For the 2024 plan, the Office of Personnel Management highlighted how Part D drug coverage and other out-of-pocket medical cost savings can be achieved with Medicare Advantage plans. Medicare Advantage plans for feds are not a new benefit. There are a few things that make a big difference for feds looking to overlap coverages and increase their benefits.
Medicare Advantage, or Part C, is one of the types of health plans that Medicare has, it is one of those offered by private insurance companies. MA plans are a different way to receive Part A and Part B benefits instead of through original Medicare.
Most also have a Part D plan included for prescription drug coverage, and many MA plans provide extra services, not normally covered by the Medicare plan, including vision, hearing, dental, and wellness benefits.
Medicare Advantage for Feds: All You Need to Know
You must have Medicare Parts A and B in order to join MA plans. If you are a single filer with an income of more than $103,000 or a couple filer with an income of more than $206,000, you are subject to a monthly income adjustment amount and would have to pay more than the Part B premium of $174.70 per month.
The first income tier of IRMAA adds an extra $69.90 per month, since most MA plans also include Part D for prescription drug coverage, IRMAA also applies to Part D and the first income tier adds $12.90 per month.
Enrollment in MA plans has increased substantially in recent years and more than half of all eligible Medicare beneficiaries are enrolled. Some of the reasons for their increase include extra benefits, having the protection of an out-of-pocket limit per year (not present in original Medicare) and the convenience of having a plan instead of a Medigap plan and a separate Part D plan.
FEHB MA plans have been available to federal beneficiaries for the past four years. Although they look similar to commercial MA plans, there are important differences between them.
How Do FEHB Medicare Advantage Plans Work?
Some of the FEHB MA plans charge $0 for the services covered by Medicare: doctor visits, inpatient and outpatient care, labs, scans, acupuncture, chiropractic and more.
There are still out-of-pocket charges for prescription drugs, but starting in 2025 there will be a maximum out-of-pocket of $2,000 per person on all FEHB MA plans.
Hearing, vision, and dental care are other areas where you may still have some out-of-pocket costs in FEHB MA plans.
Many FEHB MA plans include a significant Part B premium rebate, which significantly decreases the net Part B premium. The amount of the rebate varies by plan.
