Medicare & government pension do I need both?
My wife & I attended your speech in Arlington Heights Tuesday 7/28/2015 & we really enjoyed it.
My question or quandary is as a retired federal employee who has only worked for the. Federal Government since high school first as a member of Uncle Sams Misguided Children (aka UNITED STATES MARINE CORPS,[USMC] ) then various executive agencies; DC GOVERNMENT, CSC, VA, GSA, FAA, DOE, thus I don’t qualify for social security. I do have aNICE pension & have retained my federal employee health benefits(FEHB) but should I sign up for Medicare when I turn 65? I haven’t been able to see the interaction of Medicare with the VA benefits even with the & FEHB I am billed for the doctor visits & medicine if I signup for that will those co-pays go away?
Terry Says: Wow, this is a bit out of my territory. But in searching I found two good sites that explain and help you make decisions regarding this situation. The first is the actual Federal employee benefits site: https://www.opm.gov/healthcare-insurance/healthcare/medicare/coordination-of-medicare-and-fehb-benefits/.
The second site is privately run, but its advice seems a bit easier to follow and understand. Use this link: http://www.myfederalretirement.com/public/247.cfm
I will let you work with your employee benefits department — but it appears that once you qualify for Medicare, it becomes the primary payer and FEHB is a secondary payer. I think, but you should confirm this, that means you do not need a Medicare supplement or Part D. But again, this is way beyond my area of expertise so be sure to ask about those two issues.
Below is a graphic from the latter site, which I found helpful — but it also confirms how complicated this topic is — and how important that you seek information from the government!
* * * * * *
Your FEHB health plan carrier brochure (most are available at https://www.opm.gov/insure/08/spmt/plansearch.aspx) explain how they coordinate benefits with Medicare, depending on the type of Medicare managed care plan you have. If you are eligible for Medicare coverage read this information carefully, as it will have a real bearing on your benefits.
The Original Medicare Plan (Original Medicare) is available everywhere in the United States. It is the way everyone used to get Medicare benefits and is the way most people get their Medicare Part A and Part B benefits now. You may go to any doctor, specialist, or hospital that accepts Medicare. The Original Medicare Plan pays its share and you pay your share. Some things are not covered under Original Medicare, like prescription drugs.
FEHB and Medicare Primary Payer Chart
| When Either You or Your Covered Spouse are Age 65 or over, Have Medicare and FEHB, and You are: | The Primary Payer is: |
| An active employee with federal government (including when you or a family member are eligible for Medicare solely because of a disability) | FEHB |
| An annuitant | Medicare |
| A reemployed annuitant with federal government | FEHB, if position not excluded from FEHB (ask your employing office) |
| A Federal judge who retired under title 28, U.S.C., or a Tax Court judge who retired under Section 7447 of title 26, U.S.C. (Or your covered spouse is this type of judge) | Medicare |
| Enrolled in Part B only, regardless of your employment status | Medicare, for Part B services |
| A former federal employee receiving Workers’ Compensation and the Office of Workers’ Compensation has determined that you are unable to return to duty | Medicare, except for claims related to the Workers’ Compensation injury or illness |
| When You or a Covered Family Member Have Medicare Based on End Stage Renal Disease (ESRD) and FEHB, and: | The Primary Payer is: |
| Are within the first 30 months of eligibility to receive Part A benefits solely because of ESRD | FEHB |
| Have completed the 30-month ESRD coordination period and are still eligible for Medicare due to ESRD | Medicare |
| Become eligible for Medicare due to ESRD after Medicare became primary for you under another provision | Medicare |
| When You or a Covered Family Member have FEHB and: | The Primary Payer is: |
| Are eligible for Medicare based on disability | Medicare, if you are an annuitant. FEHB, if you are an active employee |
