Helping Federal Employees and Annuitants Understand Their Benefits

 

Medicare Part A, B, C and D

Do Federal Retirees Need to Sign up for Medicare?




 

The Original Medicare Plan (Medicare Part A & B) 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 your supplemental FEHB coverage often pays the difference and if you carry both Part A and B most FEHB plans waive the deductible, copayments and coinsurance. Some things are not covered under Original Medicare, like prescription drugs.

 

Medicare Part B Premiums 2022 Part B Premiums 
CMS Increased Part B Premiums 14.5% for 2022!

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Are you eligible for Medicare?

Usually monthly premiums for Medicare Part A (Hospital Insurance) are free if you or your spouse paid Medicare taxes while working. This is referred to as  "premium-free Part A." If you must buy Part A, it will cost you up to $411 each month.

Most people get Part A without having to pay a premium. Premiums for Part A are free at 65 if:

  • You already get retirement benefits from Social Security or the Railroad Retirement Board.
  • You're eligible to get Social Security or Railroad benefits but haven't filed for them yet.
  • You or your spouse had Medicare-covered government employment.

If you're under 65, you can get premium-free Part A if:

  • You got Social Security or Railroad Retirement Board disability benefits for 24 months.
  • You have End-Stage Renal Disease (ESRD) and meet certain requirements.

In most cases, if you opt to purchase Part A, you must also take Medicare Part B and pay a monthly premium for both.

Medicare 2022 Part B Premiums

The standard Part B monthly premium amount in 2022 is $170.10, a 14.5% increase from last year. Couples in the lowest catagory earning less than $182,000 a year will pay $4,082.40 a year for Part B coverage while the the highest income group pays $13,879.20 a year for the same Medicare Part B Coverage! Most people pay the standard Part B premium amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you'll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

 

If your yearly income in 2020 (for what you pay in 2022) was You pay each month (in 2021) (Increase from last year)
File individual tax return File joint tax return File married & separate tax return
$91,000 or less $182,000 or less $91,000 or less $170.10 (+ $21,60)
above $91,000 up to $114,000 above $182,000 up to $228,000 Not applicable $238.10 (+ $30.10)
above $114,000 up to $142,000 above $228,000 up to $284,000 Not applicable $340.20 (+ $43.20)
above $142,000 up to $170,000 above $284,000 up to $340,000 Not applicable $442.30 (+ $56.30)
above $170,000 and less than $500,000 above $340,000 and less than $750,000 above $91,000 and less than $408,000 $544.30 (+ $69.10)
$500,000 or above $750,000 and above $409,000 and above $578.30 (+ $74.30)

 

Medicare 2021 Part B Premiums

The standard Part B premium amount in 2021 is $148.50. Most people pay the standard Part B premium amount. If your modified adjusted gross income as reported on your IRS tax return from 2 years ago is above a certain amount, you'll pay the standard premium amount and an Income Related Monthly Adjustment Amount (IRMAA). IRMAA is an extra charge added to your premium.

 

If your yearly income in 2019 (for what you pay in 2021) was You pay each month (in 2021)
File individual tax return File joint tax return File married & separate tax return
$88,000 or less $176,000 or less $88,000 or less $148.50
above $88,000 up to $111,000 above $176,000 up to $222,000 Not applicable $207.90
above $111,000 up to $138,000 above $222,000 up to $276,000 Not applicable $297.00
above $138,000 up to $165,000 above $276,000 up to $330,000 Not applicable $386.10
above $165,000 and less than $500,000 above $330,000 and less than $750,000 above $88,000 and less than $412,000 $475.20
$500,000 or above $750,000 and above $412,000 and above $504

Medicare Claim Number Code (Prefix)

Your Medicare claim number is your Social Security number followed by one of the suffixes listed below. The suffix identifies your benefit status.

  • A – Primary Claimant (wage earner)
  • B – Spouse (spouse of retired worker)
  • B1 – Aged Husband, age 62 or over
  • B2 – Young Wife, with a child in her care
  • B3 – Aged Wife, age 62 or over, second claimant
  • B5 – Young Wife, with a child in her care, second claimant
  • B6 – Divorced Wife, age 62 or over
  • BY – Young Husband, with a child in his care
  • C1-C9 – Child (includes minor, student, or disabled child)
  • D – Aged Widow age 60 or over
  • D1 – Aged Widower, age 60 or over
  • D2 – Aged Widow (2nd claimant)
  • D3 – Aged Widower (2nd claimant)
  • D6 – Surviving Divorced Wife, age 60 or over
  • E – Widowed Mother
  • E1 – Surviving Divorced Mother
  • E4 – Widowed Father
  • E5 – Surviving Divorced Father
  • F1 – Parent (father)
  • F2 – Parent (mother)
  • F3 – Stepfather
  • F4 – Stepmother
  • F5 – Adopting Father
  • F6 – Adopting Mother
  • HA – Disabled Claimant (wage earner)
  • HB – Aged Wife of Disabled Claimant, age 62 or over
  • HC – Child of Disabled Claimant
  • M – Uninsured – Premium Health Insurance Benefits (Part A)
  • M1 – Uninsured – Qualified For (but refused health insurance benefits – Part A)
  • T – Enrolled in Medicare but temporarily delayed Social Security Retirement Benefits or Uninsured – Entitled to Health Insurance Benefits (Part A) under deemed or renal provisions
  • TA – Medicare Qualified Government Employment (MQGE)
  • TB MQGE – Aged Spouse
  • W – Disabled Widow
  • W1 – Disabled Widower
  • W6 – Disabled Surviving Divorced Wife
  • WA – Railroad Retirement

TriCare For Life

If you are retired military or a military spouse and have TriCare you must sign up for Medicare Part B in the 3 months before turning 65 in order to continue with TriCare for life. TriCare participants are able to suspend their FEHB enrollment if they wish after retiring from federal service; federal  employees can't suspend FEHB coverage while still working. 

The time you had with TriCare counts towards the 5 years of FEHB coverage that participants must have to carry FEHB coverage into retirement and you must be enrolled in a FEHB plan at retirement to be able to suspend it. If you choose to stay with TriCare and suspend FEHB participation as a civilian retiree, you can sign back up for FEHB during any subsequent open season should you need private insurance coverage. This would be desirable if health care providers are not taking new Medicare/TriCare patients when you move to a new location or otherwise lose your doctor. "

Signing Up for Medicare

 

If you are retired and receiving Social Security you will automatically be enrolled in Part A and B and should receive your Medicare card three months before your 65th birthday. If you decide not to take Part B follow the instructions that you receive with your enrollment package. If you aren't receiving Social Security you have a 7 month Medicare enrollment window that starts 3 months before your birthday.  You can sign up online at https://www.socialsecurity.gov/medicare/apply.html or you can visit your local Social Security Office to apply. Call 1-800-772-1213 for additional information and assistance. You can also sign up for Medicare at https://www.medicare.gov under the "New to Medicare" section. It takes about 15 minutes to register and sign up online.  

If you are retired but covered under a working spouse’s medical plan or you are still working, sign up for Part A and then advise them that you do not want part B because you are covered by your employer or under a working spouse plan as the case may be.  All current federal employees and those retirees with new employer health care coverage or are covered under their spouse should elect this when they turn 65 to delay Part B without penalty until their working spouse retires,  or they leave federal service, or their new employer.

 

How to withdraw from Medicare Part B After Signing Up?

You can withdraw from Medicare Part B at any time if desired. Once you withdraw from Medicare B you would have to notify your FEHB provider, Blue Cross Blue Shield in your case, immediately because they would revert back to primary provider for medical services. To cancel Medicare Part B coverage you will have to use form CMS-1763. This form isn’t available online and you must contact your Social Security Administration office to complete the form. They will discuss the consequences of canceling your coverage, including how penalties are accessed, and process the form for you over the phone. The Social Security FAQ titled How do I terminate my enrollment with Medicare Part B when I have other health insurance explains the process in more detail. Typically your monthly premium for Part B may go up 10% for each full 12-month period that you could have had Part B, but didn’t sign up for it.

How a CSRS retiree can have Medicare premiums withheld from their annuity payment?

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 withhold Medicare premiums from annuity payments. 

Resources

Social Security, Medicare & Government Pensions Guide

 
Official - Social Security, Medicare & Government Pensions

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