Is Medicare Advantage + FEHB Possible?

[zl55lz]

There is a thread on another forum which didn't get much action, maybe because there are not a lot of FEHB enrollees there. I found it interesting so thought I would bring it up here since I know there are some FEHB annuitants here.

The question there I guess was to maybe find a way to lower costs, but as stated there, the FEHB brochures do indeed show, in section 9, the option of a person keeping the FEHB plan and enrolling in a private (I guess) Medicare Advantage Plan. I haven't ever heard of anyone ever doing so, but wondered if anyone here has, or has anything to say about it.

I guess the original response might be "why?" since FEHB is usually good, but after I thought about it, I thought the following situation, as one example, could make sense:

A person could sign up for BCBS Focus at a little over $250 per month premium for a self and one (or some other cheaper plan). At this time Focus has no skilled nursing days and no out of network coverage (except for some exceptions).

If a person really can enroll in both FEHB and an MA plan at the same time, a person could then sign up for a normal Medicare Advantage plan (not FEHB MA options) which has a zero premium which works well with an enrollee's providers; most MA plans I have seen do offer up to 100 days of skilled nursing for some cost or another. This could act as solid coverage (since I think the MA plan would be primary). Then the FEHB plan would act as a secondary.

Anyone heard of such a thing? Maybe it isn't allowed? Comments?

 

[zl55lz]

There is a thread on another forum which didn't get much action, maybe because there are not a lot of FEHB enrollees there. I found it interesting so thought I would bring it up here since I know there are some FEHB annuitants here.

The question there I guess was to maybe find a way to lower costs, but as stated there, the FEHB brochures do indeed show, in section 9, the option of a person keeping the FEHB plan and enrolling in a private (I guess) Medicare Advantage Plan. I haven't ever heard of anyone ever doing so, but wondered if anyone here has, or has anything to say about it.

I guess the original response might be "why?" since FEHB is usually good, but after I thought about it, I thought the following situation, as one example, could make sense:

A person could sign up for BCBS Focus at a little over $250 per month premium for a self and one (or some other cheaper plan). At this time Focus has no skilled nursing days and no out of network coverage (except for some exceptions).

If a person really can enroll in both FEHB and an MA plan at the same time, a person could then sign up for a normal Medicare Advantage plan (not FEHB MA options) which has a zero premium which works well with an enrollee's providers; most MA plans I have seen do offer up to 100 days of skilled nursing for some cost or another. This could act as solid coverage (since I think the MA plan would be primary). Then the FEHB plan would act as a secondary.

Anyone heard of such a thing? Maybe it isn't allowed? Comments?

There has been a post in that other forum. Apparently not allowed per regulations. If anyone finds out differently, please post.

 

[W2R]

I have no idea whether it's allowed or not but I would assume it's not allowed, any more than signing up for 2-3 different health insurance plans at the same time would be allowed. ? I'm not smart about insurance, though, so don't take my advice. This is why I hadn't responded up to now, but nobody else has either so I thought I would.

Personally I'm not interested in switching to Medicare Advantage since my FEHB BCBS has done pretty well by me. I worked two grueling years past the point when I was completely FI except for health insurance, so that I could qualify to keep my FEHB plan (there was no ACA back then). No way am I just going to throw it out the window now that I am retired. So far it has paid for every cent except dental and prescriptions, so I don't see how MA could be worth it to me.

Frank has Medicare Advantage since he was not a fed and can't get federal retiree benefits. We have several of the same prescriptions and he pays more for them than I do. He hasn't paid for dental so far, but he hasn't had much dental work.

 

[Involuntary Retiree]

I'm glad you're asking the questions, although I have no answers for you. I will be following along to learn. I'm a FERS retiree but have a few years until Medicare applies, so I haven't yet done much (any?) research on the interplay between FEHB and Medicare.

 

[teej1985]

FEHB has some Medicare Advantage plans. There would be no reason to have a private Medicare Advantage plan in addition to FEHB. The FEHB Medicare Advantage plans are way better than what you get on the private market, presumably because they are group plans.

 

[zl55lz]

FEHB has some Medicare Advantage plans. There would be no reason to have a private Medicare Advantage plan in addition to FEHB. The FEHB Medicare Advantage plans are way better than what you get on the private market, presumably because they are group plans.

There could be reasons, IF a person could enroll in a publicly offered MA plan and FEHB, which I still don't know if it is possible or not. Word is it is not, but FEHB plan brochures seem to indicate it is. For example, as I stated in my original post, a person could enroll in FEHB BCBS Focus with a low premium which gives zero days of Skilled Nursing Days (as of now), but then enroll in the MA plan which usually gives up to 100 days SNF days for varying amounts of cost. Original Medicare only covers days 1-20 in full. Also, some MA plans give many Rx for a zero cost, whereas most FEHB plans have varying amounts of Rx copays/coinsurance.

I do agree that the FEHB MA option plans appear to be much better than public MA plans, but they come with a price, which some retirees might not want. I do agree that one should only suspend FEHB if they choose no FEHB, never cancel. If one cancels FEHB it is lost permanently.

All that said, my research shows for my situation that Original Medicare + FEHB to be the best combo, but it does come with a cost.

 

[zl55lz]

I'm glad you're asking the questions, although I have no answers for you. I will be following along to learn. I'm a FERS retiree but have a few years until Medicare applies, so I haven't yet done much (any?) research on the interplay between FEHB and Medicare.

I gave myself plenty of time--a year?--ahead of time to think things through and have now looked at these things for several years.

One thing I learned is to precisely define terminology. I read things from many who talked about "Original Medicare" when what they were talking about was Medigap plans. Medigap plans are supplemental coverage offered by private companies to cover a % which Original Medicare does not. "Original Medicare" involves Part A and Part B. Part C is Medicare Advantage plans offered by private companies but one has to be enrolled in Parts A&B too. Part D is Medicare Rx coverage. Adding FEHB into the equation adds another dimension. The newer FEHB Medicare Advantage plans add another. But, I have found retiree options to be far superior to when working. I now am on a FEHB plan (with Parts A&B) which gives us a yearly $1800 tax free fund which covers Rx copays and coinsurances. I haven't paid a cent out of pocket since enrolling for medical costs other than premiums.

 

[zl55lz]

A post on that other forum now shows that combining an FEHB plan with a publicly offered Medicare Advantage plan is allowed, at least according to one MA company. This does apparently agree with what some FEHB plans state in Section 9 of their brochures. Interesting concept.

 

[teej1985]

I suppose you could just link to the bogleheads thread, lol.

 

[powerplay]

I believe the way it would work is you would suspend your FEHB and choose a commercially available advantage plan. You would then be paying for medicare Part B plus any charge for the advantage plan.

 

[zl55lz]

I suppose you could just link to the bogleheads thread, lol.

I suppose that would have made it simpler and easier!!!

 

[zl55lz]

I believe the way it would work is you would suspend your FEHB and choose a commercially available advantage plan. You would then be paying for medicare Part B plus any charge for the advantage plan.

Actually, it is a thread specifically about wanting to have both FEHB and a publically offered Medicare Advantage plan (not suspending FEHB) so they could apparently reap the perks of a Part B reduction through the MA plan, AND get a low cost FEHB plan with a HRA.

For example, I believe they had in mind a zero premium MA plan with a Part B reduction of about $100/mo off the Part B premium of $165.90, and then also the FEHB plan premium of about $100 minus a HRA reimbursement of $75/mo. So, the total net cost between the two plans (and Part B) would be very low per month for a self only. They would also get two plans for their needs and two Rx coverages. It sounds like a lot of room for possible problems in my opinion, but maybe it could work once ironed out.

 

[Helen]

I don't have the answer to your question, but I want to share my nightmare with FEBH, Medicare and Social Security.

I am on Federal BCBS Basic and I have been very happy with the coverage, so I was on the fence about whether I needed Part B. I turned 65 in May and by August I decided I would enroll for a year and see how it went. Then I changed my mind, they wanted $1,060.66 for a premium, but they didn't say anything about how many months it was for, or whether it was retroactive to May. So, I changed my mind and called and cancelled. I was amazed how easy it was to both enroll and to cancel.

Then I went in for a doctor appointment, but I got a statement from Medicare saying the payment was denied and I owed the full amount. So I called BCBS and explained what happened, he suggested I stay on the line and we would call Medicare together because he received no notification that I had dropped Part B. We called OPM, Social Security and Medicare over a two-day period and spent 10 hours on the phone trying to get this corrected. I am so grateful my BCBS guy stayed with me on the phone throughout the process.


We finally straightened it out to where BCBS recognized I was not on Medicare Part B (the screw up was between SS and Medicare.)

The insurance has been straightened out but I still don't have my $1,060 back. I have spent another two hours on the phone with Social Security. They all agree they owe me the money; the problem seems to now be with the social security employees. I have never tried to deal with more unhelpful and unmotivated people which is especially aggravating after waiting on hold for over an hour to talk to someone.

In summary, this solidified my choice of not going on Part B as I hope to never have to get in between these two agencies again.

 

[zl55lz]

I don't have the answer to your question, but I want to share my nightmare with FEBH, Medicare and Social Security.

I am on Federal BCBS Basic and I have been very happy with the coverage, so I was on the fence about whether I needed Part B. I turned 65 in May and by August I decided I would enroll for a year and see how it went. Then I changed my mind, they wanted $1,060.66 for a premium, but they didn't say anything about how many months it was for, or whether it was retroactive to May. So, I changed my mind and called and cancelled. I was amazed how easy it was to both enroll and to cancel.

Then I went in for a doctor appointment, but I got a statement from Medicare saying the payment was denied and I owed the full amount. So I called BCBS and explained what happened, he suggested I stay on the line and we would call Medicare together because he received no notification that I had dropped Part B. We called OPM, Social Security and Medicare over a two-day period and spent 10 hours on the phone trying to get this corrected. I am so grateful my BCBS guy stayed with me on the phone throughout the process.


We finally straightened it out to where BCBS recognized I was not on Medicare Part B (the screw up was between SS and Medicare.)

The insurance has been straightened out but I still don't have my $1,060 back. I have spent another two hours on the phone with Social Security. They all agree they owe me the money; the problem seems to now be with the social security employees. I have never tried to deal with more unhelpful and unmotivated people which is especially aggravating after waiting on hold for over an hour to talk to someone.

In summary, this solidified my choice of not going on Part B as I hope to never have to get in between these two agencies again.

Since you are on Medicare Part A and not Part B, does BCBS Basic still give you the $800 HRA or is that only if you have Part B too? I know some plans call it a Health Reimbursement Account and some a Medicare Reimbursement so didn't know if Basic would still give it if not enrolled in Part B.

 

[teej1985]

You're not going to get the $800 if you don't take part B. That's the whole point, to encourage you to take part B so that BCBS pays out less.

 

[zl55lz]

You're not going to get the $800 if you don't take part B. That's the whole point, to encourage you to take part B so that BCBS pays out less.

Thanks for the info. If so, it must specifically be a Medicare Reimbursement Account, not an HRA like many plans.