FEHB and Medicare Explained

Summary

In this video, Sarah from iHealth Brokers discusses how the Federal Employee Health Benefits (FEHB) program interacts with Medicare. She explains the differences between Original Medicare (Parts A and B), Medicare Supplement plans (Medigap), and Medicare Advantage plans. The video emphasizes the importance of understanding the costs and benefits of each option, especially regarding premiums, potential penalties, and coverage. Sarah provides insight into the choices available for FEHB participants, offering advice on making informed decisions for better healthcare coverage and savings, while also promoting iHealth Brokers' services for free assistance with Medicare enrollment.

Takeaways

• 😀 FEHB (Federal Employee Health Benefits) didn't always interact with Medicare frequently, but this has changed recently.
• 😀 FEHB participants can enroll in Medicare Part A (hospital insurance) without a premium, providing coverage for inpatient care, skilled nursing, and hospice care.
• 😀 There's no premium for Medicare Part A for most people, but Part B (medical insurance) does have a premium, which is currently $170.10 per month.
• 😀 If you delay enrolling in Medicare Part B, you may face a 10% penalty for each 12-month period you were eligible but didn't enroll.
• 😀 Original Medicare coverage may not be enough for some, prompting people to enroll in both FEHB and Medicare Part A & B, though it comes with additional costs.
• 😀 The cost of Medicare Part B depends on your income and can increase if you earn more.
• 😀 Some individuals find it more affordable to switch from FEHB to a Medicare Supplement (Medigap) plan, which offers broader coverage at a lower cost.
• 😀 Switching to a Medigap plan means that you will lose access to FEHB benefits and won't be able to switch back.
• 😀 Medicare Advantage (Part C) replaces original Medicare and may include benefits like prescription drug coverage, dental, vision, and hearing, but it can be less flexible.
• 😀 Medicare Advantage plans are often more affordable than Original Medicare plus Medigap, and they allow for temporary suspension of FEHB coverage, with the option to return later.

Q & A

What is the role of FEHB in relation to Medicare?

FEHB (Federal Employees Health Benefits) offers health coverage for federal employees and retirees, but it doesn't always provide full coverage for all healthcare needs. Many people with FEHB also enroll in Medicare, particularly Medicare Part A for hospital insurance, to ensure more comprehensive coverage.

Is there a premium for Medicare Part A?

For most people, there is no premium for Medicare Part A. It covers inpatient hospital care, skilled nursing facility care, home health care, and hospice care.

What happens if you choose not to enroll in Medicare Part B immediately?

If you delay enrolling in Medicare Part B, you may face a late enrollment penalty. The penalty is 10% of the base premium for every 12-month period you went without Part B coverage.

How much is the current premium for Medicare Part B?

The base premium for Medicare Part B is $170.10 as of 2022, though it may be higher based on your income.

Can FEHB benefits be enough to cover all healthcare needs?

While FEHB provides solid healthcare coverage, it may not always be enough for all medical expenses. Some individuals may need additional coverage from Medicare, especially for services not fully covered by FEHB.

What is the difference between Original Medicare and a Medicare Supplement (Medigap) Plan?

Original Medicare includes Part A and Part B, covering a wide range of healthcare needs. A Medigap plan is an additional insurance policy that helps cover out-of-pocket costs like copayments and deductibles. Some people may find that switching to a Medigap plan, instead of keeping FEHB, is more cost-effective.

What are the costs associated with enrolling in a Medicare Supplement plan?

While the exact cost varies, Medicare Supplement plans often have premiums in addition to the Part B premium. Some people find these plans more affordable than continuing with FEHB, but costs should be carefully compared.

What happens if you switch to a Medicare Supplement plan from FEHB?

If you switch to a Medicare Supplement plan, your FEHB coverage will be terminated, and you will not be able to switch back to FEHB.

What is Medicare Advantage, and how does it differ from Original Medicare?

Medicare Advantage (Part C) replaces Original Medicare entirely. It often includes additional benefits like prescription drug coverage, dental, vision, and hearing care, which Original Medicare doesn't provide. However, it may come with more limited provider networks compared to Original Medicare.

Can you temporarily suspend your FEHB if you enroll in a Medicare Advantage plan?

Yes, if you choose to enroll in a Medicare Advantage plan, you can temporarily suspend your FEHB coverage and resume it later if needed.