When you turn 65 and are eligible for Medicare—and you’re also covered under the Federal Employees Health Benefits (FEHB) Program—your choices can affect your coverage, premiums, and out-of-pocket costs. Here are your main options and considerations:
What Stays the Same
You can keep your FEHB coverage after enrolling in Medicare. Federal retirees often find that the combination of Medicare + FEHB provides comprehensive coverage with minimal out-of-pocket costs.
Key Medicare Enrollment Points
Part A (Hospital Insurance):
- Most people enroll in Part A at 65, as it’s premium-free if you or your spouse worked 10+ years.
- FEHB does not replace Part A.
Part B (Medical Insurance):
- You must pay a monthly premium for Part B.
- Enrolling in Part B is optional, but:
- If you’re still working, you may delay Part B without penalty (FEHB is creditable).
- If retired, delaying Part B can cause late enrollment penalties and gaps in coverage.
Part D (Prescription Drug):
- FEHB includes credible prescription drug coverage, so you don’t need Part D.
Your Main Options at Age 65
Option 1: Keep FEHB and Enroll in Medicare Parts A & B
- Most popular option for federal retirees.
- Medicare becomes primary, FEHB becomes secondary.
- Many FEHB plans waive cost-sharing (like copays and deductibles) when Medicare is primary.
- Excellent coverage, very low out-of-pocket costs.
Option 2: Keep FEHB and Only Enroll in Medicare Part A
- You avoid the Part B premium.
- FEHB remains your primary insurer.
- You pay out-of-pocket costs (copays, deductibles) per your FEHB plan rules.
- Less expensive monthly, but potentially higher cost when using services.
Option 3: Drop FEHB and Rely on Medicare Alone
- Strongly discouraged for federal retirees.
- You lose access to the generous FEHB program.
- You may need a Medicare Supplement (Medigap) or Medicare Advantage plan to replace FEHB benefits.
- Not usually cost-effective compared to keeping FEHB.
Option 4: Suspend FEHB to Join a Medicare Advantage Plan (MA)
- Only allowed if enrolling in a Medicare Advantage plan with prescription drug coverage (MAPD).
- You can re-enroll in FEHB during Open Season later if needed.
- Riskier, as MA plans vary and may have network restrictions, unlike FEHB.
Cost Comparison Example (Varies by Plan)
| Coverage Combo | Monthly Cost | Pros | Cons |
|---|---|---|---|
| FEHB + Medicare A & B | ~$300–$500 (Part B premium + FEHB premium) | Very low out-of-pocket costs; nearly full coverage | Higher monthly cost |
| FEHB + Medicare A only | ~$150–$250 (FEHB premium only) | Lower monthly premium | You pay more when you use care |
| Medicare Only | ~$174.70+ (Part B premium) | Lower monthly cost | No FEHB safety net; higher out-of-pocket risk |
| Medicare Advantage + Suspend FEHB | Varies by plan (some $0) | Lower monthly premium | Potential provider/network limitations |
Other Tips
- Some FEHB plans (like GEHA, Blue Cross Basic, NALC) offer Medicare coordination options that reduce or even eliminate your FEHB premium when you have Medicare.
- Open Season is every November–December—you can switch FEHB plans annually.