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.
The question and response have been edited for clarity and confidentiality.
A Fed Times reader asks:
“I’m a retired federal employee. When I retired, my wife and I were covered by GEHA and Medicare.
In January 2025, I switched to the GEHA/United Health Care Medicare Advantage Plan, and so far it has worked well. I seem to receive not only the previous Medicare/GEHA benefits, but also the reduction in Part B premiums and a quarterly allowance for over the counter health items.
Here’s my question: when I talk to my private sector friends who are under commercial Medicare Advantage plans, they say once you make the switch from Medicare and a separate private health insurance plan to a commercial Medicare Advantage plan, you can never switch back. You can change your Medicare Advantage plan, but you can never go back to Medicare and a separate supplemental private health insurance company plan.
Is the same true for feds? In other words, during the fall 2024 federal open season, can I switch back from Medicare Advantage with GEHA/United Health Care and revert to my original plan of Medicare A and B and GEHA under FEHB?
My private sector friends complain that over time, their selection of health care providers has dwindled, and they sometimes cannot get the health care providers that want to have. Could this happen in the federal employee program?”
Kevin’s response:
You can switch to any other Medicare Advantage plan offered by a FEHB plan in any future Open Season, or go back to any other FEHB plan.
FEHB rules do not permit exclusions or waiting periods for preexisting conditions.The commercial market works differently, however.
With just Original Medicare (Parts A & B), individuals have no catastrophic protection and face out-of-pocket costs which include Part A & B deductibles and 20% of the bill for all Part B medical services. To help limit out-of-pocket costs, most retirees in the commercial market supplement Original Medicare with a Medigap policy.
RELATED
When you first enroll in Medicare Part B there is a six month Medigap open enrollment period where insurance companies cannot deny you coverage if you have a pre-existing condition.
However, in most states, after this period ends insurance companies that offer Medigap policies could deny coverage for pre-existing conditions or charge you more. Therefore, for non-feds, the decision to enroll in Medicare Advantage must be carefully considered.
Switching from Medicare Advantage to original Medicare and Medigap in the future may not be an option or could lead to higher prices.
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.
