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OPM.gov / Insurance / Healthcare / Medicare / Active Federal Employee /
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Active Federal Employee 

If you are an active Federal employee, there are different things to consider when deciding to enroll in Medicare. FEHB provides robust coverage that is compatible with Medicare. Your healthcare needs may be the deciding factor in determining if enrolling in Medicare now is the best choice for you.

What to consider

Part A is premium-free for most people. In addition to the advantage of not paying a monthly premium, having Part A will help cover some of the costs that your FEHB plan may not cover, such as deductibles, coinsurance, and charges that exceed the FEHB plan’s allowable charges.

  • You have the option to defer enrolling in Part A if you’re enrolled in a High Deductible Health plan with a Health Savings Account (HSA) and want to continue contributing to the HSA account.

Defer enrolling in Part B. As an employee, your FEHB coverage is primary. You can save on paying Part B premiums by deferring enrolling in Part B until your retirement.

FEHB plans do not offer Part B premium reimbursements or waive other costs. Since FEHB is your primary coverage, your FEHB plan does not help in paying for Medicare premiums.

Avoid billing errors, by telling your FEHB plan that you have Medicare. As soon as you enroll in Medicare, let your FEHB plan know that you or a covered family member has Medicare coverage.

What happens if you don’t take Part B as soon as you’re eligible

You’ll get a second opportunity to enroll in Medicare during the Special Enrollment Period (SEP) to enroll in Part B when you stop working or are no longer covered by your employer’s health plan. By enrolling during the SEP, you will not be subject to the late enrollment penalty.

  • When you retire, ask your employing office to complete form CMS-L564 Request for Employment Information to facilitate enrolling in Part B during the SEP.

How FEHB and Medicare work together

Premiums: Your FEHB premiums will continue to be deducted from your salary. On the other hand, your Medicare premiums may be deducted from your Social Security or RRB retirement benefit or billed to you.

  • You may have to pay higher Part B premiums based on your income. Check the Medicare cost tables to see if you have to pay a higher premium for Part B or Part D coverage.

Canceling FEHB coverage may risk your eligibility to continue FEHB coverage in retirement. Check the eligibility rules to ensure that you meet the eligibility criteria to have FEHB coverage in retirement before canceling your coverage.

FEHB is your primary coverage if you receive workers’ compensation benefits and are determined unable to return to duty. FEHB is your primary coverage and will pay first except for care you receive related to your workers compensation injury.

Examples

Scenarios you may experience or have questions about.

You continue to work for the Federal government past age 65 and are enrolled in Medicare. Your FEHB coverage will be your primary coverage until you retire.

You retire at age 65 from the Federal government and begin working in the private sector. You don’t get health insurance coverage under your new employer. If you know you’re not going to enroll in your private sector employer’s health plan, you can avoid Medicare Part B late enrollment penalties, by signing up for Medicare when you retire.

You are not yet eligible for Medicare and cover your spouse under your FEHB family plan. Your spouse has Medicare coverage also.  Since your spouse is covered under your FEHB plan, FEHB is primary and your spouse’s Medicare coverage is secondary.

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