Posted on Friday, 1st December 2023 by Dennis Damp

I’ve spent most of my time evaluating our health care options this past two months. This year’s focus was on the new Medicare Advantage (MA) plans offered by GEHA and the Medicare Prescription Drug Plan (MPDP) offered by Blue Cross and Blue Shield and 16 other providers. So much to consider and research before staying the course with our current plans or moving to a new option.

Observations

Medicare Advantage (MA) Plans with their Part D prescription coverage offer considerable savings. I outlined the GEHA MA plan benefits in my article titled, Comparing FEHB Plans to their Medicare Advantage (MA) Option.

It would seem the best of both worlds, Part B subsidies that increase monthly Social Security checks, lower prescription costs, gym memberships, and other attractive benefits. Unfortunately, there are drawbacks, especially for those with health issues that often require pre-approvals for tests and medical procedures.

Who Pays for Added Benefits and Subsidies?

According to the Medicare website, “Medicare Advantage is a Medicare-approved plan from a private company that offers an alternative to Original Medicare for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D.”

To provide the same level of services and extended benefits, they must reduce costs, operate efficiently, and review the medical necessity of tests and procedures ordered by your doctor.

In most cases, you can only use doctors who are in the plan’s network and in many cases, you may need to get approval from your plan before it covers certain drugs or services. This added layer of approvals and subsequent appeals can delay tests and procedures for critically needed services.

Feedback

I received a number of replies to my request for input about FEHB MA plans.

One of our newsletter subscribers opted into the Mail Handlers Standard MA plan last fall. He did extensive research and finalized the decision using the CHECKBOOK’s FEHB plan comparison service. His wife had extensive medical expenses due to unexpected heart disease after enrolling.

They paid nothing for her procedures or hospital stay. Their prescription costs range from $0 to $50 for 90-day periods. Just two were $50 because they are new brand name drugs.  He is satisfied with the plan and staying enrolled for 2024.

Note: Order Checkbook’s guide at Guidetohealthplans.org and save 20% by entering promo code FEDRETIRE at checkout. The online and print Guide is available.

Dona’s husband had his first knee replaced without incident. At the time they were enrolled in the Aetna FEHB plan before the MA option was available. Medicare was their primary provider.

They signed up for one of the FEHB sponsored MA plans and all went well the first year. Her husband’s other knee required replacement and his doctor submitted the request for approval to his Medicare Advantage plan office. A week before the scheduled surgery, his custom knee was denied.

They appealed the decision, and it was turned down again. Another off-the-shelf orthotic device was submitted; they had to cancel the operation again. Dona transferred back to the their original FEHB plan during the next open season.

Dan agrees that the GEHA MA plans look very attractive! He was enrolled in BCBS Basic and has evaluated other plans because of increasing premiums.

He is switching to GEHA Standard this year and signing up for their MA plan after considerable research. He stated, “Between the savings in monthly premiums, being able to drop my FEDVIP Dental plan and my COLA for next year I will be looking at around a $400 increase in my retirement check each month.”

A blog visitor replied, “I too have been a GEHA Standard enrollee for many years and I was very interested in the new MA advantage plan. It all looked good until I started checking the in-network providers.”

He went on to say, “Not a single quality hospital in my area is included in the network (and only about 1/2 of my physicians). Yes, I know that you can ask the provider to accept payment from UHC and that you also have the option of paying the bill directly and then being reimbursed but do I really want to be bothered with that every time I have a test or need a service from one of the non-network providers.”

He is going to explore other MA plans in his area or stay with GEHA standard.

What Option is Best for You, MA or MPDP?

After weighing all of the factors and exploring plans, the Medicare Prescription Drug Plan (MPDP) is an attractive choice for me and my family. Even though I would be subject to a Part D income-related monthly adjustment amount (IRMAA), it would still provide significant prescription savings overall as I noted in my previous article.

Unfortunately, it is only offered by 17 plans in 2024 and GEHA isn’t one of them. I won’t abandon my GEHA plan to take advantage of it, I’m satisfied with their Standard plan and its low monthly self plus-one premium of $326.79. Changing to BCBS Basic, which offers this feature, would increase my monthly payment by $186.91 to $517.13.

With the MPDP, Medicare A & B remains your primary provider and the FEHB plan picks up all of your copays, coinsurance and deductibles. You typically don’t have the pre-approval issues that you may experience with MA plans.

Drug costs are much lower under Part D, especially with the added enhancements included by your FEHB plan, and you are able to pick it up without a late enrollment penalty!

Hopefully, GEHA and others will offer the MPDP option in 2025.

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Conclusion

Most are drawn to the FEHB MA options for the cost savings. Who wouldn’t want your PART B Premiums reduced and, in some cases, eliminated? Then you add in the significant prescription cost savings, and other benefits.

Initially, I felt it worth the risk to sign up for the MA option due to the ability to opt out at any time during the year and return to your original FEHB plan. Dona, one of the respondents to my query about MA plans, mentioned they switched back to their original plan after having the problems with getting her husband’s knee replaced.

She stated, “He got his new card and assumed all was ok and he was out of Medicare Advantage.” The plan still had her husband partially enrolled in the MA plan and she proclaimed, “Getting this corrected was a nightmare process that took months and months and many calls to finally fix. He once again had to delay his knee surgery.”

Yes, the MA plans are attractive and may be a good fit for you and yours. Take your time to explore the options, review the information provided by each carrier, and call to ask questions that you need the answer to before enrolling.

Good health is fleeting and you never know what is around the corner at any age. I’ve been back and forth on the issue of signing up for an MA plan all year. I’ll be staying with my GEHA Standard plan again this year, and hope they will offer the MDPD option during the 2025 open season.

Previous Open Season Articles

• Comparing FEHB Plans to their Medicare Advantage (MA) Option
• The FEP Medicare Prescription Drug Program (MPDP) Part 1
• Prescription Drug Coverage and MA Plans in 2024 – Part 2
• 2024 FEHB Plan Selection Guide – Which Plan is Best for YOU

Helpful Retirement Planning Tools

• Retirement Planning for Federal Employees & Annuitants
• The Ultimate Retirement Planning Guide – Start Now
• Deciding When To Retire – A 7-Step Guide
• Annuity Expectations – Before and After
• TSP Guide
• Budget Work Sheet
• Medicare Guide
• Social Security Guide

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.

Tags: BCBS PDP, FRHB MA Plans, MA, Medicare Advantage, Medicare Prescription Drug Program, MPDP, PDP
Posted in BENEFITS / INSURANCE, ESTATE PLANNING, FINANCE / TIP, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, WELLNESS / HEALTH

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Posted on Friday, 24th November 2023 by Dennis Damp

This article compares the Government Employees Health Association (GEHA) Standard Plan to their new MA Option. You will have to review the specific plan of interest to ensure it covers the services you need for the upcoming year.  

Open season closes December 11, we have less than two weeks to decide whether to stay the course or move to another potentially lower cost plan with the benefits and services needed. Today, with the rising cost of everything, it is an essential and time-consuming task.

The FEHB Medicare Advantage Conundrum

Many Federal Employee’s Health Benefit (FEHB) plans offer a Medicare Advantage (MA) option that appears to provide considerable savings and expanded benefits for federal employees and annuitants. I’ve been a GEHA Standard plan subscriber for the past 10 years; they provided exceptional services and low-cost benefits without fail all these years.

What can their MA Standard and High option provide that I don’t already have? Much to my surprise, their MA options appear to provide considerably more benefits than I had imagined and decided to outline them here for our newsletter subscribers and website visitors.

Who is on First and What is on Second (Abbott and Costello)

There are two GEHA MA plans this year, a standard and high option both managed by United Healthcare, one of the largest healthcare providers nationwide. I’ll focus on the Self Plus One Standard option for this review. The standard monthly premium is $326.79 and the High option costs $540.95.

Actually, GEHA’s standard premium is one of the lowest available and they provide comprehensive coverage and great service overall. There aren’t any additional premiums required when you opt for their Medicare Advantage offerings. Stange but true. Plus, both plans provide a Part B subsidy, $75 for the Standard Plan and $100 for their High Option.

Just the Facts Please

There aren’t any additional premiums for the MA options PLUS your Part B premiums withheld by Social Security decrease by either $75 or $100 for both you and your spouse.

In other words, if you file a joint tax return with a modified adjusted gross income of less than or equal to $206,000 your Part B premium would be $174.70 for each of you. If you are enrolled in the Standard GEHA plan, Social Security will reduce your Party B premium by $75 to $99.70 and your Social Security check will increase by $75 for both you and your spouse!

According to GEHA’s letter sent October 4, 2023.  “Enrollment is voluntary. Annuitants (and/or their eligible dependents) may opt in or out of the enhanced level of benefits at any time throughout the year.” You don’t need to wait until the next open season to move back to your original plan.

With that cavate, there seems to be little risk. If you aren’t satisfied you can opt out and return to your original GEHA plan and revert back to traditional Medicare Part A and B.

GEHA Standard MA Advantages

The following list highlights some of the major benefits of the FEHB MA Standard option:

• The MA plan provides a $75 Part B premium subsidy
• Free gym membership
• Over-the-counter item allowance of $40
• No need to coordinate benefits between Medicare and GEHA
• Eliminates the annual Medical out-of-pocket maximum of $6,500 / $13,000
• Provides 30 additional acupuncture visits per year
• Unlimited speech and occupational therapy visits
• No copayment for durable medical equipment
• Zero copay for routine podiatry
• $2,500 hearing aid allowance, limited to UnitedHealthcare hearing network providers

To clarify, the GEHA MA option is a national PPO plan and enrollees pay $0 deductibles, copays, and coinsurance as you currently have under the Standard GEHA plan. This includes $0 for preventative services, physician office visits (primary and specialists), hospital visits, emergency room or urgent care, and ambulance service.

Medicare advantage enrollees will receive a new medical card that you must provide to your doctor’s receptionist during your next visit, and to the pharmacy where your prescriptions are filled. Keep your GEHA card as well, you must remain a GEHA member to enroll in their UnitedHealthcare managed MA plans.

Prescription Drug Tiers (A Significant Advantage)

Once you elect a MA plan, a Medicare Part C Plan, you are automatically enrolled in Medicare Part D drug coverage. Those over 65 and new enrollees in the GEHA Medicare Advantage plan may receive a Late Enrollment Penalty Letter for Part D from Social Security. If you receive this notice, call the plan to let them know it was received. You will not be penalized for a late Part D enrollment when sighing up for a FEHB sponsored MA plan.

Secondly, if you decide to opt out of the program you will not be penalized for Part D late enrollment if you should decide to reenroll down the road.

Significant prescription cost savings

If the actual cost of a drug is less than the normal cost-sharing amount shown on the following chart for that drug, you only pay the actual cost, not the higher cost-sharing amount. I’ve paid less than a dollar for some generic prescriptions.

GEHA provides supplemental drug coverage in addition to your Part D prescription drug benefit when you sign up for their MA plans. The drug copays in this section are for drugs that are covered by both your Part D prescription drug benefit and your supplemental drug coverage.

The Standard GEHA plan cost for a Tier 2 drug is 40% ($250 max) compared to a straight $40 copay under their MA option. I researched two prescriptions that my wife and I were prescribed recently and was amazed at the savings.

Drug Cost Comparisons

• Jardiance TAB 10MG, $80 for a 90-day supply for the MA plan compared to $500 with GEHA Standard
• Advair HFA AER 115/21, $40 MA, $157 per month under the GEHA Standard Plan

Check the cost of your prescriptions under the GEHA Standard MA plan. Compare them to the GEHA Standard non-MA plan costs or call GEHA and they will provide the costs for you.

GEHA Standard MA Plan Prescription Drug Costs

Pharmacy out-of-pocket maximum

When your total out-of-pocket costs (what you pay) reach $3,500 you will not pay any copay or coinsurance.

Cost Savings Analysis

You may run into difficulties if you’re required to pay a higher Part B and D premium based on your income due to the income-related monthly adjustment amount (IRMAA). The increased premium payments are based on your Modified Adjusted Gross Income (MAGI).

Only 7% of those on Medicare pay an income adjusted amount for their part B and D premiums.

Most required to pay an IRMAA will be in the first bracket, those filing an individual tax return with a MAGI of greater than $103,000 but less than or equal to $129,000, or those filing a joint return with a MAGI greater than $206,000 but less than or equal to $258,000.

Once you move to a bracket that requires an IRMAA, those enrolled in an MA plan would also pay Part D IRMAA premiums as well.  However, for those in the first bracket, that would only amount to $12.90. Let’s work up the numbers.

The Numbers Game

For this analysis a couple is filing a joint return with a MAGI of $212,000. They are in the first IRMAA bracket and their premiums will be as follows:

• $326.79 – GEHA Standard FEHB for Self Plus One
• $489.20 – Part B premium $174.70 plus an IRMAA of $69.90 ($244.60). Each person will pay $244.60. After the Part B subsidy of $75 is applied, $169.60 would be deducted from each of your Social Security checks monthly.
• $25.80 – Part D premium, the IRMAA, $12.90 times two, for each person. The $12.90 will also be deducted from each of your Social Security checks every month.

The couple’s total premiums will be $841.79. This is adjusted down by the Medicare Part B subsidy of $75 per month for each member, two in this case. Social Security will reduce your part B premium by this subsidy therefore increasing each of your Social Security checks by $75.

Essentially, this reduces your total monthly premium by $150 to $691.79. Then factor in your lower prescription drug costs and the additional benefits such the $40 over-the-counter item allowance and the elimination of the annual medical out-of-pocket maximum. Lots to consider.

Dental and Eye Care Potential Savings

You will also find generous dental and eyecare benefits that may allow you to drop or reduce your FEDVIP coverage. Compare you FEDVIP plan coverage to the GEHA Standard MA plan benefits to see if that is feasible for you.  I would reduce my healthcare benefit costs by another $75 if I dropped my FEDVIP coverage. Here is a link to additional services provided under this MA Plan:

• Additional Services

Compare Plans

Use OPM’s FEHB Plan Comparison Tool and Consumers’ Checkbook 2024 Guide to Health Plans to find the best FEHB plan for your needs. The Consumers’ Checkbook Guide is available in print and online formats.

Checkbook’s Guide helps active and retired federal employees find a FEHB plan that meets their needs at a cost they can afford. By answering a few questions, a personalized cost estimate is provided for each plan that includes the premium plus expected out-of-pocket costs.

For retirees, Checkbook’s Guide provides a yearly cost estimate for every FEHB plan with Medicare Part A only and a separate estimate with Medicare parts A and B. This allows users to see which plans coordinate best with Medicare, the cost reduction of adding Medicare Part B, and whether the FEHB plan offers Medicare Part B premium rebates.

Federal Retirement readers can order Checkbook’s guide at Guidetohealthplans.org and save 20% by entering promo code FEDRETIRE at checkout. The online and print Guide is available now.

Use these two excellent tools to drill down to and find the plan best suited for your personal situation. Review individual FEHB brochures, they provide the plan’s official statement of benefits.

Precautions

I wrote an article earlier this month that talked about issues hospitals, especially in rural areas were having with certain MA plans. If you missed the article, click on the link below to review it, and read the Caution Section.

• Prescription Drug Coverage and MA Plans – Part 2

There are always exceptions and it is best to talk with your primary providers to ensure they accept the MA plan you are enrolling in. According to one article I read, “a growing number of hospitals and health systems nationwide are pushing back and dropping some or all contracts with the private plans altogether.”

Use the following link to see if your providers are in their network:

• https://retiree.uhc.com/geha/find-a-provider

The FEHB MA plans appear to be more robust and hopefully less susceptible to these issues, more research on my part is needed to confirm this. If anyone reading this has experienced problems with their FEHB MA plans, please let me know so that I can relay them to our subscribers and blog readers.

Summary

I’ve been hesitant to switch to a MA plan since they were first introduced under the FEHB umbrella several years ago. Knowing that you can opt out of the GEHA MA program at any time, and revert back to a standard GEHA Self Plus One plan with Medicare A and B is one of the major deciding factors for me. After a little more research on my part, I may sign up before open season ends on December 11^th.

The only reservation is the potential for referrals that may be required under the MA plan for services such as MRIs and various tests that are needed as we age.

Another consideration is that retiree’s income can change each year due to retirement plan RMDs, increased interest and dividend income, and unanticipated capital gains, that could increase your IRMAA in the out years.  If that is the case you can always opt out and return to the Standard GEHA plan. Those in higher IRMAA tiers could end up paying more for their coverage even with Part B subsidies.

I talked with Camille Hemmerich, one of the GEHA UnitedHealthcare Customer Service Advocates this week to verify a number of issues. She was very helpful and we discussed most of the above to one degree or another.

Call their help line at 1-844-491-9898 for clarification that you may need and to sign up. They are available from 8 a.m. to 8 p.m. local times, 7 days a week or visit www.geha.com/MedicareAdvantage.

When you call, be prepared to answer questions to confirm your identity and determine which MA plan you are eligible to enroll in. Camille was able to answer all of my questions to my satisfaction and backed up her replies with references.

Helpful Retirement Planning Tools

• Retirement Planning for Federal Employees & Annuitants
• The Ultimate Retirement Planning Guide – Start Now
• Deciding When To Retire – A 7-Step Guide
• Annuity Expectations – Before and After
• TSP Guide
• Budget Work Sheet
• Medicare Guide
• Social Security Guide

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.

Tags: FEHB, FEHB MA, FEHB Open Season, MA and Part B, Medicare Advantage Plans
Posted in BENEFITS / INSURANCE, ESTATE PLANNING, FINANCE / TIP, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION, UNCATEGORIZED, WELLNESS / HEALTH

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Posted on Friday, 17th November 2023 by Dennis Damp

Open season runs from November 13^th through December 11^th.  There are tools available to evaluate provider options, select your 2024 plan, and submit changes to OPM. Use the following resources to make an informed decision for you and your family’s health care needs.

Forward this article to others that can use this “Open Season” information.

Obtain Copies of Plan Guides

   Active Employees

• Request hard copies of desired plan brochures through your benefits coordinator. If you don’t know who that is, ask your supervisor.
• Download plan brochures from the OPM website.
• Request copies direct from plan providers. I typically request and receive brochures direct from GEHA and Blue Cross Blue Shield weeks before they are available on the OPM site.

   Annuitants (Retirees)

• Sign up for FEHB Open Season Online – This site is devoted to federal annuitants. Request plan brochures to be mailed to your home address or you can download brochures to your computer. You must register to use this site and annuitants can change enrollments online.
• Download plan brochures from the OPM website.
• Request copies direct from plan providers.

Determine Plan Costs – 2024 FEHB Plan Rates (All rates are now posted online).

Compare Plans

Use OPM’s FEHB Plan Comparison Tool and Consumers’ Checkbook 2024 Guide to Health Plans to find the best FEHB plan for your needs. The Consumers’ Checkbook Guide is available in print and online formats.

Checkbook’s Guide helps active and retired federal employees find a FEHB plan that meets their needs at a cost they can afford. By answering a few questions, a personalized cost estimate is provided for each plan that includes the premium plus expected out-of-pocket costs.

For retirees, Checkbook’s Guide provides a yearly cost estimate for every FEHB plan with Medicare Part A only and a separate estimate with Medicare parts A and B. This allows users to see which plans coordinate best with Medicare, the cost reduction of adding Medicare Part B, and whether the FEHB plan offers Medicare Part B premium rebates.

Federal Retirement readers can pre-order Checkbook’s guide at Guidetohealthplans.org and save 20% by entering promo code FEDRETIRE at checkout. The Guide will be released online no later than the first day of Open Season. Print books will be mailed the week prior to the start of Open Season.

Use these two excellent tools to drill down to and find the plan best suited for your personal situation. Review individual FEHB brochures, they provide the plan’s official statement of benefits.

Changing Enrollment

Annuitants (Retirees)

• Annuitants can change plans online at FEHB Open Season Online. The online service is easy to use and you can track your change submissions.
• Call Open Season Express 1-800-332-9798.
• Send regular mail (Postmarked no later than final date of Open Season) to:

Office of Personnel Management
Open Season Processing Center
P.O. Box 5000
Lawrence, KS 66046-0500

When sending requests by mail clearly state your Open Season request. If you are making an enrollment change, be sure to tell OPM the plan you want, the type of coverage (Self Only, Self Plus One or Family), and the enrollment code. You must include your annuity claim number and social security number on your request. If you are choosing Self Plus One or Family coverage, OPM will also need your dependent and other insurance information.

Federal Employees

• You may be able to enroll online using Employee Express.
• Department of Defense employees can enroll using the DoD automated enrollment systems.
• Health and Human Services and Department of Veterans Affairs employees can enroll using MyPay.
• Department of Energy employees can enroll using the DOE automated systems.
• You can submit Standard Form 2809, Employee Health Benefits Election Form (PDF file) [849 KB], to your Human Resources Office. (Unless you are a U.S. Postal Service employee)
• Postal Service employees can enroll using the PostalEASE online and telephone enrollment system.

Federal Employees Dental and Vision Insurance Program (FEDVIP)

Dental and vision benefits are available to eligible Federal and Postal employees, retirees, and their eligible family members on an enrollee-pay-all basis. Enrollment takes place during the annual Federal Benefits Open Season in November and December. New and newly eligible employees can enroll within the 60 days after they become eligible.

Register online at www.BENEFEDS.com to review and download plan brochures, use their plan comparison tool, and to initiate a change or cancel enrollment. If you aren’t a registered user sign up now. You will be able to review your Dental, Vision, Long Term Care and Flexible Spending accounts. Enrollees can initiate changes during open season, when there is a life event change, or to cancel coverage at any time.

For enrollment/premium questions regarding dental and vision insurance, contact BENEFEDS at 1(877) 888-3337.

Medicare Impact on FEHB Plans

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

• The FEP Medicare Prescription Drug Program (MPDP) – Part 1
• Prescription Drug Coverage and MA Plans in 2024 – Part 2
• A Marriage of Convenience – Medicare & FEHB
• Medicare Advantage Plans (Heads Up for he the Upcoming Open Season)
• Medicare and FEHB Options – What Will You Do When You Turn 65?
• What to Consider Before Enrolling in Medicare B
• How to Delay Part B Premiums

Summary

With high Medicare Part B premiums and inflation increasing the cost of everything, it pays to seek out the best coverage for the lowest possible price.

If you are considering a FEHB Medicare Advantage Plan there may be coverage and provider availability issues to consider. You may have to use preferred providers in their network and because the plan becomes your primary provider, not Medicare, certain preapprovals or authorizations may be required for treatment. Ensure your doctors are on their list and that approved medical facilities are available in your area.

Kiran Ahuja, the OPM Director said, “Federal employees and annuitants should take advantage of Open Season to conduct a wellness and financial check-up for their health care coverage to ensure they are getting the most from their benefits,” she also stated, “From our data, less than 5 percent of federal enrollees change their health plans during Federal Benefits Open Season, which means our workforce could be leaving behind valuable savings.”

Use the comparison tools mentioned in this article to evaluate your options and contact the plans of interest for clarifications if needed.

Helpful Retirement Planning Tools

• Retirement Planning for Federal Employees & Annuitants
• The Ultimate Retirement Planning Guide – Start Now
• Deciding When To Retire – A 7-Step Guide
• Annuity Expectations – Before and After
• TSP Guide
• Budget Work Sheet
• Medicare Guide
• Social Security Guide

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.

Tags: 2024 FEHB Open Season, 2024 FEHB Plan Selection Ground, Medicare Advantage FEHB Plans, New FEHB MA Plans
Posted in BENEFITS / INSURANCE, ESTATE PLANNING, FINANCE / TIP, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION

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Posted on Friday, 10th November 2023 by Dennis Damp

The Inflation Reduction Act’s Part D reforms will impact FEHB plans in 2024. Historically, most federal annuitants didn’t need to consider Part D because FEHB prescription drug benefits were as good or better and didn’t have an additional premium. However, OPM has allowed FEHB plans to offer Part D prescription drug plans (PDP) in 2024, which means more federal annuitants will benefit from improved coverage.

We’ll walk you through the important changes and annuitants’ two options to receive Part D coverage—PDPs and FEHB Medicare Advantage (MA) plans.

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

Part D Prescription Drug Plans (PDP)

The following 17 FEHB plans will offer a PDP next year:

To receive OPM approval, the PDP must offer prescription drug coverage that’s as good as or better than the FEHB plan.

After our review, we agree with OPM: The PDP benefits are indeed as good or better, and this is especially true for the PDPs highlighted above that have a $2,000 annual prescription drug out-of-pocket maximum.

If you have Medicare Part A or Parts A & B and you’re currently enrolled in one of the 17 FEHB plans above, you’ll be auto-enrolled in the PDP (except for BCBS plans which only auto-enrolls if you have Parts A & B). Your plan will notify you of auto-enrollment and you’ll have 30 days to opt out if you wish. You’ll then receive a new Part D prescription drug insurance card and coverage will commence 1/1/2024.

Most federal annuitants, especially those with moderate to high prescription drug costs, will benefit tremendously from these changes. If you aren’t enrolled in one of the 17 FEHB plans offering a PDP, consider switching to enjoy these improved prescription drug benefits. You’ll need to contact the plan directly to enroll, either through the website or a toll-free number.

There are a few cases where the PDP might not be the best choice for a federal annuitant.

• If you have income above $103,000 as an individual or above $206,000 as a couple, you’ll pay IRMAA for the PDP. Annuitants below the income threshold pay no extra premium. Keep in mind that Part D IRMAA is far less than Part B IRMAA, $12.90/month in the first tier compared to $69.90/month. The benefits of improved prescription drug coverage will outweigh Part D IRMAA for many.
• If you receive drug manufacturer assistance when purchasing a prescription drug, you’ll lose that option with Part D enrollment. Annuitants will need to weigh their current discounted price against the drug price from the PDP, and the additional benefits that the PDP provides.
• Members enrolled in the FEP Medicare Prescription Drug program have no coverage for drugs obtained and/or purchased overseas. Those who travel overseas frequently or go for extended stays may wish to opt-out of the program or consider purchasing travel insurance which often protects against health care expenses not covered by your health plan.

If you decide to unenroll from the PDP, you can rejoin in the future with no late penalty. FEHB prescription drug coverage is considered creditable coverage.

FEHB Medicare Advantage Plans

Medicare Advantage plans package original Medicare, Parts A & B, with Part D prescription drug coverage. For FEHB plans that offer an MA option, you pay the FEHB premium and the applicable Part B premium. Most of the FEHB MA plans have generous Part B premium reimbursements and no additional costs for approved healthcare services from providers that accept Medicare and the plan, besides prescription drugs.

The combination of no out-of-pocket healthcare costs outside of prescription drugs and at least partial Part B premium reimbursement can produce savings. For every FEHB and FEHB MA plan, Checkbook’s Guide to Health Plans for Federal Employees provides a yearly cost estimate, which is a combination of the for-sure expense of premium (both FEHB and Part B in this case) and the likely out-of-pocket costs you’ll face based on age, family size, and expected healthcare usage.

A D.C.-area couple with a 70-year-old primary insured with average healthcare expenses, income below $206,000, and self-plus-one enrollment could save $8,270 in likely healthcare expenses next year by switching from BCBS Standard to United Choice Primary Retiree Advantage.

Likely Healthcare Expenses 2024

While an FEHB MA plan will be the least costly plan for most, it may not be the right plan for you.

• Like PDPs, you’ll be subject both Part B and Part D IRMAA if your income is above the threshold ($103,000 for individuals or $206,000 for couples). The savings gained by enrolling in an FEHB MA plan will be eroded by these IRMAA payments, but this could still be the cheapest plan if your income places you into just the first IRMAA tier.
• If you spend a considerable amount of time abroad, only UnitedHealthcare Medicare Advantage plans provide routine overseas care. All FEHB MA plans would cover emergency overseas care.
• Your provider choice may be limited. While the plans state that you can see anyone that accepts Medicare, the provider must accept the plan as well. Make sure to check how any current or future providers will be covered before enrolling in an MA plan. Also, keep in mind that since you must have Medicare Part B to enroll in an MA plan, you could always use your Part B benefit to go outside the MA provider network. You would be subject to the Part B deductible of $240 and would be responsible for 20% of the allowed Medicare charge in that case.

Caution

Don’t confuse the new FEHB MA options with private sector Medicare Supplement and MA plans being sold on TV ads and through the mail. If you decide to enroll in a private sector MA plan, one outside of our FEHB program, you should suspend your FEHB plan. If you cancel your FEHB plan, you can’t return to the FEHB program.

With the FEHB MA offerings you MUST KEEP your FEHB plan; during the next open season, you can change to any of the FEHB plans available in your area if desired. If you sign up for a Medicare Supplement plan you can’t suspend your FEHB plan, you can only cancel your coverage! Read the following article on this subject if you are considering a Medicare Supplement plan:

• Don’t risk losing your FEHB coverage.

Are MA Plans Too Good to be True?

How do the MA plans pay you a Part B reimbursement, in some cases a substantial one, and pay the bills? Well, they have to manage their program through improved efficiencies and cost reductions elsewhere. Typically, through the use of their provider networks and prior authorization for many tests and procedures. Nothing is for free, there is an underlining cost that must be paid.

The MA plans are under contract with Medicare to provide what Medicare originally covered. Your providers will send you a new MA plan card to use when you go in for health care services.

Generally, the FEHB sponsored MA plans appear to be a better option than private sector non FEHB sponsored plans. Yet, you still have to look under the hood to ensure the providers you need are in the network and will accept your new plan.

Many MA plans require prior authorization for expensive procedures, surgeries, and tests; providers must be preferred and accept Medicare assignment. This can be frustrating; check with the plan you are interested in to see exactly what hoops you must jump through to get the services you need, when you need it.

One of our newsletter subscribers relayed how she had to go through 6 weeks of therapy before the carrier would approve an MRI and then further delayed the test for other reasons.

Here are links to several recent articles that discuss some of the pitfalls of Medicare Advantage (MA) plans across the country, especially in rural areas:

• Hospitals are dropping Medicare Advantage left and right
• ‘Deny, deny, deny’: By rejecting claims, Medicare Advantage plans threaten rural hospitals and patients, say CEOs

Corrections to the Last Article

In my last article titled The FEP Medicare Prescription Drug Program (MPDP), I confused the funding for the new Part D plans with the MA option. In the article sent out to our subscribers I stated the following:

The FEP Medicare Prescription Drug Program (MPDP) is a prescription drug program with a Medicare contract.

The Final Word

This Open Season will be one of the most important in recent history for annuitants. Improved Part D coverage will help most federal annuitants, but many will need to change plans to receive these benefits.

PDPs provide better prescription drug coverage for all FEHB plans that offer one, especially for the plans that offer the $2,000 annual maximum for prescription drug expenses.

FEHB MA plans can offer an even greater way to save, not just on prescription drugs but on all healthcare expenses. There are more FEHB MA plans to choose from for plan year 2024.

Prescription drug coverage under the PDP and MA plans can reduce your costs significantly. My wife was prescribed Jardiance recently and the cost under my GEHA Standard Plan for a 90 day supply was $500. Under their GEHA Standard MA plan that same drug costs $80! Quit a savings; we were able to get a significant discount through the manufacturer for as little as $10 per month.

I highly recommend Checkbook’s 2024 Guide; their online plan comparison tool provides all of the information you will need to make an informed decision on what plan is best for you.

Kevin Moss is a senior editor with Consumers’ Checkbook. Checkbook’s 2024 Guide to Health Plans for Federal Employees will be available on the first day of Open Season, November 13^th. Check here to see if your agency provides free access. The Guide is also available for purchase and Federal Retirement readers can save 20% by entering promo code FEDRETIRE at checkout.

Helpful Retirement Planning Tools

• Retirement Planning for Federal Employees & Annuitants
• The Ultimate Retirement Planning Guide – Start Now
• Deciding When To Retire – A 7-Step Guide
• Annuity Expectations – Before and After
• TSP Guide
• Budget Work Sheet
• Medicare Guide
• Social Security Guide

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.

Tags: MA Plan Questions, MA Plans, Medicare, Medicare Advantage Plans, MPDP, Prescription Drug Plans, Social Security
Posted in BENEFITS / INSURANCE, ESTATE PLANNING, FINANCE / TIP, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION

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Posted on Thursday, 2nd November 2023 by Dennis Damp

I received several emails from Blue Cross and Blue Shield (BCBS) plan members about this new offering. Federal employees and annuitants enrolled in Medicare and one of the BCBS plans will automatically be enrolled in the new MPDP plan unless they opt out.

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The BCBS website is fairly straightforward and addresses many of the concerns you may have about transferring to the new program. However, you must be aware of certain situations before making the move.

A second article will be published next week that provides more information on the 17 plans now offering the Part D prescription drug program. I’ll be working with Kevin Moss, the senior editor with Consumers’ Checkbook on the upcoming article.

Before proceeding, I’m preparing an article about the expanded FEHB Medicare Advantage plans that are now offered. If anyone has experienced problems with the MA plan they signed up for last year, please email with the issues you ran into. I would also like to hear from those who are satisfied with their FEHB MA plan and why. Your input will help me relay this information to all of our subscribers and blog readers. Send your input to ddamp@aol.com.  Thanks in advance.

Overview

The FEP Medicare Prescription Drug Program (MPDP) is a prescription drug program with a Medicare contract. When you move to the MPDP you will retain the same Federal Employee Plan (FEP) health benefits you always had as per their 2024 Plan Guide. There are additional drugs available, often times at lower costs, with a cap on the maximum out-of-pocket expenses that your current plan does not have.

Members with the MPDP option will have an annual pharmacy out-of-pocket maximum, a cap (or maximum) on the amount you’ll pay in copays and coinsurance. It’s a cap on the amount you’ll pay on prescription drugs for the year. Once you reach the maximum for the year, you pay nothing for your prescriptions for the rest of the year.

The cap for their FEP Blue Focus and Basic option is $3,500 per year while the Standard options is capped at $2,000.

Eligibility

Federal employee Plan (FEP) members, enrolled in Medicare Part A and/or Part B primary and are a resident of the U.S. or a U.S. territory are eligible for MPDP.

Prescriptions & Their Cost

You can order prescriptions and refills at one of their 65,000+ in-network retail pharmacies or through the FEP Mail Service Pharmacy (Basic and Standard Option only).

The MPDP has four drug tiers:

• Tier 1: Generics
• Tier 2: Preferred brand name
• Tier 3: Non-preferred brand name
• Tier 4: Specialty drugs

Explore the available drugs and their costs for each of their three major programs:

• 2024 FEP Blue Focus MPDP Drug List
• 2024 Basic Option MPDP Drug List
• 2024 Standard Option MPDP Drug List

Specialty drugs are considered tier 4 drugs with MPDP. Depending on how the drug is dispensed, you can buy specialty drugs by going to a retail pharmacy or by mail.

Federal employees and recent retirees with security clearances
can search thousands of high-paying defense and government contractor jobs.

Traveling Overseas

Section 5f of the BCBS 2024 guide lists Important things you should keep in mind about the FEP Federal Prescription Drug Program (FEDP). You should read this section carefully. When you go to this section cursor down the pages until you come to the section titled, FEP MEDICARE PRESCRIPTION DRUG PROGRAM. The online guide doesn’t list page numbers.

If you travel overseas and opt-out of the MPDP option, according to the plan brochure, “Your pharmacy coverage works outside the U.S. Since there are no Preferred retail pharmacies overseas, you need to pay for your prescriptions out-of-pocket and then submit your receipts and a completed claim form to get reimbursed. Overseas prescription drug claims must be submitted within one year of the purchase date.”

The 8^th bullet on this list states, “Members enrolled in the FEP Medicare Prescription Drug program have no coverage for drugs obtained and/or purchased overseas.”

If you travel overseas frequently or go for extended stays this would be something for you to consider and you may wish to opt-out of the program using the form BCBS provides.

Income Adjusted Part B and D Premiums

Higher income plan participants may have to pay an additional Part D Income Related Monthly Adjustment Amount (IRMMA) over and above your plan premium. I called customer service to ask about this issue and they stated, “there’s no separate premium for prescription drug coverage.” I was advised to contact Medicare.

Only 7 percent of all who pay Part B and D premiums are subject to an IRMMA. What most don’t realize is that your Required Minimum Distributions (RMDs), dividends, capital gains, and higher interest we are earning can increase your Modified Adjusted Gross Income (MAGI) sufficiently to where you too will have to pay this in any given year. Medicare premiums for 2024 are determined by what your MAGI was in 2022.

Those with household incomes over a certain limit will pay anywhere from an additional $12.90 to $81 a month for their Part D coverage. If you file jointly, both will have this amount automatically deducted from their Social Security check each month. Review the 2024 Medicare Part B and D premiums to determine what your additional payment would be.

The extra amount you have to pay isn’t part of your plan premium. You don’t pay the extra amount to your plan. If Social Security notifies you about paying a higher amount for your Part D coverage, you’re required by law to pay the Part D-Income Related Monthly Adjustment Amount (Part D IRMAA).  You’ll lose your Part D coverage If you don’t pay the Part D IRMAA.

Summary

If you don’t travel overseas or aren’t subject to an IRMMA, the new MPDP Part D plan seems to make sense and will save you money. The nice thing about this plan is that you still have your full FEHB plan options and you aren’t moving to a Medicare Advantage Part C plan that may have certain limitations such as available medical facilities in your area or a limited provider network.

Medicare will still be your Primary provider for Parts A and B, and BCBS pays what Medicare doesn’t including most copayments, coinsurance, and deductibles. BCBS will also provide this expanded Part D prescription drug coverage, under a contract with Medicare, if you don’t opt-out of the MPDP program.

Another consideration is that the BCBS Basic plan offers a Medicare Part B reimbursement that will offset any potential Part D premiums you may be subject to as explained above. Basic Option members who have Medicare Part A and Part B can get up to $800 with a Medicare Reimbursement Account.

All you have to do is provide proof that you pay Medicare Part B premiums. Each eligible active or retired member on a contract with Medicare Part A and Part B, including covered spouses, can get their own $800 reimbursement.

Medicare Advantage (MA) plans that pay a Medicare premium subsidy work differently. Your Social Security check increases by the amount of the monthly subsidy. In other words, you pay less for your Part B premiums.

Explore the plan thoroughly to confirm it meets you and your family’s needs, check on the availability of the prescriptions you use. Review section 5f and 9 of their brochure and review the MPDP web pages before deciding.

If you decide to opt-out of the MPDP call BCBS at 888-338-7737 between 8 am and 5 pm Eastern time to process your opt-out form over the phone. You can also send in the form they sent you with the initial letter.

Acording to the letter that BCBS sent out, “If you enroll in the MPDP and decide later that you want to go back to the traditional FEP pharmacy benefit, you can mail them at the address on the letter you received or call 1-800-MEDICARE to disenroll.”

Checkbook’s 2024 Guide to Health Plans for Federal Employees will be available on the first day of Open Season, November 13th. Check here to see if your agency provides free access. The Guide is also available for purchase and Federal Retirement readers can save 20% by entering promo code FEDRETIRE at checkout.

Helpful Retirement Planning Tools

• Retirement Planning for Federal Employees & Annuitants
• The Ultimate Retirement Planning Guide – Start Now
• Deciding When To Retire – A 7-Step Guide
• Annuity Expectations – Before and After
• TSP Guide
• Budget Work Sheet
• Medicare Guide
• Social Security Guide

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.

Tags: BCBS MPDP, Medicare Prescription Drug Program, MPDP, MPDP Part D
Posted in BENEFITS / INSURANCE, ESTATE PLANNING, FINANCE / TIP, LIFESTYLE / TRAVEL, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION

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Posted on Friday, 20th October 2023 by Dennis Damp

Throughout the year I occasionally stray from retirement planning and discuss issues that impact everyone. Some readers appreciate my commentary, while others wish I would keep my observations and opinions to myself.

This is one of those subjects that everyone should be concerned about. A recent poll found that “Seventy-one percent of registered voters surveyed said that current levels of security at the U.S. border are not strict enough, with a majority of Democrats and Biden voters saying that more needed to be done to secure the border with Mexico. Eighty-two percent of independents voiced their disapproval with current border policies.”

The president’s address to the nation Thursday evening proclaimed strong support for Israel and additional support for Ukraine but didn’t mention tightening security at our borders. I understand Europe and the middle east needs our assistance and intervention, how about America’s security interests. Can’t we do both, especially when they could be interrelated.

American’s welcome immigrants that come to this country legally, follow our rules, learn our language, add value to society as a whole, and assimilate into the communities where they live. My grandparents, on both sides, immigrated to the United Stated in the early 1900s. They came to participate in the great American experiment and succeeded in doing so.

Strange But True

Someone forces their way into your home. You don’t know who they are or where they came from; they have no regard for your personal property or our laws. Yet, you give them free room and board, pay for their healthcare, educate their children, and let them apply for benefits, all at YOUR expense.

If they choose to reside elsewhere, you pay their plane or bus fare to wherever they wish to go. When they arrive at their destination, they are provided housing and in some cities like New York, a stay in a five-star hotel, food, and everything that many Americans are struggling to obtain.

All of this is happening while there are over 582,000 homeless Americans nationwide on any given night according to The Department of Housing and Urban Development (HUD), many are veterans that served this country. Our working poor need similar support, but they are left to fend for themselves while resources dry up, due to the massive influx of immigrants flooding our support systems.

The current administration and the head of Homeland Security proclaim our border is closed! Watch the news feeds, mass border crossings, thousands sleeping on the streets and shelters bursting at the seams across the country. Then tell me with a straight face our border is closed and secure. The facts and news reports speak volumes and proclaim the truth. America is under siege.

Descending Into chaos

Millions are streaming across our border because our government offers unrestricted access and rewards illegal entrants with travel to their destination of choice, food, lodging and healthcare! Who wouldn’t want to come to America or take the risks to life and limb to get here?

When they arrive and call family and friends back home, others soon join the ever-growing caravans heading our way. When there aren’t penalties, only rewards, for violating our laws it’s no wonder why we have a problem. It’s insane. Those who choose to apply for a visa are pushed further back in the line!

This attitude is systemic today in America. We encourage the plundering of stores and there shelfs striped clean while many district attorneys release repeat offenders back on the street to do it over and over again without consequences or restitution. Car jackings are increasing and overall crime is rampant due to lack of civility and again without a cost to the criminals committing these crimes.

Civilization is predicated on following society norms, why are we abandoning law and order and allowing anarchy to prevail and fester?  Justice is designed to be blind for a reason. There are no acceptable reasons for committing a criminal act. It doesn’t matter if you are rich or poor, what your religion, race or gender is, citizen or illegal immigrant; if you commit an unlawful act, you deserve the prescribed punishment by law, period.

Just the Numbers Please!

Illegal immigrants, frequently called undocumented immigrants, are foreign-born individuals who lack a valid visa or other necessary immigration documentation due to entering the U.S. without inspection, exceeding the allowed duration of their temporary visa, or breaching the terms of their admission.

The Department of Homeland Security (DHS) reports 6,319,669 southern land border encounters since 2021, the vast majority were single adults. During fiscal year 2023, 2,202,039 were encountered at our southern border!

Does this sound like a closed border? This doesn’t count the encounters at all other borders and the million plus gotaways that crossed the border unencountered over the past three years and headed for this country’s interior unfettered.

Border Crossings/Encounters

The DHS separates border crossings into three categories:

• Apprehension: The arrest of a potentially removable noncitizen by DHS where they are temporary detained after crossing the border illegally between ports of entry. They can be arrested under Title 8 and they can file for asylee status.
• Inadmissible noncitizen: A foreign national who has not been inspected and admitted to the United States who is subject to the grounds of removal specified in INA Section 212. These individuals are ineligible for entry under Title 8.
• Expulsion: Noncitizen expelled under Title 42 authority to their country of last transit or, if a person cannot be returned to the country of last transit, to their country of origin (see Title 42). This was rescinded this year and no longer applies.

The encounters recorded by DHS don’t necessarily correspond to the number of people attempting to cross the border. Many illegals cross the border after being expelled multiple times. Plus, they totally ignore the million plus gotaways that CBP doesn’t encounter.

One border encounter can incorporate groups of different sizes, ranging from a single person to an entire family, and they are listed as only a single incident (encounter).

The Jackels at Our Gate

Security should be first and foremost considering what happened on September 11, 2001 and what is happening worldwide today! With the escalating Mideast crisis and the fact that many terrorist groups have a vendetta against America, our borders must be secured.

The U.S. State Department issued a worldwide travel advisory on October 16^th urging Americans overseas to exercise increased caution. The advisory cited “increased tensions in various locations around the world, the potential for terrorist attacks, demonstrations or violent actions against U.S. citizens and interests.”

This too should be a concern for all Americans. We have no idea what radicals are already here or soon to come and what their plans are in times like this. Foreign insurgents could be participating in demonstrations now, in America, to spur discontent and push crowds to riot.

Is the FBI and other security agencies investigating this or are they too pre-occupied with silencing parents that express their concerns, at school board meetings, about what is being taught in their children’s schools!

Dozens of terrorist groups including Islamist extremist networks such as al-Qaeda, and the Taliban still want to exact revenge on America. Add to this list, China, Russia, and Iran; and many others may already have cells established throughout the country due to our open border policy. This puts our infrastructure and personal safety at risk.

The Sleeping Giant

We are the sleeping giant allowing this to happen, and it won’t be without consequences.

Border patrol releases many thousands each day into the country without fully vetting them, not counting the thousands of gotaways. It is costing billions of dollars to care for those entering the country illegally.

Not to mention the increased crime this is fostering and instability as cartels, crime syndicates, and potential terrorist cells take hold in all corners of this country. Around 100,000 Americans die from drug overdoses each year, many from the fentanyl that is coming across our southern border.

As noted above, the definition of an illegal immigrant is “one that lacks a valid visa or other necessary immigration documentation…” They can claim to be anyone from anywhere, apply for asylum and be sent to the destination of their choice. Border patrol has no way of confirming the information they provide.

The current administration wants to increase spending on the border, not to stop the flow of migrants but to accommodate more illegals, by building additional processing centers and hiring more CBP agents to process them! Enforce the laws on the books now and change the immigration laws that foster this fiasco.

Remembering 9/11

We were attacked on 9/11 and just around three thousand died, this country rose up and fought back. Yet, we ignore the drug deaths, lawlessness, and the potential for terrorists to enter this country that our open border perpetuates. This too is a war that must be fought.

Most of those crossing our border can’t be vetted, they have no paperwork and there isn’t time or the resources to check records in their proclaimed country of origin. Many are simply processed and released into the country to go wherever they please. Single males and families alike are released and provided a date, years down the road, to appear for a hearing which most never attend.

Border Patrol reports that illegal immigrants from over 100 countries have entered America over the past three years! Many from counties that foster terrorism around the globe including Iran, Afghanistan, Iraq, Turkey, Saudia Arabia, and many others.

I’m not suggesting that many of those crossing our borders illegally aren’t good, hardworking people. However, we know little to nothing about them and criminal elements: cartel members, gangs, potential terrorist cells, and illegal drugs are also entering at an alarming rate. We encourage this invasion by not returning them to their country of origin and making them file for entry like everyone else on the waiting list.

This isn’t just one administration’s problem, in September of 2022 Newsweek reported, “The U.S. Border Patrol is reporting more than three times the number of encounters at the U.S.-Mexico border than it experienced under the former President.” The previous administration’s numbers were much lower but still too high. All presidents over the past 50 years and congress have let America down by not passing updated immigration legislation years ago.

The attack on 9/11 woke America up to the terrorists that were out to do us harm. Did we learn nothing from the experience?

Helpful Retirement Planning Tools

• Retirement Planning for Federal Employees & Annuitants
• The Ultimate Retirement Planning Guide – Start Now
• Deciding When To Retire – A 7-Step Guide
• Annuity Expectations – Before and After
• TSP Guide
• Budget Work Sheet
• Medicare Guide
• Social Security Guide

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.

Tags: Illegal Immigrants, Open Borders, Southern Border Invasion
Posted in LIFESTYLE / TRAVEL, RETIREMENT CONCERNS, UNCATEGORIZED

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Posted on Friday, 13th October 2023 by Dennis Damp

More than 71 million Americans will see a 3.2% increase in their Social Security benefits and Supplemental Security Income (SSI) payments in 2024. Social Security retirement benefits will increase on average more than $50 per month starting in January.

Federal retiree’s annuities under the Civil Service Retirement System (CSRS) receive the full 3.2% increase while those under the Federal Employees Retirement System (FERS) receive 2.2%.

Federal benefit rates increase when the cost-of-living rises, as measured by the Department of Labor’s Consumer Price Index (CPI-W). The CPI-W rises when inflation increases, leading to a higher cost-of-living. This change means prices for goods and services, on average, are higher. The cost-of-living adjustment (COLA) helps to offset these costs.

Review all COLAs from 1999 to the present and discover how the cost of living is calculated each year.

Medicare Premiums 2024

The Centers for Medicare & Medicaid Services (CMS) released the 2024 premiums on October 12, 2023 for the Medicare Part A and Part B programs, and the 2024 Medicare Part D income-related monthly adjustment amounts.

Most people do not have to pay for Part A which covers hospital care. If you or your spouse worked for at least 10 years in Medicare-covered employment, you should be able to qualify for premium-free Part A insurance.

Each year, the Medicare Part B premium, deductible, and coinsurance rates are determined according to provisions of the Social Security Act. The standard monthly premium for Medicare Part B enrollees will be $174.70 for 2024, an increase of $9.80 from $164.90 in 2023. The annual deductible for all Medicare Part B beneficiaries will be $240 in 2024, an increase of $14 from the annual deductible of $226 in 2023.

The increase in the 2024 Part B standard premium and deductible is mainly due to projected increases in health care spending and, to a lesser degree, the remedy for the 340B-acquired drug payment policy for the 2018-2022 period under the Hospital Outpatient Prospective Payment System.

Medicare Part B Income-Related Premiums

Medicare B (Medical Insurance) covers physician and outpatient care. These premiums are based on your income. The higher your income the greater percentage of the full cost of this coverage is assumed by the Medicare participant.

Medicare Part B Income-Related Monthly Adjustment Amounts

There are separate Part B income-adjusted rates for:

• high-income beneficiaries who only have immunosuppressive drug coverage
• Premiums for high-income beneficiaries with full Part B coverage who are married and lived with their spouse at any time during the taxable year but file a separate return, and for
• Premiums for high-income beneficiaries with immunosuppressive drug only Part B coverage who are married and lived with their spouse at any time during the taxable year but file a separate return

Medicare Part D (Prescription Drug Coverage)

The 2024 Part D premium is $55 plus any income adjusted amount as noted below.

A beneficiary’s Part D monthly premium has been based on his or her income. These income-related monthly adjustment amounts affect roughly 8 percent of people with Medicare Part D. These individuals will pay the income-related monthly adjustment amount in addition to their Part D premium.

This income-related monthly adjustment amount is deducted from Social Security benefit checks or paid directly to Medicare.

There are separate Part D income-adjusted rates for Premiums for high-income beneficiaries who are married and lived with their spouse at any time during the taxable year but file a separate return.

Summary

Costs continue to rise and our COLAs aren’t keeping up with the increases across all sectors. Everyone is looking for ways to cut costs and economize wherever possible.

Even though our COLAs aren’t as generous as we like, we are fortunate to have them. I know many retirees who retired a decade ago, and are taking home the same annuity they retireed with. Those with fixed incomes are truly suffering due to the government’s excessive spending and unwillingness to balance the budget.

Helpful Retirement Planning Tools

• Retirement Planning for Federal Employees & Annuitants
• The Ultimate Retirement Planning Guide – Start Now
• Deciding When To Retire – A 7-Step Guide
• Annuity Expectations – Before and After
• TSP Guide
• Budget Work Sheet
• Medicare Guide
• Social Security Guide

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, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION

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Posted on Friday, 6th October 2023 by Dennis Damp

Each year OPM announces changes to the Federal Employee’s Health Benefit (FEHB) plans. This year is no exception, and there are a number of significant improvements to our health benefits program coming next year.

These changes include expanded coverage for fertility, including broader coverage of in-vitro fertilization (IVF) related services, gender affirming care, prevention and treatment of obesity, mental health and substance use disorder, telehealth, antibiotic stewardship, and maternal health.

Participating Carriers

For 2024, the FEHB Program has 69 participating carriers offering a total of 159 plan choices (in 2023, there were 271 plans to choose from). The reduction in health plan choices is attributed mainly to the exit of one carrier, Humana.

All FEHB enrollees have a choice of 17 nationwide fee-for-service plan options open to all and there are 5 additional nationwide fee-for-service options for those eligible to enroll in Compass Rose, Foreign Service Benefit Plan, Rural Carriers Benefit Plan, and the Panama Canal Area Benefit Plans. There are 137 Health Maintenance Organization (HMO) plan options in 2024. The number of local or community-based HMOs varies by area.

You will also find 16 High Deductible Health Plans (HDHPs) and 8 Consumer Driven Health Plans (CDHPs) offered in 2024, 4 of which are nationwide.

Postal Service Employees and Annuitants

Postal Service employees, annuitants, and eligible family members may continue to participate in the FEHB Program through December 31, 2024. The first opportunity to select a Postal Service Health Benefit (PSHB) plan will take place during Open Season in late 2024, and coverage under the PSHB health benefits program will begin January 1, 2025.

Postal Service employees and Postal Service annuitants enrolled in FEHB plans on December 31, 2024, who did not enroll in a new PSHB plan during Open Season in 2024 will automatically be enrolled in a PSHB plan.

FEHB & Medicare Part B

Many retirees enrolled in Medicare pay part B premiums. A number of FEHB plans are offering partial to full reimbursement of part B premiums if you enroll in their plan. Use the provider lists in this article, that offers this benefit, to narrow your search.

Should You Change to a Lower Cost FEHB Plan When You Sign Up for Medicare?

The CDPHP Universal Benefits Inc. (Standard Option) that serves upstate, Hudson Valley, and Central New York will be offering full reimbursement of Part B premiums next year.

The following six FEHB plans offering a total of seven options continue to provide Part B reimbursement if you are enrolled in Parts A and B: (Two of these six already have their 2024 guidance available, I’ve linked to both.)

• Blue Cross Blue Shield Service Benefit Plan (Basic Option)
• Health Alliance Plan (High & Standard Options)
• Medical Mutual of Ohio Southwest (Standard Option)
• Medical Mutual of Ohio Northeast (Standard Option)
• UPMC Health Plan (Standard Option)
• GEHA Benefit Plan (High Option)

There are 29 FEHB plans offering a total of 38 options that continue to reimburse some or all of the Part B premium for members enrolled in the Plan’s Medicare Advantage Plan and Medicare Part B:

• Aetna Advantage (Advantage Option)
• Aetna Direct (Consumer Option)
• APWU (High Option)
• Compass Rose (High Option)
• Foreign Service Benefit Plan (High Option)
• Health Alliance HMO (Standard Option)
• HealthPartners (High Option)
• Kaiser Permanente – Colorado (High & Standard Options)
• Kaiser Permanente – Georgia (High & Standard Options)
• Kaiser Permanente – Hawaii (High Option)
• Kaiser Permanente – Mid-Atlantic States (High & Standard Options)
• Kaiser Permanente – Fresno, California (High & Standard Options)
• Kaiser Permanente – Northern California (High & Standard Options)
• Kaiser Permanente – Southern California (High & Standard Options)
• Kaiser Permanente – Northwest (High & Standard Options)
• Kaiser Permanente – Washington Core (High & Standard Options)
• MHBP (Standard Option)
• MD I.P.A. (High Option)
• NALC Health Benefit Plan (High Option)
• Rural Carrier Benefit Plan (High Option)
• SAMBA Health Benefit Plan (High and Standard Options)
• UnitedHealthcare Choice Open Access HMO (High Option)
• UnitedHealthcare Choice Plus Advanced (Tampa, Orlando, Miami, and Atlanta)
• Value Option)
• UnitedHealthcare Choice Plus Advanced (Chicago, San Antonio, DC, Northern Virginia, and Maryland) (Value Option)
• UnitedHealthcare Choice Plus Primary – East Region (High Option)
• UnitedHealthcare Choice Plus Primary – West Region (High Option)
• UnitedHealthcare Choice Primary – East Region (High Option)
• UnitedHealthcare Choice Primary – West Region (High Option)
• UPMC Health Plan (Standard Option)

Summary

With the expanded coverage now offered, explore each plan carefully to ensure they cover what you need at a cost you can afford. Compare plans using OPM’s Online Comparison Tool and Checkbook.org offers a comprehensive online comparison tool and/or a paperback book version. They will be available when Open Season starts on November 13.

For retirees, Checkbook’s Guide provides a yearly cost estimate for every FEHB plan with Medicare Part A only and a separate estimate with Medicare parts A and B. This allows users to see which plans coordinate best with Medicare, the cost reduction of adding Medicare Part B, and whether the FEHB plan offers Medicare Part B premium rebates. They also review FEHB Medicare Advantage plan options which can be less expensive for many retirees.

Order Checkbook’s guide at Guidetohealthplans.org and save 20% by entering promo code FEDRETIRE at checkout. The Guide will be released online no later than the first day of Open Season. Print books will be mailed the week prior to the start of Open Season.

With the continued increases across the board in everything this year, I’ll be looking closely at plans that pay partial to full part B premium reimbursements. More to come on FEHB Medicare Advantage Plans in an upcoming article that I’ll coauthor with Kevin Moss, a senior editor with Consumers’ Checkbook.

The 2024 provider plan booklets should be available by mid to late October. You will be able to download copies on OPM’s site or you can request hard copies from providers. Retirees can have brochures sent to them by Connecting to FEHB Open Season Online when open season starts. I typically request several brochures through this service each year.

Helpful Retirement Planning Tools

• Retirement Planning for Federal Employees & Annuitants
• The Ultimate Retirement Planning Guide – Start Now
• Deciding When To Retire – A 7-Step Guide
• Annuity Expectations – Before and After
• TSP Guide
• Budget Work Sheet
• Medicare Guide
• Social Security Guide

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.

Tags: 2023 FEHB Open Season, FEHB, FEHB Medicare advantage Plans
Posted in BENEFITS / INSURANCE, ESTATE PLANNING, FINANCE / TIP, RETIREMENT CONCERNS, SOCIAL SECURITY / MEDICARE, SURVIVOR INFORMATION

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