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Frequently Asked Questions Insurance

Medicare and FEHB

  • You can find information about Medicare and resources on how to address issues with your Medicare enrollment at medicare.gov.
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  • Medicare has two new provisions: Part C (Medicare Advantage) and Part D (Medicare Prescription Drug Coverage). Part C: You can enroll in a Medicare Advantage plan to get your Medicare benefits. Medicare Advantage is the term used to describe the various private health plan choices available to Medicare beneficiaries. Part D: There is a monthly premium for Part D coverage. Most Federal employees do not need to enroll in the Medicare drug program, since all Federal Employees Health Benefits Program plans will have prescription drug benefits that are at least equal to the standard Medicare prescription drug coverage. Still, you may want to be aware of the benefits Medicare is offering, so you can help others make informed decisions. If you have limited savings and a low income, you may be eligible for Medicare's Low-Income Benefits. For people with limited income and resources, extra help in paying for a Medicare prescription drug plan is available. Information regarding this program is available through the Social Security Administration (SSA). For more information about this extra help, visit SSA online at www.ssa.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
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  • Fewer than 4% of enrollees change FEHB plans each year.  As is the case when we receive other types of refunds and rebates for FEHB, such as improper payments, MLR rebate funds will be used to offset future increases for the plan from which we receive a rebate. Individuals who are no longer enrolled or switch plans do not get the benefit of the MLR rebate for their previous plan.  This is consistent with HHS rules for treatment of rebates for non-Federal governmental plans in 45 CFR part 158, which do not require a precise match of rebate to enrollee in group markets.  Since the rate adjustment involves no new cost it assures that the maximum benefit is provided to the greatest number of individuals.
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