Walton Francis: ‘Choose wisely’ during Open Season

Open Season is coming to a close and if you haven’t already made a decision on your federal health insurance, there’s no time like the present.

Federal benefits expert Walton Francis joined Federal News Radio Senior Correspondent Mike Causey on Dec. 2 for an online chat to talk about everything from Aetna to zero medical costs. And in between, a little more on why a switch to self-plus-one is a good idea, and what retirees can do to get the most out of Medicare.

Do your research, don’t be afraid of change

“Choose wisely,” Francis said, but don’t be intimidated by the wide variety of options available to you.

“That’s what Open Season’s for,” Francis said. “It’s only for (12) more days; use your week and a half wisely.”

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This year’s Open Season star is the self-plus-one option. It’s the first time employees can enroll themselves and one eligible family member. During a previous online chat, Francis said the savings from self-plus-one are likely to range between $100 and $200.

Some people have found, however, that self-plus-one plans are the same or higher than self-and-family plans.

“I think the news for many people is how similar the premiums are to a family plan,” Causey said. “The premiums are based on usage. Many plans with high numbers of retirees also have higher costs. Next year they will have a better idea of their retiree — heavy users — population. That will be reflected in premiums. In the meantime you can still save premium dollars next year by considering self-plus-one coverage.”

Whether or not you decide to go with self-plus-one — or stick with what you’ve got — Causey and Francis urged federal employees to at least take a look at other plans. Because that’s where they’ll save money.

Even for the many people enrolled under popular Blue Cross Blue Shield, both benefits gurus said there’s no harm in looking at a more basic plan.

“Basic benefits (for BCBS) are just as good overall,” Francis said, when asked whether there was an upside to moving from a high option plan.

“It always pays to check out Blue Cross standard and basic.” Causey said. “Check with your doctor to be sure he/she is in the network. If your doctor is in the network, Blue Cross basic is worth a look. Premiums are much lower than Blue Cross standard. Both are excellent plans.”

Francis advised feds not to limit their choice to Blue Cross, but to look at other plans and compare how they stack up against their personal circumstances such as age, family size, pay system, etc.

Retiring and (Medicare) wraparounds

Francis also had advice for employees nearing retirement as well as those who are already retired.

Asked whether it was wise to delay signing up for Medicare if an employee is 65 but actively employed, Francis said yes.

“There is no penalty for delaying enrollment until you retire,” he said.

For those wondering if there were plans with fewer retirees enrolled, Causey said it was hard to say, but “very likely Blue Cross standard is up there with lots of retirees,” and SAMBA has a high option for retirees.

Francis also said had this to say about the differences for plans that offer Medicare wraparound coverage:

“The wraparound plans waive payments of deductibles, admission charge, co-pays and co-insurance for hospital and doctor,” he said. “Very few of them offer any additional benefits, but a few do. For example, Blue Cross basic and NALC offer slightly better drug benefits. So the benefits are essentially identical, but that hides an important point: No deductible means a lot more in a high deductible or consumer-driven plan, like Aetna Direct or MHBP High Deductible.”

“If you’re going to have Medicare wraparound, then for heaven’s sake look for a plan with a lower premium,” Francis added. “Why pay more when you’re already going to be getting free care through the wraparound? Given that it’s free, why aren’t you in the lower cost ones so you can save money.”

Don’t forget

Open Season ends Dec. 14. The Office of Personnel Management’s special Open Season number is 800-332-9798 and here is OPM’s premiums site. If you haven’t already, check out Francis’ Checkbook Guide to Health Plans for Federal Employees.

Francis will be back Dec. 9 on Your Turn.

We’ve also been answering submitted questions here.