Should I enroll in Medicare Part B if I am enrolled in an HMO for my federal retiree coverage?

Section VII.e. Federal Retirees
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Last Update: March 10, 2011

Federal retiree HMOs (through the Federal Employees Health Benefit Program or FEHBP) provide coverage to all their subscribers, even if they don't have Medicare. You do not need Medicare Part B as you would if you were in a fee-for-service plan. Since your HMO copayments may be small (such as $10 per doctor visit), it may not be worth paying the monthly Medicare Part B premium for Medicare to pay your out-of-pocket costs.

However, if at any point you want to switch to a fee-for-service plan (for example, if your doctor leaves the HMO's network), you would need Medicare Part B. If you wait to enroll in Part B until the need arises, you may have to pay a premium penalty for late enrollment. Some other things to consider:

  • If you travel extensively in the United States, Part B coverage could be used to help pay for non-emergency medical services while traveling out side of the HMO's service area.
  • You could use Part B coverage to go out of network to see a specialist in cases where the HMO primary care physician will not provide a referral.
  • A number of FEHBP plans have left the program in the past several years. You may want to take Part B when you first become eligible so that you do not have to pay a Part B premium penalty in the event that your plan stops providing FEHBP coverage.
    To find out what the Part B premium penalty is, click on the link in the GO TO box.
For more information, contact the National Association of Retired Federal Employees (NARFE) at 800-627-3394.


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GO TO
Medicare Part B late enrollment penalty

 
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NARFE (National Association of Retired Federal Employees)

 
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