Federal retirees: What steps need I take to get Medicare?

[Amethyst]

It is looking, more and more, as if the reasons for me to take up Med B are a) if I don't do it now, the cost will go up and up each year; and b) what if something happens to FEHB, where everyone Will Be Sorry they didn't take Med B when they could?

Under IRMAA, Medicare would cost me, alone, $3600 a year at this year's rates. That nearly doubles the $4080 we are paying for BCBS Basic. $800 a year would help, of course.

That is a pretty high cost, however, if the only real benefit is to avoid co-pays. I am still trying to suss out whether there are other major benefits, or (conversely, but importantly) avoidance of difficulties, to be had.

I have BCBS Basic coverage, and we have never had a problem finding network coverage anywhere we have been in the USA so far.

BCBS Basic does reimburse you $800 if you have Medicare Part B, but that is less than half what Medicare Part B would cost me each year.

 

[ABQ2015]

Under IRMAA, Medicare would cost me, alone, $3600 a year at this year's rates. That nearly doubles the $4080 we are paying for BCBS Basic. $800 a year would help, of course.

That is a pretty high cost, however, if the only real benefit is to avoid co-pays. I am still trying to suss out whether there are other major benefits, or (conversely, but importantly) avoidance of difficulties, to be had.

Is the $3600 based on salary before retirement? If your income is significantly lower today, my understanding is that you can file an appeal based on this life changing event.

https://boomerbenefits.com/reconsideration/

"There are a number of reasons that you might qualify for a lower premium. Social Security calls these Life-Changing Events.

The most common reason is that you’ve stopped working or are working less hours as you move into retirement. In that case, your monthly income is likely quite a bit less than when you were working. For example, let’s say you are single and your income was $90,000 when you retired in 2016. After retirement, your income is only $40,000 from Social Security and IRA distributions. This gives you a pretty good case as to why you should not have to pay a higher Part B premium based on your former income."

But if you are relatively healthy and can afford the co-pays that might arise from a significant medical event (someone discussed their husbands $200K+ heart attack and having no out of pocket costs with FEHB and Part B but this might not be the case with cancer since oncology prescriptions are so expensive), maybe it is not worth the extra cost. The important message seems to be to not opt out of FEHB.

 

[Golden sunsets]

It is looking, more and more, as if the reasons for me to take up Med B are a) if I don't do it now, the cost will go up and up each year; and b) what if something happens to FEHB, where everyone Will Be Sorry they didn't take Med B when they could?

Under IRMAA, Medicare would cost me, alone, $3600 a year at this year's rates. That nearly doubles the $4080 we are paying for BCBS Basic. $800 a year would help, of course.

That is a pretty high cost, however, if the only real benefit is to avoid co-pays. I am still trying to suss out whether there are other major benefits, or (conversely, but importantly) avoidance of difficulties, to be had.

I think you nailed it Amethyst. I can't think of another reason, given the current system. The question is, what changes to Medicare might occur? What changes to Healthcare insurance in general might occur? What happens if Medicare for all becomes law? What if OMB overhauls FEHB to meld it with the ACA? Many unknowns.

 

[donheff]

It is looking, more and more, as if the reasons for me to take up Med B are a) if I don't do it now, the cost will go up and up each year; and b) what if something happens to FEHB, where everyone Will Be Sorry they didn't take Med B when they could?

Under IRMAA, Medicare would cost me, alone, $3600 a year at this year's rates. That nearly doubles the $4080 we are paying for BCBS Basic. $800 a year would help, of course.

That is a pretty high cost, however, if the only real benefit is to avoid co-pays. I am still trying to suss out whether there are other major benefits, or (conversely, but importantly) avoidance of difficulties, to be had.

I worry a little about your b - if FEHB changes so that Part B becomes a requirement, I would pay a hefty penalty. But, although members and their staff are on Obamacare, they flip back to FEHB in retirement. So there is motivation to treat FEHB well and, hopefully, provide a decent exit path for their retired former comembers and staff if they change it significantly.

 

[Amethyst]

We are retired.

Is the $3600 based on salary before retirement? If your income is significantly lower today, my understanding is that you can file an appeal based on this life changing event.

.

 

[grayv]

It is looking, more and more, as if the reasons for me to take up Med B are a) if I don't do it now, the cost will go up and up each year; and b) what if something happens to FEHB, where everyone Will Be Sorry they didn't take Med B when they could?

in your situation, I would not worry about delaying medicare. it would be interesting to direct deposit the "medicare amount" in a mutual fund each month, and watch it grow.

 

[Amethyst]

With the gigantic bills the country's running up, there's no telling what Congress will do to us in future to find the needed money.

That said, hard to believe that even the most malevolent Congress would change FEHB to require Medicare, and still penalize, at the full rate, people who didn't sign up earlier.

In cases like that, some grandfathering typically takes place (IOW, "sign up now and pay only 50% of the penalty you'd otherwise have paid if you'd signed up when you shoulda, you old slacker cheapskate").

I worry a little about your b - if FEHB changes so that Part B becomes a requirement, I would pay a hefty penalty. But, although members and their staff are on Obamacare, they flip back to FEHB in retirement. So there is motivation to treat FEHB well and, hopefully, provide a decent exit path for their retired former comembers and staff if they change it significantly.

 

[Dreamer]

I had BCBS Standard and Medicare Part B for both my DH and myself. I kept the BCBS Standard because that is what several of my retiree friends kept. After reading the early retirement site, I switched this year to BCBS Basic and have Medicare Part B for us. We have not had a problem with any of our medical expenses, since our doctors are in network and I am looking forward to each of us receiving $800.00 back this year.

 

[RAE]

That said, hard to believe that even the most malevolent Congress would change FEHB to require Medicare, and still penalize, at the full rate, people who didn't sign up earlier.

Agreed. Of all the things I could possibly worry about these days, this would be near the bottom of the list.

 

[Amethyst]

Honestly, if we were not in IRMAA territory I would consider this. Until starting this thread, I didn't know about the $800 rebate.

I had BCBS Standard and Medicare Part B for both my DH and myself. I kept the BCBS Standard because that is what several of my retiree friends kept. After reading the early retirement site, I switched this year to BCBS Basic and have Medicare Part B for us. We have not had a problem with any of our medical expenses, since our doctors are in network and I am looking forward to each of us receiving $800.00 back this year.

 

[donheff]

Honestly, if we were not in IRMAA territory I would consider this. Until starting this thread, I didn't know about the $800 rebate.

I don't believe the carriers were offering these rebates eight years ago when I turned 65. Given our IRMAA status I would still have skipped Part B.

 

[Redbugdave]

Another angle...you can suspend your Federal Health Coverage. That is not the same as discontinuing it. By suspending it...if you want to rejoin...you can pick it back up again. That way, if you want to try just Medicare Part B and no Federal you can see how it goes. Many military retirees that have Tricare and retired from Civil Service keep their Federal Coverage but just suspend it as backup. Why would you drop out of Federal Health coverage for good when you can keep it in your back pocket...just in case?

 

[teej1985]

Another angle...you can suspend your Federal Health Coverage. That is not the same as discontinuing it. By suspending it...if you want to rejoin...you can pick it back up again. That way, if you want to try just Medicare Part B and no Federal you can see how it goes. Many military retirees that have Tricare and retired from Civil Service keep their Federal Coverage but just suspend it as backup. Why would you drop out of Federal Health coverage for good when you can keep it in your back pocket...just in case?

Because you can't do that. Perhaps Tricare is an option for suspending, but medicare alone certainly isn't.

Can only suspend for a Medicare Advantage plan.

 

[Amethyst]

Due to IRMAA, Medicare would cost me nearly twice as much as FEHB. If it covered more, I could see it. Apparently, though, it doesn't.

Another angle...you can suspend your Federal Health Coverage.?

 

[Redbugdave]

Teej is right...You can suspend your Federal if you have Medicare and an Advantage Plan. I did not know that about the Advantage Plan. You need to see the costs of the various plans vs benefits. I learned something new from this.
See the PDF form:
https://www.opm.gov/forms/pdf_fill/ri79-9.pdf

 

[Michael Moore]

My wife and I only get CSRS pensions (each on our own w*rk history) and no SSA RSI payments. When we filed for Medicare the local SSA office said they were not able to do anything about having the Medicare premiums deducted from the checks from OPM.

With the degradation of the USPS service and the short due dates on the premium payments we decided to try for deductions again. What I found out is that you need to talk to CMMS (Center for Medicare and Medicaid Services), not SSA

CMMS toll free number 1-800-633-4227

When you call tell them what you want to do and that you want to "escalate" the request (be sure to use that term). We called early 02/2021. I got a notice late 03/2021 and a refund for most of the last premium check I'd sent in. On the other hand, my wife heard nothing, called again in early 05/2021, and was told that it appeared the request had gone through but that she'd need to call back after June 01 to follow up as the billing cycle was closed until then. She got the usual bill and sent in the check, and hopefully things will get sorted out in a few months.

We did have to make separate phone calls and talked to different teleservice center workers. We don't know where her request went astray, at CMMS or SSA. One difference is that mine was processed by the Kansas City Payment Center, and her's would be through the San Francisco PC.

So if you go through the process, be aware that you might have to jump through the hoops several times before things "click". Have your OPM and Medicare ID #s handy and the award dates too.

NB: I retired from SSA, and my wife w*rked half her career there, so we are aware how the "do more with less" ethos was being applied before we retired, and my contacts with people who are still w*orking at SSA make it clear that things have only gotten worse on the w*rkloads and w*rk conditions.

cheers,
Michael

 

[Amethyst]

Wow. Thanks for the heads up!

My wife and I only get CSRS pensions (each on our own w*rk history) and no SSA RSI payments. When we filed for Medicare the local SSA office said they were not able to do anything about having the Medicare premiums deducted from the checks from OPM.

With the degradation of the USPS service and the short due dates on the premium payments we decided to try for deductions again. What I found out is that you need to talk to CMMS (Center for Medicare and Medicaid Services), not SSA

CMMS toll free number 1-800-633-4227

When you call tell them what you want to do and that you want to "escalate" the request (be sure to use that term). We called early 02/2021. I got a notice late 03/2021 and a refund for most of the last premium check I'd sent in. On the other hand, my wife heard nothing, called again in early 05/2021, and was told that it appeared the request had gone through but that she'd need to call back after June 01 to follow up as the billing cycle was closed until then. She got the usual bill and sent in the check, and hopefully things will get sorted out in a few months.

We did have to make separate phone calls and talked to different teleservice center workers. We don't know where her request went astray, at CMMS or SSA. One difference is that mine was processed by the Kansas City Payment Center, and her's would be through the San Francisco PC.

So if you go through the process, be aware that you might have to jump through the hoops several times before things "click". Have your OPM and Medicare ID #s handy and the award dates too.

NB: I retired from SSA, and my wife w*rked half her career there, so we are aware how the "do more with less" ethos was being applied before we retired, and my contacts with people who are still w*orking at SSA make it clear that things have only gotten worse on the w*rkloads and w*rk conditions.

cheers,
Michael