Federal Employee's CSRS & FERS Federal Civil Service Retirement
& Financial Planning Resources
Medicare Health Benefit's Plan Menu
If you fall under one of the following criteria you are eligible to sign up
- People 65 years of age and older.
- Some people with disabilities under 65 years of age.
- People with End-Stage Renal Disease (permanent kidney failure requiring
dialysis or a transplant).
- Part A (Hospital Insurance). Most people do not have to pay for Part A.
If you or your spouse worked for at least 10 years in Medicare-covered
employment, you should be able to qualify for premium-free Part A insurance.
(Someone who was a Federal employee on January 1, 1983 or since
automatically qualifies.) Otherwise, if you are age 65 or older, you may be
able to buy it. Contact 1-800-MEDICARE for more information.
- Part B (Medical Insurance). Most people pay monthly for Part B.
Generally, Part B premiums are withheld from your monthly Social Security
check or your retirement check.
- Part C (Medicare Advantage). If you are eligible for Medicare, you may
have choices in how you get your health care. Medicare Advantage is the term
used to describe the various health plan choices available to Medicare
beneficiaries. If you are eligible for Medicare, you may choose to enroll in
and get your Medicare benefits from a Medicare managed care plan. These are
health care choices (like HMOs) in some areas of the country. In most
Medicare managed care plans, you can only go to doctors, specialists, or
hospitals that are part of the plan. Medicare managed care plans provide all
the benefits that Original Medicare covers. Some cover extras, like
prescription drugs. To learn more about enrolling in a Medicare managed care
plan, contact Medicare at 1-800-MEDICARE (1-800-633-4227) or at
You can enroll in a Medicare Advantage plan to get your Medicare benefits.
Medicare Advantage is the term used to describe the various private health
plan choices available to Medicare beneficiaries.
- Part D (Medicare prescription drug coverage). There is a monthly premium
for Part D coverage. Most Federal employees do not need to enroll in the
Medicare drug program, since all Federal Employees Health Benefits Program
plans will have prescription drug benefits that are at least equal to the
standard Medicare prescription drug coverage. Still, you may want to be
aware of the benefits Medicare is offering, so you can help others make
informed decisions. If you have limited savings and a low income, you may be
eligible for Medicare's Low-Income Benefits. For people with limited income
and resources, extra help in paying for a Medicare prescription drug plan is
available. Information regarding this program is available through the
Social Security Administration (SSA). For more information about this extra
help, visit SSA online at
www.ssa.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
The FEHB health plan brochures explain how they coordinate benefits with
Medicare, depending on the type of Medicare managed care plan you have. If you
are eligible for Medicare coverage read this information carefully, as it will
have a real bearing on your benefits.
The Original Medicare Plan (Original Medicare) is available everywhere in the
United States. It is the way everyone used to get Medicare benefits and is the
way most people get their Medicare Part A and Part B benefits now. You may go to
any doctor, specialist, or hospital that accepts Medicare. The Original Medicare
Plan pays its share and you pay your share. Some things are not covered under
Original Medicare, like prescription drugs.
The decision to enroll in Medicare is yours. OPM encourage you to apply for
Medicare benefits 3 months before you turn age 65. It's easy. Just call the
Social Security Administration toll-fee number 1-800-772-1213
to set up an appointment to apply. If you do not apply for one or more Parts of
Medicare, you can still be covered under the FEHB Program. Visit their website
for forms and additional information.
If you can get premium-free Part A coverage, OPM advises you to
enroll in it. Most Federal employees and annuitants are entitled to
Medicare Part A at age 65 without cost. When you don't have to pay premiums for
Medicare Part A, it makes good sense to obtain coverage. It can reduce your
out-of-pocket expenses as well as costs to FEHB, which can help keep FEHB
Everyone is charged a premium for Medicare Part B coverage. The Social
Security Administration can provide you with premium and benefit information.
Review the information and decide if it makes sense for you to buy the Medicare
Part B coverage.
If you are eligible for Medicare, you may have choices in how you get your
health care. Medicare Advantage is the term used to describe the various private
health plan choices available to Medicare beneficiaries. The information in the
next few pages shows how we coordinate benefits with Medicare, depending on
whether you are in the Original Medicare Plan or a private Medicare Advantage
If you are eligible for Medicare and not eligible for Social Security, you can have Medicare
premiums withheld from your annuity payments. OPM must receive a request for the
withholding from the Centers for Medicare and
Medicaid Services. They cannot withhold premiums based on your direct
request or even one from the Social Security Administration. The request must
come from the Centers for Medicare and Medicaid Services (CMS) to
Medicare premiums from annuity payments.
I have heard from a number of retirees concerning Medicare. One of the
principal benefits of signing up for Medicare B is that Medicare pays all of
your copayments except for prescription drugs. Read Tammy Flanagan's three
articles listed under resources below to discover all of the pros and cons of
purchasing Medicare options for federal retirees.
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