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What if I'm a retired federal worker and covered under the FEHB plan?
What if I'm a retired federal worker turning 65 with coverage under a Federal Employee Health Plan under the Federal Employee Health Benefits (FEHB) that includes creditable drug coverage? I'm ready to turn 65 and become Medicare eligible for the first time. What issues might I consider when deciding whether to enroll in a Medicare prescription drug plan?
As a retired federal worker with coverage under the Federal Employee Health Plan (FEHB) that includes creditable drug coverage, you have a few options to consider regarding Medicare and prescription drug coverage.
Here are some issues to consider:
Your FEHB drug coverage: If your FEHB plan provides "creditable coverage" (meaning the coverage is at least as good as Medicare's prescription drug coverage), you do not need to enroll in a Medicare prescription drug plan (Part D) when you become eligible for Medicare. However, it is important to confirm with your FEHB plan administrator that your coverage is indeed creditable.
If you do not have creditable coverage, you may be subject to late enrollment penalties if you do not enroll in a Part D plan when you become eligible for Medicare.
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1. Cost: Even if your FEHB coverage is creditable, you may still want to consider enrolling in a Medicare Part D plan if it will save you money. Compare the costs and coverage of your FEHB plan to the Part D plans available in your area. You may find that a Part D plan offers better coverage at a lower cost, especially if you take expensive medications.
2. Network: Check to see if your preferred pharmacy is in the network of the Part D plan you are considering. If it is not, you may have to switch pharmacies or pay higher out-of-pocket costs.
3. Coverage gaps: Medicare Part D plans have a coverage gap (also known as the "donut hole"), which is a temporary limit on what the plan will cover for prescription drugs. If you take a lot of medications, you may reach the coverage gap quickly. Consider whether the coverage gap could be a problem for you and whether you are willing to pay the out-of-pocket costs.
4. Flexibility: If you enroll in a Medicare Part D plan, you will have the flexibility to change plans during the annual enrollment period (October 15 to December 7 each year). This could be beneficial if your medication needs a change or if you find a plan that better meets your needs.
5. Coordination of benefits: If you enroll in a Medicare Part D plan, your FEHB plan will coordinate benefits with Medicare. This means that your FEHB plan will continue to cover your medications, but Medicare will pay first, up to the limits of the Part D plan.
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6. The decision to enroll in a Medicare Part D plan depends on your individual situation, including your FEHB coverage, medication needs, budget, and preferred pharmacy. Be sure to do your research and consider all of your options before making a decision.
7. Remember, there is a penalty for not having Medicare Part D prescription drug coverage if you are eligible for it but do not enroll when you initially become eligible. This penalty is known as the Part D late enrollment penalty (LEP).
8. The Part D late enrollment penalty is calculated based on the number of months you went without creditable prescription drug coverage after becoming eligible for Medicare Part D. Creditable coverage refers to prescription drug coverage that is at least as good as standard Medicare Part D coverage.
MedHelpCenter.us recommends that you call the Senior Health Insurance Agency at 813-592-8568 for further help and explanation.
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