I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

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Topic Author
Tdubs
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I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

Until recently, the conventional wisdom has been that for federal retirees using FEHB plans, taking Medicare part B might give you peace of mind by covering almost all copays and deductibles, but it wasn't the best financial choice. This was usually true even for some plans like BCBS that partially rebated the Part B premium--typically about $800/yr.

That doesn't seem to be true anymore. UnitedHealthcare recently started a Medicare Advantage Choice plan that Checkbook shows is flat out the least expensive comprehensive plan out there. It is new enough that I haven't seen much discussion of it on BH. For example, see this recent thread.

viewtopic.php?t=338887

I'm still working and a couple years out from Medicare, and I'm trying to estimate my potential medical expenses in retirement. This UH plan seems to moot all the old discussion about Part B and whether to suspend FEHB coverage to take a Medicare Advantage plan. If there is a hitch, I can't find it.

If you don't have access to Checkbook, here is an accessible brief summary.

https://fedretire.net/new-medicare-adva ... -retirees/

Here's my positive take on it: In a nutshell, there are no copays, deductibles, inpatient or outpatient fees for just about anything. Generic drugs are $7/mo, higher for more expensive brand names, but nothing that will break the bank. It's a PPO, but that doesn't seem to matter much. No referrals to specialists needed. As long as an out-of-network provider takes Medicare and is willing to bill UnitedHealthcare, that's $0 too. In practice, I don't know how often out-of-network practices are willing to do that. I'm in GEHA now and I'm pretty happy now with the UH provider network we have.

Premiums: UnitedHealthcare rebates almost the full price of Medicare Part B, $144.60/mo. per member. You have to enroll in one of several UnitedHealthcare FEHB plans. It is a national plan, and prices vary apparently by region. The one I'm looking at--Choice Plus Advanced--would be about $270/mo for a self plus 1 plan. So for $270/mo, my spouse and I would have hardly any OOP costs except the copays on prescriptions. I stay in FEHB, get peace of mind, and lowest cost.

In my case, there aren't complicating factors. I won't be close to IRMAA, and my spouse and I both turn Medicare age in the same month and year.

If you are in this plan, I'd like to hear about it. If you aren't, what questions would you ask before enrolling?

Here's a link to UH's fed plans.

https://www.uhcfeds.com
Last edited by Tdubs on Sun Apr 18, 2021 9:42 am, edited 1 time in total.
gtd98765
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by gtd98765 »

Doesn't this depend on financial and health circumstances though? Say a couple is in a high IRMAA bracket and would pay $10K or more per year for Medicare part B; is the couple really likely to accumulate $10K in co-pays that would be avoided by part B? Or is there a financial aspect that I am missing here?
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Tdubs
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

gtd98765 wrote: Sun Apr 18, 2021 9:22 am Doesn't this depend on financial and health circumstances though? Say a couple is in a high IRMAA bracket and would pay $10K or more per year for Medicare part B; is the couple really likely to accumulate $10K in co-pays that would be avoided by part B? Or is there a financial aspect that I am missing here?
Certainly higher IRMAA brackets would change the calculation. In my case, IRMAA is not a concern. But I did run the numbers in Checkbook. Even if you were in the second bracket ($176k to $222k), the UH plan with Medicare Part B still wins for a person with average expenses (as defined by Checkbook) over not taking Medicare.
MichDad
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by MichDad »

There are two main reason why I've opted out of Medicare Part B:

1. My wife and I have been making substantial Roth conversions since we retired in 2018 and those conversions would have bumped us into high IRMAA surcharge territory. We'll be making substantial Roth conversions for at least another six years. By the time I turn age 72, we'll have saved seven years' worth of Medicare Part B premiums. Because we have a Health Savings Account, I keep detailed records of our health care spending. The savings we would have achieved in co-pays, deductibles, and other expenses would have been very minor as compared to our savings in Medicare Part B premiums.

2. We live outside the USA for several months each year. Medicare does not cover health care expenses outside the USA. So, paying Medicare Part B premiums for those months would be, for us, a waste of money. Our FEHB plan covers our health care worldwide -- and at preferred provider rates.

MichDad
trueblueky
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by trueblueky »

You might look at Aetna, which is part of FEHB and has a plan designed to work with Medicare. There may be additional options by the time you retire, since OPM ended its only-two-plans-per-provider rule.
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Tdubs
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

MichDad wrote: Sun Apr 18, 2021 9:49 am There are two main reason why I've opted out of Medicare Part B:

1. My wife and I have been making substantial Roth conversions since we retired in 2018 and those conversions would have bumped us into high IRMAA surcharge territory. We'll be making substantial Roth conversions for at least another six years. By the time I turn age 72, we'll have saved seven years' worth of Medicare Part B premiums. Because we have a Health Savings Account, I keep detailed records of our health care spending. The savings we would have achieved in co-pays, deductibles, and other expenses would have been very minor as compared to our savings in Medicare Part B premiums.

2. We live outside the USA for several months each year. Medicare does not cover health care expenses outside the USA. So, paying Medicare Part B premiums for those months would be, for us, a waste of money. Our FEHB plan covers our health care worldwide -- and at preferred provider rates.

MichDad
Both good reasons for your case. But for those who may only do conversions for a few years, stay in the US, and are below $222k income, these new plans (Aetna has one too) seem to undermine the case for two common decisions made by federal employees in the past: (1) suspend or, worse, leave FEHB for outside plans, and (2) not take Part B. Both of those decisions are difficult or impossible to take back, and now, it seems, are also financially unwise.
Topic Author
Tdubs
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

trueblueky wrote: Sun Apr 18, 2021 10:23 am You might look at Aetna, which is part of FEHB and has a plan designed to work with Medicare. There may be additional options by the time you retire, since OPM ended its only-two-plans-per-provider rule.
I will. The Aetna plan is runner-up to UH according the Checkbook and worth a look.
Topic Author
Tdubs
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

Bump.
tj
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by tj »

Tdubs wrote: Sun Apr 18, 2021 10:33 am
trueblueky wrote: Sun Apr 18, 2021 10:23 am You might look at Aetna, which is part of FEHB and has a plan designed to work with Medicare. There may be additional options by the time you retire, since OPM ended its only-two-plans-per-provider rule.
I will. The Aetna plan is runner-up to UH according the Checkbook and worth a look.
Aetna has a FEHB Medicare Advantage Plan and Aetna Direct.

The big question is is if these FEHB Medicare Advantage plans have the pitfalls of regular Medicare Advantage Plans - which is more red tape with managaging your care unlike Aetna Direct where they just bill medicare and aetna direct pays the rest. There have been numerous boglehead threads of frustrations with Medicare Advantage - but also some who have good experiences.

The good news is that FEHB Medicare Advantage doesn't work out for someone's needs - they can just switch to a different FEHB plan at the next open season.

Also the Checbook is wrong, or at least, misleading. For Aetna Direct, it says No Part B rebate, but you get a $900 HRA that can be used towards Part B premiums (or any other medical expense).
Topic Author
Tdubs
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

tj wrote: Sun Apr 18, 2021 5:36 pm
Tdubs wrote: Sun Apr 18, 2021 10:33 am
trueblueky wrote: Sun Apr 18, 2021 10:23 am You might look at Aetna, which is part of FEHB and has a plan designed to work with Medicare. There may be additional options by the time you retire, since OPM ended its only-two-plans-per-provider rule.
I will. The Aetna plan is runner-up to UH according the Checkbook and worth a look.
Aetna has a FEHB Medicare Advantage Plan and Aetna Direct.

The big question is is if these FEHB Medicare Advantage plans have the pitfalls of regular Medicare Advantage Plans - which is more red tape with managaging your care unlike Aetna Direct where they just bill medicare and aetna direct pays the rest. There have been numerous boglehead threads of frustrations with Medicare Advantage - but also some who have good experiences.

The good news is that FEHB Medicare Advantage doesn't work out for someone's needs - they can just switch to a different FEHB plan at the next open season.

Also the Checbook is wrong, or at least, misleading. For Aetna Direct, it says No Part B rebate, but you get a $900 HRA that can be used towards Part B premiums (or any other medical expense).
When I run the numbers in Checkbook, it looks like they list that $900 for Aetna as a Part B rebate, not as a health savings account.

I suspect there must be some catch to the UH plan given its low cost, but since there is no requirement for referrals to specialists, I wonder what red tape would exist that I don't already deal with now in my current plan with GEHA. Can they use a different standard for "medically necessary" procedures than Medicare?
tj
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by tj »

Tdubs wrote: Sun Apr 18, 2021 6:27 pm
tj wrote: Sun Apr 18, 2021 5:36 pm
Tdubs wrote: Sun Apr 18, 2021 10:33 am
trueblueky wrote: Sun Apr 18, 2021 10:23 am You might look at Aetna, which is part of FEHB and has a plan designed to work with Medicare. There may be additional options by the time you retire, since OPM ended its only-two-plans-per-provider rule.
I will. The Aetna plan is runner-up to UH according the Checkbook and worth a look.
Aetna has a FEHB Medicare Advantage Plan and Aetna Direct.

The big question is is if these FEHB Medicare Advantage plans have the pitfalls of regular Medicare Advantage Plans - which is more red tape with managaging your care unlike Aetna Direct where they just bill medicare and aetna direct pays the rest. There have been numerous boglehead threads of frustrations with Medicare Advantage - but also some who have good experiences.

The good news is that FEHB Medicare Advantage doesn't work out for someone's needs - they can just switch to a different FEHB plan at the next open season.

Also the Checbook is wrong, or at least, misleading. For Aetna Direct, it says No Part B rebate, but you get a $900 HRA that can be used towards Part B premiums (or any other medical expense).
When I run the numbers in Checkbook, it looks like they list that $900 for Aetna as a Part B rebate, not as a health savings account.

I suspect there must be some catch to the UH plan given its low cost, but since there is no requirement for referrals to specialists, I wonder what red tape would exist that I don't already deal with now in my current plan with GEHA. Can they use a different standard for "medically necessary" procedures than Medicare?
I don't see why they couldn't.
ikowik
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by ikowik »

Just a general observation
United Health is notorious among healthcare providers for being "difficult", meaning lots of paper work, hoops to jump through and general obstructiveness.
Topic Author
Tdubs
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

tj wrote: Sun Apr 18, 2021 6:49 pm
Tdubs wrote: Sun Apr 18, 2021 6:27 pm
tj wrote: Sun Apr 18, 2021 5:36 pm
Tdubs wrote: Sun Apr 18, 2021 10:33 am
trueblueky wrote: Sun Apr 18, 2021 10:23 am You might look at Aetna, which is part of FEHB and has a plan designed to work with Medicare. There may be additional options by the time you retire, since OPM ended its only-two-plans-per-provider rule.
I will. The Aetna plan is runner-up to UH according the Checkbook and worth a look.
Aetna has a FEHB Medicare Advantage Plan and Aetna Direct.

The big question is is if these FEHB Medicare Advantage plans have the pitfalls of regular Medicare Advantage Plans - which is more red tape with managaging your care unlike Aetna Direct where they just bill medicare and aetna direct pays the rest. There have been numerous boglehead threads of frustrations with Medicare Advantage - but also some who have good experiences.

The good news is that FEHB Medicare Advantage doesn't work out for someone's needs - they can just switch to a different FEHB plan at the next open season.

Also the Checbook is wrong, or at least, misleading. For Aetna Direct, it says No Part B rebate, but you get a $900 HRA that can be used towards Part B premiums (or any other medical expense).
When I run the numbers in Checkbook, it looks like they list that $900 for Aetna as a Part B rebate, not as a health savings account.

I suspect there must be some catch to the UH plan given its low cost, but since there is no requirement for referrals to specialists, I wonder what red tape would exist that I don't already deal with now in my current plan with GEHA. Can they use a different standard for "medically necessary" procedures than Medicare?
I don't see why they couldn't.
Well, the brochure says "You pay nothing for Medicare-covered service from any provider." So the standard seems to be what Medicare will cover, not UH.
tj
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by tj »

Tdubs wrote: Sun Apr 18, 2021 7:15 pm
tj wrote: Sun Apr 18, 2021 6:49 pm
Tdubs wrote: Sun Apr 18, 2021 6:27 pm
tj wrote: Sun Apr 18, 2021 5:36 pm
Tdubs wrote: Sun Apr 18, 2021 10:33 am

I will. The Aetna plan is runner-up to UH according the Checkbook and worth a look.
Aetna has a FEHB Medicare Advantage Plan and Aetna Direct.

The big question is is if these FEHB Medicare Advantage plans have the pitfalls of regular Medicare Advantage Plans - which is more red tape with managaging your care unlike Aetna Direct where they just bill medicare and aetna direct pays the rest. There have been numerous boglehead threads of frustrations with Medicare Advantage - but also some who have good experiences.

The good news is that FEHB Medicare Advantage doesn't work out for someone's needs - they can just switch to a different FEHB plan at the next open season.

Also the Checbook is wrong, or at least, misleading. For Aetna Direct, it says No Part B rebate, but you get a $900 HRA that can be used towards Part B premiums (or any other medical expense).
When I run the numbers in Checkbook, it looks like they list that $900 for Aetna as a Part B rebate, not as a health savings account.

I suspect there must be some catch to the UH plan given its low cost, but since there is no requirement for referrals to specialists, I wonder what red tape would exist that I don't already deal with now in my current plan with GEHA. Can they use a different standard for "medically necessary" procedures than Medicare?
I don't see why they couldn't.
Well, the brochure says "You pay nothing for Medicare-covered service from any provider." So the standard seems to be what Medicare will cover, not UH.
That doesn't mean that you won't have frustrations with getting procedures scheduled. I won't be medicare eligible for 30 years so it doesn't really affect me. Who knows what it will looks like when I'm eligible or if I even last that long in the government.
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Nestegg_User
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Nestegg_User »

ikowik wrote: Sun Apr 18, 2021 6:56 pm Just a general observation
United Health is notorious among healthcare providers for being "difficult", meaning lots of paper work, hoops to jump through and general obstructiveness.
I'll "+1000" to that

I had serious problems getting them to pay for something (dr provided significant documentation... they still didn't pay). They left the area the next year!!! I WON'T ever use them again...been with BC/BS (still considered by many providers as the standard...if it's not acceptable then they might not take anything)
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Tdubs
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

Nestegg_User wrote: Mon Apr 19, 2021 2:09 am
ikowik wrote: Sun Apr 18, 2021 6:56 pm Just a general observation
United Health is notorious among healthcare providers for being "difficult", meaning lots of paper work, hoops to jump through and general obstructiveness.
I'll "+1000" to that

I had serious problems getting them to pay for something (dr provided significant documentation... they still didn't pay). They left the area the next year!!! I WON'T ever use them again...been with BC/BS (still considered by many providers as the standard...if it's not acceptable then they might not take anything)
Was this an experience you had with a UH Medicare Advantage plan?
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Nestegg_User
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Nestegg_User »

Tdubs wrote: Mon Apr 19, 2021 10:54 am
Nestegg_User wrote: Mon Apr 19, 2021 2:09 am
ikowik wrote: Sun Apr 18, 2021 6:56 pm Just a general observation
United Health is notorious among healthcare providers for being "difficult", meaning lots of paper work, hoops to jump through and general obstructiveness.
I'll "+1000" to that

I had serious problems getting them to pay for something (dr provided significant documentation... they still didn't pay). They left the area the next year!!! I WON'T ever use them again...been with BC/BS (still considered by many providers as the standard...if it's not acceptable then they might not take anything)
Was this an experience you had with a UH Medicare Advantage plan?
No... it was a regular health insurance plan...
but I've never had the same problem with other plans (and consider that it is corporate policy, and the dr apparently had similar experiences with other patients; I sort of look at it as "if I would have had the same experience with property insurance), that company would have been the one with customers waiting for months for relief whereas other companies have already supplied their customers with funds for bringing their property back to habitable status... which would I rather have ( "do you feel lucky")...I'd rather have a better company as it seems to be in their culture (for insuring profits over customers)
Topic Author
Tdubs
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

Nestegg_User wrote: Mon Apr 19, 2021 9:18 pm
Tdubs wrote: Mon Apr 19, 2021 10:54 am
Nestegg_User wrote: Mon Apr 19, 2021 2:09 am
ikowik wrote: Sun Apr 18, 2021 6:56 pm Just a general observation
United Health is notorious among healthcare providers for being "difficult", meaning lots of paper work, hoops to jump through and general obstructiveness.
I'll "+1000" to that

I had serious problems getting them to pay for something (dr provided significant documentation... they still didn't pay). They left the area the next year!!! I WON'T ever use them again...been with BC/BS (still considered by many providers as the standard...if it's not acceptable then they might not take anything)
Was this an experience you had with a UH Medicare Advantage plan?
No... it was a regular health insurance plan...
but I've never had the same problem with other plans (and consider that it is corporate policy, and the dr apparently had similar experiences with other patients; I sort of look at it as "if I would have had the same experience with property insurance), that company would have been the one with customers waiting for months for relief whereas other companies have already supplied their customers with funds for bringing their property back to habitable status... which would I rather have ( "do you feel lucky")...I'd rather have a better company as it seems to be in their culture (for insuring profits over customers)
My only data point is my FIL. He had a UH medigap plan and was very happy with it. So, I'm interested in the experience of others, like yours. Fortunately, federal retirees can switch out of plans they hate every year.
tj
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by tj »

Tdubs wrote: Mon Apr 19, 2021 10:48 pm
Nestegg_User wrote: Mon Apr 19, 2021 9:18 pm
Tdubs wrote: Mon Apr 19, 2021 10:54 am
Nestegg_User wrote: Mon Apr 19, 2021 2:09 am
ikowik wrote: Sun Apr 18, 2021 6:56 pm Just a general observation
United Health is notorious among healthcare providers for being "difficult", meaning lots of paper work, hoops to jump through and general obstructiveness.
I'll "+1000" to that

I had serious problems getting them to pay for something (dr provided significant documentation... they still didn't pay). They left the area the next year!!! I WON'T ever use them again...been with BC/BS (still considered by many providers as the standard...if it's not acceptable then they might not take anything)
Was this an experience you had with a UH Medicare Advantage plan?
No... it was a regular health insurance plan...
but I've never had the same problem with other plans (and consider that it is corporate policy, and the dr apparently had similar experiences with other patients; I sort of look at it as "if I would have had the same experience with property insurance), that company would have been the one with customers waiting for months for relief whereas other companies have already supplied their customers with funds for bringing their property back to habitable status... which would I rather have ( "do you feel lucky")...I'd rather have a better company as it seems to be in their culture (for insuring profits over customers)
My only data point is my FIL. He had a UH medigap plan and was very happy with it. So, I'm interested in the experience of others, like yours. Fortunately, federal retirees can switch out of plans they hate every year.
Well, medigap is irrelevant in this case, they just pay what's leftover after Medicare pays. Where the UHCFeds Medicare Advantage gets confusing is that UHC somehow replaces Medicare, or it would not be branded that way.

You would be missing out on a normal FEHB being "secondary" which might cover things that Medicare doesn't cover, like physicals.
Topic Author
Tdubs
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Joined: Tue Apr 24, 2018 7:50 pm

Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

tj wrote: Mon Apr 19, 2021 11:11 pm
Tdubs wrote: Mon Apr 19, 2021 10:48 pm
Nestegg_User wrote: Mon Apr 19, 2021 9:18 pm
Tdubs wrote: Mon Apr 19, 2021 10:54 am
Nestegg_User wrote: Mon Apr 19, 2021 2:09 am

I'll "+1000" to that

I had serious problems getting them to pay for something (dr provided significant documentation... they still didn't pay). They left the area the next year!!! I WON'T ever use them again...been with BC/BS (still considered by many providers as the standard...if it's not acceptable then they might not take anything)
Was this an experience you had with a UH Medicare Advantage plan?
No... it was a regular health insurance plan...
but I've never had the same problem with other plans (and consider that it is corporate policy, and the dr apparently had similar experiences with other patients; I sort of look at it as "if I would have had the same experience with property insurance), that company would have been the one with customers waiting for months for relief whereas other companies have already supplied their customers with funds for bringing their property back to habitable status... which would I rather have ( "do you feel lucky")...I'd rather have a better company as it seems to be in their culture (for insuring profits over customers)
My only data point is my FIL. He had a UH medigap plan and was very happy with it. So, I'm interested in the experience of others, like yours. Fortunately, federal retirees can switch out of plans they hate every year.
Well, medigap is irrelevant in this case, they just pay what's leftover after Medicare pays. Where the UHCFeds Medicare Advantage gets confusing is that UHC somehow replaces Medicare, or it would not be branded that way.

You would be missing out on a normal FEHB being "secondary" which might cover things that Medicare doesn't cover, like physicals.
Annual physicals are covered in this plan. As I noted in my OP, the problem I have is that I can't find a hangup to this plan. UH can't refuse payment when I visit a primary care physician or specialist in or out of network as long as they take Medicare. I realize some people have had a poor experience with UH in their standard plans or with many other Advantage plans that nickel and dime you on copays and other fees, but how would that happen to me in a plan that has no deductible and covers completely all copays and other costs from office & ER visits, tests, and procedures?
tj
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Joined: Wed Dec 23, 2009 11:10 pm

Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by tj »

Tdubs wrote: Tue Apr 20, 2021 7:45 am
tj wrote: Mon Apr 19, 2021 11:11 pm
Tdubs wrote: Mon Apr 19, 2021 10:48 pm
Nestegg_User wrote: Mon Apr 19, 2021 9:18 pm
Tdubs wrote: Mon Apr 19, 2021 10:54 am

Was this an experience you had with a UH Medicare Advantage plan?
No... it was a regular health insurance plan...
but I've never had the same problem with other plans (and consider that it is corporate policy, and the dr apparently had similar experiences with other patients; I sort of look at it as "if I would have had the same experience with property insurance), that company would have been the one with customers waiting for months for relief whereas other companies have already supplied their customers with funds for bringing their property back to habitable status... which would I rather have ( "do you feel lucky")...I'd rather have a better company as it seems to be in their culture (for insuring profits over customers)
My only data point is my FIL. He had a UH medigap plan and was very happy with it. So, I'm interested in the experience of others, like yours. Fortunately, federal retirees can switch out of plans they hate every year.
Well, medigap is irrelevant in this case, they just pay what's leftover after Medicare pays. Where the UHCFeds Medicare Advantage gets confusing is that UHC somehow replaces Medicare, or it would not be branded that way.

You would be missing out on a normal FEHB being "secondary" which might cover things that Medicare doesn't cover, like physicals.
Annual physicals are covered in this plan. As I noted in my OP, the problem I have is that I can't find a hangup to this plan. UH can't refuse payment when I visit a primary care physician or specialist in or out of network as long as they take Medicare. I realize some people have had a poor experience with UH in their standard plans or with many other Advantage plans that nickel and dime you on copays and other fees, but how would that happen to me in a plan that has no deductible and covers completely all copays and other costs from office & ER visits, tests, and procedures?
If you're willing to be the guinea pig, that's great! I believe this year is the first year that this plan has existed. There's probably not much data about people who have used this plan.
Topic Author
Tdubs
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Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

tj wrote: Tue Apr 20, 2021 8:40 am
Tdubs wrote: Tue Apr 20, 2021 7:45 am
tj wrote: Mon Apr 19, 2021 11:11 pm
Tdubs wrote: Mon Apr 19, 2021 10:48 pm
Nestegg_User wrote: Mon Apr 19, 2021 9:18 pm

No... it was a regular health insurance plan...
but I've never had the same problem with other plans (and consider that it is corporate policy, and the dr apparently had similar experiences with other patients; I sort of look at it as "if I would have had the same experience with property insurance), that company would have been the one with customers waiting for months for relief whereas other companies have already supplied their customers with funds for bringing their property back to habitable status... which would I rather have ( "do you feel lucky")...I'd rather have a better company as it seems to be in their culture (for insuring profits over customers)
My only data point is my FIL. He had a UH medigap plan and was very happy with it. So, I'm interested in the experience of others, like yours. Fortunately, federal retirees can switch out of plans they hate every year.
Well, medigap is irrelevant in this case, they just pay what's leftover after Medicare pays. Where the UHCFeds Medicare Advantage gets confusing is that UHC somehow replaces Medicare, or it would not be branded that way.

You would be missing out on a normal FEHB being "secondary" which might cover things that Medicare doesn't cover, like physicals.
Annual physicals are covered in this plan. As I noted in my OP, the problem I have is that I can't find a hangup to this plan. UH can't refuse payment when I visit a primary care physician or specialist in or out of network as long as they take Medicare. I realize some people have had a poor experience with UH in their standard plans or with many other Advantage plans that nickel and dime you on copays and other fees, but how would that happen to me in a plan that has no deductible and covers completely all copays and other costs from office & ER visits, tests, and procedures?
If you're willing to be the guinea pig, that's great! I believe this year is the first year that this plan has existed. There's probably not much data about people who have used this plan.
Still a couple years away from Medicare. I hope to learn from the experience of others when the time comes, but right now I'm just left to wonder how this plan isn't sweeping away the competition.
delamer
Posts: 17458
Joined: Tue Feb 08, 2011 5:13 pm

Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by delamer »

Based on the information in the links (in the original post), it looks like the Part B premium reimbursement is for only one person.

So if a couple is getting coverage, they’d still be on the hook for one Part B premium with the UH retiree plan. Can anyone confirm this?

I’m two years into Medicare eligibility, and have GEHA standard option without Part B. So far so good. But we would be subject to the higher premium under IRMAA, which was definitely a factor in deciding against Part B.

Also, remember that you can enroll in Part B at any open season — albeit at a higher premium if you don’t enroll at 65. Checkbook did an analysis:

If you do decide to drop (or not start) Part B you can join it later. But there is a 10 percent a year penalty if you later decide to join or rejoin. As a financial matter, however many years you elect to do without Part B, you will be money ahead for approximately the first five or six years after joining or rejoining (those who start out paying the higher income-tested premium well be much more money ahead). After that, the penalty will outweigh your earlier savings (except for those who were once above, but now fall below, the income-tested premium). If you never join or rejoin, you will (on average) save annually roughly the amounts indicated in our Guide showing costs with and without Parts B—generally about half the cost of the Part B premium, though this varies somewhat from plan to plan. Thus, either not joining or dropping Part B is not an irrevocable decision, and later rejoining Part B need not be highly costly.

Link at: https://www.checkbook.org/newhig2/year2 ... ter-age-65
One thing that humbles me deeply is to see that human genius has its limits while human stupidity does not. - Alexandre Dumas, fils
Topic Author
Tdubs
Posts: 1832
Joined: Tue Apr 24, 2018 7:50 pm

Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by Tdubs »

delamer wrote: Tue Apr 20, 2021 9:30 am Based on the information in the links (in the original post), it looks like the Part B premium reimbursement is for only one person.

So if a couple is getting coverage, they’d still be on the hook for one Part B premium with the UH retiree plan. Can anyone confirm this?

I’m two years into Medicare eligibility, and have GEHA standard option without Part B. So far so good. But we would be subject to the higher premium under IRMAA, which was definitely a factor in deciding against Part B.

Also, remember that you can enroll in Part B at any open season — albeit at a higher premium if you don’t enroll at 65. Checkbook did an analysis:

If you do decide to drop (or not start) Part B you can join it later. But there is a 10 percent a year penalty if you later decide to join or rejoin. As a financial matter, however many years you elect to do without Part B, you will be money ahead for approximately the first five or six years after joining or rejoining (those who start out paying the higher income-tested premium well be much more money ahead). After that, the penalty will outweigh your earlier savings (except for those who were once above, but now fall below, the income-tested premium). If you never join or rejoin, you will (on average) save annually roughly the amounts indicated in our Guide showing costs with and without Parts B—generally about half the cost of the Part B premium, though this varies somewhat from plan to plan. Thus, either not joining or dropping Part B is not an irrevocable decision, and later rejoining Part B need not be highly costly.

Link at: https://www.checkbook.org/newhig2/year2 ... ter-age-65
I also wondered if the Part B reimbursement was just for one person, but according to Checkbook's cost comparison tool, premium reimbursement doubles if you have a spouse with Medicare Part B.
delamer
Posts: 17458
Joined: Tue Feb 08, 2011 5:13 pm

Re: I have FEHB. Do I need Medicare Part B? The New Answer is Yes!

Post by delamer »

Tdubs wrote: Tue Apr 20, 2021 10:55 am
delamer wrote: Tue Apr 20, 2021 9:30 am Based on the information in the links (in the original post), it looks like the Part B premium reimbursement is for only one person.

So if a couple is getting coverage, they’d still be on the hook for one Part B premium with the UH retiree plan. Can anyone confirm this?

I’m two years into Medicare eligibility, and have GEHA standard option without Part B. So far so good. But we would be subject to the higher premium under IRMAA, which was definitely a factor in deciding against Part B.

Also, remember that you can enroll in Part B at any open season — albeit at a higher premium if you don’t enroll at 65. Checkbook did an analysis:

If you do decide to drop (or not start) Part B you can join it later. But there is a 10 percent a year penalty if you later decide to join or rejoin. As a financial matter, however many years you elect to do without Part B, you will be money ahead for approximately the first five or six years after joining or rejoining (those who start out paying the higher income-tested premium well be much more money ahead). After that, the penalty will outweigh your earlier savings (except for those who were once above, but now fall below, the income-tested premium). If you never join or rejoin, you will (on average) save annually roughly the amounts indicated in our Guide showing costs with and without Parts B—generally about half the cost of the Part B premium, though this varies somewhat from plan to plan. Thus, either not joining or dropping Part B is not an irrevocable decision, and later rejoining Part B need not be highly costly.

Link at: https://www.checkbook.org/newhig2/year2 ... ter-age-65
I also wondered if the Part B reimbursement was just for one person, but according to Checkbook's cost comparison tool, premium reimbursement doubles if you have a spouse with Medicare Part B.
Thanks. I admit to being surprised at that.

Given that we are subject to IRMAA, I’m not sure if the new plan is our best option. But it is worth investigating at $270/month. We now pay $290/month for FEHB only.
One thing that humbles me deeply is to see that human genius has its limits while human stupidity does not. - Alexandre Dumas, fils
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