Medicare decision for 2018

[nubill]

Next year I will turn 65 and be eligible for Medicare. I am a retired federal employee and have Federal BC/BS for me and DW. DW is 4 years younger. I have been told by my primary care physician that in order to stay, I must switch to a United Healthcare Medicare Advantage Health plan because BC/BS will not be my primary insurance and they do not accept Medicare.
I do not know if during open season this November if United Healthcare is an option. Has anyone not signed up for Medicare? I am told that the penalty is 10% per year when I eventually sign up? If I wait until DW turns 65 the penalty will be 40%. Any other options? We now live in FL.

 

[donheff]

Sounds ridiculous. If your primary physician takes Federal BC/BS they will be required to accept you if you retain it. You don't even have to take Medicare Part B, in which case Federal BC/BS will be the sole payer for regular physician bills. That is what I do now (albeit with GEHA as my insurer but ready to switch to BC/BS if I conclude their network is better in my area). The primary decision you have to make is whether or not to buy-in to Part B. I consulted a number of knowledgeable sources and decided it was more cost effective not to. But, naturally, I had a couple of serious accidents and other medical issues that have made me question that decision. DW reaches Medicare age later his year and we are considering enrolling her in Part B. The main advantages are that the insurer promises to pay all costs not covered by Part B (so no co-pays and deductibles, no nothing). GEHA informs me that this applies to out of network doctors as well as in network which could open up your choices significantly. The other factor is that if you don't take Part B initially it will costs you an additional 10%/year to take it later. I recommend that you call BC/BS to verify that your physician can't reject you and remain in their network (whether or not you take Part B) and to confirm that they too would supplement out of network doctors who take Part B. I only have the later assertion by phone from GEHA.

 

[Gotadimple]

A clinic can refuse to accept medicare. However, I'm not so sure they can refuse to accept Medicare but accept you if you have an Medicare Advantage plan - that depends on the MA carrier.

UHC (United Health Care) has a tendency to want to cover all of Florida, but that doesn't mean their strategy hasn't changed to a by-county basis. You can call them and ask this question directly. UHC can tell you what their policy is for contracting with physicians. As can Medicare. So two calls: 1) UHC 2) Medicare (they may also know if UHC is renewed for coverage in 2018 in your county)

Simply put: some carriers will not contract with a provider for Medicare Advantage if they also do not accept Medicare.

Seriously, as good as your federal benefit is, I would not avoid signing up for Medicare. You never know when your benefits can be reduced, then, you'll need coverage, and get stuck with an enormously higher premium (in addition to large cost sharing if you do not also get a supplement or MA plan). Delay in applying for Medicare could disqualify you from applying for Medicare Supplement coverage, applying for MA shouldn't be an issue, if the network and coverage meets your needs.

- Rita

 

[MBSC]

This sounds like The Villages Health. If so, please note the phrase "eligible for Medicare." A person is still eligible for Medicare if they do not sign up.

If you are eligible for Medicare or are enrolled in Medicare, The Villages Health primary care only accepts the following Medicare Advantage plans:

UnitedHealthcare® The Villages® MedicareComplete® (HMO) Plan 1
UnitedHealthcare® The Villages® MedicareComplete® (HMO) Plan 2
AARP® Medicare Complete Choice® (Regional PPO)
AARP® Medicare Complete Choice® (HMO)
UnitedHealthcare® Medicare Advantage Dual Complete
UnitedHealthcare® Group Medicare Advantage PPO

The Villages Health does not accept patients with Medicare or Medicare with a traditional Medicare supplemental policy.

https://www.thevillageshealth.com/insurance.php

 

[rodi]

I thought there was a federal BC/BS medicare supplement... (Plan F type). My MIL is a federal retiree and has BC/BS through the OPM as a medicare supplement. It's great for DH - who is her legal guardian and therefore pays all her bills. He gets statements that say "This is not a bill"... and if he ever gets a bill - he calls the provider and tells them to submit to the secondary insurer (bc/bs)... and voila - the bill goes away.

 

[Fedup]

I thought there was a federal BC/BS medicare supplement... (Plan F type). My MIL is a federal retiree and has BC/BS through the OPM as a medicare supplement. It's great for DH - who is her legal guardian and therefore pays all her bills. He gets statements that say "This is not a bill"... and if he ever gets a bill - he calls the provider and tells them to submit to the secondary insurer (bc/bs)... and voila - the bill goes away.

That's what my husband has. No headache about who pays what. Hopefully it will make things much easier when he gets much older like 80-90s time frame.

 

[ABQ2015]

I have not heard about an FEHB Medicare supplement but I'm still a few years away from Medicare. While it seems expensive and unnecessary to enroll in both FEHB and Medicare Part B, especially in earlier senior years, I agree with Gotadimple that FEHB benefits could be reduced in the future or the retiree could develop costly health issues at a later time. To save some money, you can suspend you FEHB coverage if you enroll in an approved Medicare Advantage plan and later re-enroll in FEHB if needed.

From the OPM website:
If you provide documentation to your retirement system that you are suspending your FEHB coverage to enroll in a Medicare Advantage plan, you may reenroll in FEHB if you later lose or cancel your Medicare Advantage plan coverage. However, you must wait until the next Open Season to reenroll in FEHB, unless you involuntarily lose your coverage under the Medicare Advantage plan (including because the plan is discontinued or because you move outside its service area)...

 

[nubill]

Thanks for all the responses. MBSC is correct, the doctors are part of the Villages Health Care system as is donheff, (it is ridiculous). DW has an appointment in two weeks and I have one the end of July. I will get a chance to speak with the office manager. I’ll do more investigation with OPM about BC/BS supplements. Options may be available next open season which starts near the end of this year. Last year they created a Self + 1 plan for two people which is slightly less than the family plan.

 

[Gotadimple]

I agree with Gotadimple that FEHB benefits could be reduced in the future or the retiree could develop costly health issues at a later time. To save some money, you can suspend you FEHB coverage if you enroll in an approved Medicare Advantage plan and later re-enroll in FEHB if needed.

But, I believe, you will also need to enroll in Part B to be eligible for Medicare Advantage. FEHB does (used to?) offer MA plans. Not sure you can jump between FEHB and MA AND avoid the delayed enrollment Part B premium increases. Check with OPM about this option.

More stuff to think about.

- Rita