WASHINGTON (Army News Service, Dec. 3, 2014) – Many federal employees say they’re happy with their health insurance and are not planning to shop around for another.
That would be a mistake, said Federal Employees Health Benefits, or FEHB, expert Walton Francis, who is also an economist.
Francis estimated that some 50 percent of FEHB enrollees could save around $2,000 a year by choosing a plan with lower premiums and out-of-pocket costs.
Shopping for an affordable plan is increasingly important because, officials said, the average premium rates for FEHB enrollees will increase about 3.8 percent, dental coverage rates will increase 1.7 percent and vision will increase about 1.5 percent.
The last day to shop around, Dec. 8, is fast approaching though.
While going through the fine print on dozens of plans would be daunting for anyone, Francis suggests at least reading the plan summaries, found within the 2015 guide published by the Office of Personnel Management. That guide can be found at http://www.opm.gov/healthcare-insurance/healthcare/plan-information/guides.
Francis hosted an online question and answer session, Dec. 1, in conjunction with the Washington Post Federal Diary.
One session participant’s son has attention deficit hyperactivity disorder, which requires many appointments with therapists and psychiatrists. The participant wondered which plan was best for their family. Francis said all FEHB plans have to cover mental health the same as physical health. The key is to shop around and find a plan accepted by the mental health provider.
Another participant, who was planning on becoming pregnant, asked which plan is best for her growing family. Francis said that most plans give free or very low-cost maternity coverage — including delivery.
When it comes to health and dental plans, many federal workers use the same plan for both. Francis said while that works for some, during open season it’s a good idea to check if more savings could be realized by splitting dental and medical coverage into separate plans. As always, he said, check with one’s doctor and dentist to see if those plans are accepted.
Francis also suggested a Flexible Spending Account for expenses that health, dental and vision plans don’t cover, or even to pay co-pays on existing insurance.
Many federal workers are also military retirees who are covered by TRICARE. For them, Francis said, TRICARE “is a better deal on cost (premium, plus out of pocket) than any FEHB plan.”
Additionally, Francis disagreed with one participant in the chat who suggested that FEHB plans were getting more “stingy.”
“In fact, they are overall getting better as plans improve their offerings to meet Affordable Care Act standards, particularly in the areas of catastrophic maximums and preventive benefits,” Francis said. “Plans are, however, getting more heavily into pre-approval for expensive imaging like MRIs and specialty drugs.”
Federal workers who are not shopping around each year for a plan that may be better than their current one are “making a big mistake,” Francis said.
“First, without fail, consider you and your family’s health status and consider that the match between the plan’s benefits and what you need may no longer be so good.
“Second, download the plan brochure and look at the page on how benefits change for next year. You may see good news or bad news, but you need to know.
“Third, check to make sure that any really important doctors are still in your plan network next year, and while you are at it, find out what other networks they are in … by calling the doctor’s office,” he said.
And finally, Francis said, “consider giving yourself a one or two thousand dollar increase in take-home pay and reduced spending by looking at just one or two other plans with lower premiums and equal or better benefits.”