Federal Employee Retirement Health Benefits (FEHB) and Medicare


If you are covered by Federal Employee Health Benefits and become eligible for Medicare, you probably have questions regarding which coverage to take or if you can have both. Below, we review all possible scenarios for those on FEHB and Medicare. Thus, ensuring you have a clear understanding of how the two coverage types work together.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

Medicare vs. FEHB Coverage

FEHB is the world’s largest employer-sponsored group health insurance program. This coverage is for federal workers and retirees, as well as their families and spouses. Like Medicare, FEHB includes coverage for inpatient and outpatient services. So retired, former, and active federal employees who are eligible for both programs – as well as those who are eligible for FEHB through their current or former spouse – often wonder if they can have both Medicare and FEHB at the same time.

The short answer is yes. You can have Medicare and FEHB coverage simultaneously. But do you need both? Well, it can be beneficial. We’ll discuss how and why – please also check out our video or podcast below.

Listen to this Podcast Episode Now! Listen to this Podcast Episode Now!

Do You Need Both Medicare and Federal Employee Health Benefits?

Although most people who are eligible for Medicare and FEHB won’t need a Medicare Supplement or Medicare Part D plan, the truth is that FEHB can be expensive. Thus, these beneficiaries often ask if there’s a way to coordinate their coverage that will also minimize their out-of-pocket costs. With Medicare, there are a few ways to do this.

How Does FEHB Work With Medicare?

For those on FEHB and enrolling in Medicare, it is important to know that Medicare will always pay secondary to FEHB while you or your spouse are still employed. Although the coverage may look similar, often you will find that Medicare offers more extensive coverage for things like durable medical equipment, home health care, and prosthetic devices – to name a few.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

FEHB With Medicare Part A

Those who have paid Medicare taxes for enough quarters are eligible to enroll in Medicare Part A, premium-free. Often, it is recommended that those who are eligible for premium-free Medicare Part A enroll in the coverage, even if they are still working. Although it will pay secondary to your FEHB, it is an earned benefit that you should take full advantage of.

FEHB With Medicare Part B

For Medicare’s Part B outpatient coverage, you’ll need to pay a monthly premium – no matter how many quarters you pay Medicare taxes. Additionally, you’ll still have to pay the FEHB premium. So, if you have FEHB, you can delay Medicare Part B for as long as you’re working and may save money by doing so.

When deciding whether to pick up Medicare Part B, calculate what you’d pay in Medicare Part B premiums for the year (higher-income earners are responsible for larger premiums). Then, calculate your best estimate for the dollar amount you’d need to pay in copayments for outpatient services on FEHB.

If you find that you would pay more in premiums, you’ll indeed save money by delaying Medicare Part B. Yet, those whose copays on FEHB in an average year outweigh their would-be Medicare Part B premiums should consider enrolling in Medicare Part B. Remember, once you enroll in Medicare Part A and Part B, Medicare will become your secondary coverage while FEHB acts as primary while you are still working.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

With this combination of coverage, you can see any practitioner who accepts Medicare and receive benefits through Medicare Part B that FEHB doesn’t provide.

FEHB With Medicare Part D

When you have FEHB, it is not necessary to enroll in Medicare Part D. Federal Employee Health Benefits covers prescription drugs at no additional cost, so having a Medicare Part D plan would not be beneficial.

Suspending FEHB for Medicare Plus Supplemental Coverage

If you have Original Medicare and FEHB but want coverage through a Medicare Advantage, you’ll need to suspend your FEHB coverage. Suspending FEHB is not the same as canceling. Meaning, you can re-enroll if you decide to suspend your FEHB. However, if you enroll in a Medicare Supplement plan, you will be required to cancel your FEHB. 

Advantage plans, also known as Medicare Part C, become your primary coverage. Medicare pays the private insurance company offering the policy to take on the beneficiary’s risk. Most of these plans include dental, vision, hearing, and prescription drug coverage.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

For as long as you suspend your FEHB, you won’t have the prescription drug coverage you used to receive.So, ensuring your Medicare Part C plan has drug benefits is crucial. If you choose to return to your FEHB plan, you can do so during Open Season.

If you choose a Medigap plan to go with your Medicare Part A and Part B coverage, you should also look for a Medicare Part D plan to cover prescription drugs, as a lack of creditable drug coverage will leave you vulnerable to a penalty.

FEHB Coverage After Retirement

It’s never mandatory to take Medicare – yet, there can be consequences to delaying enrollment. When you have FEHB, you’re safe from the Medicare Part B late enrollment penalty for as long as you or your spouse is actively working.

When you or your spouse retires, however, things get more complicated. Once you or your spouse stops working you will be granted a Special Enrollment Period. This will allow you 63 days from the time of the event to enroll in Medicare if you have delayed coverage. Otherwise, you’ll be subject to the late enrollment penalty whenever you enroll.

Find Medicare Plans in 3 Easy Steps

We can help find the right Medicare plans for you today

As long as you keep FEHB, whether or not you’re working, your prescription drug coverage is sufficient, and you’ll avoid the late enrollment penalty for Medicare Part D.

Mail Handlers Insurance and Medicare

The Mail Handlers Benefit Plan (MHBP) has been serving federal and postal employees for over 50 years. Aetna administers the MHBP, whose plan options include Self Only, Self Plus One, and Self and Family – similar to FEHB.

It’s best to have MHBP and Medicare when you become Medicare-eligible. Medicare will be the primary insurance and MHBP will give you access to things Medicare doesn’t cover like additional options for chiropractic care.

FAQs

Is FEHB a Medicare Supplement?
Although FEBH works very similarly to a Medicare Supplement (Medigap) plan, they are not the same. Medigap plans are provided by private insurance companies whereas FEBH is administered by the federal government.
Do retired federal employees lose FEHB plans when they become eligible for and enroll in Medicare?
No, federal employees may keep their FEHB after they become eligible for Medicare.
How do I suspend FEHB for Medigap or Medicare Advantage?
Contact your retirement office to find out how to suspend your FEHB enrollment. Unless you move outside of your Medicare Advantage plan’s service area, you can only re-enroll in FEHB during Open Season.
When Medicare becomes primary, do my FEHB premiums change?
No. Your FEHB premiums will remain the same, regardless of whether you also enroll in Medicare.
Do I need Medicare Part D if I have FEHB?
No, FEHB includes creditable prescription drug coverage, meaning it’s as good as Medicare Part D.
What is the best FEHB plan to supplement Medicare?
There are over 200 FEHB plans to choose from when electing coverage. With that being said, the top three carriers for 2022 are CDPHP, Aetna, and Blue Cross

How to Get Help Understanding Your Options with FEHB and Medicare

Our agents are Medicare experts and can walk you through the process of identifying your options. Then, we can help you make the best choice for your needs.

Give us a call at the number above to learn more today. Or, if you prefer, fill out an online rate form to explore plan options in your area!

Enter ZIP Code

Enter ZIP Code

Enter your ZIP code to pull plan options available in your area.

Compare Plans

Compare Plans

Select which Medicare plans you would like to compare in your area.

Get Quote

Get Quote

Compare rates side by side with plans & carriers available in your area.

Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

52 thoughts on “Federal Employee Retirement Health Benefits (FEHB) and Medicare

    1. Hi David! Unfortunately, we have no way of knowing how many retirees are currently covered under FEHB. Regarding premiums, they vary from state to state. According to FedSmith, the average monthly premium in Alaska for a family plan is around $400.

    Comment

    Your email address will not be published.

    Speak with an agent today!

    Compare 30+ Carriers
    and Plans in Your Area
    X