FEHB Plans with Medicare Reimbursement Explained

If you're a federal employee or retiree, you're likely familiar with FEHB plans, which offer comprehensive health insurance coverage. FEHB plans with Medicare reimbursement are a specific type of plan that can help you save money on healthcare costs.

These plans allow you to combine your FEHB coverage with Medicare, which can help you pay less out-of-pocket for certain medical expenses. Medicare reimbursement can be a big help, especially if you're already paying for Medicare Part B.

As a federal employee or retiree, you'll want to choose a plan that works well with Medicare, so you can make the most of your benefits. To do this, you'll need to consider the plan's Medicare reimbursement rules and how they might affect your healthcare costs.

The FEHB program is a health insurance plan available to federal employees, including active, retired, and former employees, as well as their spouses.

It includes coverage for inpatient and outpatient services, similar to Medicare.

You can enroll in both Medicare and FEHB at the same time, and enrolling in Medicare won't cause you to lose your FEHB plan.

Here are your options:

Federal employees have access to the Federal Employees Health Benefits (FEHB) program, which offers a range of plans for workers, their spouses, and dependents up to age 26.

Most people enrolled in the FEHB pay about 30% of their premium, while their employer pays 70%. You can choose from various plan options, including consumer-driven plans, high-deductible plans, and Health Savings and Reimbursement Accounts.

The FEHB program covers routine physician appointments, lab testing, specialist visits, prescription medications, inpatient care, surgery, and maternity services. You can search available plans by zip code to find the right fit for your healthcare needs.

You can keep your FEHB plan and forego Medicare coverage, or you can enroll in Medicare Part A or both Medicare Part A and Part B while keeping your FEHB plan.

As a federal employee, you're part of a special group that has its own health benefits program called FEHB. This program offers a wide range of plans for you, your spouse, and your children up to age 26.

Most people enrolled in FEHB pay about 30% of their premium, while their employer pays 70%. This can be a great deal, especially if you're not yet eligible for Medicare.

You can choose from various plan options, including consumer-driven plans, high-deductible plans, and health savings and reimbursement accounts. These plans can help you save money on out-of-pocket costs.

Here are some examples of the types of plans you can choose from:

You can also choose to keep your FEHB plan and enroll in Medicare Part A, Medicare Part B, or both. This is a great option if you want to have extra coverage and minimize your out-of-pocket costs.

TRICARE is a health insurance program designed for military personnel, their families, and retirees. It's a comprehensive plan that covers a wide range of medical services, including doctor visits, hospital stays, and prescriptions.

Beneficiaries eligible for both TRICARE and Medicare should understand how the two programs work together. TRICARE is the primary health insurance for military personnel and their families, while Medicare is a separate program for seniors and those with disabilities.

TRICARE has different plans, including Prime, Extra, Standard, and Plus, each with varying levels of coverage and costs. The plan you choose depends on your location, income, and other factors.

If you're enrolled in a FEHB plan and also have Medicare, you can use your FEHB plan alongside Medicare to round out your coverage.

Some FEHB plans may not cover certain services, like home health care, and if that's the case, Medicare Part A would cover eligible services.

You can search for available FEHB plans by zip code to find the right fit for your healthcare needs.

There are various plan options, including Consumer-driven plans, High-deductible plans, and Health Maintenance Organization (HMO) plans.

Routine physician appointments, lab testing, and specialist visits are typically covered by FEHB plans.

If you're eligible for premium-free Medicare Part A, it's generally recommended that you enroll in the coverage, even if you're still working and have a FEHB plan.

Medicare Part A will pay secondary to your FEHB plan and may help cover some of the costs that your FEHB plan doesn’t cover.

Here are some common benefits and reimbursement scenarios to consider:

If you're unsure whether to enroll in Medicare Part B, consider calculating what you'd pay in Medicare Part B premiums for the year and compare it to your copays on FEHB in an average year.

If you have Medicare and are retired, you may consider a FEHB plan with lower costs.

You can change your plan annually during the Open Season, which takes place from November 15th to December 31st.

Some FEHB plans provide coverage for services Medicare doesn’t cover, such as dental.

This can be a valuable option if you need additional coverage beyond what Medicare offers.

Some FEHB plans waive deductibles, copayments, and coinsurance when Medicare is your primary payer.

This can help reduce your out-of-pocket expenses and make your healthcare more affordable.

FEHB plans offer a range of options to suit different healthcare needs, including consumer-driven plans, high-deductible plans, and health savings and reimbursement accounts.

There are several types of plans to choose from, including Consumer-driven plans, High-deductible plans, Health savings and reimbursement accounts, Lower premium plans, Fee-For-Service (FFS) plans, Preferred Provider Organization (PPO) plans, and Health Maintenance Organization (HMO) plans.

Routine physician appointments, lab testing, specialist visits, prescription medications, inpatient care, surgery, and maternity services are all covered under FEHB plans.

You can search available plans by zip code to find the right fit for your healthcare needs.

Here are some key features of FEHB plans:

FEHB plans can be expensive, but they often provide better benefits than Medicare alone, including a solid ceiling on maximum out-of-pocket costs and coverage for services Medicare doesn't cover, such as dental.

As a federal worker, you're likely aware that you'll have access to a benefits package when you retire that covers much of the same costs as Medicare.

You can still get Medicare, even if you use the federal retiree benefits package. This is important to know, as it means you have options for your healthcare coverage.

Federal retirees who qualify for premium-free Medicare Part A can use the program to offset the costs of their federal plan. This can help lower your healthcare expenses in retirement.

You can be enrolled in both the federal workers health insurance program and Medicare at the same time. This flexibility is a valuable benefit for federal workers.