Does your bucket list include actively participating in the annual federal health insurance open season? Is plowing through up to 30 health plan brochures the equivalent of gliding down the grand canals of Venice, or running with the bulls in Spain, or visiting all 50 state capitals?
Probably not. Fun it isn’t. Comparing health plan brochures and discussing premiums, deductibles and the role of Medicare Part B in your life is hardly dinner table or cocktail party fare. And yet, picking right plan between now and close of business Dec. 9 may be the most important financial decision you will make this year. Or if you or someone in your family has a serious accident or medical condition it could be the most important choice you will ever make. Medical bills are the number one cause of bankruptcy in the U.S., but most of us don’t think about it when picking our health plan.
Thinking about a potentially catastrophic medical emergency is not pleasant — it’s awful. But stuff happens. Think of your friends, office mates, relatives or yourself — how did they, and you, do this year?
Walton Francis, editor of Consumers’ “Checkbook Guide to Health Plans for Federal Employees” says “the most important reason for buying health insurance is to protect you against financial catastrophe.” Because of that he suggests you may want to check out the “limit to you” column of Checkbook or its online version, which many agencies have purchased for employees. The limit to you includes both annual premiums you will pay regardless of what kind of health year you have in 2002, and the guarantee of the health plan for hospital, medical or prescription drugs. In other words it’s the financial limit you will have to pay in a worst-case scenario. That limit to you ranges from $4,000 to $5,000 in the Kaiser, Carefirst United HDHP; to as much as $9,000 to $10,000 for Aetna open access and SAMBA high option for a self-only plan. Naturally your out-of-pocket maximum will be higher if you have a family plan.
If you’re like many feds you’ve either decided to remain in the same plan for 2020, or will, maybe, shop over the weekend. Not such a great idea. Francis says as many as six out of 10 retirees and workers may be in the “wrong” plan — wrong in the sense that while it’s a good plan, you may be paying more than you need. So how do you know?
Bear in mind the primary reason you buy health insurance is its catastrophic coverage, or how much you would have to pay out of pocket in 2020 if you or a family member suffers a major medical problem or accident. Here’s a checklist of things you should consider, starting with your plan’s catastrophic coverage:
Legendary lothario Giacomo Casanova escaped from a Venetian prison in 1755 where he was sentenced to five years for repeated adultery. While incarcerated in “the Leads” facility, named for the lead that coated its walls and roof, Casanova found an iron rod in the prison yard and fashioned it into a digging tool. For several months he worked on a tunnel out of his cell but he was suddenly forced to move to another cell. He gave his iron tool to the prisoner next to him, a monk named Balbi, who agreed to dig one tunnel joining their cells and the outside. They succeeded and split up once back in central Venice, avoiding police detection.