical therapy visits because Medicare covers less than FEHB as a primary? Where can I find a document showing the differences in quality of coverage using FEHB as a secondary or primary? In my case I have BCBS Standard or PPO. An extreme example would be experiment treatment BCBS covers as a primary but does not as a secondary costing tens of thousands of dollars. This happened to a friend of ours. Thank you for the video. ❤️❤️❤️
Every FEHB Plan is required to identify, in the plan’s annual booklet, how it interacts with Medicare and how it will pay if you don’t have Medicare.
See pages 145-151 of your booklet here www.fepblue.org/our-plans/-/media/PDFs/Brochures/2022/Standard-and-Basic-Option-brochure_2022.pdf
I notice you’ve posted about this a few times. I’ve also notice no one really answer you. It looks like the only way to tell is to compare Medicare benefits to FEHB and assume if Medicare doesn’t cover it FEHB won’t cover it even if FEHB would cover it for a non Medicare insured. Thanks for pointing this out.
Great videos and great information. Is it true that Blue Cross basic plan will help pay your Medicare part B plan if you decide to take it
Good morning. Thank you so much for the compliment.
Basic Option members who pay Medicare Part B premiums can be reimbursed up to $800 each year! You must submit proof of Medicare Part B premium payments through the online portal, EZ Receipts app or by fax or mail. Upon approval, you will receive reimbursement by direct deposit or check depending how you set up your account.
Read more here: www.fepblue.org/our-plans/Medicare/-/media/PDFs/Other/MRAQRG2021-interactive.pdf?la=en&hash=CF0E3532EE5CED60EA88ECB582A78722
Thank you very much! Do you also do financial (pension) planning?
I am not a Certified Financial Planner, Santiago. I am a federal benefits specialist who helps employees understand their pensions (CSRS/FERS), Social Security and Thrift Savings Program (TSP). I consult on those topics but don't do financial planning.
Thank you for your videos. Very informative. So I have F EHB after retirement I’m only 64, but my husband turned 65 a month before I retired so does he have to get Medicare part B within eight months after my retirement even though I kept FEHP insurance as an annuitant?
I'm glad you find the videos helpful Karen. I apologize for the delay in getting back to you. I've been out of the country for most of April. Since I've returned, I'm slogging through a mountain of work and trying to acclimate from an 11 hour timezone difference.
No one "has" to get Medicare Part B but, as I've outlined in the video, if you/your husband don't,
(a) FEHB becomes a secondary insurance once age 65 and retired.
(b) Because of (a), you may end up paying a little more out of pocket. Please read Section 9 of whatever FEHB plan you have - they're all a little different. www.opm.gov/healthcare-insurance/healthcare/plan-information/summary-of-benefits/
(c) If your husband doesn't enroll in Part B within his Special Enrollment Period (up to 8 months after you retire) but he changes his mind later, he will be required to wait for the January - March annual open season. Additionally, when we enroll in open season, there is a 10% per year penalty added to premiums for each year we could have been enrolled but were not. Read more here: www.medicare.gov/basics/get-started-with-medicare?s_kwcid=AL!18036!3!647869775405!p!!g!!medicare%20plan&gclid=CjwKCAjwuqiiBhBtEiwATgvixPGQwjM-yPdxW9bifRARporLzW00WzHiseolaGi_uYwa1qAhGHYiuxoCGiQQAvD_BwE
Don't hesitate to let me know if you have further questions.
I disagree with her suggestion about stating "you don't need Part C", and that when you sign up for an Advantage plan, it's a "private insurance" type of Advantage plan, when some Advantage plans are OPM approved FEHB Medicare Advantage plans, see time stamp: 14:42. OPM provides hundreds of dollars in credit on some FEHB Advantage plans, which reduces the Medicare Part B premium cost; plus they are further incentivised by gym memberships, over-the-counter/out-of-pocket expense coverage, massages, and more. Yes, you have both a greatly reduced ($95 monthly) Part B premium along with a FEHB plan premium, but it's nearly 100% health insurance coverage; i.e., co-pays and deductibles are nearly zero which can lead to a break even situation after the perks. This reduces billing paperwork headaches. Do the math.
Thank you for you input. You are, of course, welcome to disagree with any of the things I say. I'm always willing to learn and dissent allows me an opportunity to research things I think I know. That said, if you go to HHS.gov here: www.hhs.gov/answers/medicare-and-medicaid/what-is-medicare-part-c/index.html you can specifically read, "Medicare Advantage Plans, sometimes called 'Part C' are offered by *_private companies_* approved by Medicare. If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D)." These are not supplements to Medicare (as FEHB is) but rather you have Parts A and B traditional OR Part C.
I would never recommend people do away with their FEHB plans, even when/if they get Medicare - it's great insurance, acts as a secondary payer, there's an annual open season, the government pays 72% of the weighted average cost, and cancellation after retirement is a permanent decision.
As you've stated, there are a number of plans (within the 260+ available) that offer reimbursement for Part B premiums. Here's what I do recommend: When you turn 65 or older, and are making a decision about whether to enroll in Medicare, do your homework. Read everything. As you've stated, "do the math". AND look at the 259+ FEHB plans you don't currently have. You may find one that works very well as a Medicare supplement even if you didn't want it as a stand-alone plan.
Thank you so much for this helpful video. But I was a little confused towards the end. If I’m >65 & still working but my wife (>65) has already signed up for Medicare (not Part B), will I fall under the 10% penalty by waiting until retirement to sign up for Part B?
Thank you for taking the time to watch the video, respond, and give me an opportunity to answer you question. So long as you are covered under health insurance through your employer you (and your wife too if she's on your policy) do not need to sign up for Part B. You have a Special Enrollment Period which will last up to 8 months after you retire, no matter how old you are, during which you can enroll without a penalty.
What changes does the Postal Reform Act play on making these choices. One thing I read was that if you have Tricare or Champ you no longer are required to enroll in Medicare Part B. I went to Medicare upon reaching 65( already retired) and am paying for BC BS premiums as well as carrying Champ. I am not pleased with my health care with Medicare being primary. Can I drop Medicare so I will be grandfathered in 2025 when the act starts? Can I just go with BC BS and Champ as secondary
Hi Andi. To be honest, I haven't had time enough to read through and untangle everything with the Postal Reform Act. I need to!! I have not read what you mention though and that would require a completely separate change to Tricare.
Here's what I do know:
The new law will require eligible postal annuitants and their eligible family members to enroll in Medicare Part B as a condition of coverage. However, there are important exceptions to this requirement.
1. Anyone who is a postal annuitant as of January 1, 2025, is not required to enroll in Medicare Part B as a condition of receiving health benefits through the PSHB program. Any family members of such a postal annuitant are also exempt from the Part B enrollment requirement.
2. Postal employees who are at least age 64 as of January 1, 2025, will not be required to enroll in Medicare Part B when they retire (as a postal annuitant) as a condition of receiving health benefits through the PSHB program. Any family members of such a postal employee are also exempt from the Part B enrollment requirement.
3. A postal annuitant or family member who can demonstrate that s/he resides outside the United States will not be required to enroll in Medicare Part B as a condition of receiving health benefits through the PSHB program.
And - **** here's what you likely read ****
4. A postal service annuitant or family member is not required to enroll in Medicare Part B if the annuitant or family member is enrolled in health benefits provided by the Department of Veterans Affairs or eligible for health services from the Indian Health Service. CHAMPVA is a Department of Veterans Affairs program and, in fact, requires the person not be eligible for Tricare (see below paragraph directly from the VA). TRICARE is a regionally managed health care program for active duty and retired members of the uniformed services, their families, and survivors.
From here: www.va.gov/COMMUNITYCARE/programs/dependents/champva/CHAMPVA_faq.asp
"To be eligible for CHAMPVA, the beneficiary cannot be eligible for TRICARE. CHAMPVA provides coverage to the spouse or widow(er) and to the children of a Veteran who:
is rated permanently and totally disabled due to a service-connected disability, OR
was rated permanently and totally disabled due to a service-connected condition at the time of death, OR
died of a service-connected disability, OR
died on active duty and the dependents are not otherwise eligible for Department of Defense TRICARE benefits.
Effective October 1, 2001, CHAMPVA benefits were extended to those age 65 and older. To be eligible for CHAMPVA, you must also meet the following conditions:
If the beneficiary was 65 or older prior to June 5, 2001, and was otherwise eligible for CHAMPVA, and was entitled to Medicare Part A coverage, then the beneficiary will be eligible for CHAMPVA without having to have Medicare Part B coverage.
If the beneficiary turned 65 before June 5, 2001, and has Medicare Parts A and B, the beneficiary must keep both Medicare Parts A & B to be eligible for CHAMPVA.
If the beneficiary turned age 65 on or after June 5, 2001, the beneficiary must be enrolled in Medicare Parts A and B to be eligible for CHAMPVA.
Debbie, excellent video! A couple of questions about the government payment of 72% of the cost for health insurance. I think you stated something like, "health insurance is one of the best benefits from the federal government" and you referenced the 72% number. Doesn't the government pay 80% of all Medicare Part B costs and probably a much higher percentage for Part A costs? I know it isn't a direct comparison but doesn't the 80% offset the 72%? Unless I am missing something, if a person suspends their FEHB and stops paying their premium can't they get a no or low premium Advantage plan (potentially from the same provider they are using under FEHB) for the same or a lower cost than the FEHB)? The amount the federal government pays an advantage plan for each beneficiary more than offsets the 72%.
Again, I may be missing something but if an individual chooses to cancel their FEHB (for life) and purchase a Medigap and a drug plan the costs would in many cases be cost comparative and the individual would not have to worry about pre-approvals and other cost savings schemes that private insurers my implement.
It seems to me that the 72% number is a red herring. I'd like to hear your thoughts. Thanks!
Oh my gosh, Keith. Please accept my apology for not getting back to you in a more timely manner. I'm just now seeing this comment. Yikes.
Thanks sincerely for the compliment.
My thoughts are these: I did say something like, "health insurance is one of the best benefits you have as a federal employee". I said that not simply because they continue to pay 72% of the weighted average cost of the plans even after retirement (unheard of by 99% of private sector employers) but also because family members can stay on the plan in retirement (again, not "typical" for private sector), because we have hundreds of different plans to choose from - all vetted by the government and high-quality plans, and because we have an open season every year.
We pay for Medicare Part A through a payroll tax that equals 1.45% of every paycheck (more for high wage earners). It's 2023 deductible for the first 60 days of inpatient care is $1,600 but from days 61 - 90, there is a $400/day co-insurance. This increases to $800/day for days 91-150. You pay all costs for anything over 150 days. When I say "you" I mean the person themselves OR their other insurance. With FEHB/Tricare (or any other insurance) that insurance acts as the secondary payer.
Part B covers 80% of the fair and reasonable costs, yes, but it's not free and the government isn't "paying it". Medicare Part B premiums in 2023 run from $164.90 to $560.50 per person per month (based on modified adjusted gross income from two years prior).
People can suspend FEHB if they have Tricare, ChampVA or a Medicare Part C plan. Suspension can be temporary - people are able to return to FEHB during a future open season so the risk would be for just one year. If you don't like it, you can come back. I am not aware of any free Advantage plans. There are some inexpensive ones but I would definitely want to make sure they are going to cover everything I may want/need before getting one. We have several Advantage plans right under FEHB's umbrella in fact.
If you have further questions or want to talk more about this, don't hesitate to let me know. Our busiest season is over. While things are not quiet, they are quietER.
Debbie
Excellent video. Super informative. I just have one question. Maybe someone in the comments can help me.
At what percentage does the federal government tax my pension. I'm a US Postal service employee. I live in Texas where there is no state tax. And... Go!
Thank you so much for the compliment. Short answer: most of the money you receive from your pension will need to be reported on your federal income tax. It's pretty seamless. There is a spot on your federal retirement application you can check to have your payroll office attach the W-4 they have on file for you. You can change your tax withholding any time after retirement, by submitting a new W4P to OPM. You pay taxes based on whatever bracket you fall into. Longer answer, because some of your pension is a "refund" of the money you've paid in over the years, OPM determines your "tax free portion" by dividing the money you paid in by an actuary factor based on your age (or yours and your spouse's ages added together if you elected a survivor benefit. Another great question for a potential video - thank you!. www.irs.gov/publications/p721
Here is my situation I am currently a federal employee and I am 66 and I have federal health and Medicare part A. I don’t have part B because as I understand it as long as I am still working I won’t be penalized when I sign up for part B. Is that correct
Thanks for information about MEDICARE which I really need to know when is the best time to sign up. My husband, 63 retired who is now using my FEHB. Unfortunately, too late for me to learn that I must be enrolled with FEHB 5 yrs prior to retirement or else I can’t keep it. My husband was the one who has Kaiser when he was at work before he retired last year. I thought I had to be with his Kaiser because it’s required for him to use the family plan because it’s much cheaper. I just started with Kaiser at age 60 when my husband retired last year. Please elaborate on this matter. Thanks for your videos. God bless you.
Thank YOU for being here and taking the time to interact. Did your husband retire from the federal government? If so, your coverage under his federal plan counts towards your 5 years. Let's address this first and then I'll answer the rest.
@@debbiehatch8016 No, my husband is not FERS.
@@MSalem-gt5dy Darn. I was hoping he was a federal retiree. As you've said, in order to have FEHB in retirement you would have needed to be enrolled 5 years prior. Since your husband has already retired and you are on his insurance, you would not qualify for the Medicare Special Enrollment Period.
Your initial enrollment period - the only time you can sign up without a penalty - begins 3 months prior to your 65th birthday. It continues through the month of your birthday and 3 months after it. For example, if your birthday is in June, you can enroll anytime March to September. Your husband's initial enrollment period will begin 3 months prior to HIS 65th birthday.
Debbie, thanks for the crystal clear, very useful information.
I am a fed employee retiring in Dec. I will get Part B and keep my FEHB, which is BCBS. My wife is self employed and is covered under my BCBS. She is becoming 65 in Dec as well. Should she get part B? Will my BCBS be her primary if she waited until she retires? If she does wait, will she be subject to penalty when she retires and is ready to sign up for part b? Thanks in advance.
Thank YOU - both for the nice compliment, as well as the opportunity to clarify things a bit.
There are three times we can sign up for Medicare Part B; two of those without penalty, one with.
The Initial Enrollment Period (IEP) is 3 months before, the month of, and 3 months after we turn 65. No penalty.
The Special Enrollment Period (SEP) is up to 8 months after we leave a job where we have health insurance. No penalty.
The Annual Open Season which runs from 1 January to 31 March each year. 10% per year penalty for each year you could have been enrolled but weren’t.
The allowance for the SEP is not simply that the person hasn’t retired. It applies only if the person is working in a job that provides them health insurance. www.ssa.gov/help/iClaim_medSEP.html
Since your wife is covered under YOUR insurance, if she waits to sign up, she faces the open season penalty.
@@debbiehatch8016 I called OPM, Medicare, SS, NARFE with a similar question & I got all different answers. Even a BC/BS Rep. for Medicare gave a different answer. His thing was, if my wife stays on my insurance (FEHB) 65 in April, I’m 59 early retirement, she will not pay a penalty if she takes part B down the line. He said as long as we have CREDIBLE COVERAGE no penalty will be applied. OPM said she’s fine & has credible coverage. Medicare & SS says, since I’m retired, she needs to take part B or she’ll get penalized 10% every year she didn’t take it. I see you believe she will be penalized. Right now I have family coverage (have son on it too) & pay 515.00 a month. Was trying to save the monthly payment of 164.00 Medicare will be taking out. Glad I came upon this.
Thank you so much. Your videos are so informative.
In your first example (23:37), you described my situation. When my spouse signed up for Medicare part A he did not sign up for part B. Since he’s covered under my FEHB plan. But when I do reach 65 we both have the opportunity at that time to sign up for Part B if we choose, without penalty?
Thank you for taking time to leave me a nice message and compliment. I'm glad you found the video helpful. When you reach 65, if you are still working, and still have your spouse on your FEHB, neither of you need to sign up. You can both enroll up to 8 months after you retire, no matter how old you are, without penalty. This is called the Special Enrollment Period.
Here's what I hope is an easy way to understand it. You have three different times when you can enroll.
(1) Initial Enrollment Period: 3 months before, the month of and 3 months after, a person (everyone is an individual here) turns 65. OR
(2) Special Enrollment Period: Up to 8 months after retiring IF you were covered under your own, or a spouse's FEHB and that person was still working, at 65. OR
(3) During the annual open season January - March. It is signing up during open season that comes with the penalty.
@@debbiehatch8016 Thank you!!! That is very helpful.
I have the FEP Blue standard plan. If and when I enroll in Medicare Part B is it a good idea to go to the FEP Blue basic plan? Will the coverage be as good as with the standard plan + Medicare Part B?
Betty, Here is a comparison of the Fed Blue plans. www.fepblue.org/our-plans/compare-plans Whether Basic will "be as good or not" is a very personal assessment. Basic is less expensive and does come with a Part B premium reimbursement but you are required to see Preferred Providers. Does that work for YOU?
Debbie - Thank you for this video. One question. I am a Federal retiree (a few months shy of age 65) now working in commercial industry. I am using my FEHB policy, not my current employer’s health insurance. Under these conditions, I consider myself as a Federal retiree using my FEHB benefit, with respect to the details you discuss (such as penalties/allowances for not signing up for Medicare Part B at age 65). Just wanted a confirmation here. Thank you. Jim M.
I apologize for the delay in getting back to you. I don't always receive notification from You Tube that someone has asked a question. Your assessment is 100% correct. You are a retiree using FEHB; it is not based upon your current employment.
I got interested on HSA which you mention it’s an investment. I’m 60 now still a federal employee. Do you think it’s better if I consider to start investing in HSA. I plan to retire at 65. Please discuss more of advantages, pros and cons, of HSA.
Pros: (1) The money goes into the account before taxes and so long as you use it for medical expenses, you don't ever pay taxes on it. (2) The HSA is yours for the rest of your life. It's not a use or lose account that goes away.
Cons: (1) You have to be enrolled in a high deductible health insurance plan in order to participate. (2) You can not contribute to it once you are 65.
I just read up on Medicare part A and it looks like there are Medicare part A deductibles of around $1600 that reset every 60 days for hospitalization. At this time with kaiser FEHB I don't have any big deductibles ($50 to $100) and only small co-pays($15). Like most people I don't have a fat savings account to pull deductibles from. So it looks more and more that I would be better off not using Medicare A and I don't need part B because my Kaiser covers everything except dental. The other concern I have is if Kaiser and Medicare disagree on a procedure that I can get now would leave me out in the cold and/or having to pay for something that is currently covered.
I'm certainly not trying to convince you to get or do anything. The Medicare / FEHB decision is one many people struggle with. As you say, the 2023 Medicare Part A deductible will be $1,600 for the first 60 days of an inpatient stay. Then there is a coinsurance amount of $400 per day for the 61st through 90th day of a hospitalization and $800 per day for lifetime reserve days. But there is no premium for Part A - you have paid for that as a tax out of your paycheck, as long as you've been working. Also, be aware that you would not pay the deductible or co-insurance for Part A out of pocket; Kaiser would cover those as the secondary insurance. healthplans.kaiserpermanente.org/federal-employees-fehb/wp-content/uploads/2022/10/2023-FEHB-Brochure-73-003.pdf
@@debbiehatch8016 Thanks
I’m a retired federal employee, age 60. My spouse turns 65 this fall, does she qualify to wait to decide if she should take Part B until I turn 65 or does special enrollment only apply if I was still working? Thanks
Hi Robert. The Special Enrollment Period only applies if insurance is coming from current employment (not retirement).
Hi, Deb. I really enjoy your videos. I am a LPN at a VA Med Ctr. My SCD is 09/18/01. I will be 58 in July, and would like to retire the end of 2022, with a MRA + 10. Is it true I can’t touch any of my money in my TSP until I am 59 1/2? Thank you.
Thank you so much for the compliment, David. It is not true that you can't touch your TSP until 59 1/2 but that's what a lot of people say. If you pull from a traditional IRA under age 50 1/2, you will be required to pay regular income tax as well as a 10% penalty. Since that is the rule for IRAs and many employees think they're TSP is an IRA, they start quoting this. The fact is, our TSP functions similarly to an IRA but is it not one. It is an eligible employer account.
So long as the employee is going to turn 55 or older in the year they leave the government (you have indicated MRA which is 55 - 57 based on the year you were born), s/he will have access to TSP right away paying regular income taxes only. No 10% penalty.
Let me add one additional thing. What I've written above is regarding traditional TSP. If you're doing Roth TSP and you'd like your earnings from that to be tax-free THEN you can't pull any of the Roth funds prior to age 59 1/2.
@@debbiehatch8016 Thank you so much for answering. 🙂 Mine is just the traditional TSP.
Thank you for your videos. They are very informative and helpful. I am not sure how to clearly ask this question so please bear with me for a minute. If a government employee retires at 58 with 30 years, and was covered by a FEHB plan for the last five years of their government employment, does that employee have to remain enrolled in a FEHB plan in retirement to maintain eligibility to have a FEHB plan? The employee is planning to live outside of the US for several years after retirement and will pay for private health insurance in the other country. Upon returning to the US, can the retiree then sign up for a FEHB plan, or does a retiree lose their FEHB eligibility if he/she is not signed up for any period after retirement? I hope that makes sense, thank you.
what a great question as we are doing the same. Im sad she didnt answer you.
Yes, you have to remain in (pay the premium) to keep FEHB plan coverage in retirement. You have to contact the OPM approved (American) health insurance company to determine of they provide coverage Internationally; i.e. coverage depends on the plan you have. Mail Handlers Benefit Plan (MHBP) for instance, covers medical services received up to 80% for out of pocket expenses when out of the country and you must submit a claim to the plan for reimbursement. Make sure you call first and get the details of what data/records are required for reimbursement. if you stop paying your premium you will lose FEHB coverage forever with very few exceptions. Call OPM for information on how you can suspend coverage; paying for foreign insurance in another country is not one of the approved options to suspend coverage,.
I have Kaiser FEHB(Federal Employee Health Benefit) insurance.
If I sign up for Social Security and get medicare Plan A, my FEHB stays the same meaning that I keep my doctor, keep my same medical coverage, my Kaiser Dr still calls the shots etc. so what does medicare plan A actually do for me?
Good morning. Medicare Part A does not pay the doctor. It takes care of inpatient care, skilled nursing facility care, home health care, and hospice. You pay no premium if you or your spouse paid Medicare taxes for at least 10 years while working.
www.medicare.gov/what-medicare-covers/what-part-a-covers
Can you have both the FEHB and HSA ? I have the BCBS federal insurance basic plan which for me is great for me.
You can have FEHB and an HSA, yes but it would have to be a High Deductible Health Plan. BCBS is not a HDHP. I'm glad you're happy with your plan and the benefits its providing. :-)
Thank you for the reply. I just found out this afternoon I would need to switch plans. I see on the fed benefits site where it list who offers it. I wish my plan was one of them. But I’m happy with what I have and plan to stay put. 😊
@@luckypenny4263 Perfect.
I am so confused. My husband is retired from federal law enforcement and receives FEHB benefits. He continues to work for a local (non-federal agency) but does opt out of their medical insurance. He will be 65 in three weeks and was told he doesn't have to take Part B because he is still working. From the video, it seems you are saying that he would only be exempt from penalties (for not enrolling now in Part B) if he were receiving medical benefits through his current employer. Can you clarify please.
Debbie,
There is so much conflicting information “out there”. A lot of people think they can opt out of Medicare without potential ramification as long as they are (simply) working. That’s not the case. The Social Security Administration notes three distinct times when we can enroll in Medicare Part B.
Our Initial Enrollment Period: 3 months before, the month of, and 3 months after our 65th birthday.
Our Special Enrollment Period (SEP): If you are 65 or older and have group health insurance based on your own or your spouse’s CURRENT employment (meaning yes, it has to be insurance through the job, not based on retirement), you may wait to enrollment during a SEP. This is up to 8 months after your employment ends or you are no longer covered under the employer plan, whichever is first.
Annual open season: 1 January - 31 March, taking effect in July. If your husband enrolls in open season, but could have been in the program sooner, he faces a 10% per year penalty for each year he was not enrolled.
Here is a link directly to SS so you can read it for yourself. www.ssa.gov/help/iClaim_medSEP.html
I couldn't find the links for OPM below as it applies to my insurance for FEHB
Here are the links I referenced in the video. Here are applicable links mentioned in the video. (1) OPM's general information about FEHB and Medicare. www.opm.gov/healthcare-insurance/healthcare/medicare/coordination-of-medicare-and-fehb-benefits/ Remember to ALSO look at your specific FEHB Plan booklet. (2) Coverage at the VA and Medicare. www.va.gov/health-care/about-va-health-benefits/va-health-care-and-other-insurance/ and (3) Tricare for Life and Medicare. www.tricare.mil/medicare
If it is something else you're looking for, let me know specifically what it is (or what your question is). I'm happy to help.
Thank you I'm trying to decide whether to take Medicare B. Retired at the end of 2021 my cost would be regular cost plus extra for being over $91. I changed to Blue focus with the thought that as needed I can to higher insurance in blue cross-range and not take B as an option or should look into suspending if that is an option for me. All 43 years are government under CSRS with FEHB the entire time.
@@deveeda56 Suspending it is only an option if you have Tricare/CHAMPVA (through the military) or a Medicare Supplement. IF you get Part B, you will not have any co-pays or deductibles. Your FEHB will pay them for Medicare and waive their own. Check pages 124 etc of your plan booklet for more information. www.fepblue.org/our-plans/-/media/PDFs/Brochures/FEP-Blue-Focus-brochure-2022.pdf
Debbie, I'm getting so much conflicting information from SS. I have FEHB (GEHA). I'm retired. I'm 72. I want medicare B now, and I'm getting the message from SS than because I've had GEHA since I retired (and before) there will not be a penalty. I don't know what to believe. Where can I get help to know for sure. If there is a penalty I want to cancel my request for medicare B before it goes into effect. SS said to send in the form and put SEP on the envelope. Thanks for any advice
The question from me would be, "how long ago did you retire?" The Special Enrollment Period (SEP) lasts for 8 months after a person retires. Enrolling during the SEP does not have a penalty. Penalties apply only if you sign up during the Medicare open season 1 Jan - 31 Mar. www.medicare.gov/basics/get-started-with-medicare/sign-up/ready-to-sign-up-for-part-a-part-b
Can you explain IRMAA for part D? Who is responsible to pay for IRMAA part D ? I am enrolled in senior Advantage 2 with my insurance and being reimbursed for part B.
You likely already know this but I want to give a detailed answer that may help others understand too. IRMAA stands for income-related monthly adjustment amount. It's an additional amount that single tax filers with a MAGI above $91,000 and those married filing joint with a MAGI above $182,000 have to pay for their Medicare Parts B and/or D. IRMAA was first enacted in 2003 as a provision of the Medicare Modernization Act. This provision applied only to high-income enrollees of Medicare Part B. In 2011, IRMAA was expanded under the Affordable Care Act to include high-income enrollees of Medicare Part D as well. In most circumstances, the government pays a major share (about 75%) of your Part B and/or Part D coverage. If you have a larger income, you’ll have to pay a larger percentage share of your coverage. This larger share is your IRMAA. The individual his/herself is responsible for it - not the insurance company. That said, as you've noted, SOME insurance plans reimburse members for part of their Medicare costs. If you have had a change in income, and are not making as much as you were two years ago, you can ask the Social Security Administration to review your IRMAA and potentially lower it.
Here's a link to information about IRMAA. www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-part-d-costs/part-d-costs-for-those-with-higher-incomes
Here's a link to Kaiser's information. healthy.kaiserpermanente.org/content/dam/kporg/final/documents/health-plan-documents/summary-of-benefits/medicare/2022/summary-of-benefits-special-needs-ca.pdf
@@debbiehatch8016 Thank you do much for providing the information and links!
I still didn’t get a clear answer do I have to pay for Medicare part b when I turn 65 with FEHB benefits?
It's not that cut and dried Gia. Do you "have to"? No, it's voluntary. If you don't, you may find that you end up paying a lot more out of pocket and there are penalties if you change your mind later. What you need to do is take the time to go to opm.gov/ Type in the name of your FEHB plan (there are over 260) and read specifically how your plan will interact with Medicare. Then make your personal decision.
@@debbiehatch8016 thanks!
What happens to FEHB for spouse and minor children when you turn 65 and Medicare kicks in for you? Thanks
At that point, if you're retired, Medicare becomes your primary with FEHB taking a secondary role. If you're still working, FEHB remains primary even when you are over 65. Your children, and your spouse if not yet 65, will continue to have FEHB as their only coverage.
I am a x usps employee so i did not sign up for fehb plan then but can i sign up now that i am retired after 10 yrs?
You cannot. To have FEHB in retirement we must (a) have been covered under any combination of federal plans for the last 5 years of work and (b) we must be enrolled in an FEHB plan on the date we retire.
When I die, my FEHI coverage, what happens with my spouse's coverage? Both of us are enrolled and have Medicare A and B, Will OPM drop to a single rate or will she still have to pay for Married plus one?
Hi John. If your spouse is the only person on the plan (e.g. you don't have children under 26) yes, the FEHB plan will be changed to Self Only.
Debbie,
Thanks for this wonderful video. I am 52 years old and work for the federal government. How do we enroll in your classes? Have a Great Day!
Thank YOU for the nice compliment Gerald. Unfortunately I can't publish my schedule and sign-ups on You Tube. I am working on my calendar tomorrow and Friday for the months of October to December. I am happy to add you to my notification list if you'd like. My email is debbie@pinnaclepersonnelservices.com In that schedule, there will be a link to Eventbrite. You'd simply go there to sign up.
I’ve been pleased with our FHEB. I couldn’t afford public sector health benefits lol I have now
One of the biggest benefits Federal employees have. For sure!
What about if my father passed away and I'm her daughter with no health insurance.
I was outside of the country all of April and am just now trying to catch up. I'm not sure I understand your question. If your father passed away and you don't have health insurance, you can apply for it through your state funded program (this is Medicaid - if you're low income) or go onto the marketplace (if you can afford it). My video was about Medicare. You don't qualify for that until you are 65.
Hi Debbie, my husband and I are trying to cancel my coverage outside of open season. I am enrolled in Medicare a and b as well as d. We have tried calling and video chatting with OPM in an effort to get me off the policy. We know it can be done, but no one tells us how to do it. Do we need to send a written and signed letter or is there some form we need to fill out? Any help or advice you could give us would be helpful. Thank You, Nancy Stewart.
Hi Nancy.
Are you working or retired? If you are working, and participating in Premium Conversion (by default, unless you opted out, you are) you can only disenroll during the annual open season or with a Qualifying Life Event.
The major QLEs that permit enrollment or change in enrollment are:
(1) A change in family status including:
marriage
birth or adoption of a child
acquisition of a foster child
legal separation
divorce
death of a spouse or dependent
(2) A change in employment status including:
you are reemployed after a break in service of more than 3 days
you return to pay status after your coverage terminated during leave without pay status or because you were in leave without pay status for more than 365 days
your pay increases enough for premiums to be withheld
you are restored to a civilian position after serving in the uniformed services
you change from a temporary appointment to an appointment that entitles you to a Government contribution
you change to or from part-time career employment
(3) You or a family member lose FEHB or other coverage including:
under another FEHB enrollment because the covering enrollment was terminated, canceled, or changed to Self Only
when enrolled in a prepaid health maintenance organization (HMO) and you or a covered family member move or change worksite outside of the HMO's enrollment area
under another federally-sponsored health benefits program
under Medicaid or similar State-sponsored program for the needy
under CHAMPVA, TRICARE, or TRICARE-for-Life
when you had previously suspended your FEHB coverage to participate in one of these programs
when your membership in the employee organization sponsoring the FEHB plan terminates
under a non-Federal health plan
If you are retired, you can cancel or suspend your FEHB coverage by completing an RI 79-9. www.opm.gov/forms/pdf_fill/ri79-9.pdf
@@debbiehatch8016 we thought it was form OPM 2809. The problem is we can’t get anyone to tell us where to send the form. We are both retired.
@@mattthescrapwhisperer I am racing to class this morning. I will respond in more detail asap this evening.
@@debbiehatch8016 Many thanks!
@@mattthescrapwhisperer My students are at break. Either form (RI 79-9 / SF 2809) can be used. Why do we have two forms to do the same thing? Don't ask.
Print and sign the form. Make a copy for yourself. Mail the original to
U.S. Office of Personnel Management
Retirement Operations Center
P.O. Box 45
Boyers, PA 16017-0045
Someone told me Medicare part D is good to have it is that right?
Hi Tammy. I definitely it would don’t make judgements as to “good” or “bad”. If you have any FEHB plan or Tricare, your insurance is considered comparable to Part D. That means you don’t need it.
Please go to OPM.gov and type in the name of your insurance plan to see how it interacts with Medicare.
Can you pin the link to the top of the comments?
Yes
I tell you what, you are one attractive lady.
Thank you.