Is Medicare Advantage better than FEHB?

Asked by: Prof. Fiona Feeney  |  Last update: February 11, 2022
Score: 4.2/5 (67 votes)

Most MA plans are comparable to FEHB plans in hospital and medical benefits, but the prescription drug benefits will not be as good as in the FEHB program because the plans have a “coverage gap” where you are responsible for all or most drug costs until you reach a catastrophic limit.

Is Medicare Advantage the best option?

Is Medicare Advantage or Medigap Coverage Your Best Choice? Generally, if you are in good health with few medical expenses, Medicare Advantage is a money-saving choice. But if you have serious medical conditions with expensive treatment and care costs, Medigap is generally better.

Can you have Medicare Advantage and FEHB?

When you enroll in a Medicare Advantage plan, you may not need FEHB coverage because the Medicare Advantage plan will provide you with many of the same benefits. You should review the Medicare Advantage Plan benefits carefully before making a decision to suspend or cancel FEHB coverage.

What is the biggest disadvantage of Medicare Advantage?

Medicare Advantage can become expensive if you're sick, due to uncovered copays. Additionally, a plan may offer only a limited network of doctors, which can interfere with a patient's choice. It's not easy to change to another plan; if you decide to switch to Medigap, there often are lifetime penalties.

Do I need both FEHB and Medicare?

Answer #1 —You don't need both.

However, to quote OPM “generally, plans under the FEHB program help pay for the same kinds of expenses as Medicare.” In many cases FEHB proves to be more comprehensive, often including emergency care outside the U.S., as well as dental and vision, which Medicare does not cover.

FEHB and Medicare for Retirees | Should You Sign up for Part B?

23 related questions found

Do most federal retirees take Medicare Part B?

About 70% of federal retirees enroll in Part B, which means paying two premiums and in essence two duplicative insurance programs. A portion of the retirees that join Part B might do so as a hedge against the elimination of FEHB retiree benefits.

Do federal retirees with FEHB need Medicare Part B?

Most people who have retiree coverage must enroll in Medicare Part A and Part B when first eligible. ... As a federal retiree, if you don't enroll in Medicare, your FEHB plan will act as your primary insurer and won't pay less because you qualify for Medicare.

Is Medicare Advantage more expensive than Medicare?

Clearly, the average total premium for Medicare Advantage (including prescription coverage and Part B) is less than the average total premium for Original Medicare plus Medigap plus Part D, although this has to be considered in conjunction with the fact that an enrollee with Original Medicare + Medigap will generally ...

Can you go back to Original Medicare from an Advantage plan?

At any point during your first year in a Medicare Advantage plan, you can switch back to Original Medicare without penalty. ... If it isn't your first time in a Medicare Advantage plan, you're not eligible to switch to Original Medicare using a trial right.

What is the most popular Medicare Advantage plan?

AARP/UnitedHealthcare is the most popular Medicare Advantage provider with many enrollees valuing its combination of good ratings, affordable premiums and add-on benefits. For many people, AARP/UnitedHealthcare Medicare Advantage plans fall into the sweet spot for having good benefits at an affordable price.

What is the difference between FEHB and Medicare?

your FEHB plan is the primary payer of health benefits expenses and Medicare is the secondary payer if you are employed in the federal service; Medicare is the primary payer and FEHB is the secondary payer if you are not employed in the federal service.

Are federal retirees automatically enrolled in 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.

Can federal retirees get Medicare Advantage plans?

Federal retirees have Medicare Advantage (MA) plans to consider joining. Our analysis shows that some of these offerings are an outstanding value.

What are the disadvantages of Medicare?

Disadvantages of Medicare Advantage
  • Limited service providers. If you choose one of the more popular Medicare Advantage plan types, such as an HMO plan, you may be limited in the providers you can see. ...
  • Complex plan offerings. ...
  • Additional costs for coverage. ...
  • State-specific coverage.

Do you still pay Part B premium with Medicare Advantage?

You continue to pay premiums for your Medicare Part B (medical insurance) benefits when you enroll in a Medicare Advantage plan (Medicare Part C). Medicare decides the Part B premium rate. ... Insurance companies are only allowed to make changes to the premium rate once a year.

How do I choose the best Medicare Advantage plan?

Factors to consider when choosing a Medicare Advantage plan
  1. costs that fit your budget and needs.
  2. a list of in-network providers that includes any doctor(s) that you would like to keep.
  3. coverage for services and medications that you know you'll need.
  4. Centers for Medicare & Medicaid Services (CMS) star rating.

Can you be denied a Medicare Supplement plan?

Your Medicare Supplement deadline is its Open Enrollment Period. ... Within that time, companies must sell you a Medigap policy at the best available rate, no matter what health issues you have. You cannot be denied coverage.

How much does the government pay Medicare Advantage plans?

How Much Does the Government Pay Medicare Advantage Plans? The federal government pays out over $1,000 each month for each enrollment for every individual. $1,000 is a substantial amount when considering the number of enrollees they see, and bonus payments received through the bonus system.

Does traditional Medicare have a maximum out of pocket?

There is no limit on out-of-pocket costs in original Medicare (Part A and Part B). Medicare supplement insurance, or Medigap plans, can help reduce the burden of out-of-pocket costs for original Medicare. Medicare Advantage plans have out-of-pocket limits that vary based on the company selling the plan.

What is the difference between Medicare and Senior Advantage?

With Original Medicare, you can go to any doctor or facility that accepts Medicare. Medicare Advantage plans have fixed networks of doctors and hospitals. Your plan will have rules about whether or not you can get care outside your network. But with any plan, you'll pay more for care you get outside your network.

What is the average monthly cost of a Medicare Advantage plan?

The average premium for a Medicare Advantage plan in 2021 was $21.22 per month. For 2022 it will be $19 per month. Although this is the average, some premiums cost $0, and others cost well over $100. For more resources to help guide you through the complex world of medical insurance, visit our Medicare hub.

Does getting a Medicare Advantage plan make you lose original Medicare?

If you join a Medicare Advantage Plan, you'll still have Medicare but you'll get most of your Part A and Part B coverage from your Medicare Advantage Plan, not Original Medicare. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care.

Is Medicare Part A free to everyone?

Most people get Part A for free, but some have to pay a premium for this coverage. To be eligible for premium-free Part A, an individual must be entitled to receive Medicare based on their own earnings or those of a spouse, parent, or child.

How much does FEHB cost in retirement?

FERS retirees must elect either 50% or 25% survivors annuity for your spouse to be eligible for FEHB coverage in retirement after the annuitant's death. The 50% election will cost you 10% of your full annuity and the 25% survivor annuity election will cost you 5% of your full annuity in retirement.