Medicare and Obamacare ?

[omni550]

For those of us who will be approaching 65 soon and were counting on Medicare for age 65 and beyond, does anyone know how Obamacare will affect this?

omni

[heeyy_joe]

Yeah. Expect longer lead times to get an appointment with a doctor.

[MichaelB]

See the KFF timeline for all the measures that impact Medicare http://www.cbpp.org/files/status-of-...urt-ruling.pdf

The primary impact on individuals comes from the closing of the drug coverage gap and the reduction in reimbursement / subsidy for the Medicare Advantage program.

[JOHNNIE36]

Quote:

Originally Posted by MichaelB See the KFF timeline for all the measures that impact Medicare http://www.cbpp.org/files/status-of-...urt-ruling.pdf The primary impact on individuals comes from the closing of the drug coverage gap and the reduction in reimbursement / subsidy for the Medicare Advantage program.

Michael, I just read in the paper the other day where the reduction in Medicare Advantage supplements has been delayed. From what I read, any reduction in those supplements will not take place iin 2014. Maybe later but who knows when.

[MichaelB]

Quote:

Originally Posted by JOHNNIE36 Michael, I just read in the paper the other day where the reduction in Medicare Advantage supplements has been delayed. From what I read, any reduction in those supplements will not take place iin 2014. Maybe later but who knows when.

Right. One year delay in the rollout of the cuts.

[donheff]

I don't know what to make of Medicare Advantage. IIRC it was supposed to offer a temporary subsidy to allow private sector companies to ramp up alternatives to Medicare. Somehow that has morphed into permanent subsidies so private companies can compete. If we switched to a private sector "Advantage only" approach clearly costs would have to go up or services come down. How is that sensible. If we keep a two tier system like today's should and will these subsidies continue? Are Medicare Advantage plans a safe bet? I don't know and plan to steer clear of them.

[DONKELBY]

Maybe this is not the right place to put this, but, I retired in 2002 at age 53 from the Department of Defense. I have kept my FEHB and plan on doing so. My wife is covered on my insurance. I just turned 64 and she will be 61 in November. How will this Obamacare affect us? Can I just keep my current insurance with no penalty? Will she still be covered under my insurance?
Obamacare is so confusing and I have been trying to find somewhere to ask my questions but am having a hard time. I hope you can help.
Thanks in advance

[MichaelB]

Quote:

Originally Posted by DONKELBY Maybe this is not the right place to put this, but, I retired in 2002 at age 53 from the Department of Defense. I have kept my FEHB and plan on doing so. My wife is covered on my insurance. I just turned 64 and she will be 61 in November. How will this Obamacare affect us? Can I just keep my current insurance with no penalty? Will she still be covered under my insurance? Obamacare is so confusing and I have been trying to find somewhere to ask my questions but am having a hard time. I hope you can help. Thanks in advance

Donkelby, welcome to the forum. Perhaps another member with knowledge of FEHB can share some details. Here is a helpful brochure "FEHB and Medicare". At first glance, your spouse can continue covered under your benefit and you will be covered by a combination of FEHB and Medicare. https://www.opm.gov/healthcare-insur...5-12-final.pdf
Obamacare coverage is for people under age 65, and in any case does not appear to affect you or your spouse.

[donheff]

Quote:

Originally Posted by DONKELBY Maybe this is not the right place to put this, but, I retired in 2002 at age 53 from the Department of Defense. I have kept my FEHB and plan on doing so. My wife is covered on my insurance. I just turned 64 and she will be 61 in November. How will this Obamacare affect us? Can I just keep my current insurance with no penalty? Will she still be covered under my insurance? Obamacare is so confusing and I have been trying to find somewhere to ask my questions but am having a hard time. I hope you can help. Thanks in advance

Yes, you can, and likely should, keep your FEHB. At 65 you will go on Medicare Part A (technically, you don't have to but that is a complicated conversation). Your FEHB then supplements Medicare and will continue to pay doctors visits as it does today. Many Feds also take Medicare Part B. I started Medicare a month ago and DID NOT take Part B. that too is a complicated issue.

[haha]

Quote:

Originally Posted by donheff Yes, you can, and likely should, keep your FEHB. At 65 you will go on Medicare Part A (technically, you don't have to but that is a complicated conversation). Your FEHB then supplements Medicare and will continue to pay doctors visits as it does today. Many Feds also take Medicare Part B. I started Medicare a month ago and DID NOT take Part B. that too is a complicated issue.

If I promise not to ask dumb questions, will you take a shot at an outline explanation of the issues you mention? It does not affect me directly, or anyone I know, but I am interested.

Ha

[donheff]

Quote:

Originally Posted by haha If I promise not to ask dumb questions, will you take a shot at an outline explanation of the issues you mention? It does not affect me directly, or anyone I know, but I am interested. Ha

Heck, since there is at least minimal interest I will expand on what I mentioned here. Feel free to PM me if you want to discuss further. Almost all feds retain their health insurance in retirement because it is a solid reliable program. But you continue to pay the full freight after Medicare kicks in even though the Fed program no longer handles the primary hospitalization costs at that point. The primary choice you have to make is whether to pay ~$100/month more for Part B. if you do, the Fed insurers promise you won't pay any out of pocket for anything (assuming you stay in network and with Mediacre accepting doctors). The calculation to make is whether it is worth $1200/ year each to avoid deductibles and copays. Many who do the analysis conclude that it isn't. My decision not to take Part B was based on current costs and my conclusion that the max out of pocket we could face in the future is not very daunting in any event. If I conclude that I would have saved a few bucks with Part B, NBD. The downside is that Part B goes up 10%/ year for every year you delay signing up.

The other issue - whether to sign up for Medicare at all is more confusing. Technically, your FEHB policy remains in full effect so Medicare seems superfluous. But, the policies all state that they will only pay Medicare rates for Medicare eligible policy holders. So doctors visits are paid at the Medicare Part B rate rather than the plan rate in any event. If the plan continued to cover hospitalization, that would only pay Medicare A rates as well. The Government and all the plans push Feds to sign up for Medicare A and I have read of confusion and slow payment issues plaguing some who chose not to so I wasn't interested in testing those waters. I have read some questions about whether it would be better to skip Medicare A if retiring overseas but I haven't read enough to know whether that makes sense.

I don't know why the law was never amended to require eligible Feds to sign up for Part A. I guess when they started deducting Medicare coverage from our salaries and made us part of the program they forgot to add a requirement. It hasn't turned out to be much of an issue since most assume it is a requirement and sign up (like I did) even if they find out that it isn't.

[donheff]

Just an addendum, the above applies to people under the old CSRS system. I think people under the new FERS system must take PART A if they are eligible for Social Security. Not sure if CSRS people eligible for SS thru other employment might be required to take Part A under SS laws.

[DONKELBY]

Quote:

Originally Posted by donheff Heck, since there is at least minimal interest I will expand on what I mentioned here. Feel free to PM me if you want to discuss further. Almost all feds retain their health insurance in retirement because it is a solid reliable program. But you continue to pay the full freight after Medicare kicks in even though the Fed program no longer handles the primary hospitalization costs at that point. The primary choice you have to make is whether to pay ~$100/month more for Part B. if you do, the Fed insurers promise you won't pay any out of pocket for anything (assuming you stay in network and with Mediacre accepting doctors). The calculation to make is whether it is worth $1200/ year each to avoid deductibles and copays. Many who do the analysis conclude that it isn't. My decision not to take Part B was based on current costs and my conclusion that the max out of pocket we could face in the future is not very daunting in any event. If I conclude that I would have saved a few bucks with Part B, NBD. The downside is that Part B goes up 10%/ year for every year you delay signing up. The other issue - whether to sign up for Medicare at all is more confusing. Technically, your FEHB policy remains in full effect so Medicare seems superfluous. But, the policies all state that they will only pay Medicare rates for Medicare eligible policy holders. So doctors visits are paid at the Medicare Part B rate rather than the plan rate in any event. If the plan continued to cover hospitalization, that would only pay Medicare A rates as well. The Government and all the plans push Feds to sign up for Medicare A and I have read of confusion and slow payment issues plaguing some who chose not to so I wasn't interested in testing those waters. I have read some questions about whether it would be better to skip Medicare A if retiring overseas but I haven't read enough to know whether that makes sense. I don't know why the law was never amended to require eligible Feds to sign up for Part A. I guess when they started deducting Medicare coverage from our salaries and made us part of the program they forgot to add a requirement. It hasn't turned out to be much of an issue since most assume it is a requirement and sign up (like I did) even if they find out that it isn't.

Thanks for this info, it kinda makes sense to me. I currently rely on the V.A. for all my medicine and doctors visits. I only go to a private MD if I have a really bad cold or other issues that I don't want to go to the V.A. for.
I will have to apply for Medicare next year, how early do you apply for it?
I won't apply for part B because I get all my medicine from the V.A.

[W2R]

Donkelby, I applied for Medicare online. You should do it 3 months before your 65th birthday IIRC. Once you have received your Medicare card, you need to call your FEHB insurer to inform them that you are going on Medicare, so that they know they will have to interact with Medicare in paying your bills.

I have FEHB, and Medicare Part B. Most Federal retirees seem to have Part B, although some like Don Heff do not.

The amount you spend on FEHB doesn't change whether you get Medicare or not. Part A is free, but you get Part B, that's an additional $104.90/month right now.

[DONKELBY]

Quote:

Originally Posted by W2R Donkelby, I applied for Medicare online. You should do it 3 months before your 65th birthday IIRC. Once you have received your Medicare card, you need to call your FEHB insurer to inform them that you are going on Medicare, so that they know they will have to interact with Medicare in paying your bills. I have FEHB, and Medicare Part B. Most Federal retirees seem to have Part B, although some like Don Heff do not. The amount you spend on FEHB doesn't change whether you get Medicare or not. Part A is free, but you get Part B, that's an additional $104.90/month right now.

Thanks for the response. If I don't get part B, will my wife still be covered under mine?

[donheff]

Quote:

Originally Posted by DONKELBY Thanks for the response. If I don't get part B, will my wife still be covered under mine?

If you keep your family FEHB she will remain covered. She will need to make the same decision about Part B that you make when she turns 65.

[rescueme]

Quote:

Originally Posted by omni550 For those of us who will be approaching 65 soon and were counting on Medicare for age 65 and beyond, does anyone know how Obamacare will affect this? omni

It dosen't. Medicare is a separate program from ACA (Obamacare). See:
Medicare & the Marketplace | Medicare.gov