Reg Jones Expert's View

This time my remarks are directed to retirees. These days most of you who are 65 and older are covered by Medicare Part A. If you spent at least one pay period working for the federal government after December 31, 1983, I know you are. That first pay period in January 1984 was when federal employees first had Medicare deductions taken out of their salaries. Most of the rest of you either acquired Medicare coverage through your own Social Security-covered work history or by being married to someone who was covered by Medicare.

Some of you already have Medicare Part B. While Part A is free (because you paid for it through payroll deduction), its focus is hospital stays, skilled nursing, home health care and hospice care. The focus of Medicare Part B is doctor’s services, outpatient medical and surgical services, lab tests, and home health care. Medicare Part B is optional. If you want it, you have to pay the premiums. Last year they were $78.20 a month; this year they are $88.50. That’s a little over a 13 percent increase in one year!

So here’s the big question. Is it worth it for you to enroll in Medicare Part B when you become eligible or if you are already enrolled, should you keep that coverage? As with most important things in life, there’s no easy answer. However, if you are enrolled in a fee-for-service plan, such as Blue Cross-Blue Shield or GEHA, you should be covered by Medicare Part B. And, if you are enrolled in an HMO, you should strongly consider enrolling in Part B.

The reason is simple. While there is a considerable amount of overlap between FEHB plans and Medicare, there are coverage gaps in both. By carrying FEHB coverage and Parts A and B, the odds of your having any out-of-pocket costs other than those for medicine are reduced almost to the vanishing point.

Another consideration is what it would cost you to enroll in Medicare Part B if you declined to do so when you first became eligible. That window of opportunity starts three months before your 65th birthday and runs until three months after the month in which you turn 65. If you don’t sign up then, you have to wait for the next general enrollment period, which is always held between January 1 and March 11. If you sign up then, you’ll pay 10 percent more for each 12 months you could have had coverage but failed to enroll. Further, your coverage won’t become effective until the following July. Clearly the penalty for not enrolling mounts geometrically with every passing year.

Next time I’ll talk about the changes in benefit amounts for the survivors of employees who die in service.