Q: My wife and I are federal retirees and annuitants. We continue to enroll in the CareFirst Blue Cross/Blue Shield standard option. We do not have Medicare Part B. The Blue Cross 2010 Plan Booklet and several explanation of benefits from Blue Cross explain that by law, physicians who do not accept Medicare can only charge us up to 115 percent of what Medicare allows. The law applies to federal retirees and annuitants without Medicare Part B. Please confirm that what I summarized above is correct. A: What you read on Page 23 of your plan brochure is correct.
Browsing: 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…
Q: If you are the retiree with survivor benefits and the survivor dies first, what forms do you need to fill out? Do you inform Medicare? Do you change health benefits from family to single? What form do you fill out to remove the survivor benefits? A: All you need to do is call the Office of Personnel Managment at 888-767-6738 to report the death of your spouse. A benefits specialist will guide you through the process and provide the forms your need.
Q: The 2011 open-enrollment season will to intoduce a voluntary sub-option for annuitants who receive Medicare Part B. Can you give me an update on this Office of Personnel Management proposal? Will all the participatng plans offer this, especially Blue Cross/Blue Shield? A: On April 7, OPM issued its annual call letter to plans participating in the Federal Employees Health Benefits program. In the letter, it encouraged them to propose “pilot programs wherein participating carriers offer a sub-option for Medicare-eligible annuitants as an alternate choice within their existing option(s). The sub-option may include premium pass-through accounts to be used solely…
Q: I will retire in August at the age of 67. My husband is 68 and works in the private sector. We are covered under my FEHB insurance. We have participated in an HMO for the past 10 years and are satisfied with the services we have received. We both have Medicare Part A, but not Part B. We have not used Part A because of my status as active employee. In one of your previous articles, you stated, “if you are enrolled in an HMO, which already covers most of your medical expenses, you may decide not to enroll…
Q: My husband turns 65 next year and will be eligible for Medicare Part B. I am a federal employee, and he has been on my FEHB plan for years because he is on Social Security Disability. If I understand this correctly, if Medicare Part B will not pay for a procedure or doctor, then Blue Cross also will not pay. Do we even have to take Medicare Part B? I plan on keeping my Blue Cross after retirement. If we do not take Medicare Part B, will this affect my FEHB plan coverage. A: Medicare and your health benefits…
Q: I am retiring June 30, 2010. I am already retired from the military and have used my Tricare benefits until now. Under the new health care plan that passed in Congress, I am already receiving letters from doctors that I have been seeing for years, telling me they will no longer accept Tricare or Medicare. I want to carry the Federal Employees Health Benefits Plan into retirement. Does my use of Tricare qualify for the five-year rule? A: Not unless you were enrolled in the FEHB program on the day you retired. If you were, your years of coverage…
Q: I am working full time as a Coast Guard civilian. I have Mail Handler’s self-only medical insurance, but I am also covered by my wife’s medical insurance, which is what I really use. Her provider sent me a letter informing me that because she is retired and I’m turning 65 on April 28 that I need to sign up for Medicare Parts A and B to continue my coverage through them. I signed up with her insurance company as a single member and my wife changed her plan. Her former employer and her annuity will continue to pay for…
Q. I am 59 years old, and will be eligible for Medicare as of May 1 because of a disability. At present I am covered under my husband’s insurance through FEHBP (my husband is now deceased). Do I need to enroll in Medicare Part B, and if I do, then does my health insurance change? Will I become Medicare Primary and what FEHBP offers as a supplement or can I continue to keep my existing plan? A. It’s up to you to decide whether to enroll in Medicare Part B and pay the required premiums. If you do, Medicare Part…
Q. Why does Medicare become one’s primary insurer when they reach 65? I am a retired federal employee with FEHB, which becomes secondary at that age. Is Medicare better? A. Medicare becomes primary because the law requires it. The law applies to anyone who is retired and enrolled in Medicare. It does not apply to those age 65 or older who are still employed. In their case, any private or public health insurance they have remains primary and Medicare secondary. Note: While you have already paid for Medicare Part A (Hospital Insurance) through payroll deduction, whether or not you enroll…