I Want to Join a Medicare Advantage Plan. Should I Drop FEHB?

Understanding the Plans

The Federal Employees Health Benefit Plan (FEHBP) is a medical plan provided to federal retirees. The plan provides retirees with health benefits that include prescription drug coverage, hospitalization and basic medical services. All FEHB plans provide coverage that is equivalent to or better than those services 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.

Medicare Advantage Plan is a health plan that is available to individuals over age 65 or if you meet other specific eligibility requirements. The original Medicare programs consists of four components; hospital care, routine medical coverage such as doctors services or testing, Medicare advantage which consists of a breakdown of plans that you can choose to meet your specific medical needs and the fourth component is the Medicare prescription drug coverage.

The Differences in the Plans

Typically Medicare and FEHB programs cover the same basic expenses; however there are a few differences.
Typically FEHBP provides coverage beyond what Medicare provides such as coverage outside of the United States, and extensive dental and vision care. FEHB plans may only partially cover some of the specialized medical needs such as medical supplies or home health care.

The Medicare Advantage Plan offers five different types of health plan options. Individuals who are eligible can choose from one of the five different plans that will best fit their health care needs. Medicare does cover some additional expenses that FEHB may not cover completely such as orthopedic devices or durable medical equipment but may also have steeper co-pays.

What is the Best Coverage?

Many people find that carrying both the Medicare Advantage Plan and FEHB has many benefits. Determining the best coverage does depend on your needs. Individuals can carry Medicare Advantage Plans and FEHB and coordinate the plans to maximize coverage and minimize costs. Enrolling in a Medicare Advantage plan will make Medicare your primary insurance coverage. Changing any plan must be done during an open enrollment period which can be coordinated with the plan administrator.

3 Responses to “I Want to Join a Medicare Advantage Plan. Should I Drop FEHB?”

  1. Lonnie says:

    Would my FEHB premiums reduce if I added Medicare Advantage?

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  3. FEHB monthly premiums are not reduced if and when you enroll in Medicare, whether you remain in original Medicare (Parts A and B) or choose the a Medicare Advantage option. However, you can, if you so desire, elect to “suspend” your FEHB coverage to enroll in a Medicare Advantage plan. By “suspending” your FEHB coverage through the US Office of Personnel Management (OPM), you retain the ability to re-enroll back into the FEHB program during a subsequent federal benefits open season.