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Do I Need Medicare if I Have Federal Employee Benefits?

Federal employees did not participate in Medicare when Congress originally enacted the program because they had the Federal Employees Health Benefits system. Beginning in 1983, Medicare participation became compulsory for federal employees. Special considerations apply when employees are eligible for Medicare and FEHB benefits.

  1. Free Hospital Insurance

    • The original Medicare program has two parts: Part A Hospital Insurance principally covers inpatient hospital services. Part B Medical Insurance covers doctor's fees and other outpatient services. Part A has no premium for workers who paid into Medicare at least 10 years. Federal employees, whether or not retired, should always apply for Medicare Part A three months before becoming 65.

    Part B Coverage

    • FEHB is the primary payer for active federal employees. Current federal employees generally do not enroll in Part B since it has a premium but will not pay for charges covered by FEHB. Employees whose FEHB plan is a health maintenance organization should check if their HMO offers incentives to federal members enrolled in Medicare Parts A and B.

    Retired Employee Decision

    • Medicare is the primary payer for retired federal employees. Employees can enroll in Part B if the overall coverage will save them money because FEHB picks up the cost of Part B deductibles, co-insurances and co-payments and provides additional coverage such as prescriptions. Employees can decline Part B if it is more advantageous to keep the current FEHB coverage and avoid the Part B premium, which can be as high as $353.60.

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