U.S. Office of Personnel Management

The Federal Employees Health Benefits Program and Medicare




Since I Have FEHB Coverage, Do I Need Medicare Coverage?

If you can get Part A premium-free, you should take it, even if you are still working. This will help cover some of the costs that your FEHB plan may not cover, such as deductibles, coinsurance, and charges that exceed the plan's allowable charges. There are other advantages to enrolling in Part A, such as being eligible to enroll in a Medicare managed care plan.

Do I Have to Take Part B Coverage?

You don't have to take Part B coverage if you don't want it, and your FEHB plan can't require you to take it. There are some advantages to enrolling in Part B:

  • You must be enrolled in Parts A and B to join a Medicare+Choice plan.

  • You have the advantage of coordination of benefits (described later) between Medicare and your FEHB plan, reducing your out-of-pocket costs.

  • Your FEHB plan may waive its copayments, coinsurance, and deductibles for Part B services.

  • Some services covered under Part B might not be covered or only partially covered by your plan, such as orthopedic and prosthetic devices, durable medical equipment, home health care, and medical supplies (check your plan brochure for details).

  • If you are enrolled in an FEHB HMO, you may go outside of the plan's network for Part B services and receive reimbursement by Medicare (only when Medicare is the primary payer).

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Page modified 8 June 2001