FEHB retimement question

[PessOptimist]

Under “Retirement and IRA talk” I find “Medicare and FEHB” and “Medicare and Social Security” All valid threads and apply to me in one way or another. This question is for an acquaintance who is trying to make decisions and not finding the answers. So a new thread.

Jane retired from federal service under the MRA+30 rule. John is still a full time federal employee.

Jane decided to enroll in FEHB for retirees. She is considering converting to Johns FEHB but John may not work long enough to get retirement benefits. If Jane becomes a family member under John’s FEHB, when John leaves federal employment will Jane be able to enroll in retirees FEHB or will it be gone?

Specific example that no one seems to be able to answer. Advice is “try it and see what happens”. Will be far too late at that point. Typical OPM or FEHB contractor answer.

Anyone have any experiences with this?

PO

 

[FogSailing]

PO: I was under the impression that if you elected out of FEHB benefits, then you are out of the system. I am no expert (and I understand how John could pick up Jane as his wife under his FEHB) but it seems to me that if John left government before retirement and was not eligible for FEHB benefits, then his wife will have lost her rights to benefits as well. I hope you get a better answer than mine but that's how I understand the system.

FS

 

[Scout333]

Under “Retirement and IRA talk” I find “Medicare and FEHB” and “Medicare and Social Security” All valid threads and apply to me in one way or another. This question is for an acquaintance who is trying to make decisions and not finding the answers. So a new thread.

Jane retired from federal service under the MRA+30 rule. John is still a full time federal employee.

Jane decided to enroll in FEHB for retirees. She is considering converting to Johns FEHB but John may not work long enough to get retirement benefits. If Jane becomes a family member under John’s FEHB, when John leaves federal employment will Jane be able to enroll in retirees FEHB or will it be gone?

Specific example that no one seems to be able to answer. Advice is “try it and see what happens”. Will be far too late at that point. Typical OPM or FEHB contractor answer.

Anyone have any experiences with this?

PO

I have heard there is a way to re-enroll in FEHB but would be due to a change in life event such as divorce, death, etc. Safest would be to maintain her own coverage. How large a savings is there between Self x 2 vs Self Plus One?

 

[Maricar19]

Your friend can send an email regarding this question to opm:retire@opm.gov and while waiting for the response (it takes 2 -3 weeks for a response), she can check this website and if she can't find the answer, send a question also:Search Results fehb

 

[Maricar19]

From same website by R Jones: This is somewhat similar to your question, PO:

Q. If we suspend Blue Cross Blue Shield coverage in favor of Tricare, can we only re-enroll during Open Season? Would pre-existing conditions be covered? Can BC/BS Federal deny re-enrolling us if we have cancer? Is there a financial penalty if we do decide to re-enroll?

A. Yes, you could re-enroll in the Federal Employees Health Benefits Program during any Open Season, and there wouldn’t be any financial penalty for doing that. Further, pre-existing conditions cannot be considered by any FEHB plan, whether you are enrolling or re-enrolling.

 

[RazorCat]

PO: I was under the impression that if you elected out of FEHB benefits, then you are out of the system. I am no expert (and I understand how John could pick up Jane as his wife under his FEHB) but it seems to me that if John left government before retirement and was not eligible for FEHB benefits, then his wife will have lost her rights to benefits as well. I hope you get a better answer than mine but that's how I understand the system.

FS

When I retired at the end of 2013 the rule was you had to maintain FEHB coverage going into retirement, or lose it permanently. You could switch plans during your final year, but had to carry that plan into retirement to maintain FEHB enrollment eligibility.
To my knowledge, that rule hasn't changed.
One thing we did this year to lower our BCBS coverage costs was to switch to the Self Plus One plan. But, I was reading on federalretirement.net that there may be rate issues for some. I recommend researching your coverage if you're thinking about this new plan.
FEHB Health Insurance| FEHB Rates | Federal Employee Health Benefits
This the link to some of the issues you should be aware of.
FEHB Self Plus One - A Major Disappointment | Federal Employee's Retirement Planning Guide

 

[Skorcher]

Under “Retirement and IRA talk” I find “Medicare and FEHB” and “Medicare and Social Security” All valid threads and apply to me in one way or another. This question is for an acquaintance who is trying to make decisions and not finding the answers. So a new thread.

Jane retired from federal service under the MRA+30 rule. John is still a full time federal employee.

Jane decided to enroll in FEHB for retirees. She is considering converting to Johns FEHB but John may not work long enough to get retirement benefits. If Jane becomes a family member under John’s FEHB, when John leaves federal employment will Jane be able to enroll in retirees FEHB or will it be gone?

Specific example that no one seems to be able to answer. Advice is “try it and see what happens”. Will be far too late at that point. Typical OPM or FEHB contractor answer.

Anyone have any experiences with this?

PO

That would be a risky move. Both of them could be without FEHB in retirement. Why doesn't Jane get self plus one or family coverage as a retiree and John drop his FEHB? The premiums are the same as her plan and there is no risk of losing FEHB due to the five year rule.

 

[Stoplight]

Under “Retirement and IRA talk” I find “Medicare and FEHB” and “Medicare and Social Security” All valid threads and apply to me in one way or another. This question is for an acquaintance who is trying to make decisions and not finding the answers. So a new thread.

Jane retired from federal service under the MRA+30 rule. John is still a full time federal employee.

Jane decided to enroll in FEHB for retirees. She is considering converting to Johns FEHB but John may not work long enough to get retirement benefits. If Jane becomes a family member under John’s FEHB, when John leaves federal employment will Jane be able to enroll in retirees FEHB or will it be gone?

Specific example that no one seems to be able to answer. Advice is “try it and see what happens”. Will be far too late at that point. Typical OPM or FEHB contractor answer.

Anyone have any experiences with this?

PO

Great question, and follow-on discussion, PO !!!

I can't add anything worthwhile to the discussion about what to do NOW...things have changed, since I retired in 2012 (i.e., like self + 1). What I DO know is, my #1 priority was to carry a health insurance plan into retirement, that the Wife could use, too !!! For years, I didn't have FEHB, and was on the Wife's Self+1 Plan...cheaper, and better benefits than FEHB !!! OTOH, it was through her County's Board of Education (NOT a State retirement thing !)...her County was WAY more progressive than the Feds !

I decided I needed to join the FEHB 5 years before I retired, so I could carry it over into retirement, and if her County decided to dump health care, we'd have the option to pick her up on mine...Her "Self" and my "Self" was still way cheaper than picking her up on the FEHB "Family", which was all that was available when I retired....

So fast forward to today : Her Plan is still in effect ; STILL cheaper than the FEHB Self+1 option, so we still carry "self only" on both of our accounts ; she's gotten a "health care premium holiday" each year for the last few years...based on favorable claims, they don't deduct the premium for 1 month ! :smile: ; AND...when she becomes eligible for Medicare next year, her County insurance rate goes down, since it's no longer "primary"...unlike the FEHB, which changes NOTHING re: premiums when you hit Medicare !!! That never made sense to me...

I know...we have a sweet deal ! But depending on Jane and S.O.'s priorities and financial plan in retirement, I'd recommend she do NOTHING to jeopardize missing out on the FEHB retirement option for them both !!! Keep that FEHB into retirement !!!


Stoplight...

 

[RazorCat]

That would be a risky move. Both of them could be without FEHB in retirement. Why doesn't Jane get self plus one or family coverage as a retiree and John drop his FEHB? The premiums are the same as her plan and there is no risk of losing FEHB due to the five year rule.

Definitely the way to go. One caveat is she'll have to opt for at least the 25% survivor benefit so he can maintain coverage if he were to outlive her. But, then she should anyway.

 

[2moryrs]

Hello,
From what I have read in the Q and A's in the National Active and Retired Federal Employees (NARFE) magazine, Jane could suspend her FEHB benefit so that she does not lose her eligibility. Once you opt out of FEHB entirely, you cannot get back in. Suspend benefit is the way to go. IMHO

 

[2moryrs]

So fast forward to today : Her Plan is still in effect ; STILL cheaper than the FEHB Self+1 option, so we still carry "self only" on both of our accounts ; she's gotten a "health care premium holiday" each year for the last few years...based on favorable claims, they don't deduct the premium for 1 month ! :smile: ; AND...when she becomes eligible for Medicare next year, her County insurance rate goes down, since it's no longer "primary"...unlike the FEHB, which changes NOTHING re: premiums when you hit Medicare !!! That never made sense to me...

In reading Q and A's in the NARFE magazine (see my other post), it seems that if you sign up for medicare part B which has a cost, BCBS used to waive the copay when you visited your Doc and between the medicare part B and BCBS you had virtually no out of pocket expenses. Example: My husband is healthy and chose not to purchase part B medicare. We have to pay his copay and what BCBS does not pay. Medicare part A is only for hospital admissions. Be sure that you get admitted. Medicare won't cover costs if not an admission.

 

[PessOptimist]

Re: FEHB retirement question

Thanks for the replies everyone. The reason the question came up is that Jane found out the FEHB payment is post tax in retirement. Since she has new employment this means a significant amount. Jane and John have college and high school age children.

I have researched many retirement things and people often ask me. I don’t go further in my research if the question does not pertain to me. I do try to point people in the right direction.

So fast forward to today : Her Plan is still in effect ; STILL cheaper than the FEHB Self+1 option, so we still carry "self only" on both of our accounts ; she's gotten a "health care premium holiday" each year for the last few years...based on favorable claims, they don't deduct the premium for 1 month !

; AND...when she becomes eligible for Medicare next year, her County insurance rate goes down, since it's no longer "primary"...unlike the FEHB, which changes NOTHING re: premiums when you hit Medicare !!! That never made sense to me...

In reading Q and A's in the NARFE magazine (see my other post), it seems that if you sign up for medicare part B which has a cost, BCBS used to waive the copay when you visited your Doc and between the medicare part B and BCBS you had virtually no out of pocket expenses. Example: My husband is healthy and chose not to purchase part B medicare. We have to pay his copay and what BCBS does not pay. Medicare part A is only for hospital admissions. Be sure that you get admitted. Medicare won't cover costs if not an admission.

Thanks 2moryrs. I guess the magic word would be “suspend”?

I included the quote from your latest reply because I am not sure who you were replying to or if this is your own situation. I don’t think it applies to the scenario I posted originally.

Maricar, thanks also, Tricare does not enter in to scenario I posted.

All that being said about the original post, let’s keep this FEHB “retimement” question thing going because there are so many different scenarios and one wrong decision to save a few $K can end up with no health insurance later.

If one of the admins would be so kind as to change retimement to retirement I would be very greatful.

PO

 

[RazorCat]

Re: FEHB retirement question

Somewhat older thread, but I wanted to share some information with those interested.
We've carried BCBS Standard for quite a few years, and it's been a decent plan for situation. My wife's job involves studying and filing medical insurance, so she sees the benefits and pitfalls of all FEHB plans. Based on her advice we switched to the BCBS Basic plan this past Open Season. Our premium was reduced by around $155.00 per month. Deductibles are lower, no co-pay for office visits (although many Dr. offices don't know this so you pay and then get refunded), and if you can opt for generic prescriptions your part is no more than $10.00 per prescription. This may be the area that makes it less of a bargain for those on multiple meds that don't offer a generic alternative. The caveat is you have to use only "In Network" providers. We were lucky in that all our current services are In Network. Emergency care is exempt from that requirement.
We've yet to find a downside to switching.
Just an FYI in case anyone finds that plan might meet their needs.
you can compare plan costs and benefits here.
https://www.opm.gov/healthcare-insurance/healthcare/plan-information/compare-plans/