An In-Depth Look at Medicare Part B

Here's what you need to know about Part B to maximize your coverage and save the most money. 

• Plan Choice—Almost all national plans waive their hospital and medical deductibles, copays, and coinsurance for members enrolled in both Medicare Parts A and B. In effect, they wrap around Medicare. With Medicare Parts A and B and most national PSHB plans, you will have close to 100% coverage of almost all medical expenses, with the big exception of prescription drugs and a few other services like chiropractor or acupuncture visits. With Part B, make sure you find a plan that has wrap around benefits, which reduces cost-sharing for medical services and helps offset the expense of the second premium. The Guide will show you how the plans rank based on estimated yearly cost when you have just Part A or when you have Parts A and B. Soon-to-be retired employees can see the Medicare comparisons by choosing Retiree as your employment status and by selecting an age of 65 or older. In the Washington, D.C. area, a retired couple enrolled as self-plus-one with income below $212,000 would see a range of adding Part B as low as $0 and as high as $4,300, the entire amount of both Part B premiums. Make sure you understand how Part B impacts out-of-pocket expenses with your existing PSHB plan before deciding on your plan choice in retirement. 
• Part B Reimbursement—A few PSHB plans offer partial Part B premium reimbursement, including two national plans: Blue Cross Basic and GEHA High. Of course, if you're enrolled in a CDHP/HDHP plan, you can also use the HRA plan contribution to help pay for your Part B premiums as well. 
• Expanded Access to Doctors—If you join Part B, you can use the Part B benefit to go outside the PSHB plan provider network. If you decide to do this, you might have to pay the annual Part B deductible of $257 and 20% of the Medicare allowed charge for the service. For any BCBS members, this added out-of-network flexibility strengthens the case of considering Blue Cross Basic compared to Blue Cross Standard. One of the biggest differences between BCBS Standard and Basic is the out-of-network provider benefit available in the Standard plan. Without Part B, you receive no insurance benefit from going out-of-network if you're enrolled in BCBS Basic. With Part B, you can see any provider that accepts Medicare, using the Part B benefit.

• Medicare Advantage Eligibility—By joining Part B, federal retirees gain access to Medicare Advantage (MA) plans offered by a few PSHB carriers. Aetna, GEHA, UnitedHealthcare, Kaiser, and others offer special MA plans for federal retirees. Some of these MA plans waive all out-of-pocket medical expenses for approved medical services, except for prescription drugs, and provide generous Part B premium reimbursement.