Since I Have FEHB Coverage, Do I Need Medicare Coverage?





A Brief Description of the FEHB

FEHB is the Federal Employees Health Benefit Plan which is provided to federal retirees. Coverage provided through FEHB plans are fairly inclusive and typically provide individuals with all or most of the coverage they need. The plan is an inclusive health plan that provides retirees with health benefits that include prescription drug coverage, hospitalization and basic medical services. FEHB plans provide coverage that is equivalent to or even better than the coverage provided by Medicare. FEHB provides all of the general services provided by Medicare however the specifics may vary slightly such as prescription coverage or hospitalization costs.

A Brief Description of Medicare

Medicare is a health insurance plan available to those at age 65 or if you meet certain other eligibility requirements such as a disability. Medicare coverage offers programs consist of Part A, Part B, Part C and Part D. Between these four Medicare coverage options most individuals are covered for most routine health needs including hospitalization and prescription medications.

The Benefits of Having Both Plans

Typically people who enroll in both plans can maximize their coverage options. The benefits that one plan does not provide are usually provided by the other plan. Technically if you have FEHB you do not need Medicare coverage however it is not a bad idea to carry both insurance plans. If you are enrolled in both FEHB and Medicare coverage you will have to determine which are the primary payer and the secondary payer, which will depend on your specific circumstances. The primary payer will determine some of the costs and coverage associated with your medical expenses. The nice thing about having both plans is that in the event that something unforeseen occurs such as the need for durable medical equipment or home health aid. When you have both plans if your primary insurance does not cover the cost, your secondary insurance would kick in. Keep in mind that co-pays and out of pocket costs may exist even with both plans.

Option One

While Medicare and FEHB programs do cover the same basic medical expenses, having both plans may decrease the costs of out-of pocket expenses. It is possible to keep FEHB coverage and enroll only in Part A, B, C or D rather than all of them. To determine which part will offer you the most savings and the best coverage you will have to take a look at your needs to determine the best options. Consider the health care options like a menu of choices and pick those that will work best together. FEHB offers good coverage but the premiums and out of pocket expenses may be higher without compensating your coverage with a Medicare plan.

Option Two

You can choose to keep your FEHB coverage until the time that you find you need additional or more cost-effective options then enroll in one or all of the available Medicare coverage plans. If you are recently retired there is no penalty for enrolling outside of the open enrollment period as long as you do so within eight months of your date of retirement. Otherwise any changes to the plans will need to be done within the open enrollment period.

Option Three

It is also an option for you to drop your FEHB coverage completely and enroll in a Medicare program that meets your needs without the hassle of having to deal with two forms of coverage. If you do so and later decide that you want to reenroll in FEHB this is a possibility that you can work with your plan administrator to coordinate. Determining the best medical coverage does depend on your needs. Should your needs change you should consider changing your coverage to minimize the out of pocket costs.



One Response to “Since I Have FEHB Coverage, Do I Need Medicare Coverage?”

  1. Dave says:

    Your description of option 3 is very dangerously misleading. If you drop your FEHB coverage completely, you can never get it back again. You can SUSPEND the FEHB plan if you want to enroll in Medicare Advantage, but you have to specifically state you’re suspending rather than canceling or dropping.