News from Your Ohio Chapter

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FEHB, MEDICARE A AND B, ADVANTAGE PLANS: Linda Carter, UPMA Gold

Insurance is so confusing; and then those postcards promoting Medicare Part D just added to the confusion. As postal employees and annuitants eligible for Federal Employees Health Benefits, we are fortunate to have many good options under the FEHB from many insurance providers that are much better in meeting our health needs than most private sector employees. I regret I am unable to provide much info to those who have contacted me about the Part D Plan. I copied the info below from OPM, and provided the link below where you can find much more info. The blue underlined links will take you directly to specific information you may need. Good luck in your decisions during this open season that runs until December 11. The strongest advice for all of us is DO NOT CANCEL YOUR FEBH. If you decided to try something new, always contact OPM to SUSPEND your FEHB so you can return to the program later if you decide to do so. Once you CANCEL, you cannot go back. Here is the link I used: 

https://www.opm.gov/healthcare-insurance/healthcare/medicare/medicare-vs-fehb-enrollment/

What Does Medicare Cover? View more

Original Medicare has several parts:

Part A (Hospital Insurance) helps pay for:

·        inpatient hospital care

·        critical access hospitals

·        skilled nursing facility care

·        some home health care

·        hospice care

Part B (Medical Insurance) helps pay for:

·        doctors' services

·        ambulance services

·        outpatient hospital care

·        x-rays and laboratory tests

·        durable medical equipment and supplies

·        home health care (if you don't have Part A)

·        certain preventive care

·        limited ambulance transportation

·        other outpatient services

·       other medical services Part A doesn't cover, such as physical/occupational therapy.

Part D (Medicare Prescription Drug Coverage)

---Under this program, private companies provide Medicare Prescription Drug Coverage and you pay a monthly premium. Federal retirees already have excellent access to health benefits coverage for drugs through participation in the FEHB Program. However, if you choose to enroll in Part D, Medicare benefits for drugs will be primary (will pay first) in most cases for FEHB enrollees. (Medicare C plans that include prescription drugs will also be primary to FEHB benefits.) There is a monthly premium for Part D coverage. Most Federal employees do not need to enroll in the Medicare drug program, since all Federal Employees Health Benefits Program plans will have prescription drug benefits that are at least equal to the standard Medicare prescription drug coverage. Still, you may want to be aware of the benefits Medicare is offering, so you can help others make informed decisions. If you have limited savings and a low income, you may be eligible for Medicare's Low-Income Benefits. For people with limited income and resources, extra help in paying for a Medicare prescription drug plan is available. Information regarding this program is available through the Social Security Administration (SSA). For more information about this extra help, visit SSA online at www.ssa.gov(external link), or call them at 1-800-772-1213 (TTY 1-800-325-0778).

---It will almost always be to your advantage to keep your current FEHB coverage without any changes. The exception is for those with limited incomes and resources who may qualify for Medicare's extra help with prescription drug costs. Contact your benefits administrator or your FEHB Program insurer for information about your FEHB coverage before making any changes.

---It is important to note that FEHB Program prescription drug coverage is an integral part of your total health benefits package. You cannot suspend or cancel FEHB Program prescription drug coverage without losing your FEHB plan coverage in its entirety (in other words, losing coverage) for hospital and medical services which would mean you might have significantly higher costs for those services.

---Because all FEHB Program plans have as good or better coverage than Medicare Advantage Plans, they are considered to offer creditable coverage. So, if you decide not to join a Medicare drug plan now, but change your mind later and you are still enrolled in FEHB, you can do so without paying a late enrollment penalty.

·        Do FEHB Plans and Medicare Cover the Same Types of Expenses? View more

Generally, plans under the FEHB Program help pay for the same kind of expenses as Medicare. FEHB plans also provide coverage for emergency care outside of the United States which Medicare doesn't provide. Some FEHB plans also provide coverage for dental and vision care. Medicare covers some orthopedic and prosthetic devices, durable medical equipment, home health care, limited chiropractic services, and some medical supplies, which some FEHB plans may not cover or only partially cover (check your plan brochure for details).

·        Since I Have FEHB Coverage, Do I Need Medicare Coverage? View more

If you are entitled to Part A without paying the premiums, you should take it, even if you are still working. This may help cover some of the costs that your FEHB plan may not cover, such as deductibles, coinsurance, and charges that exceed the plan's allowable charges. There are other advantages to Part A, such as (if you also enroll in Part B,) being eligible to enroll in a Medicare Advantage Plan.

·        Should I Change Plans? View more

Once Medicare becomes the primary payer, you may find that a lower cost FEHB plan is adequate for your needs, especially if you are currently enrolled in a plan's high option. Also, some plans waive deductibles, coinsurance, and copayments when Medicare is primary.

. I Want to Join a Medicare Advantage Plan. Should I Drop My FEHB Coverage? View more

When you enroll in a Medicare Advantage plan, you may not need FEHB coverage because the Medicare Advantage plan will provide you with many of the same benefits. You should review the Medicare Advantage Plan benefits carefully before making a decision to suspend or cancel FEHB coverage. You should contact your retirement system to discuss suspension and reenrollment.

·        Can I Reenroll in FEHB If I Disenroll From the Medicare Advantage Plan? View more

If you provide documentation to your retirement system that you are suspending your FEHB coverage to enroll in a Medicare Advantage plan, you may reenroll in FEHB if you later lose or cancel your Medicare Advantage plan coverage. However, you must wait until the next Open Season to reenroll in FEHB, unless you involuntarily lose your coverage under the Medicare Advantage plan (including because the plan is discontinued or because you move outside its service area). In this case, you may reenroll from 31 days before to 60 days after you lose the Medicare Advantage plan coverage, and your reenrollment in FEHB will be effective the day after the Medicare Advantage plan coverage ends (or ended).

WEP/GPO FIELD HEARING: FROM Dave Cook, UPMAR Legislative Chairman

Social Security Subcommittee Field Hearing on Social Security’s Disservice to Public Servants: How the Windfall Elimination Provision and Government Pension Offset Mistreat Government Workers. The Hearing is on November 20, 2023 at 2:00 PM (Central Standard Time) in Baton Rouge, Louisiana. 

HERE IS WHAT WE ARE WATCHING:      Dave Cook, UPMAR Legislative Chair

WEP/GPO Update- Dave Cook, UPMAR Legislative Chairman

H.R. 82 Social Security Fairness Act has 300 Cosponsors- 201(D) 99(R)

S. 597 Social security Fairness Act has 49 Cosponsors- 39(D) 7 (R) 3

Other bills to watch regarding WEP/GPO are:

H.R. 4260 Public Servants Protection and Fairness Act has 102 Cosponsors 102(D)

H.R. 4583 Social Security 2100 Act has 179 Cosponsors 179(D)

S-2780 Social Security 2100 Act has 4 Cosponsors 4(D)

                                                                                                                          November 16, 2023

Executive Board Meeting held 11/12/2023

Your Ohio Chapter executive committee held a board meeting Sunday November 12 in the meeting room at the Embassy Suites hotel at the Akron-Canton Airport. The meeting was called to welcome the newly elected officers and transition from last years officers to the new slate.

    The usual business of the chapter was completed along with discussions of the 2024 Chapter Convention and the 2024 Central Area Officers Summit CAOS.

    The Convention will be held May 31-June 2, 2024. This years location will be the Salt Fork State Park Lodge, 14755 Cadiz Road in Lore CityOhio, 43755. There are 148 rooms and 53 cabins along with RV and primitive camping options. The park offers trails, pools, a marina, disk golf, fishing, a nature center and much more.

    CAOS will be September 21, 2024 at the Embassy Suites hotel in Canton. This meeting to train UPMA officers is open to all members. 

    The board recognized VP Laura Reese for her talents and energy preparing and winning the "Star" award for our Ohio Chapter at this years National Convention. Likewise Paul Joseph was recognised for receiving his award as Editor of our Chapter newsletter. 

Updated list of planned S & DC implementation in July of 2024                            10/2/23

For General Open Season information, click the above link to use Live Help or send a secure webmail message.

For information on comparing health plans visit http://www.opm.gov/healthcare-insurance/healthcare/plan-information/compare-plans.

For more information regarding the Patient Protection and Affordable Care Act's requirement visit www.irs.gov/uac/Questions-and-Answers-on-the-Individual-Shared-Responsibility-Provision.

For information on the Federal Employees Dental & Vision Insurance Program (FEDVIP) visit the secure enrollment website www.benefeds.com or call 1-877-888-3337, TTY 1-877-889-5680.

For more information on Open Season or health care reform legislation, visit www.opm.gov/insure.

For information on Medicare, visit www.medicare.gov.

WEP AND GP0 UPDATE: Dave Cook. UPMAR Legislative Chairman:           10/25/23

Bills in the House:

H.R 82 Social Security Fairness Act-Cosponsors- 298 (201-D, 97-R); H.R. 4583 Social Security 2100 Act-

Cosponsors- 179 (179-D); H.R. 4260 Public Servants Protection and Fairness Act of 2023- Cosponsors- 101 (101-D)

Bills in the Senate:

S.597 Social Security Fairness Act- Cosponsors- 46 (36-D, 7-R, 3-I); S.2280 Social Security 2100 Act- Cosponsors 4 (4-D)

For more information: www.house.gov; www.senate.gov

FEHB OPEN SEASON: from OPM
Federal Benefits Open Season begins Nov. 13, 2023 and ends Dec. 11, 2023. The annual open season gives federal employees and other eligible individuals the opportunity to review their FEHB and vision/dental (FEDVIP) plan options, make changes, and enroll for the upcoming benefit year that begins January 1, 2024. Specific plan information including 2024 FEHB premium rates will be released by OPM in October

IMPORTANT DATES TO REMEMMBER:

January 13 – 15, 2024
Membership Kickoff Caribe Royale Orlando, FL

March 17 – 20, 2024
Legislative Summit Arlington, VA

May 30 - June 2, 2024
Ohio Chapter Convention Salt Fork State Park Lore City, Oh

August 24 – 30, 2024
National UPMA Convention Caribe Royal Resort Orlando, FL