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Posted on Thursday, 14th January 2021 by

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OPM is currently experiencing high call volumes and longer than normal wait times on the Retirement Information Office Toll Free number (888-767-6738). Their highest call volume is on Monday and Tuesday mornings.

Request a 27 page Federal Retirement Report™ today.
A one hour session with a Certified Financial Planner is incuded.

To minimize wait times, consider calling the Retirement Information Office outside of these hours. Their hours are Monday – Friday 7:40AM EST to 5:00PM EST. As long as you are in queue at 5:00PM, your call will be answered. Also, consider using their Customer Support Center, contacting them via email at retire@opm.gov, or their self-service site at www.servicesonline.opm.gov. Their Customer Support Center is basically a Frequently Asked Question (FAQ) page with links to information of interest for retirees.

It’s always difficult getting through to OPM, especially this time of year. What I do is dial their number; if its busy, I hang up and immediately click on redial. I typically get through in several minutes using this technique. Expect long wait times, I’ve waited on hold for up to 45 minutes. You can also email questions to retire@opm.gov anytime to ask questions or request assistance with their personal retirement issues.  It can take several weeks to get a reply via email.

When you do get through ask the customer service representative to initiate access to their online services portal if you haven’t already done so. OPM must send you your access information via regular mail and it can take several weeks to receive this information. You can do many things online without having to call OPM. Here is a link to an article on how to sign up for OPM’s online services:

Request a Federal Retirement Report

Retirement planning specialists provide a comprehensive Federal Retirement Report™ including annuity projections, expenditures verses income, with a complete benefits analysis. This comprehensive 27-page benefits summary will help you plan your retirement.

Request Your Personalized Federal Retirement Report™ Today

Find answers to your questions: The best time to retire, retirement income vs expenditures, FEGLI options and costs, TSP risks and withdrawal strategies, and other relevant topics. Determine what benefits to carry into retirement and their advantages. You will also have the opportunity to set up a personal one-on-one meeting with a CERTIFIED FINANCIAL PLANNER.

Helpful Retirement Planning Tools

Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Posted in ANNUITIES / ELIGIBILITY, BENEFITS / INSURANCE, RETIREMENT CONCERNS, SURVIVOR INFORMATION

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Posted on Thursday, 7th January 2021 by

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Corrections:  I misquoted the 2021 COLA in last week’s article titled “1% Pay Raise Approved for 2021 – GS Pay Charts Available;” it is 1.3% not 1.6%  The blog article was corrected.

Generally, in late December federal retirees receive a Notice of Annuity Adjustment that provides abundant information for annuitants and their survivors. The mailed statements were apparently delayed this year and I still haven’t received a copy. However, I signed on to OPM Services Online and printed out my January 2021 Annuity Statement, and reviewed my Annual Summary of Payments report. Whenever your annuity payment is modified, for whatever reasons, OPM sends out a Notice of Annuity Adjustment outlining the changes to your monthly payment. This year’s statement includes a 1.3% COLA, and they will send out another statement to show the health care premium changes for 2021.


Request a Federal Retirement Report™Request a Personalized 27-page Retirement Planning Report.
A one hour session with a Certified Financial Planner is included.


This document provides annuity and benefit information for you and your family. It includes the annuitant’s Claim number, the amount withheld for each item deducted from your annuity payment, and your gross and net payment. This document specifies the monthly survivor annuity currently payable in the event of the annuitant’s death and includes an annual Notice of Survivor Annuity Election Rights. You will also find OPM contact information and they include a recommendation to register and log on to their online services. The online Annuity Statement also lists the survivor’s monthly annuity payment.

This form provides instructions on how to make benefit elections such as how to apply for a survivor election for a spouse you marry after retirement, survivor annuity elections for a former spouse, and others.

I elected a full survivor’s annuity for my wife when I retired as a CSRS employee. My wife will receive 55% of my full annuity when I die. The full FERS survivor’s annuity is 50%. I divided the surviving spousal monthly annuity listed on this document by my gross monthly benefit; my wife will receive 60% of what I was receiving while alive. When I elected a full annuity, my annuity was reduced by 10%. What many don’t realize is that the surviving spouse of a CSRS retiree receives 55% of the unreduced annuity amount or in my case 60% of what I was receiving monthly while alive. Many believe the surviving spouse receives 55% of what the federal annuitant was receiving prior to death. This is good information to have when finalizing your estate plans.

I keep the Notice of Annuity Adjustments that I receive in my retirement folder and include a copy in our estate binder along with OPM’s annuity and FEGLI insurance verification forms that OPM sends out upon request or you can download then online. This is an important document and needs to be readily available if you or your survivor need to contact OPM or require benefit clarifications.

I receive many questions each year from retirees and survivors that misplaced their CSA retirement Claim Number and need to contact OPM. If you file this form in your retirement planning or estate file this information will be readily available when needed.

1099 Tax Forms Coming Soon

Federal annuitants typically don’t receive their 1099R Tax Forms until the end of January or the beginning of February by regular mail. If you are registered to use OPM’s Retirement Services Website your 1099 R is often available earlier for download. I generally download a copy of my 1099 R to start my tax return early.

To get a head start on your taxes visit OPM’s Online Services later this month and download a copy. You must be registered to use the site. If you aren’t registered read the article titled “Connect to OPM’s Online Services” to understand the registration process and sign up. It doesn’t take long however you may have to wait for your password to be sent via regular US mail and that can take several weeks. If you haven’t signed up yet do it now. The site offers retired federal employees many helpful options such as changing your direct deposit information, address changes, 1099 R copies, download annuity and insurance verification documents, and much more.

Request a Federal Retirement Report

Retirement planning specialists provide a comprehensive Federal Retirement Report™ including annuity projections, expenditures verses income, with a complete benefits analysis. This comprehensive 27-page benefits summary will help you plan your retirement.

Request Your Personalized Federal Retirement Report™ Today

Find answers to your questions: The best time to retire, retirement income vs expenditures, FEGLI options and costs, TSP risks and withdrawal strategies, and other relevant topics. Determine what benefits to carry into retirement and their advantages. You will also have the opportunity to set up a personal one-on-one meeting with a CERTIFIED FINANCIAL PLANNER. Helpful Planning Tools

Helpful Retirement Planning Tools

Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Posted in ANNUITIES / ELIGIBILITY, BENEFITS / INSURANCE, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE

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Posted on Friday, 1st January 2021 by

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Those planning to retire soon will benefit somewhat from the small 1% federal employee’s pay raise this year. Primarily, your annual leave buy back will be at the new pay rate starting the first pay period of 2021. If you plan on staying another year or longer the raise will increase your high three average earnings that is used to determine your monthly annuity. Retirees ended up with a 1.3% COLA this year, a bit more than the federal employees increase, still not enough considering inflation and especially higher health care costs.

Request a Federal Retirement Report™ to review projected annuity payments,
income verses expenses, FEGLI, and TSP projections.

The President signed an Executive Order in December.  The 1% pay raise 2021 charts are now available along with all special rates and wage grade salaries.

The pay raise will take effect with the first full pay period of 2021. We published the new pay table on January 1, including the locality pay area definitions outlining the pay rates for all regions nationwide.

The rates of basic pay or salaries of the statutory pay systems are included. The general categories are listed below:

  • The General Schedule
  • The Foreign Service Schedule
  • schedules for the Veterans Health Administration of the Department of Veterans Affairs
  • Senior Executive Service
  • Certain Executive, Legislative, and Judicial Salaries
  • The Executive Schedule

OPM was fast to react to the Presidential Order and released the new tables in late December.

Following are links to the new 2021 locality pay tables:

Click here for: Special Rates Tables

Helpful Retirement Planning Tools

Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Posted in ANNUITIES / ELIGIBILITY, BENEFITS / INSURANCE, ESTATE PLANNING, FINANCE / TIP, RETIREMENT CONCERNS, SURVIVOR INFORMATION

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Posted on Saturday, 19th December 2020 by

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The year started off with a bang: market up, unemployment the lowest it had been in decades, and hopes were high for the new year.  That changed course abruptly when COVID overtook life as we knew it, yet we persevered and are on the road to recovery at years end thanks to the Warp Speed initiative. We suffered through a brutal election and still survived; there is much to be thankful for.

 

Retirees were caught in the middle due to our higher risk factors and many nursing homes were decimated by this disease.  Over 42 percent of all COVID deaths were at nursing homes and assisted living facilities! In some states like New York, the death rate at these facilities were even higher.  I can’t understand how the politicians and so-called experts running the show thought it would be appropriate to send COVID patients back to their nursing home or assisted living facility. I wonder if their mothers, fathers, and grandparents resided there if they would have pushed this narrative. Oh, I forgot, they can afford private nursing care for their loved ones! These same Politicians implore us to forgo family and friends during the holidays, and are caught violating their own edicts. OK, I know what you are thinking, I should know they expect us to do what they say, not what they do! They are special, truly privileged and unaccountable for their own behavior. I understand!!! 

Now that vaccines are available, we expect that our most vulnerable: the elderly, health care and frontline workers will be the first in line for vaccination.  If they do otherwise, God help them. Our most vulnerable MUST be protected first.

Our small businesses, restaurants, and even churches are on the brink of destruction, many won’t survive. These small businesses are the mom-and-pop enterprises that have sustained their families and the surrounding communities for years.  They know how to do things right but aren’t given a chance to earn a living.

When my wife and I go to the big box stores they are functioning, social distancing isn’t followed as one might expect in crowded isles, etc. Sure, all are wearing masks, many with it below their nose to breath. Yet, a small business and their employees are robbed of their livelihood even when so called science says the risks are minimal. I marvel at the hypocrisy when I hear the mayor of New York shut down restaurants that account for around 2 percent of infections knowing full well that over 40% of the infections are from indoor social activity.  No one knows just how many of those infections are coming from the big box stores!

I started writing this article with something entirely different in mind to close out the year, just can’t help myself these days.

I sincerely want to thank my site visitors, newsletter subscribers, and blog followers. Over the past three years we’ve had over 7 million visit our web sites and view just under 9 million pages and our blog received over 621,000 visits. I sincerely appreciate all of you for your patronage, you are truly appreciated and thank you so much for following me all of these years, some for as many as two decades.

My best to you and yours this holiday season, may you have a healthy, safe and prosperous New Year.

Helpful Retirement Planning Tools

Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Posted in BENEFITS / INSURANCE, LIFESTYLE / TRAVEL, RETIREMENT CONCERNS, WELLNESS / HEALTH

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Posted on Tuesday, 15th December 2020 by

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Our readers are a diverse group from all walks of life and I understand that opinions differ, often times dramatically.  My column focuses on my personal experiences and perspective on issues of the day, and often how it impacts our retirement planning and retired life. I discuss benefits and venture into investing, politics, and everything in between knowing that at times I may lose some followers. Yes, I talk about controversial issues and hope that disparate beliefs will find common ground intermingled with commonsense along the way.

 

 

This country is divided with each group stuck in the fast lane and traveling 90 miles an hour. We often ignore the other’s perspective and go for the jugular with each retort. When we discuss controversial topics, it shouldn’t stop us from presenting our thoughts with the intent to engage, not enrage the other party. What I’ve discovered over the years is that we often find common ground.

Many Americans are confused as to why President trump was and still is so popular. Trump is rough around the edges, and certainly not politically correct or a politician. He can be and often is offensive and battles like there is no tomorrow.  All that said, why is he so admired? Certainly not for his meek demeanor; it’s what he has accomplished and that he inevitably gets things done!  We all listen to Presidential state of the union addresses each January and oftentimes lament at years end that little if anything was accomplished. Trump did more in his first term than anyone could have imagined. He developed ways to make things happen that ordinary politicians would have never thought possible. This is why President Trump is so admired and over 74,000,000 voted for him this election, Joe Biden received 81,000,000 votes, 18.4 million more than former President Obama in 2012!

Our country is now energy independent, major peace agreements were signed in the far east, illegal immigration addressed, COVID vaccines are here, we had the best economy in history until the virus hit, the lowest unemployment rate for minorities, VA Choice, he commissioned the new Space Force, the First Step Act, he was open minded about many social issues that are near and dear to the other side and had more minority votes than any other republican president. His accomplishments are remarkable by any standard and can’t be denied.

His warp speed COVID campaign was unquestionably a success. The media constantly ridiculed the president when he proclaimed that a vaccine would be available before end of year. He was called a liar, accused of using the pandemic to bolster his campaign. Joe Biden said he wouldn’t trust a vaccine that Trump produced!  Two weeks after the election two vaccines were announced with more on the way; millions will be vaccinated before January!

Unfortunately, many if not most politicians on both sides work for the good of the party instead of what’s best for the country. Without term limits, our congressman and senators work harder to preserve their jobs than they do to represent the best interests of those they serve. Trump broke that mold and both sides hated him. The established republican party fought him tooth and nail. Maybe both parties could learn something from President Trump. “Get things done for the right reason, and keep our country on an even keel.” Not on a party high. Some believe President Trump was just as party focused. His legions of followers are not party cronies, they are average disenfranchised Americans frustrated with the inability of our leaders to work together for the common good. They are sick and tired of politicians cozying up to lobbyists instead of focusing on the real issues impacting our everyday lives.

The beauty of living in America is that our constitution protects our rights of free speech, religion, and so much more. Many today feel obligated to silence anyone that doesn’t conform to their beliefs. Whether we like it or not, it’s their right as an American. When we refuse to listen to dissent, divergent opinions, and disengage just because a person is either conservative or liberal or anything in between is disingenuous.  Nothing gets accomplished without discussion and compromise.

I hope the new administration truly supports the moderate platform that Joe Biden espoused when running for President. I believe politicians must compromise and find commonsense solutions for the good of the country. Otherwise, chaos will continue unabated. Unfortunately, this courtesy wasn’t extended to President Trump when he won in 2016. The attacks never ended and the distractions caused significant damage to this country including delays to our COVID response.  Only time will tell.

Helpful Retirement Planning Tools

Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Posted in UNCATEGORIZED

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Posted on Wednesday, 9th December 2020 by

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John read my article titled “Changes for the 2021 FEHB Open Season – Save Some Serious Money” and asked what my wife’s OPP costs were for the surgeries I mentioned. Many want to know if what our FEHB plans pay is enough to offset and warrant paying Part B premiums?

Request a Federal Retirement Report™ to review projected annuity payments,
income verses expenses, FEGLI, and TSP projections.

This is a great question and one I could easily answer. I keep all of the GEHA Explanation of Benefits and Medicare’s Summary Notices. My wife and I are enrolled in GEHA Self Plus One standard plan. A summary of the total costs and what we paid for her two eye surgeries and treatment in 2020 follows:

  • Service Provider Charges = $57.440
  • Medicare Allowed & Paid = $40,516
  • GEHA Payments = $2,202
  • Member Responsibility = $0

That was just for my wife this past year, I too had my share of medical care and paid $0 except for prescription copayments.

If you don’t have secondary health insurance the costs under Medicare A and B are significant. In 2020 the deductible was $198 ($202 in 2021) for Part B medical services. After your deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor services (including most doctor services while you’re a hospital inpatient), outpatient therapy, and durable medical equipment (dme).

When hospitalized under Part A you must pay $1,408 for each benefit period and then coinsurance for extended days in the hospital. For example, days 61-90: $352 ($371 in 2021) coinsurance per day of each benefit period.

Without secondary coverage either through the FEHB program, Medicare Advantage or others, costs would be prohibitive to say the least.  In my wife’s case our costs would have been around $8,000 and more when adding in the deductible and other costs.

Another key factor is how well your plan responds when things go wrong. My wife’s first surgery failed and we were fortunate to have GEHA and medical providers we trusted to do whatever was necessary to get things turned around.

There is much to consider when deciding on what plans are best for you and your family. Out of Pocket costs are a major consideration.

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Schedule A Retirement Benefits Seminar in Your Area

Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Posted in BENEFITS / INSURANCE, FINANCE / TIP, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION

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Posted on Monday, 7th December 2020 by

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As the 2021 FEHB Open Season draws to a close Monday, December 14th, there’s still time to look for a new plan or confirm your existing plan is the right choice. Here are a few things to consider.

  • Enrollment status – 90% of the time self-plus-one enrollment is cheaper than self-family enrollment, but not always. Check your plan’s premiums to confirm you’re enrolled in the less costly enrollment option. For example, if you happen to be in NALC High, you can save $726 switching from self-plus-one to self-family enrollment
  • Plan changes – The enrollee share of the premium increased 4.9% in 2021. Many plans had no benefit changes, but some did. Will your doctors still be in your plan next year? Will your prescription drugs still be on the formulary? Even if you’re not considering switching plans, there’s still homework to be done this Open Season to make sure there won’t be any significant changes to your existing plan.
  • Medicare Advantage – Several Medicare Advantage plans have the lowest estimated yearly costs in Checkbook’s Guide to Health Plans for Federal Employees for all available FEHB plans in low, average, and high health care expense years. United Advantage Retiree Advantage and Aetna Advantage Medicare Advantage are both available in the lower 48 states. Both have partial Medicare Part B premium reimbursement and have $0 cost sharing for most health-care expenses, except prescription drugs. Both allow you to see out-of-network doctors if the provider participates with Medicare. A couple in Charleston, SC, with average health-care expenses could save $1780 in estimated yearly costs with United Advantage Retiree Advantage compared to Blue Cross Basic. If you live in one of the 15 states with a United Choice plan, the savings can be even more dramatic. The United Choice plans have the same $0 cost sharing except for prescription drugs, but they reimburse almost the entire Medicare Part B premium. A couple in the Washington, D.C. area could save $3000 with United Choice Primary Retiree Advantage compared to Blue Cross Basic. To enroll in any of these Medicare Advantage plans you must first enroll in the regular FEHB plan version, have Medicare Parts A and B, and then sign up with either UnitedHealthcare (844-481-8821) or Aetna (866-241-0262).
  • Medicare Part B – Whether to sign up for Medicare Part B depends on a few things. First, if you fall into one of the high-income categories (more than $88,000 individual or $176,000 couple), Medicare Part B is of limited value due to the increase in the Part B premium. Second, some plans have better Medicare coordination benefits than others, including some plans that have partial Part B premium reimbursement. If you’re with a plan that doesn’t coordinate well with Medicare, you might reconsider whether having Part B is the right choice for you.

Checkbook’s Guide to Health Plans for Federal Employees can be purchased at GuidetoHealthPlans.orgSave 20% by entering promo code FEDRETIRE at checkout.

Several of our previous articles compared the new FEHB MA plans to GEHA Standard and Blue Cross Blue Shield Basic Self-Plus-One plans and another provides a comprehensive guide to this years Open Sesason. Review these for additional assistance with making your choices:

Medicare Impact on FEHB Plans

Review the following articles that describe the impact Medicare has on your FEHB provider payments.

This article is a collaboration between Kevin Moss of Checkbook.org and Dennis Damp, host of www.federalretirement.net.

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Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

 

Posted in BENEFITS / INSURANCE, ESTATE PLANNING, FINANCE / TIP, LIFESTYLE / TRAVEL, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION

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Posted on Friday, 27th November 2020 by

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There were a lot of questions concerning the new Medicare Advantage (MA) plans that we reviewed in my previous article. I recently ran a comparison of the Aetna MA (Z26) Plan to GEHA’s Standard (316) Plan and Blue Cross & Blue Shield’s (BCBS) Basic (113) Plans using OPM’s FEHB Plan Comparison Tool and Checkbook’s Guide to Health Care Plans. You can order Checkbook’s online access and guide at Guidetohealthplans.org  and save 20% by entering promo code FEDRETIRE at checkout.

Request a Federal Retirement Report™ to review projected annuity payments,
income verses expenses, FEGLI, and TSP projections.

The new MA plans mentioned in the last article require that the employee or annuitant retain their FEHB plan coverage within that group. For example, if you sign up for the Aetna Z26 Self Plus One plan you are automatically enrolled in their Medicare Advantage component at no additional charge if you are enrolled in Medicare. The MA portion for these new plans is often free to subscribers. You only pay the FEHB plan premium. Check each plan for specifics. Basically, I believe these new MA plans simply provide the cost sharing that many other providers automatically offer once you sign up for Medicare.

Introduction

The OPM guide provides a comparison of all plans within a group, you can’t select just Self Plus One for example. Their tool compares up to three plans simultaneously. It is easy to use and lists plan premiums, enrollment codes, links to brochures, provider directories, RX pricing tools, phone numbers, and general plan information for both in and out of network providers. You must then calculate all of the other costs that you may incur such as Medicare Part B premiums subtracting any Part B reimbursements and then estimate other potential costs. Their tool also lists savings incurred when the member is enrolled in Medicare: waivers of deductibles, copayments, coinsurance and out-of-pocket maximums for each plan.

The Checkbook comparison is targeted to an individual’s personal situation: enrollment category, whether or not you have Medicare, your age, and you select either of three health care categories: expected average, low, or high health care expenses. They identify all plans that you are eligible to enroll in after entering your zip code and they provide links to plan brochures, benefit summaries, and formulary and provider directories.

The Checkbook comparison tool user selects whether or not they have Medicare and which parts they are enrolled in. After entering their estimated annual adjusted gross income (AGI), the program determines if your Medicare premium will be income adjusted.  Medicare Part B premiums in 2021 range from a low of $148.50 to as high as $504 a month depending on your annual income.

The program compares up to four individual plans at a time. It is very comprehensive and provides an estimated total cost per plan, a benefits summary, and ratings for each service.

Plan Comparisons

I compared the three plans using the following parameters:

  • Retired
  • Self Plus One plans with both having Medicare Part A and B
  • Plans available for zip code 15108 (Pittsburgh Area)
  • An AGI of $176,000 and less for a couple – Part B Premium of $148.50/person
  • Age 71 with low and average healthcare expenses

There is considerably more detail in the Checkbook analysis. The two reports list monthly plan costs as follows:

  • OPM – GEHA Standard $291.92 / Checkbook $589 (Includes Part B Premiums)
  • OPM – Aetna Advantage (MA) $275 / Checkbook $572 (Includes Part B Premiums)
  • OPM – BCBS Basic $409.87 / Checkbook $707 (Includes Part B Premiums)

The figures reported by checkbook include the Medicare premiums paid by the couple. You would have to add your Medicare premiums to the OPM listed plan premiums. Then for the final cost you must subtract the $800 annual per plan member credit BCBS provides for Part B enrollees. The Aetna plan offers a $900 annual Part B reimbursement per member. GEHA Standard doesn’t offer a Part B partial reimbursement.

Checkbook goes further by listing annual health care costs for those who use no services during the year to those who anticipate low, average or high expenses. These costs include expenses not covered by your plan for doctors, hospital, prescriptions, and other services. This figure includes your FEHB premium, Part B premiums if applicable, minus any Part B reimbursements. Here are the Checkbook figures for low and average yearly costs:

  • GEHA Standard $7,920 (Low)  / $10,670 (Average)
  • Aetna Advantage MA $5,650 (Low) / $6,650 (Average)
  • BCBS Basic $7,320 (Low) / $8,330 (Average)

The report also lists yearly costs for those with only Medicare Part A, extra cost for Part B, and any Part B rebate if applicable. Plus, you will find a chart listing important information on cost sharing. They all have wrap around benefits for those on Medicare and cover most of your deductibles, copayments and coinsurance.

Regular services are available nationwide for GEHA and BCBS, Aetna has service available in many areas. Some of the other differences are that Aetna doesn’t provide dental benefits. GEHA and BCBS provide partial reimbursement for specified dental procedures.

Hearing aids are covered by all three providers however BCBS has a 5-year replacement policy and the other two offer new aids every three years.  Aetna covers 100 days in a skilled nursing facility while GEHA covers 21 and BCBS covers the first 21 days and then charges $176 per day for day 21–100: and members pay all costs from day 101 and up.

The yearly maximum out-of-pocket expenses are also a consideration. Here are the limits for each of the three Self Plus One plans: (See the explanation in the following paragraph that describes why the figures differ between the two comparison programs.)

Out of Pocket Expenses

  • OPM – Aetna MA $15,000 / Checkbook $18,160
  • OPM – GEHA $13,000 / Checkbook $20,070
  • OPM – BCBS $11,000 / Checkbook $17,880

Insurance plans have a stated limit that you might have to pay including all costs as listed in the OPM column above. But some plans have loopholes that may leave you paying copays and deductible amounts above their limits. The Checkbook “Most you can pay in a year” figure under their column in the above table includes an estimate of the potential cost of significant gaps or loopholes, etc. It doesn’t include dental costs because there are no plan limits on these.

It’s important to review the report and provider benefit guides to ensure they cover the level of services needed. We travel, and require access to in and out of network healthcare services. BCBS Basic doesn’t offer out-of-network coverage. Aetna MA provides services in many areas and is listed as a state specific HMO. Enrollment in the Aetna MA Plan is limited: You must live or work in one of their geographic service area to enroll. With GEHA Standard members that are enrolled in Medicare A & B pay $0 for deductibles, copays and coinsurance whether your provider is in- or out-of-network, $0 for inpatient and outpatient hospital services, surgeries and office visits, and if you travel overseas you pay $0 for deductibles and copays outside the United States. BCBS also offers overseas coverage.

GEHA and Aetna both provides 90-day supply of covered drugs by mail. According to the 2021 BCBS brochure their Basic mail service prescription drug program is limited to Medicare Part B members only. If you use a specific formulary drug and decide to change plans contact the new plan to find out if your prescription is covered and what your copayments will be.

All three plans have their good points and any one of them provide acceptable coverage. When accessing plans, I look for the plan that best fits our needs and Its affordability.

I mentioned this in the previous article but it is worth repeating here. If you are considering other Medicare Advantage Part C plans that don’t require FEHB participation, and desire to discontinue your FEHB component, you may wish to suspend your FEHB Plan instead of canceling it. This way, if the MA coverage incurs more costs than anticipated or benefits are insufficient, you have a path back to a viable FEHB Plan provider during the next open season.

Another precaution, be careful when considering Medicare Supplement Plans. They are totally different from Medicare Advantage Plans and you can’t suspend your FEHB coverage and will not be allowed to return to the FEHB program if the Medicare Supplement Plan proves too costly and has insufficient coverage. Many Supplement Plan sales representatives are unfamiliar with the FEHB program and its many advantages.

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Disclaimer: The information provided may not cover all aspect of unique or special circumstances, federal regulations, medical procedures, and benefit information are subject to change. To ensure the accuracy of this information, contact relevant parties for assistance including OPM’s retirement center. Over time, various dynamic economic factors relied upon as a basis for this article may change. The advice and strategies contained herein may not be suitable for your situation and this service is not affiliated with OPM or any federal entity. You should consult with a financial, medical or human resource professional where appropriate. Neither the publisher or author shall be liable for any loss or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Posted in BENEFITS / INSURANCE, FINANCE / TIP, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION, UNCATEGORIZED

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