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exceptions, only good in the

U.S., so it may not work well

for those who retire overseas.

In addition, if your doctor

does not participate in Medi-

care (an “opt out” or “private

contract” provider), Medicare

will not pay for the services.

Per federal regulation, your

FEHB plan will be capped at

20 percent of the approved

Medicare charge, leaving you

with a huge out-of-pocket

Part B or Not Part B? That Is the Medicare Question

This is one of the most critical

decisions you’ll make in retire-

ment, with long-term impli-

cations for both your health

and your pocketbook. So on

May 12, AFSA brought back

Paula Jakub of the American

Foreign Service Protective

Association, for an encore of

her popular seminar: “Medi-

care and the FEHB–Putting It


With almost 100 attend-

ees, the house was packed.

Beginning with a brief review

of Medicare as a whole, Ms.

Jakub explained that, for

most, Medicare Part A (hos-

pitalization) is a no-brainer,

because it is premium-free for

almost everyone. Most people

sign up for it as soon as they

reach 65, even if still actively

employed. And the drug

coverage is so good in most

Federal Employees Health

Benefits plans that few federal

retirees apply for Medicare

Part D.

So what about Medicare

Part B, which covers provid-

ers (e.g., doctors, outpatient

services, radiology, etc.) and

for which you must pay a pre-

mium?Well, it’s complicated.

Taking attendees through

a series of informative slides,

Ms. Jakub advised that in

2016, Part B will cost a new

applicant at least $121 per

month, more if Modified

Adjusted Gross Income

exceeds $85,000 (single) or

$170,000 (joint return).While

many private-sector insurers

require policy holders to sign

up for Medicare Part B at age

65, federal annuitants have a


If you enroll in Part B as an

annuitant, Medicare becomes

your primary insurance and

your FEHB policy becomes

your secondary insurance.

For example, Medicare pays

80 percent of the Medicare-

approved amounts for physi-

cians/providers who accept

assignment of benefits, leav-

ing your FEHB policy to cover

the remaining 20 percent.

That often leaves retirees with

no outstanding balance.

Also, Medicare and your

FEHB plan seamlessly coor-

dinate payment (“electronic

crossover”), virtually sparing

you paperwork, another ben-

efit for retirees. For providers

who participate in Medicare

but don’t accept assignment,

Medicare still pays its portion

(although your out-of-pocket

expenses may be higher), and

payments are still coordi-

nated, sparing you paperwork.

So why might you choose

not to take Medicare Part B?

First Ms. Jakub reminded

the audience that Medicare

Part B coverage is, with rare

cost—far more than if you had

never signed up for Part B.

So make sure key doctors

and providers participate in

Medicare before you decide

whether to take Part B.

To do more research on

Medicare and your choices,

watch the seminar online at

, or visit

the Medicare website at www.

Remember; AFSA and

AFSPA cannot provide defini-

tive advice to you regarding

your choices or entitlements.

For other assistance, AFSA is

just an email away at retiree@


—Todd Thurwachter,

Retiree Counselor

Paula Jakub spoke to almost 100 AFSA Members, mostly retirees, about

their Medicare choices


Women’s Political Caucus

Honors Marguerite Cooper

On May 16, the National Women’s Political Caucus

honored Marguerite Coo-

per with their first lifetime

achievement award.

Ms. Cooper, a retired For-

eign Service officer and cur-

rent AFSA member, received

the award from NWPC Vice-

President for Membership

Sherrill Mulhern.

When Ms. Cooper joined

the Foreign Service in 1956,

fewer than 5 percent of FSOs

were female. On her first

posting, to Tel Aviv, she was

prevented from undertaking

some aspects of the job that

her supervisor considered

“not women’s work.”

In 1970, Ms. Cooper

helped to found the Wom-

en’s Action Organization,

which helped pioneer efforts