The age 65 Medicare decision.

[Epic]

So I'm about 8 months away from having to make the dreaded Medicare choice as to what to do, and I didn't see any threads on this topic.
Just looking for some real life insight as to what you did and if you were happy with your decision. Any input is appreciated.
I'll cut and paste some parts from this >>>> HERE
So, I'm with Kaiser at the moment with the Gov FEHB coverage, and they're fine I guess. The monthly deductions I don't even notice because I've been paying it for a long time, and any visit for anything is just a $20.00 copay. I'm in great shape with just one minor issue.
So, my choices seem to be:
Medicare: What you need to know
Medicare eligibility starts at age 65, but participation is optional for all except postal retirees. Medicare has four parts:
Part A: Hospital coverage which is free for most retirees.
Part B: Medical insurance for outpatient care and doctor visits, with premiums around $175 per month or higher, depending on income.
Part C: Medicare Advantage plans, which combine Parts A and B with additional benefits.
Part D: Prescription drug coverage.
Delaying enrollment in Part B when eligible – at age 65 or within eight months of federal retirement – could bring late enrollment penalties. While employed, FEHB is the primary insurance, but Medicare takes over as the primary payer after retirement.
FEHB: Cancel or suspend?
Retirees have two choices when it comes to managing their FEHB coverage alongside Medicare: canceling or suspending.
The important thing to remember about FEHB cancellation is that it’s a final decision. The action is permanent and irreversible, meaning you will no longer have access to FEHB.
On the other hand, suspension allows a temporary pause to FEHB coverage if you choose Medicare Advantage, Medicaid or are eligible for TRICARE for Life, which may benefit your individual situation better. You can reinstate your FEHB coverage during an open season later if you so choose.
Maximizing health coverage in retirement
Retirees have several strategies for combining FEHB with Medicare:
Keep FEHB and enroll only in Medicare Part A: This allows flexibility in provider choice and may be preferable for those who travel or live abroad, since Medicare would be secondary to FEHB in those scenarios.
Enroll in both Medicare Parts A and B while continuing FEHB: This offers nearly comprehensive coverage, with Medicare as the primary payer and FEHB as secondary. To reduce costs, some retirees opt for a basic FEHB plan.
Suspend FEHB and switch to Medicare Advantage: To be eligible for Medicare Advantage, retirees must first be covered by Medicare A and B. This will be the most cost-effective on the monthly budget because most Medicare Advantage plans come with a zero-dollar premium. Retirees also have the option to reinstate FEHB later.
Understanding the best mix of federal health benefits and Medicare depends on your individual situation and specific needs and plans. Navigating these options carefully and making informed decisions about healthcare coverage will help save money on premiums and avoid costly out-of-pocket expenses.

So, what have you done and are you happy with it??? How difficult was it for you or was it an easy process??
The only thing that concerns me is if I DON'T sign up for part B at 65, and then have to pay more years later should I want to switch.
I may "Suspend" my FEHB and go with Medicare, and I can always go back to FEHB later if I want to. I just haven't decided yet. This is my Due Diligence.
I also found this person with a good YT Channel with some good decent info.

THANKS ! ! ! ! !

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[tsptalk]

Good questions! I'd like to know as well. I have my head in the sand on this stuff but 65 keeps getting closer.

 

[mcash]

Epic, I think you have all the facts here as I understand them. One thing not mentioned is if you are still working. If still working you can delay enrolling in Part B. If retired you need to enroll at 65 or you pay a penalty if you choose to enroll later. As for me, I crossed that threshold this past March and enrolled in both Parts A and B. I continue with FEHB but did go with a Basic plan. The headache is Part B is costing me $185 /mo and not coming out of my Social Security check because I'm waiting till my full retirement age to file for SS. So, a little pressure on the household budget but considering all the $'s we're making in the TSP it's not really an issue.

 

[nasa1974]

There was a thread on this, but it was a few years ago.
I kept my FEHB. I also have Part A and Part B. You are correct on the penalty if you do not take Part B right away. It is 10% per year and that can get pretty expensive.
I have BCBS Basic for my FEHB coverage and the drug portion of that got changed over to Part D late last year, but I haven't seen any difference in cost for my meds.
The one nice thing about BCBS Basic is I can get reimbursed up to $800/year for my Part B cost. You have to fill out a form online and attach some documents. They just don't give it to you.

I will say one thing about my medical insurance coverage. When my wife was diagnosed with cancer, I paid zero for all of her treatments and doctor visits.

 

[tsptalk]

There was a thread on this, but it was a few years ago.

There have probably been a few threads buried. Here's one...

Thread 'Should Federal Retirees Take Medicare Part B?'

Jun 30, 2021

Found this interesting, has anyone decided not to get Part B when they are eligible?

https://www.myfederalretirement.com/federal-retirees-medicare-b/

Still a way's off for me, but I seem to recall someone mentioning that someone never enrolled in Part B, just using FEHB, on one of the forums, but I couldn't find it in here.

I know there is a penalty of 10% per year if you don't enroll when you are 1st eligible and the amount you pay is based on you income 2 years prior but I couldn't find anything specific on how that works in practice as they encourage everyone to sign up when...

• evilanne
• Replies: 15
• Forum: Retirement and IRA Talk

 

[Epic]

Thanks everyone !! This is all good info.
So just to clarify, I left federal service just about 3 years ago, so that simplifies things a bit. I did speak to someone at Kaiser, and she did mention that she could put me on a "Basic" plan, so that definitely ties in to what you guys are saying. I told her I needed to research things a bit and I would call her back once I get it all figured out and decide what to do.
Thanks again!!! Any info on this topic is greatly appreciated. It creeps up on you fast, so you need to be ready.

 

[rangerray]

You got that right. Time is flying by at lightning speed in my retirement (4 years into it), not to mention how fast I burned through the Navy and a career.


Sent from my iPhone using Tapatalk

 

[Epic]

A comment from the old thread Tom posted above.

 

[felixthecat]

Keep in mind there is a law in place for hospital Part A insurance when a provider participates in Medicare and accepts assignment, they are required to accept the Medicare-approved amount as payment in full for covered services. This means they cannot bill the patient for any amount beyond their deductible, coinsurance, or copayment, and they must submit claims directly to Medicare. On the downside, on the Part B medicare outpatient there is no law in place to protect when a provider bills for more than what medicare pays…therefore…you could be on the hook for out of pocket unexpected expense. If you have Part B…in most instances FEHB insurance will pay that out of pocket expense. If you don’t have part B, then FEHB on outpatient does not have to cover more than what medicare pays leaving you with the additional uncovered bill. This has been the thorn in my mind for awhile….still a few years away from this medicare Part B decision. I do plan on keeping FEHB insurance. I have heard of situations where not taking part b medicare has come back to bite some folks. My question is do you know of instance where part b was not chosen and FEHB/Medicare did not cover the full bill?

 

[evilanne]

I'm not planning on getting Part B when the time comes after dealing with my own & my Mother's prior issues.
If you have Tricare for Life you are required to sign up for Medicare Part B.
For 2025 the standard cost is $2220 per year (that is per person). If you hit IRMAA threshold it goes up even more....$106K for Single and $21K for MFJ. Waiting to see how it impacts my mother since we sold some stock in 2024 that put her over the current limit. If you are here and have a large traditional TSP balance, it is likely that you will be subject to IRMAA at some point if you take a large distribution or when you reach RMD age. Depending on your income 2 years prior to Medicare age, it my be more cost effective to delay MC for a coupe of years, even with the penalty, if you are subject to IRMAA.

Each plan has catastrophic protection - out-of-pocket maximum for deductibles, coinsurance, and copayments. My Plan ranges from $6.900 (single) to $13,800 (family) which may seem like a lot but if you have spouse under 65 or children you are still subject to those limits and I would assume with part B that would reduce your out of pocket expenses with the additional premium cost for Part B. These limits vary significantly between plans so you should look at the details of your plan. They may seem a little high but Part A (which is free) is the most expensive part as it covers hospitalization. Part B is you normal doctor visits, labs etc that shouldn't be too high the over all scheme, especially if you are generally healthy. It really boils down to a risk analysis and greater options with what doctors you can access. I'm willing to pay more for care that is effective and I really don't think I will ever get close to the out of pocket maximum.