FEHB

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Q. My husband will be 64 years old in a couple of weeks. He is CSRS. I have health insurance under my husband’s coverage. We are concerned because we do not know what will happen to me once he goes under Medicare because of his age. Also, what will happen to my insurance coverage after he retires in a couple of years? Will I lose my coverage once Medicare takes over? Also, if I still qualify for health insurance, will it be at a more expensive price?

A. Unless your husband cancels his FEHB enrollment, the two of you will continue to be covered by it both before and after he retires. Unless he works for the U.S. Postal Service, the cost for that coverage will be the same as it was while he was an employee. The fact that he will be covered by Medicare Part A at no cost to himself only means that his out-of-pocket cost for certain covered benefits will be reduced. While he could enroll in Medicare Part B, he would have to pay the additional premiums for that benefit. Unless he has special medical needs, the National Association for Active and Retired Federal Employees generally recommends that federal retirees not sign up for Part B.

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About Author

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

4 Comments

    • Great question. I am a federal retiree 2016 and also getting Social Security disability since 2016. The Windfall did not apply to me. I retired at age 62 and opted to keep kept my FEHB private health insurance which was my primary and Tricare Select my secondary. My payments for health insurance did not change as I paid the same amount I paid when I was working. Self High Option.

      When I was on Social Security Disability for 2 years I was contacted by Medicare because they automatically rolled me over to Medicare although I was just 64 years old. I called OPM and they told me I could suspend my FEHB coverage and keep the Original Medicare Parts A&B coverage and just pay the monthly cost of $135/month. And Tricare for Life Picks up the Secondary and will pay what Medicare does not pay. There are caveats to that but as long as you use Medicare approved providers and services you have NO OUT OF POCKET COSTS. $$ zero. That is the +++ side but the pharmacy coverage for each medication ranges from $7-$53 depending if there is a generic or name brand and if you use Express scripts for home delivery. If you pick your meds up at a military base the cost is bare minimal if any but….the military bases do not carry what you need most of the time and you should call first.

      Tricare Rule. You cannot keep Tricare coverage as secondary if you opt for a Medicare Advantage Plan. You must keep Original Medicare with Tricare for Life.

      Now there are a few more rules so you should call Medicare and Tricare For Life and Express Scripts to be sure what all applies to your particular case. Good Luck.

  1. Once her husband is Medicare age and is still a Federal employee, FEHB is primary insurance and Medicare is secondary. She is still covered unless he changes to a self-only policy. Once he retires, Medicare is primary and FEHB is secondary. Again, she is still covered unless he changes to a self-only policy. He definitely needs to not cancel his FEHB, or he won’t be eligible to keep it when he retires, as you must be covered for the 5 years immediately preceding retirement.

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