Retired Federal Govt Workers - Medicare Question

[kannon]

Afternoon.

I am a retired federal Dept of Army civilian since 2014. As I approach age 65, I will need to switch to Medicare as my primary insurance and then use one of our retirement plans as secondary insurance.

I received a Medicare Card in the mail, it said to start 1 March 2023. My birthday is later March but I was told Medicare starts the first of your birth month. Sounded ok, but still need to change my federal health insurance from its current state to "Basic" state.

I called Medicare to get more information. I was told I needed to make the insurance change BEFORE 12 Dec 2022 which ends the open enrollment time. I asked about changing to Medicare being a major life event and was told by Medicare that I need to change my health plan before 12 Dec 2022 timeframe and that Medicare would lick in 1 March 2023. AND it would include any health plan changes I make.

So ... sounds ok but when I tried to go to OPM website I could not enter into the system. Double checked - made sure my OPM number was correct. Still not able to enter system. So I callled and waited and spoke to an OPM rep. The OPM rep explained that Medicare change (and changes to federal health plans) are a major life event and that I can do this right before 1 March 2023.

So .... my question to retired federal civilians, how did you change to Medicare, when was it done, any issues I should be aware of.

Thank you!!

 

[zl55lz]

Afternoon.

I am a retired federal Dept of Army civilian since 2014. As I approach age 65, I will need to switch to Medicare as my primary insurance and then use one of our retirement plans as secondary insurance.

I received a Medicare Card in the mail, it said to start 1 March 2023. My birthday is later March but I was told Medicare starts the first of your birth month. Sounded ok, but still need to change my federal health insurance from its current state to "Basic" state.

I called Medicare to get more information. I was told I needed to make the insurance change BEFORE 12 Dec 2022 which ends the open enrollment time. I asked about changing to Medicare being a major life event and was told by Medicare that I need to change my health plan before 12 Dec 2022 timeframe and that Medicare would lick in 1 March 2023. AND it would include any health plan changes I make.

So ... sounds ok but when I tried to go to OPM website I could not enter into the system. Double checked - made sure my OPM number was correct. Still not able to enter system. So I callled and waited and spoke to an OPM rep. The OPM rep explained that Medicare change (and changes to federal health plans) are a major life event and that I can do this right before 1 March 2023.

So .... my question to retired federal civilians, how did you change to Medicare, when was it done, any issues I should be aware of.

Thank you!!

Congrats on your upcoming Medicare enrollment!

Are you on a plan in FEHB (Federal Employees Health Benefits)? Or are you on a military plan from your younger years? If one is in the regular FEHB program, it seems one has a few options.

1) Remain in the current FEHB plan and let that plan know, around a month before, that one is on Medicare effective March 1 (and which parts of Medicare) and they will coordinate FEHB benefits with Medicare. I also called Medicare.

2) Change the FEHB plan now during Open Season to a different plan and do the same process.

3) Wait until Open Season in 2023 to change plans and do the same process, but still let the current plan know before March that one will have Medicare.

4) Use the once in lifetime Qualifying Life Event 2L as shown on form OPM-2809 (not SF-2809)---OPM-2809 is for annuitants--beginning 30 days before Medicare takes effect.

Here is where it got interesting for me. I was on BCBS Standard for decades and knew BCBS Basic is much cheaper and works well with Medicare A&B. I turned 65 later in the year but I decided to change to Basic the previous Open Season. My opinion looking back is this was a mistake because I went most of the year on Basic alone with no Skilled Nursing Facility coverage (Standard had 30 days and Basic none). I did get on Medicare A/B later in the year. My birthday is later in the year so I did not use the OPM-2809 2L QLE and instead changed my plan to Aetna Direct during Open Season for the upcoming next year.

Why? Well, I was told by OPM that the 2L QLE is a once in a lifetime change, and I could use it in the future, one time only. I asked if I could still do this even if in the meantime I had changed my plan during regular Open Season and several years had passed? I was told yes.

I still don't know if that is true but it is worth a call to OPM to verify. I certainly would if I ever were to contemplate it (such as if I was in the middle of a year and felt my FEHB plan was not working for my situation). Sort of an option in my back pocket.

But again, I would double check if this is truly an option.

Having said this, we are very pleased with the Aetna Direct plan and the $1800 Medical Fund. All Rx coinsurance/copays are automatically deducted from the fund, so when I go to pick up any Rx, there has been zero out of pocket (oop), and with Medicare A and B we have had zero oop for any other costs. I have never been on a plan where we had zero oop for the year (and my spouse is a heavy healthcare user for her conditions and takes 14 different Rx) and the fund rolls over from year to year, up to 10K I believe, for a self+one with both on A&B.

Welcome to the world of Medicare and FEHB. It is discussed here a lot.

IF you are on some other insurance, military, private, etc., everything could be different and you would have to check the appropriate official sources (as you should do here anyway). These comments are my understanding/opinions based on the materials I have read. Hopefully others will comment as well.

There are other factors too such as IRMAA, whether to enroll in Part B too, etc.

You might have more questions. Many of us probably did. Please feel free to ask.

 

[donheff]

zl55lz: you mention that OPM says you can save this one in a lifetime event (item 4) for future use. But the event you describe is an opportunity to change plans within 30 days before Medicare takes effect. But the Medicare change is a once in a lifetime thing. Once you pass that point it will never take place again so there is no event to save. Am I missing something?

 

[zl55lz]

zl55lz: you mention that OPM says you can save this one in a lifetime event (item 4) for future use. But the event you describe is an opportunity to change plans within 30 days before Medicare takes effect. But the Medicare change is a once in a lifetime thing. Once you pass that point it will never take place again so there is no event to save. Am I missing something?

You hit the nail on the head. I found the language in different OPM sections to appear to state it both ways, at least in my understanding, which is why I stated I still don't know if what I was told by OPM is true and that if contemplating such a choice should verify with OPM (since they are the official source). It is entirely possible that the employee did not understand my question.

Having said that, I did in the past find this topic addressed in an article online. The question truly is whether that option is available starting 30 days before Medicare eligibility and once in a lifetime anytime thereafter, or only in the 30 day period before eligibility, period. If I can find that site again I will post further. Thanks for asking this question because it makes a huge difference in when/if one can use the option.

 

[zl55lz]

You hit the nail on the head. I found the language in different OPM sections to appear to state it both ways, at least in my understanding, which is why I stated I still don't know if what I was told by OPM is true and that if contemplating such a choice should verify with OPM (since they are the official source). It is entirely possible that the employee did not understand my question.

Having said that, I did in the past find this topic addressed in an article online. The question truly is whether that option is available starting 30 days before Medicare eligibility and once in a lifetime anytime thereafter, or only in the 30 day period before eligibility, period. If I can find that site again I will post further. Thanks for asking this question because it makes a huge difference in when/if one can use the option.

Followup--I did find the article at narfenewyork.org/qle-2l-medicare-eligible

The article has a couple things to click on about the story behind the story, etc., which gives an example of a couple who were way past age 65, and who had been on FEHB for years, using this option.

Does anyone interpret this example differently?

However, it brings up more questions for me. The only way to verify would be to contact OPM as to when this 2L option can or cannot be used.

 

[donheff]

Followup--I did find the article at narfenewyork.org/qle-2l-medicare-eligible

The article has a couple things to click on about the story behind the story, etc., which gives an example of a couple who were way past age 65, and who had been on FEHB for years, using this option.

Does anyone interpret this example differently?

However, it brings up more questions for me. The only way to verify would be to contact OPM as to when this 2L option can or cannot be used.

That is an interesting example. As I read it, becoming eligible for Medicare is a life changing event that allows you to change your FEHB plan any time from 30 days before becoming eligible and death. If you enrolled in Medicare but left your FEHB enrollment alone, you still qualify for one time use of 2L. The only time I could see using it would be a huge increase in premiums that you didn't notice during open season, like the couple in the example.

 

[W2R]

[...]
So .... my question to retired federal civilians, how did you change to Medicare, when was it done, any issues I should be aware of.

I am 74 years old and have been retired on FEHB since 2009.

To be entirely honest, it's been long enough that I don't really remember much about getting Medicare Part B started, which is why I hadn't posted here until now. One thing I think I remember is that I had to mail off a check to pay for Part B each month for about a year until I got divorced spousal SS started up at age 66 = FRA (after that it was deducted from my SS deposit). I sent them one check too many just to make sure there wasn't a gap, and they returned the excess.

Another thing I *DO* remember is that my birthday is on June 8th, and that first year on Medicare I had a doctor appointment on June 10th. Scared me silly to be cutting it that close, when I first got Part B started! But everything just fell together smoothly, as though BCBS and Medicare had each done this before a few times.

At age 70 I switched from divorced spousal SS to Age 70 SS based on my own work record, and IIRC that went smoothly as well.

Wish I could be of more help! I truly despise dealing with insurance and that's probably why I have forgotten most of this.

 

[grayv]

The only time I could see using it would be a huge increase in premiums that you didn't notice during open season, like the couple in the example.

or suddenly needing a different network. for example, Blue Cross and Springfield Clinics in Illinois parted ways.



or discovering a new expensive medication is not covered on your plan, covered on another.


I wonder when it would be effective. postmark date?

 

[zl55lz]

or suddenly needing a different network. for example, Blue Cross and Springfield Clinics in Illinois parted ways.



or discovering a new expensive medication is not covered on your plan, covered on another.


I wonder when it would be effective. postmark date?

Section 3 of at least some FEHB plan brochures addresses this issue for enrollees hospitalized at the time of plan change, but I have not seen anything addressing the timing of other services/benefits in general. Another question for OPM.