Q. I am a recent retiree and have to decide whether to obtain Medicare Part B coverage. I have, and intend to keep, my Blue Cross coverage. I am trying to determine whether I should opt for Medicare Part B for my wife and I, even though I have Blue Cross. The Medicare Part B monthly payments would range about $150 for each of us.
A. Only you can answer that question. To help you arrive at a decision, start by reading OPM’s helpful guide to Federal Employees Health Benefits and Medicare. You’ll find it at www.opm.gov/insure/health/medicare/index.asp.
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My husband (63) has been disabled for 5 years and is on Medicare part A due to a disability and is unable to work. He was not given a choice; the government automatically enrolled him in Part A. I (54) work full time and have employer provided Independence Blue Cross that I also pay into for both my husband and I to have a better plan that includes medical, prescription and dental. Blue Cross just sent my husband a letter telling him (and there was much more) “EFFECTIVE 1-1-17, IF YOU ARE NOT ENROLLED IN MEDICARE PARTS A AND B, INDEPENDENCE BLUE CROSS WILL SUBTRACT EITHER THE AMOUNT THAT MEDICARE WOULD HAVE PAID (USUALLY 80 PERCENT OF MEDICARE RATE) OR THE APPLICABLE PLAN FEE SCHEDULE FOR THE SERVICES AT OUR DISCRETION, AND PAY ONLY THE REMAINING BALANCE OF THE CLAIM AS IF YOU HAD ENROLLED IN MEDICARE PARTS A AND B. AS A RESULT YOU WILL BE RESPONSIBLE FOR THE AMOUNT THAT INDEPENDENCE DID NOT PAY IN ADDITION TO ANY APPLICABLE COPAYMENTS, COINSURANCE, AND DEDUCTIBLES. IN YOUR BENEFIT PLAN, THIS IS REFERRED TO AS THE MEDICARE EXCLUSION.” How is this fair or legal if my husband has not yet reached retirement age (67) and is currently enrolled in a plan that I pay for through my employer. By forcing us to purchase Part B, we would not only be paying for Medicare, but also paying for the SAME COVERAGE through my employee plan in addition to the excess costs Blue Cross mentions above. How is this legal and how is this fair when I pay into the plan? My take on this letter is that Blue Cross is refusing to pay for any costs that they pay now and defer THEIR cost portion to Medicare Plan B. My husband is not in a position to have to pay a penalty to Medicare for a late enrollment because he is covered under my plan. Is Independence Blue Cross allowed to strong-arm us into purchasing the Medicare plan if he is already covered under their plan and I pay for the privilege? Who do I turn to or talk to for advice? We are on a very tight budget and this will put us in the red monthly if we have to purchase another insurance plan that we DON’T NEED. I don’t understand insurance, but I do understand right from wrong and being bullied into something not necessary. If my husband is already fully covered, then wow does Blue Cross have the right to tell him he MUST purchase Medicare Part B or else??? Is this legal? What are our options? The cost to drop my husband from my employee plan and pick up Medicare Part B then C for prescriptions will far outweigh the cost of what I’m paying now by hundreds of dollars extra a month. We just don’t have it in our budget…Any advice or direction of who to talk to would be greatly appreciated. We are against the clock.
Unfortunately, we aren’t able to advise you or point you in the right direction, However, by posting your e-mail on the website, we are encouraging others who may be more knowledgeable than we are to respond.
Thank you for your response. I hope someone has an answer.
I retired from Federal employment and continued my health care coverage, as well as coverage for my husband. My husband is eligible for medicare next month. Can I drop his health care coverage under my Option C insurance, but keep his life insurance going?
Option C provides no health care coverage. It’s a way to provide you with a financial benefit in the event that a family member dies. If you want to drop that coverage you can. Doing so would have no affect on any other life insurance, such a Options A or B, where you have designated him as the beneficiary if you die.
Think twice about dropping him from your FEHB coverage. While he’ll be eligible for Medicare Part A at no cost to himself. He’d have to pay for Part B. Further, the combination of an FEHB plan and Part A alone would reduce out-of-pocket health care costs substantially. Being covered by Parts A, B and FEHB would reduce those costs to almost zero.