Comprehending the Intersection Between FEHB and Medicare

by | May 1, 2023 | Spousal IRA | 7 comments

Comprehending the Intersection Between FEHB and Medicare




#comparefehbplans #fehbandmedicare #fehbrates As a federal employee, there are rules to consider for your Federal Employee Heath Benefit or FEHB. In this video we discuss employment timing, spousal continuance and costs. We also discuss Medicare and now that work with you FEHB.

Retirement Benefits Institute has trained thousands of federal employees as they make plans for federal retirement. For more information about your federal retirement benefits, go to our website at to get support.

The information contained in this video should not be used in any actual transaction without the advice and guidance of a tax or financial professional who is familiar with all the relevant facts. The information contained here is general in nature and is not intended as legal, tax or investment advice. Furthermore, the information contained herein may not be applicable to or suitable for the individuals’ specific circumstances or needs and may require consideration of other matters. RBI is not a broker-dealer, investment advisory firm, insurance company, or agency and does not provide investment or insurance-related advice or recommendations. Brandon Christy, President of RBI, is also president of Christy Capital Management, Inc. (CCM), a registered investment advisor….(read more)


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The Federal Employees Health Benefits (FEHB) program and Medicare are two important health insurance options available to federal employees and retirees. Understanding how these programs work together is crucial for making informed decisions about health coverage.

FEHB is a group health insurance program for federal employees, retirees and their dependents. It offers a variety of plans and options, including fee-for-service plans, health maintenance organizations (HMOs), and preferred provider organizations (PPOs). Participants in the program pay premiums and co-pays for services received.

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Medicare, on the other hand, is a federal health insurance program for people who are 65 or older, as well as those with certain disabilities and chronic conditions. It is divided into four parts: A, B, C, and D. Part A covers hospital stays, while Part B covers outpatient services. Part C is also known as Medicare Advantage, and offers an alternative to traditional Medicare. Part D is a prescription drug benefit.

If you are a federal employee or retiree who is eligible for Medicare, you can choose to enroll in both FEHB and Medicare. However, it is important to understand how the two programs work together, as well as the potential costs and benefits.

One of the key things to understand is that while FEHB and Medicare both provide health coverage, they are not coordinated. This means that you can use both programs to pay for medical expenses, but you must navigate two separate systems for billing and claims processing. In some cases, this can result in higher out-of-pocket costs.

For example, if you are enrolled in FEHB and Medicare Parts A and B, you will generally use your FEHB coverage as the primary payer. This means that your FEHB plan will pay first for eligible services, and Medicare will pay second. However, if you have a high-deductible health plan (HDHP) through FEHB, you may need to pay the full deductible before your coverage kicks in. In addition, some FEHB plans may require you to pay co-pays or coinsurance that are not covered by Medicare.

It is important to note that if you enroll in Medicare Part C (Medicare Advantage) or Part D (prescription drug coverage), you will generally not need to enroll in FEHB, as these plans offer comprehensive health coverage. However, it is always a good idea to review your options carefully before making any changes to your coverage.

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In summary, FEHB and Medicare are both important health insurance options for federal employees and retirees. While you can enroll in both programs, it is important to understand how they work together, as well as the potential costs and benefits. By taking the time to review your options carefully, you can ensure that you have the coverage you need to stay healthy and secure.

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7 Comments

  1. Cathy Galvin

    Just a quick question if you don't mind. I'm on my husband's FEHB. I had heard to continue on this, should he pass before me that I would need to be on the survivor benefit. It was stated that we would need to continue to be enrolled in the Family plan. I believe here it was stated we could do the Self + One and I would still keep the FEHB?

  2. Cathy Galvin

    As a medical biller by trade, this was perfectly said – great job and thank you!

  3. The Big Ragu

    I am retiring in June of 2022 and carry FEHB for just myself being my wife has better coverage with her employer. When she retires in December of 2022 she will not be able to carry her healthcare into retirement. Well I be able to add her to my FEHB plan during open season. Thank you for your informative channel

  4. Osi Umeh

    What happens to Self + One for spousal annuities for FEHB? You had mentioned that you must have a Family Plan.

  5. Dave None

    If one drops FEHBP for a medigap plan C,F,G,N etc they can never go back
    to FEHB. The only way to keep that option to return is if you enroll in
    an Advantage plan, they will suspend coverage and allow you to return
    at a later date. Also can you please do an update to this subject as
    FEHBP now have Advantage plans, Aetna, Kaiser and UHC have these plans
    available. I would like you to do a video on how those advantage plans
    differ from the Advantage plans for Non FEHBP people. I believe that the
    pre-authorization rules for the FEBHP advantage plans are far superior,
    can you explain this?

  6. Jama Beasley

    Simply explained and covered the basics.

  7. Medicare School

    Nice video – thanks for posting! It is also important for people to know that depending on their Medicare plans chosen, they have to terminate their FEHB and can't ever go back.

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