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 am about to retire and will turn 65 later this year. My husband is 80 and is also covered under my FEHB insurance.
Due to our income, our Medicare payments will be very high: more than $12,000 per year for the two of us.
Is it more advantageous for one or both of us to never enroll in Medicare while we keep FEHB coverage? Does anyone ever drop Medicare under our situation after enrolling?”
Kevin’s response:
You’ll still want to enroll in Medicare Part A. Part A, which covers inpatient hospital, is $0 for most from paying Medicare taxes while working. With Medicare Part A, many FEHB plans will waive inpatient hospital charges.
It’s also very important to enroll in Medicare Part A to be eligible to enroll in Medicare Part D prescription drug plans. Starting in 2025, all Part D plans will have a $2,000 prescription drug catastrophic maximum per person.
If you expect your income to continue placing you in a high IRMAA level, you’ll likely be better off forgoing Medicare Part B. Without Part B you’ll continue to pay the regular out-of-pocket costs for doctor visits and outpatient services from your FEHB plan.
You’ll also lose the option to enroll in Medicare Advantage plans and the opportunity to use the Part B benefit to go outside of the provider network of your plan to see any provider that accepts Medicare.However, saving $12,000/year in Part B premiums will more than offset the benefits Part B provides.
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.
