Feds with Benefits: An introduction, and advice about Medicare Part B

Hi! My name is Kevin Moss. I’m a senior editor with Consumers’ Checkbook, a nonprofit that publishes the Guide to Health Plans for Federal Employees. Today, I’m excited to launch a new resource for Federal News Network readers, the Feds with Benefits column, where I’ll contribute my latest FEHB advice.

Since 1979, the Guide has helped both active and retired federal employees find the FEHB plan that works best for them and their families. I’ve helped produce the Guide during my entire 26 years at Checkbook, beginning with copy editing and website testing to my current role, where I lead a dedicated team committed to delivering the most comprehensive FEHB information to the federal community. Over the past few years, we’ve helped employees and annuitants better understand new FEHB policy changes and enrollment options.

Take Medicare Advantage (MA) plans for example. When some FEHB carriers began offering MA plans more than four years ago, we had to determine whether they would be an attractive option for federal annuitants. We extracted data from brochures and reached out directly to FEHB carriers for additional information needed to model these options in the same way we model FEHB plans. This allows us to provide yearly cost estimates that show federal annuitants how certain MA plans can save them thousands of dollars compared to their current FEHB plan.

Or take OPM’s push for increased fertility benefits from FEHB plans. Each year, we now extract these benefits from the FEHB plan brochures so our users can see things like how IVF coverage compares for each plan.

With our decades of experience to draw from, future Feds with Benefits columns will contain important advice on how federal employees can save money on their healthcare costs, how federal annuitants should approach both Medicare Part B and Part D enrollment decisions, in-depth information on what’s new and important for the current Open Season, and more.

To make this column more engaging and focused on your needs, we encourage Federal News Network readers to submit their FEHB questions using this form. We’ll use reader questions to guide future Feds with Benefits columns on topics that are important to you.

For a sneak peek at the type of advice you’ll see in future Feds with Benefits columns, let’s look at the following reader question I recently received.

Question: My spouse and I are looking at an annual Part B IRMAA surcharge of over $6000. Trying to decide whether opting into Part B is a good move.

Answer: I would advise against enrolling in Medicare Part B when your income places you into such a high Income Related Monthly Adjustment Amount (IRMAA) tier.  

To recap: What you pay for Medicare Part B is determined by your income. Medicare beneficiaries who file individual tax returns with modified adjusted gross income less than or equal to $103,000/year, or joint tax filers with income less than or equal to $206,000/year, pay just the Part B premium of $174.70/month. If your income is above those thresholds, you’re subject to IRMAA. In the first income tier, you’ll pay the Part B premium plus an additional $69.90/month for Part B coverage.

For you and your spouse, dollar for dollar, you’ll never receive Part B benefits that match what you’re paying in IRMAA. The only question is whether you expect to be at this high IRMAA level throughout retirement.

For many FEHB plans, having Medicare Part B eliminates out-of-pocket costs for things like doctor visits, outpatient hospital and deductible (if your plan has one). It also might provide greater access to doctors. With Part B, you can go outside of your plan network and see any doctor that accepts Medicare.

Finally, having Part B gives you access to Medicare Advantage plans, which are the least expensive for many federal annuitants. Without Part B, you’ll have to pay the regular member cost share from your FEHB plan for those services, and you’ll be limited to in-network providers. However, for those subject to a high IRMAA surcharge, the cost savings of not enrolling in Medicare Part B will more than offset the out-of-pocket costs for Part B services.

That’s it for now. I’m excited to share our advice with you in future columns. I encourage you to send in any FEHB questions you have, and I look forward to answering them with actionable advice that might help save you money or help you better understand a confusing aspect of how FEHB works.

Kevin Moss is a senior editor with Consumers’ Checkbook. Watch more of his free advice and check if the Guide to Health Plans for Federal Employees is available for free from your agency. You can also purchase the Guide and save 20% with promo code FEDNEWS.

Copyright © 2024 Federal News Network. All rights reserved. This website is not intended for users located within the European Economic Area.