FEHB Enrollment vs Medicare – What You Should Know

FEHB Enrollment vs Medicare – What You Should Know

 

Flu and cold season are here. Are you prepared? Most federal employees are satisfied with their Federal Employee Health Benefits (FEHB) coverage and don’t feel the need to add Medicare to the mix. However, it’s worth exploring both options as you plan for retirement.

Federal Educators explains what you should know about these two programs.

The Federal Employee Health Benefits (FEHB) program was designed by the Office of Personnel Management (OPM) to help federal employees and their families meet their healthcare needs. Enrollment may occur during your first 60 days as a newly eligible employee, during the Federal Benefits Open Season (mid-November to mid-December), or when you have a qualifying life event such as marriage, divorce, or birth. You are eligible for Medicare if you are age 65 or over, certain disabled persons, and persons with permanent kidney failure. You are also entitled to Medicare Part A without having to pay premiums if you or your spouse worked for at least 10 years in Medicare-covered employment.

Of course, every insurance plan is nuanced. Just like the differences between each plan in FEHB, there are several differences between FEHB and Medicare. As OPM explains, “generally, plans under the FEHB program help pay for the same kinds of expenses as Medicare.” Generally, the FEHB plans tend to be more comprehensive, grant emergency care outside of the United States, and include dental and vision, which Medicare does not. So, is it worth it to have both?

Many FEHB plans actually have a special “coordination of benefits” with Medicare. This allows the FEHB plans to pick up the secondary tab immediately and waive any deductibles, co-pays, or co-insurance. In most cases, this coordination alleviates out-of-pocket costs to the individual. Ultimately, the decision comes down to cost. Comparing the cost of carrying Medicare to the out-of-pocket exposure you would have without Medicare.

For more comprehensive benefit planning, the Federal Educators team can provide your family with resources and tools tailored to your journey. Call the Tampa office at (813) 755-7037 or request a free benefits analysis today.