How do gov't and other 'retiree' health benefits work? (55, pension, supplement)

[selhars]

Can someone please explain with some detail exactly how retiring with the gov't employee health care benefit works.

Even if you're not a gov't retiree, I'm still curious as to ho your retiree health benefit works.
Some retirees at my job get a 'stipend' to help them pay for or 'off set' -- their Medicare premium or pay for a Medigap policy. (It was a union negotiated retiree benefit)

-- IF you retire from the gov't at 65 -- do you have the option of going on Medicare OR staying with the gov't plan you had?

-- IF you stay with the gov't employee plan does your premium stay equal to what employees pay?
-- IF you go with Medicare, does your retiree gov't policy become the secondary policy to Medicare?

-- IF so, does it pay the 20 percent (or whatever amount) co-pay or deductible that Medicare won't pay?
-- And will only pay the co-pay for -- or cover -- a procedure IT would have covered as your primary insurance in the first place?

-- IF you go with Medicare, do you get some kind of retiree "supplement" to replace what's taken out of our Soc Sec. for the Medicare premium?
-- IF you go with Medicare -- does you gov't retiree benefit give you some kind of "supplement" to pay for a MediGAP policy?

Thanks.

I'm trying to figure out if I retire from the gov't and go on Medicare anyway -- what does the "gov't retiree health care benefit" really provide.

[Mr5150]

Can only speak for CAL Pers. Medicare is the primary and my Cal Pers choice is the seconday like any Medicare supplement. We didn't have the option of staying with the Gov't insurance. Which is fine. I'd rather pay a $120 a month than the $700 a month the insurance plan would have cost. The Cal Pers Medicare supplement is $333 a month, deducted from my pension, and it includes Plan D and a vision plan. We have no copay and haven't spent a cent on anything medical, except prescriptions. I pay $1.20 a month for my BP medications. I have a separate dental plan

I highly recommend it!

[theoldnorthstate]

Originally Posted by selhars

Can someone please explain with some detail exactly how retiring with the gov't employee health care benefit works.

Even if you're not a gov't retiree, I'm still curious as to ho your retiree health benefit works.
Some retirees at my job get a 'stipend' to help them pay for or 'off set' -- their Medicare premium or pay for a Medigap policy. (It was a union negotiated retiree benefit)

-- IF you retire from the gov't at 65 -- do you have the option of going on Medicare OR staying with the gov't plan you had?no, even govt retirees on FEBP are required to register and meet the same requirements for registering as a non govt retiree is required to do. as I recall I was automatically registered for Part A but had to select yes or no to Part B

-- IF you stay with the gov't employee plan does your premium stay equal to what employees pay?If you keep your govt FEHB plan you still pay the same $ and it becomes secondary to medicare. there is no separate retiree payment and active employment payment You are not required to sign up for part B, but as with anyone there can be a penalty.
-- IF you go with Medicare, does your retiree gov't policy become the secondary policy to Medicare?yes

-- IF so, does it pay the 20 percent (or whatever amount) co-pay or deductible that Medicare won't pay?usually, some policies may have different rules but whatever is in your policy as covered is covered with medicare part A/B as first then FEHB as secondary
-- And will only pay the co-pay for -- or cover -- a procedure IT would have covered as your primary insurance in the first place?yes, if a procedure in the FEHB is not covered it will not pick up payments for it. you are on your own for anything beyond medicare. But for the most part all plans are synched

-- IF you go with Medicare, do you get some kind of retiree "supplement" to replace what's taken out of our Soc Sec. for the Medicare premium?none whatsoever. If you sign up for part B you pay part B, if you sign up for a supplement you pay that and if it is FEHB it is the same as working people on FEHB
-- IF you go with Medicare -- does you gov't retiree benefit give you some kind of "supplement" to pay for a MediGAP policy?no

Thanks.

I'm trying to figure out if I retire from the gov't and go on Medicare anyway -- what does the "gov't retiree health care benefit" really provide.

Good questions, and at the additional cost you get supplemental coverage with no supplement from the government. Seems somewhat unfair doesn't it?

I did find that some procedures in the FEHB supplement are waived if you are on medicare though. They are specifically called out in the FEHB insurers' booklet that you get in Nov. It seemed to have some benefit if you do have lots of health problems and see doctors frequently. But if you are one of those annual check ups and that is it folks, those waivers are probably not too great.

Part of the risk insurance is, go overkill to minimize risk or minimize the insurance but increase risk in case a bad medical thing happens. But there is not OPM provided subsidy. to GS employees

[oldsoldier1976]

I do not know if you are a FERS or CSRS employee, I suspect the former. If you are FERS this is how it works with Medicare.

FEHB and Medicare
Your FEHB coverage will continue to be primary unless you are eligible for Medicare. Then it will become secondary. Because contributions for Medicare Part A (hospital insurance) were deducted from your pay while you were an employee, at age 65 you’ll automatically be enrolled in it. However, enrolment in Medicare Part B (medical insurance) is optional. If you decide to enroll in it, you’ll have to pay the full premiums for that coverage. Whether that additional coverage is worth the cost is something you’ll have to decide.

Health Insurance in Retirement

Premiums
With the exception of Postal Service retirees, you’ll pay the same premiums in retirement that you did as an employee. Postal Service retirees will pay more. That’s because union agreements have resulted in the Postal Service paying a higher percentage of the premiums for its employees. When Postal Service employees retire, they pay the same premiums as all other federal employees and retirees.
Note: While most employees are eligible for premium conversion, which allows for the pre-tax payment of premiums, retirees aren’t, effectively making the insurance more expensive. The law would have to be changed to allow that.

If you are some other government employee like state that is a completely different system.

[AlaskaErik]

Very easy. I get free to me health insurance from the State of Alaska until I turn 65. Then it will be secondary to Medicare. As a military retiree, at 65 I will also be eligible for Tricare for Life.

[AnnaLee2]

There is federal, state, local, and (perhaps?) other governments, many to most with some similar and some unique features. It matters which government you are asking about.

[tom1944]

In NJ at 65 all retirees have Medicare as primary coverage.

[selhars]

-- IF you go with Medicare, does your retiree gov't policy become the secondary policy to Medicare?yes

First, thanks sooo much. I may have some decisions to make very soon.

1) One of the Medicares -- I forget which -- is "free" right?
One premium is taken out of your social security -- the other one is "free" (no monthly premium, it's just gov't provided)
And "D" is never included that's always extra, right.....unless you're on an Advantage plan (but let's leave those out, for this conversation. IF you go with a Medicare approved D plan, then that increased the amount that's pulled from SS, right?

Do I have THAT right??

2) As for the retiree plan that becomes secondary:
-- You'll play the same premium for that as you did when working? Right? Anyone know what that is these day?

3) So, if Medicare covers 80% of a procedure. The FRHB insurance will pay the other 20 percent?
-- If YES -- that gets a given procedure or office list 100% paid, right? And so it'd work the same as if Medicare paid 40% for something....the FEHB plan would pick up the other 40% that's billed? Id' have NO co-pay?

OR -- Does a doc/hospital HAVE to take whatever the Medicare payment is for that plan, and can't bill the FEHB plan.

4) In the number 3) examples above is it fair to say the FEHB plan could be considered as sort of being like a "MediGAP" plan?

-----

I ask because I could be getting a fed gig soon, at age 57, and one of the factors as to whether I go with the Feds is the 'retiree health care after just 5 years' employment.'

BUT, BUT IF -- I'm planning to work until 65 to get Medicare anyway, I'm sort of debating just how much that retiree benefit is really worth.

IF IT MEANS I don't have to pay for my own Medigap insurance -- because FEHB can for all intents an purposes - be used or treated as a substitute for me paying for my own MediGAP plan -- THEN that benefit is worth being a factor in taking the job. IF NOT....then that retiree health insurance benefit goes lower on the list of factors as to which job I accept.

I'm hoping for a Fed gig at 57 ONLY, ONLY for the retiree health benefits, and the small retiree pension that would come after only working 8 years.

I'd qualify after only 5 years at age 62, but would likely work until 65, to increase the small pension that would come.

Again thanks sooo much.

(My dilemma is the Fed job isn't one I'd really want to do. I'd be sucking it up just for the retiree bennies. Sort of..."I can do anything for 5-8 years if the retiree benefits are worth it.)

[Mikala43]

We get free medical until 65 from the State of Hawaii upon DH's retirement next year (51) and we have TriCare.

[theoldnorthstate]

Not sure the med benefits are worth it given what you say.

Guess if the $ and job appealed it might be a good move

Good luck