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[TSPStrategy] Resigning instead of retiring

[TSPStrategy] Resigning instead of retiring

Have you ever wondered how many federal employees leave federal service before becoming eligible for an immediate retirement benefit? An analysis of 2021 attrition data from the Office of Personnel Management by the nonpartisan Partnership for Public Service, shows the following numbers regarding federal employees who resign from federal service versus those who retire: 

  • Under age 30:  11,142 resignations 
  • Age 30 – 39:  18,884 resignations 
  • Age 40 – 49:  13,377 resignations  
  • Age 50 – 59:  9,846 resignations; 18,567 retirements 
  • Age 60 and above:  2,877 resignations; 43,202 retirements 

Keep in mind that these numbers don't exactly match up with the 2022 OPM Statistical Abstract provided by OPM Retirement Services. According to the 2022 report, there were 84,494 FERS retirements and 12,462 CSRS retirements processed in 2021, along with 103,386 FERS retirements and 11,119 CSRS retirements processed in 2022.   

Despite these discrepancies, the bottom line is that not everyone who leaves federal employment is eligible to apply for retirement, so if you decide to leave federal employment early, do you have any entitlement to a future retirement benefit? 

You have two choices if you leave your government job before becoming eligible for retirement: 

If you leave federal service before you meet the age and service requirements to retire with an immediate retirement and you have completed at least 5 years of creditable civilian service, you may receive benefits when you reach one of the following ages: 

  • At age 62, with at least 5 years of creditable civilian service. 
  • At your MRA (age 57, if you were born in 1970 or later) if you have 30 or more years of creditable service. 
  • At age 60, if you have 20 or more years of creditable service. 
  • Between MRA and age 62 with at least 10 years of creditable service, however, your benefit will be reduced by 5 percent a year for each year (prorated monthly) you are under 62. 

To have entitlement to FEHB and FEGLI, you must retire with an immediate retirement which allows you to receive retirement benefits within 30 days of your separation. If you choose to postpone the application such as with an MRA + 10 retirement where there may be a reduction for your age, you may be permitted to reinstate your insurance coverage. You must have had coverage for the five years before your separation and your retirement must begin as a postponed, not as a deferred retirement. Be sure to carefully follow the instructions for choosing the date that you wish your retirement to begin on the FERS RI 92-19 form.       

If you are leaving your federal job and want a refund of your CSRS or FERS retirement contributions, you can get an application from your personnel office, complete it, and return it to them. If you are no longer in the federal service, follow the instructions on the Application for Refund of Retirement Deductions, SF 3106,. If you have been separated for 30 days or less, submit your application to your servicing personnel office. If you have been separated for over 30 days, apply to OPM:

U.S. Office of Personnel Management

Retirement Operations Center

Post Office Box 45

Boyers, PA 16017 

For service under FERS, you would get interest on the refund of those contributions if you worked more than one year. Interest is paid at the same rate that is paid for government securities (3.75% for 2024). If you had any service under CSRS while you worked, interest will be included in the refund of those contributions if you have more than one but less than 5 years of service. Interest is paid at 3%. 

Your retirement contributions are not taxable, but interest included in the payment is taxable. You can rollover lump sum payments representing your retirement contributions and applicable interest. 

An eligible payment can be paid either to you or directly to an IRA or other employer-sponsored plan such as a 401(k). Your choice will affect the amount of taxes you owe. OPM is required to withhold federal income tax from taxable payments over $200 at the rate of 20%. However, you may choose to take all or part of these payments in a direct rollover to an individual retirement account or an employer-sponsored retirement plan that accepts rollovers. The taxable portion can be rolled over into the TSP.    

If you choose to have the payment made to you and it is over $200, the taxable portion is subject to the 20% federal income tax withholding. The payment is taxed in the year in which it is received unless within 60 days after receiving it, you roll it over to an individual retirement account or retirement plan that accepts rollovers. You can roll over up to 100% of the eligible distribution, including the 20% withholding. To do so, you must replace the 20% withholding within the 60-day period. You will be taxed on any amount that you do not rollover. For example, if you roll over only the 80% of the distribution, you will be taxed on the remaining 20%. 

You can find more information about the taxation of payments from qualified retirement plans from the following Internal Revenue Service publications: 

IRS Publication 575, "Pension and Annuity Income" 

IRS Publication 590-A "Contributions to Individual Retirement Arrangements (IRAs)" 

IRS Publication 721, "Tax Guide to U.S. Civil Service Retirement System Payments" 

Form 4972, "Tax on Lump Sum Distributions." 

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Well Water Safety: Testing, Contaminants, and Treatment Solutions

Well Water Safety: Testing, Contaminants, and Treatment Solutions

If you rely on a private well for your water supply, well water testing is essential to ensure the safety of your drinking water, as well as for overall household use. Unlike municipal water sources, which undergo regular treatment and monitoring, private wells are the homeowner's responsibility. This means that potential contaminants – whether from natural sources, human activities, or well system malfunctions – may not be detected without proactive testing.

Well water can harbor various contaminants that might affect your health. Bacteria, like E. coli, can cause gastrointestinal illnesses, while nitrates pose a particular risk for infants. Heavy metals like lead and arsenic have links to developmental problems and long-term health risks. Other contaminants, including minerals and chemicals, might not cause immediate illness but can affect the taste, odor, or appearance of your water.

Regular well water testing is the only way to proactively identify these potential issues. By understanding what's in your water, you can make informed decisions about treatment options and protect your household's health.

Why Well Water Testing Matters

Common Contaminants and Health Risks

It's crucial to understand that even clear, pleasant-tasting well water can contain harmful contaminants. Here are some of the most concerning categories:

  • Bacteria: Bacteria like coliform and E. coli can originate from septic systems or animal waste. They typically cause gastrointestinal issues like diarrhea, nausea, and vomiting.
  • Nitrates: Nitrates often leach into groundwater from fertilizers, septic systems, or livestock operations. They're particularly dangerous for infants, leading to "blue baby syndrome" (methemoglobinemia), a condition that reduces the blood's ability to carry oxygen.
  • Lead: Lead in drinking water often comes from corroded plumbing materials. Lead exposure can cause developmental delays and learning difficulties in children, and health problems in adults, including high blood pressure and kidney issues.
  • Arsenic: Arsenic is a naturally occurring element found in some rock formations. Long-term arsenic exposure increases the risk of various cancers, including skin, bladder, and lung cancer.
  • Radon: Radon is a radioactive gas that can seep into wells from underground sources. Exposure to radon is the second leading cause of lung cancer after smoking.
  • Other Contaminants: Well water can also contain excessive minerals (hardness, iron), pesticides, industrial chemicals, and other contaminants with varying health effects.

Long-Term Health Considerations

Some contaminants may not cause immediate illness, but their effects can accumulate with long-term exposure. Regular well water testing is the best way to monitor these potential risks and take action to keep your water safe. Additionally, well water testing gives you a baseline so you can detect any changes in your water quality over time.

Peace of Mind

Knowing what's in your well water offers peace of mind. When you're sure your water is safe, you can confidently use it for drinking, cooking, bathing, and other household activities, ensuring your family's health and well-being.

When to Test Your Well Water

Recommended Testing Frequency

The Centers for Disease Control and Prevention (CDC) recommends testing your well water at least annually for total coliform bacteria, nitrates, total dissolved solids, and pH levels. More frequent testing might be necessary depending on your area's risk factors or if you notice changes in your water.

Situations Requiring Immediate Testing

In addition to routine testing, schedule water testing immediately if you experience any of the following:

  • New Well or Major Repairs: If you have a newly constructed well or have undergone significant repairs, testing ensures it's producing safe water.
  • Changes in Water Quality: Changes in taste, odor, or appearance (cloudiness, unusual colors) can indicate contamination.
  • Gastrointestinal Illness: If household members experience unexplained stomach issues, test for bacterial contamination.
  • Infants or Pregnancy: Infants and pregnant women are more susceptible to waterborne contaminants, so extra precaution is vital.
  • Malfunctioning Septic Systems: Issues with your septic system increase the risk of groundwater contamination near your well.
  • Changes in Land Use: If new agricultural operations, industrial facilities, or other potential sources of contamination move near your property, prompt testing is warranted.

Staying Proactive

Remember, well water contamination isn't always obvious. Regular testing is a crucial part of responsible well ownership and ensures a safe drinking water supply for your household.

How to Get Your Well Water Tested

Types of Tests

  • DIY Test Kits: Home testing kits provide a basic analysis for some common contaminants like bacteria, nitrates, and pH. These kits offer limited accuracy and shouldn't replace thorough professional testing.
  • Professional Laboratories: Accredited laboratories offer comprehensive water testing services that analyze a wide range of contaminants, including bacteria, heavy metals, pesticides, and volatile organic compounds (VOCs). They provide detailed reports and guidance on interpreting results.

Finding Reputable Labs

Choosing a certified laboratory is critical for accurate results and reliable recommendations. Here's how to find one:

  • State Health or Environmental Departments: Contact your state health department or the equivalent environmental agency for a list of accredited water testing labs in your area.
  • Centers for Disease Control and Prevention (CDC): The CDC provides resources for finding certified laboratories.
  • Environmental Protection Agency (EPA): The EPA maintains a list of certified drinking water laboratories by state.

Understanding Your Test Results

Labs provide a detailed analysis of your water, including the levels of detected contaminants. Compare the results to the EPA's drinking water standards to determine if any contaminants exceed safe limits. Resources from agencies like the CDC and state health departments can help you interpret your results and determine the appropriate course of action.

What to Do If Your Well Water is Contaminated

Don't Panic

While concerning, most well water contamination issues are treatable. The first step is to understand the specific contaminants present, their potential health effects, and the appropriate remediation options.

Immediate Actions

  • Stop Drinking the Water: If contaminants exceed safe levels, immediately stop drinking and using your well water for cooking or brushing teeth.
  • Use Bottled Water: Use a reliable source of bottled water for drinking, cooking, and other essential needs until you implement a solution.

Seek Professional Guidance

  • Contact Your Health Department: Consult your state or local health department for guidance tailored to the specific contaminant(s) found in your water. They can help you understand health risks and recommend next steps.
  • Consult a Well Water Specialist: A certified well water contractor can assess your well system, identify potential contamination sources, and recommend treatment options.

Treatment Options

The best treatment solution depends on the type and level of contaminant(s). Some common options include:

  • Filtration Systems: Various filters target specific contaminants like bacteria, nitrates, heavy metals, or minerals.
  • Distillation: Distillation removes minerals, some metals, and effectively eliminates bacteria and viruses.
  • Chlorination: Chlorination effectively kills bacteria and viruses but may not address other contaminants.
  • Other Technologies: Technologies like reverse osmosis or ultraviolet (UV) light treatment offer solutions for a range of contaminants.

Choosing the Right Solution

Always consult with professionals to determine the most appropriate treatment system based on your test results, well characteristics, and household needs.

Well Maintenance for Safe Water

Alongside testing, regular well maintenance is crucial for protecting your water supply and extending the lifespan of your well system. Here's why it matters:

  • Preventing Contamination: Well maintenance helps identify and address potential points of contamination before they affect your water quality.
  • Ensuring System Functionality: Regular inspections catch mechanical issues early, preventing malfunctions that could compromise water safety or lead to costly repairs.
  • Proactive Protection: Well maintenance empowers you to take proactive steps safeguarding your drinking water, rather than just reacting to problems as they arise.

Key Maintenance Practices

  • Annual Inspections: Schedule yearly checkups with a qualified well contractor to inspect your well's casing, cap, and mechanical components.
  • Proper Location and Construction: Follow guidelines for well placement at a safe distance from potential contamination sources (septic systems, livestock pens, etc.). Ensure your well is constructed according to standards, with a sanitary seal preventing surface runoff from entering.
  • Protecting Your Wellhead: Maintain a clear area around your wellhead, keep it free of debris, and ensure the well cap is securely in place.
  • Monitoring for Changes: Be observant. Report any changes in your water, unusual activity around your well, or damage to the well.
  • Septic System Maintenance: Regularly pump and inspect your septic system to prevent malfunctions that could contaminate your well.

Safeguarding Your Well Water: Key Takeaways and Next Steps

Well water testing is an essential responsibility for private well owners. Regular testing identifies potential contaminants that may pose health risks, allowing you to make informed decisions about water treatment for safe consumption and household use. Understanding common contaminants, when to test, how to choose a lab, and simple maintenance practices significantly reduces risks and ensures ongoing access to safe drinking water.

Key Takeaways

  • Well water, unlike municipal water, isn't regularly treated or monitored.
  • Bacteria, nitrates, lead, arsenic, and other contaminants can jeopardize the safety of your water supply.
  • Test your well at least annually, and more often if risk factors are present or you notice changes in your water.
  • Professional water testing laboratories provide the most comprehensive analysis and guidance.
  • Prioritize regular well inspections and maintenance to prevent contamination and protect your investment.

Don't take chances with your family's health. If you rely on a private well:

  • Locate a certified water testing lab near you. Contact your state health department for resources as a starting point.
  • Schedule your initial well water test. Discuss the details of the testing process and expected timeframe for results with your chosen lab.
  • Consult a well water professional. Have a qualified contractor inspect your well system and offer advice on maintenance best practices.

By following these steps, you'll gain the peace of mind that comes from knowing your well water is safe and protecting the well-being of your household.

#wellwatertesting #wellwater #wellwatersafety #drinkingwater #groundwater #waterquality #homeowner #watercontamination #ruralliving #privatewell #health #bacteria #nitrates #arsenic #lead #homewater #watertreatment #cleanwater #watertest #watertestingkit

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Re: [TSPStrategy] Before asking for help, know the rules

Re: [TSPStrategy] Before asking for help, know the rules

Wow.  Really amazing - I would have had a very difficult time keeping my cool!

On Apr 5, 2024, at 6:53 AM, dlstox <dlstox@gmail.com> wrote:

https://www.govexec.com/pay-benefits/2024/04/asking-help-know-rules/395485/?oref=ge_retirementplanning_nl&utm_source=Sailthru&utm_medium=email&utm_campaign=Retirement%20Planning:%20April%205%2C%202024&utm_term=newsletter_retirement_planning

Before asking for help, know the rules

Coordinating Medicare and the Federal Health Benefits Program can be hard to navigate without the right information.

Ispend a lot of time providing "to-do" lists for federal employees and retirees to help them manage their benefits. Recently, I helped a couple navigate the coordination of Medicare and FEHB. Their story illustrates the importance of knowing the rules and having a reference to support the reason for the request, before asking for help.   

The husband and younger spouse, Larry, recently retired in 2023 and has been carrying self-plus-one FEHB coverage so that: 

  1. He could continue to enjoy paying the premiums with tax-free dollars during his employment, and  
  2. So that his wife, Jane, could delay her enrollment in Part B of Medicare without a late enrollment penalty.   

Jane, the older spouse, also retired from federal employment and had always been covered under FEHB. Her coverage as a family member on her husband's enrollment provided her with continuous enrollment even though she was no longer paying the premiums. Jane turned 65 in 2019 and because she was covered under her husband's "current employment" health coverage, she could delay Part B enrollment without incurring a late enrollment penalty. I provided the following reference to them at the time she turned 65 so that they could feel more confident in the decision for the wife to delay her Medicare enrollment in Part B: The Centers for Medicare and Medicaid Services Fact Sheet: Deciding Whether to Enroll in Medicare Part A and Part B When You Turn 64, which includes the following: 

You can delay Part B until you (or your spouse) stop working or lose that employer coverage. This allows you to save the cost of your Part B premium. It also allows you to postpone your one-time "Medigap open enrollment period" until a later time, when you may want to purchase this type of coverage. You will NOT pay a penalty for delaying Medicare, as long as you enroll within 8 months of losing your coverage or stopping work (whichever happens first). You'll want to plan ahead and enroll in Part B at least a month before you stop working or your employer coverage ends, so you don't have a gap in coverage. 

Last year on Sept. 30, Larry retired from his government career, and they came to me for instructions for how to accomplish Jane's enrollment in Medicare and to get help with splitting Larry's self-plus-one FEHB enrollment into two self-only health plans, with Jane choosing a plan that would work well with Medicare.   

After discussing the pros and cons of enrolling in Medicare Part B, Jane decided that she would enroll in Part B and change to a different health plan that would give her a partial reimbursement of the Part B premium and a plan that would waive her cost-sharing when Medicare was the primary payer for her medical services. This would ensure that she would have close to $0 out of pocket costs in the future, regardless of her health and need for medical care. She compared the following three plans that provided these benefits: 

  • BC/BS Basic (Plan Code 11) 
  • Self-only: $207.44 / month; Self-plus-one:  $517.03 / month 
  • Part B reimbursement: $800 / spouse / year 
  • Waives coinsurance and copayments when using BC/BS Preferred Providers.   
  • Aetna Direct (Plan Code N6) 
  • Self Only:  $160.80 / month; Self-plus-one:  $352.64 / month 
  • Part B reimbursement:  $900 / spouse / year 
  • Waives deductible, coinsurance and copayments when Medicare is primary in and out of network.   
  • GEHA High Option (Plan Code 31) 
  • Self -only: $235.41 / month; Self-plus-one: $540.95 / month 
  • Part B reimbursement:  $1,000 / spouse / year 
  • Waives deductible, coinsurance and copayments when Medicare is primary in- and out-of-network.   

In addition to these three options, most FEHB plans provide incentives to enroll in Medicare A and B through a Medicare Advantage, or Medicare Part C, with election available at no additional charge. The three plans listed above do not require the Medicare Advantage election to receive the incentives to enroll in Medicare. Medicare Advantage options are relatively new for federal retirees and Jane was not sure about any downsides to Part C coverage and decided not to include those options in her decision. Here are a few things to consider when contemplating a Medicare Advantage enrollment: 

Medicare Advantage Plans: Caution (may vary by plan) 

For some who enroll in Medicare Part C, there is a fear that all providers may not accept the plan and there could be more difficulty getting approval for necessary medical care.  According to KFF, Medicare Advantage plans can require enrollees to get approval from the plan before receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service. Medicare Advantage enrollees can appeal the plan's decision, but relatively few do so. Traditional Medicare (Medicare Part A and Medicare Part B), in contrast, does not require prior authorization for most services. They also had read that some providers are not accepting Medicare Advantage plans such as Baptist Health in Louisville, Ky., for example, has stated that all nine hospitals, along with its clinics and physician groups, have cut ties with Advantage plans offered by UnitedHealthcare and WellCare Health Plans Inc.   

Medicare Advantage Plan: Incentives (may vary by plan) 

Enrolling in a Medicare Part C or Medicare Advantage can be tempting due to the variety of cost-saving benefits that most plans offer such as: 

  • Generous reduction in Medicare Part B premium  
  • All covered medical services have $0 copays, including preventive care, emergency room, durable medical equipment, routine podiatry, physical therapy and more. 
  • Enjoy free gym membership, extra vision benefits, dental benefits, hearing aid savings, meal delivery following a hospital stay, non-emergency transportation to medical appointments, and more. 
  • No need for a separate Medicare Part D plan. Get prescription drug coverage with full coverage in the gap and low copays. 

To accomplish these tasks, I reminded the couple that Jane now has an 8-month window to enroll in Part B of Medicare without a late enrollment penalty. This is called a Special Enrollment Period, and it began the month after Larry's retirement in September and will end eight months later on May 31, 2024. I had earlier instructed Larry to get form CMS L564 completed by his employer to provide proof that Jane was covered under "current employment" health coverage until his retirement on Sept. 30, 2023.   

It was now time to put the plan into action! After our meeting, Jane called Social Security and she was scheduled for a telephone appointment on May 24. The agent told Jane that she was not eligible for Medicare Part A based on her work record, but that she could enroll in Part B. I was astounded that Jane was told she was not eligible for Medicare! Jane retired under CSRS, and she did not have enough work credits to qualify for Social Security retirement benefits, however, all federal employees who paid the Medicare tax are eligible for Medicare on their work record and feds have been paying into Medicare since 1983. This includes those who retired under CSRS as well as FERS. In addition, she would also be entitled to Medicare even if she never worked outside the home because her husband is at least age 62 and has worked at least 10 years in Medicare-covered employment. 

If you're not yet 62 when your spouse turns 65, he or she won't be eligible for free Part A until your 62nd birthday. In this case, your spouse should still apply for Part B at 65 to avoid paying a higher Part B premium. However, if you're still working and your spouse is covered under your group health plan, he or she could delay Part B enrollment without paying higher premiums. In addition, Jane does not need proof to show Social Security that she is eligible for Medicare, they should know that she is eligible. Her Social Security earnings record shows her Medicare-taxed earnings dating back to 1983.   

Armed with this information and resources, Jane didn't want to wait to provide this information during her May 24 appointment since that would be only one week from the end of her Special Enrollment Period, so she drove to the Social Security office near her home. She went in the morning to submit paperwork for Part A and took the printout of her Social Security earnings record to prove her entitlement to premium-free Medicare Part A. She was told for the second time that she didn't qualify because the guy she spoke with on the phone the day before had noted in the system that she didn't qualify. It took a short meeting with the office supervisor to show that the system didn't show the complete information.  

After Jane convinced them that she was entitled to Medicare coverage, the representative changed the note in the system to say she did qualify. She decided to return later the same day to take advantage of the Special Enrollment Period to enroll in Part B. This time a different rep took the Part B application along with Larry's completed employer form, CMS L564, proving that she was covered under "current employment" insurance until Sept. 30, 2023. 

However, the electronic signature on Larry's employer form was called into question as it wasn't a "wet signature." This created one more potential obstacle for Jane to get enrollment in Part B without a late enrollment penalty. After another consultation with the office manager, it was determined that it was acceptable. According to the Social Security Program Operations Manual, for Section B of CMS Form L564, a wet signature is not required. An electronic signature is sufficient. 

The next task was to split Larry's self-plus-one FEHB enrollment into two self-only enrollments. This can be done by using OPM Form 2809 Qualifying Life Event 2F which allows an annuitant or eligible family member who loses FEHB coverage due to termination, cancellation, or change to self-only of the covering enrollment to change from not enrolled to enrolled and from one plan or option to another. Retirees may cancel enrollment or change from self and family or self-plus-one to self-only at any time. 

Larry and Jane wanted to make sure that the effective date of this change was the same for Larry as it was for Jane, so they called OPM at 7:40 am EST to make this change over the phone. I advised them to call OPM as close to 7:40 am EST as possible to avoid a long wait. Larry and Jane waited less than 30 minutes to be connected to someone who could help them make this insurance election.  

The OPM customer service representative was uncertain whether Jane could switch plans or if she would be required to remain in Larry's same plan. She processed the request and informed the couple that they would be notified in writing of the confirmation of their request, but due to a backlog, it could take up to 60 days.   

The moral of the story: Above all, be respectful, patient and kind. Decide if the best method is email, phone call or an in-person visit. Learn what times are least busy for conducting business. Know the rules regarding what you are trying to accomplish and bring a reference if necessary.  


[TSPStrategy] Before asking for help, know the rules

[TSPStrategy] Before asking for help, know the rules

https://www.govexec.com/pay-benefits/2024/04/asking-help-know-rules/395485/?oref=ge_retirementplanning_nl&utm_source=Sailthru&utm_medium=email&utm_campaign=Retirement%20Planning:%20April%205%2C%202024&utm_term=newsletter_retirement_planning

Before asking for help, know the rules

Coordinating Medicare and the Federal Health Benefits Program can be hard to navigate without the right information.

Ispend a lot of time providing "to-do" lists for federal employees and retirees to help them manage their benefits. Recently, I helped a couple navigate the coordination of Medicare and FEHB. Their story illustrates the importance of knowing the rules and having a reference to support the reason for the request, before asking for help.   

The husband and younger spouse, Larry, recently retired in 2023 and has been carrying self-plus-one FEHB coverage so that: 

  1. He could continue to enjoy paying the premiums with tax-free dollars during his employment, and  
  2. So that his wife, Jane, could delay her enrollment in Part B of Medicare without a late enrollment penalty.   

Jane, the older spouse, also retired from federal employment and had always been covered under FEHB. Her coverage as a family member on her husband's enrollment provided her with continuous enrollment even though she was no longer paying the premiums. Jane turned 65 in 2019 and because she was covered under her husband's "current employment" health coverage, she could delay Part B enrollment without incurring a late enrollment penalty. I provided the following reference to them at the time she turned 65 so that they could feel more confident in the decision for the wife to delay her Medicare enrollment in Part B: The Centers for Medicare and Medicaid Services Fact Sheet: Deciding Whether to Enroll in Medicare Part A and Part B When You Turn 64, which includes the following: 

You can delay Part B until you (or your spouse) stop working or lose that employer coverage. This allows you to save the cost of your Part B premium. It also allows you to postpone your one-time "Medigap open enrollment period" until a later time, when you may want to purchase this type of coverage. You will NOT pay a penalty for delaying Medicare, as long as you enroll within 8 months of losing your coverage or stopping work (whichever happens first). You'll want to plan ahead and enroll in Part B at least a month before you stop working or your employer coverage ends, so you don't have a gap in coverage. 

Last year on Sept. 30, Larry retired from his government career, and they came to me for instructions for how to accomplish Jane's enrollment in Medicare and to get help with splitting Larry's self-plus-one FEHB enrollment into two self-only health plans, with Jane choosing a plan that would work well with Medicare.   

After discussing the pros and cons of enrolling in Medicare Part B, Jane decided that she would enroll in Part B and change to a different health plan that would give her a partial reimbursement of the Part B premium and a plan that would waive her cost-sharing when Medicare was the primary payer for her medical services. This would ensure that she would have close to $0 out of pocket costs in the future, regardless of her health and need for medical care. She compared the following three plans that provided these benefits: 

  • BC/BS Basic (Plan Code 11) 
  • Self-only: $207.44 / month; Self-plus-one:  $517.03 / month 
  • Part B reimbursement: $800 / spouse / year 
  • Waives coinsurance and copayments when using BC/BS Preferred Providers.   
  • Aetna Direct (Plan Code N6) 
  • Self Only:  $160.80 / month; Self-plus-one:  $352.64 / month 
  • Part B reimbursement:  $900 / spouse / year 
  • Waives deductible, coinsurance and copayments when Medicare is primary in and out of network.   
  • GEHA High Option (Plan Code 31) 
  • Self -only: $235.41 / month; Self-plus-one: $540.95 / month 
  • Part B reimbursement:  $1,000 / spouse / year 
  • Waives deductible, coinsurance and copayments when Medicare is primary in- and out-of-network.   

In addition to these three options, most FEHB plans provide incentives to enroll in Medicare A and B through a Medicare Advantage, or Medicare Part C, with election available at no additional charge. The three plans listed above do not require the Medicare Advantage election to receive the incentives to enroll in Medicare. Medicare Advantage options are relatively new for federal retirees and Jane was not sure about any downsides to Part C coverage and decided not to include those options in her decision. Here are a few things to consider when contemplating a Medicare Advantage enrollment: 

Medicare Advantage Plans: Caution (may vary by plan) 

For some who enroll in Medicare Part C, there is a fear that all providers may not accept the plan and there could be more difficulty getting approval for necessary medical care.  According to KFF, Medicare Advantage plans can require enrollees to get approval from the plan before receiving a service, and if approval is not granted, then the plan generally does not cover the cost of the service. Medicare Advantage enrollees can appeal the plan's decision, but relatively few do so. Traditional Medicare (Medicare Part A and Medicare Part B), in contrast, does not require prior authorization for most services. They also had read that some providers are not accepting Medicare Advantage plans such as Baptist Health in Louisville, Ky., for example, has stated that all nine hospitals, along with its clinics and physician groups, have cut ties with Advantage plans offered by UnitedHealthcare and WellCare Health Plans Inc.   

Medicare Advantage Plan: Incentives (may vary by plan) 

Enrolling in a Medicare Part C or Medicare Advantage can be tempting due to the variety of cost-saving benefits that most plans offer such as: 

  • Generous reduction in Medicare Part B premium  
  • All covered medical services have $0 copays, including preventive care, emergency room, durable medical equipment, routine podiatry, physical therapy and more. 
  • Enjoy free gym membership, extra vision benefits, dental benefits, hearing aid savings, meal delivery following a hospital stay, non-emergency transportation to medical appointments, and more. 
  • No need for a separate Medicare Part D plan. Get prescription drug coverage with full coverage in the gap and low copays. 

To accomplish these tasks, I reminded the couple that Jane now has an 8-month window to enroll in Part B of Medicare without a late enrollment penalty. This is called a Special Enrollment Period, and it began the month after Larry's retirement in September and will end eight months later on May 31, 2024. I had earlier instructed Larry to get form CMS L564 completed by his employer to provide proof that Jane was covered under "current employment" health coverage until his retirement on Sept. 30, 2023.   

It was now time to put the plan into action! After our meeting, Jane called Social Security and she was scheduled for a telephone appointment on May 24. The agent told Jane that she was not eligible for Medicare Part A based on her work record, but that she could enroll in Part B. I was astounded that Jane was told she was not eligible for Medicare! Jane retired under CSRS, and she did not have enough work credits to qualify for Social Security retirement benefits, however, all federal employees who paid the Medicare tax are eligible for Medicare on their work record and feds have been paying into Medicare since 1983. This includes those who retired under CSRS as well as FERS. In addition, she would also be entitled to Medicare even if she never worked outside the home because her husband is at least age 62 and has worked at least 10 years in Medicare-covered employment. 

If you're not yet 62 when your spouse turns 65, he or she won't be eligible for free Part A until your 62nd birthday. In this case, your spouse should still apply for Part B at 65 to avoid paying a higher Part B premium. However, if you're still working and your spouse is covered under your group health plan, he or she could delay Part B enrollment without paying higher premiums. In addition, Jane does not need proof to show Social Security that she is eligible for Medicare, they should know that she is eligible. Her Social Security earnings record shows her Medicare-taxed earnings dating back to 1983.   

Armed with this information and resources, Jane didn't want to wait to provide this information during her May 24 appointment since that would be only one week from the end of her Special Enrollment Period, so she drove to the Social Security office near her home. She went in the morning to submit paperwork for Part A and took the printout of her Social Security earnings record to prove her entitlement to premium-free Medicare Part A. She was told for the second time that she didn't qualify because the guy she spoke with on the phone the day before had noted in the system that she didn't qualify. It took a short meeting with the office supervisor to show that the system didn't show the complete information.  

After Jane convinced them that she was entitled to Medicare coverage, the representative changed the note in the system to say she did qualify. She decided to return later the same day to take advantage of the Special Enrollment Period to enroll in Part B. This time a different rep took the Part B application along with Larry's completed employer form, CMS L564, proving that she was covered under "current employment" insurance until Sept. 30, 2023. 

However, the electronic signature on Larry's employer form was called into question as it wasn't a "wet signature." This created one more potential obstacle for Jane to get enrollment in Part B without a late enrollment penalty. After another consultation with the office manager, it was determined that it was acceptable. According to the Social Security Program Operations Manual, for Section B of CMS Form L564, a wet signature is not required. An electronic signature is sufficient. 

The next task was to split Larry's self-plus-one FEHB enrollment into two self-only enrollments. This can be done by using OPM Form 2809 Qualifying Life Event 2F which allows an annuitant or eligible family member who loses FEHB coverage due to termination, cancellation, or change to self-only of the covering enrollment to change from not enrolled to enrolled and from one plan or option to another. Retirees may cancel enrollment or change from self and family or self-plus-one to self-only at any time. 

Larry and Jane wanted to make sure that the effective date of this change was the same for Larry as it was for Jane, so they called OPM at 7:40 am EST to make this change over the phone. I advised them to call OPM as close to 7:40 am EST as possible to avoid a long wait. Larry and Jane waited less than 30 minutes to be connected to someone who could help them make this insurance election.  

The OPM customer service representative was uncertain whether Jane could switch plans or if she would be required to remain in Larry's same plan. She processed the request and informed the couple that they would be notified in writing of the confirmation of their request, but due to a backlog, it could take up to 60 days.   

The moral of the story: Above all, be respectful, patient and kind. Decide if the best method is email, phone call or an in-person visit. Learn what times are least busy for conducting business. Know the rules regarding what you are trying to accomplish and bring a reference if necessary.  

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