Good/bad news about your current health plan

Whether it is politics, the economy or the pandemic — there is plenty of bad news to go around. Some would say even more than usual. So, could you stand a little boost? Why not, right? After all its about time.

And the good news is this:

If you are a member of the federal-postal family, either active, retired or a survivor annuitant and you are covered by the Federal Employee Health Benefits Program, you are in good shape. Very good shape. You have, regardless of which plan you are in, some of the best coverage available. Anywhere! And dozens of options and price ranges to choose from. And you can’t be turned down because of health, lifestyle or preexisting conditions. And you can change plans during open season, or anytime if you have a life event: Get married, divorced, have a child, are widowed or move to another area. Nobody can be rejected from any plan because of preexisting conditions. And you can select from nationwide fee for service coverage plans like Blue Cross, GEHA or APWU. Or you can go with local health maintenance organizations. HMOs offer local networks for one-stop service. The health insurance hunting season runs from November 9 through December 14. The government will pay 70 plus percent of the total premium. And for many workers, Uncle Sam will subscribe to an online shopping service (Consumers’ Checkbook) so you can shop at home or the office.

Open season headlines have focused on the bad news: The fact that 2021 FEHBP premiums are going up an average of 4.9%. But that’s AN AVERAGE. You know what averages are. Some plans are actually reducing premiums for 2021.

But every silver lining has a cloud right? No matter how well you are doing, or think you are doing, there is always somebody to tell you have messed up. Or missed an opportunity. Or did the wrong thing even if you didn’t do anything. But there is hope and help right around the corner.

But now the slightly bitter news:

If you are a typical still-working civil servant, you are likely paying too much for your current health plan. It is a good plan but odds are you could get equally good coverage and pay $1,000 to $2,000 less next year in premiums and out of pocket. Even though its been a great plan over the years, it is probably time to move on. The odds that you are overpaying skyrocket if you are retired and if you’ve stuck with the same old, same old plan for years. Many of the younger, healthier members of your group plan may have moved to lower-cost (but equally good) plans leaving you in a pool of so-called “heavy users” who drive premiums up each year. Both active and retired feds who haven’t changed plans in years, if ever, can generally save lots of money by moving to a similar plan. Maybe the basic rather than the standard option of the same plan. It may have the same, or even superior coverage, and may include your primary doctors in the network. It may be the same plan name with the same benefits but different premiums.

You’ll never know until you shop around. In addition to using online services, many agencies will supply employees brochures you can order online and compare their benefits and premiums with your current plan. You can also make sure your doctor or doctors are remaining in the network of your current plan. Or maybe learn they are part of the network of a similar plan with lower, in some cases much, much lower, premiums.

It is important to learn terms like high deductible , which sound scary but can be nice. HD plans tend to have lower premiums and they can allow you to build a heath savings account. A growing number of people in the federal program now have accounts worth $10,000.

Health needs change over the years. But most people don’t even consider changing health plans because of life changes. Example: Both younger couples without kids and older couples whose children are grown may benefit from a single self-plus one plan, instead of a family plan. Or buying two separate self-only plans. Premiums may be slightly lower but meeting two deductibles may be more expensive. It pays to shop. HMOs have traditionally provided some of the best maternity benefits. Some are one-stop operations where most or all doctors and facilities are at the same spot. Retirees may find they can save premium dollars and get top-notch coverage by suspending — not dropping but temporarily suspending — their FEHBP coverage for other options.

There are lots of things you can do during the upcoming season that could decrease your premium and out of pocket costs without impacting your coverage. Click here for an example.

We’ll cover them all with input from the experts here at Federal News Network and also every Wednesday at 10 a.m. EDT on Your Turn with top experts like Checkbook’s Walton Francis and benefits experts Tammy Flanagan. The shows will be archived so you can listen again or refer them to a friend. Open season should be an opportunity, not a nightmare. So stick with us…

Nearly Useless Factoid

By Alazar Moges

Source: University of Virginia

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