Medicare Application Assistance

Medicare is a U.S. federal government health insurance program that provides health coverage primarily to:

Individuals Aged 65 and Older: Most U.S. citizens become eligible for Medicare when they turn 65. This age group constitutes the largest portion of Medicare beneficiaries.

Certain Younger Individuals with Disabilities: Medicare also covers younger individuals with qualifying disabilities who are unable to work.

Individuals with End-Stage Renal Disease (ESRD): People of any age with ESRD – such as kidney failure requiring dialysis or a kidney transplant – can be eligible for Medicare.

Medicare is divided into several parts, each covering specific healthcare services:

Medicare Part A

Often referred to as “Hospital Insurance,” Part A covers inpatient hospital care, skilled nursing facility care, hospice care, and some home health services.

Medicare Part B

Known as “Medical Insurance,” Part B covers outpatient medical services, preventive care, physician visits, laboratory tests, and durable medical equipment.

Medicare Part C

This is also called “Medicare Advantage.” Part C plans are offered by private insurance companies approved by Medicare. They combine Part A and Part B coverage and often include additional benefits like prescription drug coverage and dental or vision services.

Medicare Part D 

Part D is the prescription drug coverage portion of Medicare. It helps beneficiaries pay for the cost of prescription medications. Like Part C, Part D plans are offered by private insurance companies.

Medicare-eligible clients have several options, depending on where they live.

Medicare Supplement Plans

Medicare does not cover all medical expenses. Medicare Supplement policies offered by private health insurers help fill those gaps: costs such as co-pays, and deductibles for hospitalization and doctor visits. 

There are a variety of plans — Plan A through N — but each plan is standardized. Every carrier’s Plan F, for example, offers the same benefits. But prices vary by carrier. 

Medicare for FERS and CSRS Retirees

If you are getting ready to retire from the federal government, or already have, you may not understand how Medicare can work with your federal employee health benefit to maximize your cost and coverages.

While the federal employee health benefit plans that are available are great, they don’t cover everything! Some people don’t realize this. Medicare is built to cover some of the things that the federal health plans don’t. There are three strategies that Federal Employee retirees can use to solve their health insurance needs.

  1. Continue to carry your FEHB and only take on Medicare Part A. Some people prefer it this way because it gives them the flexibility to not have to worry about going to Medicare-approved providers, and physicians. Others may choose to go this route because they plan on moving or traveling abroad a large amount. In this scenario, their coverage is exactly the same as it is for an active federal employee.
  2. Take on Medicare A and B while continuing FEHB coverage. In this scenario, the Federal Employee will have complete coverage and very little chance of paying out-of-pocket costs. But, they will be paying two premiums every month. Medicare would be the primary insurance and the FEHB plan would be secondary. Typically, if people use this strategy, they will drop their FHB to a basic plan to reduce the costs of their secondary coverage.
  3. OPM allows federal retirees to “suspend” their FEHB coverage to go onto a Medicare Advantage plan. To be eligible for Medicare Advantage they must first be covered by Medicare A and B. The advantage of using this strategy is twofold. Number one: it will be the most cost-effective on the monthly budget. This is because most Medicare Advantage plans come with a zero-dollar premium. So that means that the only monthly cost would be their Medicare Part B premium. Number two: This strategy allows the federal employee to go back onto their FEHB, any open season that they choose if they decide they don’t like Medicare Advantage, or if they prefer to have a higher monthly cost with no additional out of pocket. 

Medicare is a critical healthcare program that provides financial assistance to millions of Americans – especially seniors and those with disabilities – to help them access necessary medical services and prescription drugs. Medicare beneficiaries may have different options and costs depending on their specific needs and the Medicare plans they choose, so it’s critical for individuals approaching Medicare eligibility to understand their options and make informed choices about their healthcare coverage. FEBA has Medicare Experts that are available to assist you with analyzing what plans may suit your situation best! Complete the form below to schedule an appointment.

Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

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