Do Most Federal Retirees Enroll in Medicare Part B?

Yes, approximately 70% of federal retirees choose to enroll in Medicare Part B. This means they are paying two premiums for two seemingly overlapping insurance programs. However, there are several reasons why this might be the case.

Advantages of Enrolling in Medicare Part B

• Coordination of benefits: When you have both Medicare and FEHB, Medicare acts as the primary payer for most services. This means that Medicare will pay first, and your FEHB plan will only pay for the remaining costs, if any. This can help to reduce your out-of-pocket expenses.
• Access to a wider network of providers: With Medicare, you can see any doctor or healthcare provider who accepts Medicare, regardless of whether they are in your FEHB plan’s network. This gives you more flexibility and choice when it comes to your healthcare.
• Coverage for some services not covered by FEHB: Medicare Part B covers some services that may not be covered or only partially covered by your FEHB plan, such as:
  • Outpatient mental health services
  • Durable medical equipment
  • Home health care
  • Certain preventive services
• Potential for lower out-of-pocket costs: Some FEHB plans waive their copayments, coinsurance, and deductibles for Part B services when Medicare is the primary payer. This can significantly reduce your out-of-pocket costs.

Disadvantages of Enrolling in Medicare Part B

• Cost: The monthly premium for Part B can be expensive, especially for higher-income beneficiaries.
• Late enrollment penalty: If you don’t enroll in Part B during your initial enrollment period, you will have to pay a late enrollment penalty for as long as you have Part B.
• Potential for duplicate coverage: Some services that are covered by Medicare Part B may also be covered by your FEHB plan. This can lead to duplicate coverage and increased costs.

Should You Enroll in Medicare Part B?

The decision of whether or not to enroll in Medicare Part B is a personal one. There are several factors to consider, including your health status, your FEHB plan coverage, and your financial situation.

If you are in good health and your FEHB plan has good coverage for the services you are likely to need, you may not need to enroll in Medicare Part B. However, if you have a chronic health condition or you are concerned about the cost of healthcare in the future, you may want to consider enrolling in Part B.

Here are some additional factors to consider:

• Your age: If you are under age 65, you are not eligible for Medicare Part B. However, you may be eligible for Medicare Part A if you have a disability or End-Stage Renal Disease.
• Your income: If you have a high income, you may have to pay a higher premium for Part B.
• Your FEHB plan: Some FEHB plans have very good coverage for the services that are covered by Medicare Part B. Others have more limited coverage.
• Your health status: If you have a chronic health condition, you may need more healthcare services than someone who is healthy. This could make Medicare Part B more valuable to you.
• Your financial situation: If you are concerned about the cost of healthcare, Medicare Part B can help to reduce your out-of-pocket expenses.

Ultimately, the decision of whether or not to enroll in Medicare Part B is up to you. You should weigh the pros and cons carefully and make the decision that is right for you.

Frequently Asked Questions about Medicare Part B

What is Medicare Part B?

Medicare Part B is the optional medical insurance part of Medicare. It covers a wide range of services, including:

• Doctor’s visits
• Outpatient hospital care
• Preventive services
• Durable medical equipment
• Home health care
• Mental health services

How much does Medicare Part B cost?

The monthly premium for Medicare Part B is determined by Medicare. The premium amount is available in the “Medicare & You” handbook produced by the U.S. Centers for Medicare and Medicaid (CMS) and is also available on the Medicare website at www.medicare.gov.

What happens if I don’t enroll in Medicare Part B as soon as I’m eligible?

If you do not enroll in Medicare Part B during your initial enrollment period, you must wait for the general enrollment period (January 1- March 31 of each year) to enroll, and Part B coverage will begin the following July 1 of that year. If you wait 12 months or more, after first becoming eligible, your Part B premium will go up 10 percent for each 12 months that you could have had Part B but didn’t take it. You will pay the extra 10 percent for as long as you have Part B.

Can I still enroll in Medicare Part B if I’m already retired?

Yes, you can still enroll in Medicare Part B if you’re already retired. You can enroll during the general enrollment period (January 1- March 31 of each year), or during a special enrollment period if you have certain qualifying events, such as losing your job or your group health insurance coverage.

What are the benefits of enrolling in Medicare Part B?

There are several benefits to enrolling in Medicare Part B, including:

• Coordination of benefits: When you have both Medicare and FEHB, Medicare acts as the primary payer for most services. This means that Medicare will pay first, and your FEHB plan will only pay for the remaining costs, if any. This can help to reduce your out-of-pocket expenses.
• Access to a wider network of providers: With Medicare, you can see any doctor or healthcare provider who accepts Medicare, regardless of whether they are in your FEHB plan’s network. This gives you more flexibility and choice when it comes to your healthcare.
• Coverage for some services not covered by FEHB: Medicare Part B covers some services that may not be covered or only partially covered by your FEHB plan, such as:
  • Outpatient mental health services
  • Durable medical equipment
  • Home health care
  • Certain preventive services
• Potential for lower out-of-pocket costs: Some FEHB plans waive their copayments, coinsurance, and deductibles for Part B services when Medicare is the primary payer. This can significantly reduce your out-of-pocket costs.

The decision of whether or not to enroll in Medicare Part B is a personal one. There are several factors to consider, including your health status, your FEHB plan coverage, and your financial situation. If you are unsure whether or not to enroll, you should talk to your doctor, a financial advisor, or a Medicare counselor.