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Thanks. I went on the federal soup forum and read quite a bit. It seems that the answer is always "depends on your circumstances". I guess I'm dumber than I thought because I can't find a definitive answer to my question. I appreciate your help and I really don't know what "personal circumstances" would make or alter the decision to add part B or not. When you say circumstances, are you referring to overall health, net worth, ongoing severe medical issues, usage of prescription drugs, or all of the above? It seems like this would be straight forward but I seem to have hit a mental block trying to figure it out.
you're welcome,
generally, your overall health and predicted costs/out of pocket
I opted out of part b for a couple reasons but they are specific to me.
I am pretty healthy, my out of pocket max for BC/BS basic is not all that high FOR ME (I can manage the costs), copays and co-insurance are all manageable for me. also, my part B premium would be quite high due to the sliding scale fees. it's just not worth the added expense, I do not spend anywhere near that much on healthcare now out of pocket to justify part B. some plans will reimburse up to $800/yr towards your medicare premium but that still puts me in the red. it may be different for you.
so your situation may be completely different from mine
you don't need a part d as someone else mentioned, FEHB plans all have drug coverage.
someone will no doubt come along and pose the question about what will happen if annuitants coverage for FEHB is discontinued in the future, are you willing to possibly face a 10%/yr penalty to then acquire part b?
of course benefits are always subject to change by congress so this is not a trivial thing to consider.
my thought is, IN GENERAL, congress is/has been pretty good in the past about grandfathering when there are big changes that have a big impact like this and could waive penalties for those who opted out of b. they don't have to but have been reasonable in the past.
also, while benefits are always subject to change so is medicare. nothing is written in stone. we can only go on our best guesses and the info we have at this time.
I believe BCBS will penalize you and pay less if you do NOT have Part B. I am starting Medicare A&B in December and will keep my BCBS as well.
My husband has been on Medicare A&B and my fed-related FepBlue and rarely pays any copayments. He had a heart attack and placement of two stents last year and between Medicare and BCBS they paid over $211k. We paid NO out of pocket!
You can put your FE Health insurance in "abeyance" if you prefer to use a supplement. That way you can always go back to FEHB if you choose.
no, they do not penalize you and pay less. they pay the medicare rates, however.
you can suspend FEHB but you need to enroll in an advantage plan to do so or risk losing FEHB
I'm curious, weren't the stents covered under part a anyway? or was in an observation status or short stay?
I am retired and have Medicare Part A. My spouse is a federal employee and has health insurance coverage for both of us {reason I don't have Medicare B}.
how is that working for you?
FEHB is nice, whether you add part B or not. keep FEHB always.
FEHB is nice, whether you add part B or not. keep FEHB always.
It works fine for me because I have had no health issues. I'm not on any daily medication and have never been. I'm just doing my research on the necessity of part B if one has FEHB. The plan is to keep FEHB and of course Med A. Med B was and is the question.
Thank you everyone! Part A & B with FEHB also. That should cover us well.
I have FEHB with Parts A&B also. Believe me, if you need serious medical care it is worth it. When I had my unexpected heart attack in 2018 the costs were well over 100K and I paid nothing out of pocket.
There are FEHB plans that offer no co-pay, no deductibles if you have Medicare Part B. Take a look at GEHA, for example.
Don't assume your health will be the same 20 years in the future.
This year Kaiser NW is offering a Medicare Advantage plan and if you have Medicare Part B and select Standard Option Senior Advantage 2 they reimburse your part B premium up to $175/mo. In my case, because my Part B is taken from my modest SS (bless that SS offset) my Part B is about $120/mo, net my cost on Kaiser NW Standard Senior Advantage 2 is $59.50/mo. GEHA Standard will be $135.77/mo.
A careful reading (or CC above) of plans would show that BCBS Standard is a very expensive option. For just about anyone, there are better. For example, we've used Aetna Direct for the past four years. Haven't paid a penny out of pocket for care or drugs, even though my drug costs are thousands per year, I've had 12 days of hospitalization and a course of treatment that cost several hundred thousand. We'll even get back over $1000 this year for part B costs. And no, I don't work for them or get paid by them.
The challenge in picking a plan is indeed that key things are rather buried. For instance, some, like GEHA, have relatively skimpy drug benefits.
Many plans, like BCBS Standard and Aetna Direct, waive all copays, co-insurance, deductibles and out of network differences IF you have Part B. Others, though, like BCBS basic, keep network restrictions. You need to read the fine print, so to speak, or rely on a third party analysis like Consumers Checkbook.
I wasn't impacted by GEHA's drug benefit as I take only 2 medications and they are cheap generics.
Agree that everyone should drill down on the details and I have found Consumer's Checkbook very useful in the past.
Kaiser NW offers a dental plan option with its Medicare Advantage offering. I was concerned that it didn't appear on the list of plans on the federal site. Then I found it as an option offered to Federal Kaiser NW members separately. FEHB doesn't permit enrollment limitations on their dental/vision offerings.
We have BCBS basic and wee are not aware of any network restrictions, all of our doctors and hospitals take the insurance around here. I’ve looked at BCBS Standard before and decided it’s too expensive.
We have BCBS basic and wee are not aware of any network restrictions, all of our doctors and hospitals take the insurance around here. I’ve looked at BCBS Standard before and decided it’s too expensive.
The network restrictions are part of your plan. It's just that BCBS Basic has a broad network, so in your case it doesn't matter. Where it could matter, though is in the event of emergency care etc. Take notice of all the news reports of out of network providers for emergency care, anesthesia and so forth. It could impact you.
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