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Frequently Asked Questions
Yes. You must be enrolled in Medicare Part A and Part B to be eligible for our retiree plans and you must continue to pay your Part B premium to the government. This is a requirement for Medicare Advantage plans. If you stop paying your Part B premium, you may be disenrolled from your plan.
Retirees with Medicare Part A&B who are enrolled in a G.E.H.A. High or Standard FEHB or PSHB plan and select the G.E.H.A. Medicare Advantage Plan:
- Will have the opportunity for reduced out-of-pocket costs with no additional premium
- Monthly part B premium reduction of $100 (High Option) or $75 (Standard Option) per enrolled member
Individuals who are retired, with Medicare A and B, and enrolled in the G.E.H.A. High or Standard medical plan in FEHB or PSHB.
There is no additional premium to enroll in the G.E.H.A. Medicare Advantage plan. You must continue to pay your G.E.H.A. High or Standard medical plan premium and your Medicare premiums.
Yes, the G.E.H.A. Medicare Advantage plans include Medicare Part D and satisfies the Part D requirement in the PSHB program. You do not need to have additional Part D coverage while enrolled in the G.E.H.A. Medicare Advantage plans.
This G.E.H.A. Medicare Advantage plan is approved by OPM as a part of the FEHB and PSHB programs. This is why you must first enroll in a G.E.H.A. High or Standard medical plan with OPM and remain enrolled in that plan code – it keeps you within the FEHB or PSHB program. Do not suspend or terminate your coverage with OPM or you will also be terminated from the G.E.H.A. Medicare Advantage Plan.
No, while you will remain a G.E.H.A. High or Standard medical plan member in the FEHB or PSHB program, enrolling in the G.E.H.A. Medicare Advantage plan will take over as the primary and only payor. You get all the benefits of Original Medicare, plus all the benefits of your G.E.H.A. FEHB or PSHB plan all in one plan. You will no longer need to coordinate between two plans.
No, you only need to contact OPM to enroll in the G.E.H.A. medical plans in FEHB or PSHB.
No, this is a custom Group Medicare Advantage plan designed specifically for retirees in the FEHB or PSHB program. The Medicare Advantage plans advertised on TV are Individual plans and are unrelated to the FEHB or PSHB program, and may require you to suspend your FEHB or PSHB plan. Never suspend your FEHB or PSHB plan if you wish to enroll or remain enrolled in the G.E.H.A. Group Medicare Advantage Plan.
Thank you for your service!
While VA Providers cannot submit claims to a Medicare Advantage plan, Veterans can request reimbursement when all of the following are true:
- You are a Medicare Advantage member or were at the time of the service
- You received Medicare-covered services from a VA Provider or facility
- You paid a higher copayment or coinsurance for the Medicare-covered services (including prescription drugs) through the VA than you would have using your Medicare Advantage plan
You can submit a request for reimbursement, by completing the VA 10-583 Form and mailing it to the address on your UCard
IRMAA is an amount Social Security determines you may need to pay in addition to your monthly Part B and D premium if your modified adjusted gross income on your IRS tax return from 2 years ago is above a certain limit. The G.E.H.A. Medicare Advantage plan’s included prescription drug coverage is considered a Part D plan therefore if you currently have a Part B IRMAA then you may incur an additional Part D IRMAA when enrolling in this plan.
Your monthly Medicare part B premium subsidy will be automatically applied to your Medicare part B premium in the form of a reduced part B premium charge.
The method in which you pay your part B premium will be the method in which you will receive the subsidy. Your reduced part B premium will be applied on your Social Security benefit, direct bill from Medicare, or Annuity benefit depending on how you pay your premium.
You will not see a line-item credit on your statement, you will see a reduced premium amount.
Yes, you will have an annual preventive care dental benefit, with a $1,000 annual maximum. The dental benefits included in the G.E.H.A. Medicare Advantage plan will coordinate with additional dental coverage in FEDVIP. You just need to show both your G.E.H.A. Medicare Advantage ID card and your FEDVIP ID card at the dental provider.
Click on the Resources tab in the menu at the top of your screen, then on the Appeals & Grievances link. This page provides detailed information about the appeals process.
PSHB Medicare Advantage and Part D Prescription Drug Coverage FAQ
Medicare Part D is prescription drug coverage for people with Medicare offered by private health insurance companies.
Retirees with Medicare Part A only, Part B only or Retirees with both Medicare Parts A & B
Retirees with both Medicare A and Medicare Part B
Postal retirees and eligible dependents who are retired with Medicare Part A only, retired with Medicare Part B only, or retired with Medicare Parts A&B will be auto enrolled into Part D prescription drug coverage within the PSHB program. G.E.H.A. High and Standard PSHB Health Plan members with Medicare Parts A & B will have the option of choosing between the G.E.H.A. Medicare Advantage plan (which includes Medical and Part D prescription drug coverage with a Part B premium subsidy) or the Part D prescription drug coverage alongside the regular G.E.H.A. PSHB medical coverage.
Most prescription coupons or copay assistance programs cannot be used in conjunction with Part D prescription drug coverage.
IRMAA is an amount Social Security determines you may need to pay in addition to your monthly Part B and Part D premium if your modified adjusted gross income on your IRS tax return from 2 years ago is above a certain limit. If you are assessed a Part B IRMAA by Social Security, and auto enrolled into Part D prescription coverage under PSHB or elect to enroll in the UnitedHealthcare Retiree Advantage plan, then you may incur an additional Part D IRMAA when enrolling in this plan.
For many people, your income decreases upon retirement. You will want to monitor your income tax filing and, the first year that you fall below the IRMAA threshold, you are encouraged to contact Medicare and request that they perform another two-year lookback. This will help decrease or eliminate the IRMAA amount that you may be charged.
Beneficiaries who file individual tax returns with modified adjusted gross income: |
Beneficiaries who file joint tax returns with modified adjusted gross income: |
Total Monthly Part B Premium Amount |
Total Monthly Part D Premium Amount |
Less than or equal to $103,000 |
Less than or equal to $206,000 |
$174.70 |
$0.00 |
Greater than $103,000 and less than or equal to $129,000 |
Greater than $206,000 and less than or equal to $258,000 |
$244.60 |
$12.90 |
Greater than $129,000 and less than or equal to $161,000 |
Greater than $258,000 and less than or equal to $322,000 |
$349.40 |
$33.90 |
Greater than $161,000 and less than or equal to $193,000 |
Greater than $322,000 and less than or equal to $386,000 |
$454.20 |
$53.80 |
Greater than $193,000 and less than $500,000 |
Greater than $386,000 and less than $750,000 |
$559.00 |
$74.20 |
Greater than or equal to $500,000 |
Greater than or equal to $750,000 |
$594.00 |
$81.00 |