Coverage under FEHB, Medicare


Q: My father retired from the Internal Revenue Service 20 years ago. He has Medicare Part A but did not take Medicare Part B and has continued his Federal Employees Health Benefits insurance plan. Until now, all bills had been covered by his Aetna FEHB insurance. Now he needs surgery, and he was informed that this insurance is secondary and Medicare Part B, which he does not have, is primary. Is that accurate? Why is he paying $16,000 a year for in private insurance if it is only secondary? Also, I got the impression that if you don’t take Medicare Part B, your insurance, which was primary when you were employed, continues to be primary. Can you please clarify?

A: Medicare Part A covers inpatient hospital care. Because your father is covered by Part A, Medicare is primary and his FEHB plan is secondary. Because he does not have Medicare Part B, his FEHB plan is his sole coverage. I recommend that you review the section of his plan brochure titled “When you are age 65 or older and do not have Medicare” to find out what charges he would be required to pay.

One thing has me puzzled. You wrote that he is paying $16,000 a year for his “private insurance.” That’s not possible. Aetna’s highest monthly premium is $865.89 for the Pennsylvania Aetna Open Access High Family option. That works out to $10,390.68 per year. If he’s enrolled in any other Aetna plan, his premiums would be less than that, often far less.


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Reg Jones was head of retirement and insurance policy at the Office of Personnel Management. Email your retirement-related questions to

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