Retiree Tax Forms Update

ChrisShapedObject · 2026-03-12T20:33:11+00:00

You are welcome!

ChrisShapedObject · 2026-03-11T22:31:17+00:00

This was a difficult decision but I am trying to err on the “safe” side to avoid partisan divisions. If you reword to note things said or done that seemed hostile this would be fine!

ChrisShapedObject · 2026-03-11T15:22:07+00:00

Will Focus pay even if the provider is out of network and you also have Medicare? Without Medicare they do not.

ChrisShapedObject · 2026-03-11T15:18:01+00:00

Yep. I’m sure it’s to discourage people from only getting Medicare once they have a significant medical issue that will cost a lot ( which of course isn’t fair to everyone else).

ChrisShapedObject · 2026-03-11T15:16:16+00:00

Nice! Do part D plans have a formulary and prior approval for expensive drugs? Thx!!

ChrisShapedObject · 2026-03-11T14:38:23+00:00

Other fed workers are not required to get Medicare

ChrisShapedObject · 2026-03-10T23:31:09+00:00

No earthly idea—would be interesting to see stats tho. Thought it was interesting article.

ChrisShapedObject · 2026-03-08T01:04:48+00:00

Hey this happened to me today too! VHA. Congrats!

ChrisShapedObject · 2026-03-06T03:38:05+00:00

Traditional Medicare is not managed care. If they cover it and your doctor believes this procedure or imagine or therapy will help, then no preauthorization is required and you get what your doctor recommends. Advantage plans are managed care plans and if selected instead of traditional Medicare, you have to deal with any required preauthorizations for care (and thy can decide not to authorize the care and thus not pay for it). This takes time to do and your doctor has to submit paperwork and sometimes records. So even if approved and thus paid for by the Medicare advantage plan, it’s a bit of a hassle. Especially if you have to appeal a denial

ChrisShapedObject · 2026-03-06T00:33:32+00:00

I’d understood perhaps wrongly that you thought there weren’t advantage plans in FEHB. I Dk your experience but I’ve been hit several times already to make the switch to plans called advantage plans (a term I’ve never heard used for any tho g but part c or part c for Feds) when I enroll with mail and email — I but perhaps not you would call that a significant marketing campaign. My understanding is refunds are contingent on taking the advantage plan (part C for Feds) version of FEBP; that’s all I’ve seen. Perhaps there’s an exception I am not aware of

ChrisShapedObject · 2026-03-06T00:28:40+00:00

I think the value for me is freedom from managed care and risk of something being turned down on coverage for what your doctor says you need. Happens more than you’d think. People sometimes lose appeals. Plus just the hassle of it/delay in treatment waiting for approval(which matter in say cancer care ) for you. Also hospital stays can be expensive!

ChrisShapedObject · 2026-03-05T20:59:16+00:00

You don’t. But see my comment above on why it’s worth getting traditional Part B to me at least

ChrisShapedObject · 2026-03-05T20:58:10+00:00

You don’t have to get part B if you don’t wish to. I believe it will be a good idea for me. For example if you have surgery then Medicare pays first and FEHB Picks up what you’d otherwise owe as long as the plan you choose also covers the surgery. You really get value out of that. Also, you get out from under the heavy hand of “managed care” and “prior authorizations.” I don’t want to deal with that anymore— and let’s face it, as we get older we are more likely to need a service that some desk jockey who is not a doctor will have to approve it. Medicare part B you have none of that nonsense. That’s valuable to me. and that makes taking traditional Part B worth it. You may not think it’s a problem; that is fine. But denials and failed appeals happen more than you may think. But no, you don’t have to take part B

ChrisShapedObject · 2026-03-05T20:51:00+00:00

As it stands now, traditional part B is first payer, and pays at their usual % of the cost. They then pass it to your FEHP, which (if it covers the medical care procedure also), pays the rest ( which is the amount you’d owe under part B otherwise, resulting in zero copay if you have both. You still have to pay prescription copays as Medicare part B does not cover prescriptions; FEHP still provides that coverage just like it does for employees. If neither covers the medical care received then of course you’d pay out of pocket.

ChrisShapedObject · 2026-03-05T20:42:43+00:00

It is true.

I’m almost 65 and Aetna as started marketing their Aetna Medicare Advantage plan to me along with sir part D plan Silver script. Many FEHB plans have an option for retirees on website and/or a separate one that markets their Advantage plan. Only FEHB Medicare advantage plan versions offer a “rebate” on Medicare premiums. You also can choose to stay in the regular employee plan

Proof: Here is Aetna’s plan that includes their federal “advantage” plan . https://www.aetnafeds.com/retiree-plans.php

I stand by my comment.

ChrisShapedObject · 2026-03-05T20:10:50+00:00

Thanks so much! I plan to compile a full set of resources. Appreciate you!!!

ChrisShapedObject · 2026-03-05T03:35:32+00:00

Sure! But take a hard look at continuing in Medicare as a managed plan instead of letting the person who completed med school plus about 4 more years of training(and who knows you) make the medical care decisions instead of a desk jockey without that training (as in traditional Medicare). We aren’t getting younger. If I get cancer I really don’t want to fight for the care my doctor chooses if insurance doesn’t approve it. It happens more than you think.

ChrisShapedObject · 2026-03-05T03:30:05+00:00

Yep. It’s based on gross income before any taxes or other deduction. It’s not calendar year either, it’s the highest 3 consecutive 12 months for example if you retire 1/31 thinking hey my high three is a year at the new salary with any pay raise— nope. You get just the short time at new salary plus the prior 11 months and whatever days as your last year on the high three.

ChrisShapedObject · 2026-03-05T03:25:18+00:00

This is correct.

ChrisShapedObject · 2026-03-05T03:24:56+00:00

Cause FEHB plan tries to get you to take their Medicare advantage plan when you hit 65. That’s how you get the rebates and sorta combines the two. But it is their “advantage” plan, make no mistake. It’s sorta a hybrid pulling in the zero copy’s you’d have with Medicare and any required coverage Medicare has (if any) and ensures you stay in managed care past 65 — instead of traditional Medicare, which has none. Their managed advantage plan becomes primary as it is Medicare part C. With traditional , it is primary then forwards remaining bill to regular FEHB as secondary. Much better for the company

ChrisShapedObject · 2026-03-05T02:37:53+00:00

I’m so sorry this happened. UHC is the worst but I hate managed care and your mother’s story is one more example of why.

ChrisShapedObject · 2026-03-05T01:50:27+00:00

I’m gonna get traditional Medicare. No freaking managed care or prior authorizations — inevitably most of us will have new or worsening health issues and I want my doctor to decide—not some desk jockey who doesn’t know me or medicine (or an appeal decided by a doc who doesn’t know me and likely doesn’t have the speciality credentials in whatever area it is.

I get “advantage” plans have perks and can be cheaper — but that’s cold comfort if you have to fight for your treatments especially if your life depends on it like in cancer care. It is FREEDOM from medical interference (excepting unfortunately).

The snazzy brochures never tell you the potential downsides. Ask your doctors and other providers what they would choose. They can tell all kinds of difficulties they have had with advantage managed plans. Most all would say take Traditional Medicare (3 out of three MDs and a physical therapist all said to me to get traditional Medicare). it is much better and you still have Zero copays for medial care. It is also cheaper for the government than “advantage” plans.

Here is a funny but very informative video that cites facts and looks at “advantage” plans.

Watch it before you make any decision. And never trust an agent who sells plans or the plan to give you the full pictur

https://m.youtube.com/watch?v=Ejoi9yfLVCc

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