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Shared Cost of Healthcare for Federal Employees

Generally, if you are a Federal employee or annuitant, you share the cost of your health benefits coverage with the government as your employer. Temporary employees, former spouses enrolled under spouse equity provisions, and most persons covered under temporary continuation of coverage (TCC) do not receive a government contribution towards the cost of their health benefits. The government’s share of premiums paid is set by law. Amendments to the FEHB law under the Balanced Budget Act of 1997 (Public Law 105-33, approved...

Premium Conversion Option for Federal Health Benefits

Premium conversion is a tax benefit. It allows you to allot a portion of your pay to your employer, who will in turn use that amount to pay your contribution for FEHB coverage.  This allotment is made on a pre-tax basis, which means that the money is not subject to Federal income, Medicare, or Social Security taxes, and in most cases, state and local taxes. The allotment reduces your taxable income, so less tax is withheld, and your paycheck is larger.   Eligibility You are eligible to have your FEHB premiums...

Health Insurance Coverage After Federal Retirement

Health Insurance Benefits After Retirement You may continue your heath insurance coverage after retirement if you meet the following conditions: 1. Your annuity must begin within 30 days or, if you are retiring under the Minimum Retirement Age (MRA) plus 10 provision of the Federal Employees Retirement System (FERS), health and life insurance coverages are suspended until your annuity begins, even if it is postponed. 2. You must be covered for health insurance when you retire. 3. You must have been continuously covered...

Eligibility for Health Benefits after Federal Retirement

When you retire, you are eligible to continue health benefits coverage if you meet all of the following requirements: •  you are entitled to retire on an immediate annuity under a retirement system for civilian employees (including FERS MRA + 10 retirements); and •  you have been continuously enrolled (or covered as a family member) in any FEHB plan(s) for the 5 years of service immediately before the date your annuity starts, or for the full period(s) of service since your first opportunity...

Pre-Packaged Long-Term Care Options for Federal Employees

Long-term care is the kind of care that you would need to help you perform daily activities if you had a chronic illness or disability. It also includes the kind of care you would need if you had a severe cognitive problem like Alzheimer’s disease. It is help with eating, bathing and dressing, transferring from a bed to a chair, toileting, continence, and so forth. Long-term care can also include assistance with such tasks as shopping, transportation, housecleaning, or preparing meals. This type of care isn’t received...

Beware of Local “Emergency Centers” Not Authorized by TRICARE

TRICARE beneficiaries may have noticed new kinds of “Emergency Centers” popping up in their area. It may seem like a tempting health care option but, free-standing emergency rooms (ER) that are not affiliated with a hospital may not be TRICARE-authorized. If a provider, such as a free-standing ER, is not authorized then TRICARE is prohibited from paying it “facility fees.” That can leave a beneficiary stuck with a big bill. Beneficiaries need to “know before you go.”  Check a free-standing...

Eligibility for Health Benefits after Federal Employment Retirement

When you retire, you are eligible to continue health benefits coverage if you meet all of the following requirements: •  you are entitled to retire on an immediate annuity under a retirement system for civilian employees (including FERS MRA + 10 retirements); and •  you have been continuously enrolled (or covered as a family member) in any FEHB plan(s) for the 5 years of service immediately before the date your annuity starts, or for the full period(s) of service since your first opportunity...

Half-Billion Dollar Gee-Whiz VA Benefits Processing Software Program is Kaput

The $500 million-plus software program that was supposed to eliminate the stubborn VA benefits backlog, the Veterans Benefits Management System (VBMS), has been taken offline for “troubleshooting,” according to internal VA documents. VBMS is supposed to transform the VA benefits administration process by converting to a paperless system. It is the lynchpin of the VA’s efforts to meet Secretary Erik Shinseki’s goal of eliminating the backlog by 2015 and bringing the average waiting time for veterans...

TRICARE and ABA Therapy for Autism Ruling

On July 26h, 2012, a United States Federal Judge ordered TRICARE to begin paying for Applied Behavior Therapy (ABA) for dependents with autism. Active duty service members are able to receive services through TRICARE’s Extended Health Care Option (ECHO) program, which defined ABA therapy as a medical intervention. Retirees are unable to receive ECHO benefits. Under TRICARE Basic, ABA therapy was defined as an educational intervention, not a medical intervention, making it ineligible for TRICARE coverage. ABA therapy,...

Republican Bill Would Offer Federal Health Plan to Seniors

In Mid-March, Republican lawmakers introduced legislation to replace Medicare with the health care plan currently offered to federal and congressional employees. The Congressional Health Care for Seniors Act would allow seniors to select any of the plans currently offered under the Federal Employee Health Benefit program, starting in 2014. Co-sponsors of the legislation include Sens. Rand Paul (R-KY), Jim DeMint (R-SC), and Mike Lee (R-Utah). Senator Lindsey Graham (R-SC) said "Medicare as we know it is a false promise....

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