The following is a question submitted by a Federal Times reader to columnist Kevin Moss, a senior editor at Consumers’ Checkbook and expert on federal employee health insurance plans for civil servants, retirees and their families.
Editor’s note: The question and response have been edited for clarity and confidentiality.
A Fed Times reader asks:
“I read your article about Medicare Advantage plans for feds, and I had a question regarding why one of these plans would not be a good choice, and you only gave an example of a person making over $103,000 or a couple making a large sum in retirement.
What about those of us single people who are making substantially less in retirement — a federal annuity around $24,000? It seems that it would be more advantageous to just stick with the current FEHB plan and forgo the Part B or any Medicare Advantage plan.
For instance, I currently pay $151/month for GEHA standard option. I’ve called GEHA to ask if they reduce their rate once we are on Medicare and they move to a secondary insurer placement, and they said the monthly amount remains at $151, so I would be paying an additional $174 on top of the $151 just to cover doctor visits because the hospital visits are covered automatically under Part A.
It would take an enormous amount of $30 co-pay visits to make up the $174 additional I would be paying. Am I missing something or does that logic stand? I also travel internationally often and need a plan that covers me anywhere in the world, which GEHA does.”
Kevin’s response:
FEHB plan selection is very important to maximize the benefit of enrolling in Part B. Not all FEHB plans eliminate out-of-pocket costs when you have Part B.
GEHA Standard does waive some out-of-pocket costs with Part B. Besides eliminating primary and specialist visit copays, GEHA Standard also eliminates the $350 plan deductible and outpatient hospital charges.
You’ll likely also have access to more doctors with Part B. You can go outside of your plan provider network and see any doctor that accepts Medicare. You will be subject to the annual Part B deductible of $240 and 20% cost of service if you exercise that option.
GEHA Standard offers a Medicare Advantage plan to members. This MA plan offers a $900/year Part B premium reimbursement and $0 out-of-pocket costs for healthcare services for approved care from providers that accept Medicare and the plan. Checkbook’s Guide to Health Plans ranks plans on estimated yearly cost, the combination of premium and likely out-of-pocket costs. Despite paying the Part B premium, the MA plan offered by GEHA Standard, with Part B premium reimbursement and $0 out-of-pocket health care costs besides prescription drugs, produces lower yearly cost estimates compared to GEHA Standard without Part B.
International coverage is an issue with MA plans.
First, since the MA plans bundle Part D prescription drug coverage, there is no reimbursement from Medicare for prescription drugs obtained or purchased overseas. Next, there is no international routine health care offered by MA plans. Many travel insurance policies would reimburse for health care expenses not covered by your health plan, however.
Have a question about your FEHB plan or the federal insurance marketplace? Send your query to benefitsexpert@federaltimes.com
Kevin Moss works for Consumers' Checkbook, a nonprofit dedicated to helping consumers make informed decisions. He leads the production of Checkbook's Guide to Health Plans for Federal Employees, a decision support tool that helps federal employees and annuitants find the FEHB plan that's the best fit.
