Question: I am turning 65 and have Federal Employees Health Benefits. I would like to know if I must enroll in Medicare A & B?

Answer: For those individuals who are currently carrying insurance from the Federal Employees Health Benefits (FEHB) I would ask are you still working?

If you are working with FEHB or your spouse is working and also covers you through FEHB you can delay your enrollment into Medicare. Although to clarify further, if you are collecting Social Security (SS) benefits you will automatically get Medicare Part A and cannot refuse that benefit. If you are covered through your current or your spouse’s current employment you can decline Medicare Part B, (because it is a large employer group plan).

In the situation where you are retired and don’t have insurance coverage through your or your spouse’s current employment you are required to sign up for Medicare Part B. Medicare Part B has a monthly premium of $170.10. Individuals tell me they don’t want to pay that much because they don’t access healthcare often. I understand the logic, but with Medicare insurance, you must enroll when you are eligible.

If you are retired and using FEHB for your insurance coverage, you must sign up for Medicare A & B because your FEHB insurance will become secondary. You will re-evaluate your FEHB coverage and make an adjustment to that plan. In the situation where you have Medicare A & B, you may want to choose an FEHB plan that covers all the co-pays left after Medicare pays. The FEHB plan doesn’t lower the premium because you have Medicare, but I strongly recommend enrolling in Medicare.

As you review FEHB plans available to you, you may use the www.OPM.gov website. This website has useful information related to Medicare and FEHB coverage. There are a couple of documents; one is the FastFacts brochure about FEHB and Medicare, the second is a larger FEHB and Medicare Booklet. These documents are useful resources to review your Medicare coverage options and FEHB.

The www.OPM.gov website includes a useful tool called “Compare Plans”. This tool allows you to compare up to three plans at a time side by side. Using the comparison function you want to review specifically how the plan works when Medicare A & B are Primary. There are many plans available in the FEHB system that waive deductibles, and copays for hospital and medical care. There are also some FEHB plans that pay your back part of your Medicare Part B premium.

As with any insurance choice, make sure your providers will accept the FEHB plan you chose for your secondary coverage. Double check the FEHB plan you chose will cover the medications you take.

Another option available, once you are enrolled in Medicare A & B, you could suspend your FEHB benefits. You could then choose a product to add to your Medicare benefit from the many plans available in Chautauqua and Cattaraugus Counties (more than 70 plans). When and if you ever decided to go back to your FEHB you would do so during the FEHB enrollment Period (November) and then make a choice from the many FEHB insurance plans available at that time.

Individuals who declined Medicare Part B because they were eligible for FEHB retiree benefits may end up paying a Medicare Part B premium penalty of 10% per year for each year they didn’t enroll. This can quickly amount to a significant increase in monthly premiums for the rest of your life. You also would have restrictions on when you could join during the year and a delay in the start of your benefits.

I strongly encourage you to join Medicare Part A & B. I suggest you use this Medicare enrollment as an opportunity to switch to a FEHB plan that would work better for you now that you have Medicare.

If you are in this situation because you declined Medicare Part B in the past, the General Enrollment Period (GEP) is now January 1 to March 31 to enroll in Medicare Part B. You have an opportunity now to correct this situation.

Senior Life Matters is a community based program sponsored by Lutheran Jamestown. For questions, concerns or to reach Janell Sluga, GCMC, call 716-720-9797 or email SLM@lutheran-jamestown.org.