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I agree about opting out of the new drug plan in BCBS.
I wanted to ask you your decision point on signing up for Medicare versus just riding into the sunset with BCBS (as Old Fed has)???
Have to admit I didn't really delve into it too deeply. I signed up for Medicare when I became eligible for it because some routine services became free of charge (at least to me personally). If I passed it by, I'd continue to pay full premiums and co-pays indefinitely under the overall BCBS policy I had before. Whether or not that turns out to be the most economical decision may take years to determine. So far, the cost of health care while on Medicare + supplement (including the premiums) has gone down, not up. I do realize I'm slightly over-insured. Better than the opposite!
I suspect part of the problem is a matter of scale. There may be "advantages" to a group as a whole, but those "advantages" tend to dissipate at the individual level...for some individuals. Kind of like statistics. They can be informative about a group, but they don't tend to apply very well to any single member of that group.
That's true, as I guess we are finding out. It might be that with any familiarity at all with rules regulating Medicare policies, one would realize that additions to premiums for not signing up for a policy when one first becomes eligible, or any gap in credible coverage until one signs up, or for those whose income is over a specific level is a given with Medicare policies, and is likely to apply to those with MDPD drug plans as well, I just didn't think of it. And, of course, not being able to apply many manufacturer's coupons to defray the costs of expensive brand name drugs for someone on any government drug plan. Guess it's up to each person to figure it out.
Have to admit I didn't really delve into it too deeply. I signed up for Medicare when I became eligible for it because some routine services became free of charge (at least to me personally). If I passed it by, I'd continue to pay full premiums and co-pays indefinitely under the overall BCBS policy I had before. Whether or not that turns out to be the most economical decision may take years to determine. So far, the cost of health care while on Medicare + supplement (including the premiums) has gone down, not up. I do realize I'm slightly over-insured. Better than the opposite!
My husband and I are in the same boat you're describing. We also have traditional Medicare Part A and B, with the BCBS policy as the secondary. We've had the BCBS policy since around 1981. We may also be overinsured, but although the premiums between Medicare and the BCBS secondary ( Self Plus One, Standard Option) is rather pricey, we have no other out of pocket expenses other than drug copays. We're finding as we get older, our need for medical services increases, so at this point we are happy with this arrangement.
I recall when we turned 65, ( 2011 for husband, 2012 for me), we debated about signing up for Medicare, or staying on the BCBS as our sole insurance. But at that time, I swear I recall that there was verbiage in the information book they sent out, and on their website as well, that while anyone that currently had the BCBS insurance and was eligible for Medicare Part A and B could forego signing up for Medicare and just keep the BCBS if they chose to do so, but that BCBS would only reimburse providers for these people at the rates they would as a secondary insurance to Medicare, so doing so would involve much higher out of pocket costs to these people. Besides, as they said, they couldn't see any reason for anyone not signing up for Medicare Part A as it was free to most people, and Part B, well, paying higher out of pocket costs to doctors and outpatient providers was up to the person. I guess at the time this didn't make signing up for Medicare mandatory if you wanted coverage, the way BCBS put it was that if you wanted to pay more for your medical costs, you could opt to stay with BCBS as your primary and sole insurance, once you became eligible for Medicare. I think this caveat may have applied to federal employees that had retired before they hit Medicare age and had taken the BCBS insurance with them, likely not people who were still working. My husband had retired from the VA several years before that, had taken the insurance with him, and was employed at another ( non-federal) job at the time, so it applied to us.
It seems this language about not having to sign up for Medicare when you turn 65 but they will reduce reimbursement if you do has disappeared from their brochures, information books and website. I looked for it a couple years later, and ever since, and I don't see a peep about it anywhere anymore. Guess that gives people more choices.
"... but that BCBS would only reimburse providers for these people at the rates they would as a secondary insurance to Medicare, so doing so would involve much higher out of pocket costs to these people"
there was never increased OOP for those not on medicare. even with BCBS (or any fed insurance) as primary in the medicare eligible age group the reimbursement is tied to medicare rates if I recall correctly.
CSRS retiree here with Medicare A and B and BCBS Basic. Just found this thread, wish I had seen it back in December when i was struggling to understand what they were hawking with the new Part D coverage. Had a discussion with an old boss I’m FB friends with, and he pointed out that since BCBS was pushing this very hard, it was probably NOT in my best interest to go along with it, so I opted out. I take 3 generics at less than $5 a month and one for $24.99.
My SIL has same coverage than me, but she’s on many more Rx than me, including some brand name stuff. She didn’t opt out, her out of pocket went up considerably, so she got out in January and back to her old coverage.
My next challenge will be next open season when us USPS employees/retirees transition to our new Postal Service-only plans. Oh goodie.
CSRS retiree here with Medicare A and B and BCBS Basic. Just found this thread, wish I had seen it back in December when i was struggling to understand what they were hawking with the new Part D coverage. Had a discussion with an old boss I’m FB friends with, and he pointed out that since BCBS was pushing this very hard, it was probably NOT in my best interest to go along with it, so I opted out. I take 3 generics at less than $5 a month and one for $24.99.
My SIL has same coverage than me, but she’s on many more Rx than me, including some brand name stuff. She didn’t opt out, her out of pocket went up considerably, so she got out in January and back to her old coverage.
My next challenge will be next open season when us USPS employees/retirees transition to our new Postal Service-only plans. Oh goodie.
LOL, yep when they are pushing something that hard stay away, like the push to get us into FERS.
I thought USPS folks retired b/4 2025 were grandfathered into FEHB?
LOL, yep when they are pushing something that hard stay away, like the push to get us into FERS.
I thought USPS folks retired b/4 2025 were grandfathered into FEHB?
That’s what I originally thought when this first came up, but they’re moving all of us, lock stock and barrel, to the new plan. I believe some current Medicare eligible retirees who have opted out of Part B may NOT have to sign up for B, but don’t quote me on that. I have B and have enough in my plate without worrying about those guys. My understanding is newly Medicare eligible retirees will be required to sign up for Part B.
When we had the opportunity to switch to FERS, I ran the numbers and I would have actually been slightly ahead had I switched. But I worried Social Security may some day be means tested, so I stayed with CSRS.
Well, I'm about to reverse what I posted last December and opt out of the new BC/BS Medicare plan as well. I received a letter today stating that they had only refilled a prescription that I've been taking for a long time for 30 days since it's not in their formulary (it's the generic form of one that IS in their formulary, so it's even cheaper, duh.) I don't feel like arguing with them, so they can shove the whole program, as far as I'm concerned. It's the only thing that works on my constant headaches, and as long as my neurologist will still prescribe it, I'm going to continue to use it.
This little wrinkle buried in the BC MDPD just snagged me the other day. I received all the advance literature about BC/BS's newfangled retiree drug plan and had been dithering over opting out. I didn't act, so ended up being auto-enrolled.
Take this as a cautionary tale and FWIW.
I only take two prescriptions but will probably always take them. One is an inexpensive generic. Co-pay under this or that insurance plan doesn't make much difference. However, I failed to double check the co-pay for Eliquis (I now take an anti-coagulant because of the arrhythmia SVT). It isn't inexpensive. Without insurance, the average retail cost for a 30 day supply of Eliquis is about $700. I've been applying a manufacturer co-pay card to re-fills ever since my cardiologist's practice first provided it to me 4 years ago. It reduced the co-pay very, very well. With one important caveat. The card cannot be used in conjunction with any "government" health insurance programs such as Medicare or Medicaid.
The previous BC/BS health plan I had while employed and transitioned to be my supplemental coverage after enrolling in Medicare was considered "commercial". The Eliquis co-pay card was applicable. BC/BS's new drug plan is essentially a Medicare Part D plan. That means it now identifies as governmental, not commercial coverage. By not opting out of the new drug plan, the co-pay card cannot be used. My co-pay for a 90 day supply of Eliquis shot up from about $35 to over $200! Actually, the co-pay for the cheaper med went up too!
So, I am now in the process of opting out of BC/BS's newfangled retiree drug plan based on the two meds I now take. No one can predict what if any other meds they might need to use in future or what if any benefit staying enrolled might provide. You can only make decisions based on what you know. One other feature of the new drug plan is that you can opt in or out once per calendar year.
I have to admit the BC/BS drug plan phone rep was well informed about this problem, understanding, and quite easy to work with. Obviously, BC/BS is getting a lot of push back from retirees who are finding the "new" plan isn't such a great deal after all.
I, too, take an expensive anti-coagulant (Xarelto) for which the manufacturer provides a co-pay card, as well as another medication for which my copayment is $125, but the manufacturer rebates $115 back to me in the form of a check. I went through the BCBS materials last November, realized that I would lose those rebates, and opted-out for that fact alone. Had I been reading and posting on City-Data back then, I would have posted a warning in this thread when it was created.
But there is another side to this coin for those who don't take medications eligible for manufacturer rebates. My wife decided not to opt out and she has seen some of her copays reduced or even eliminated. For example, I recently picked up to boxes of Pavlovid to take with us as a precaution in case we develop Covid while out of the country for the next month. My order cost me $25 and her order was completely free.
I got the letter and somehow thought i was getting switched over to this because i was turning 65. I've had Medicare already due to a disability.
So far i have paid a bit more for two of my meds. Been enrolled for about 2 months.
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