Return to Article: Employees urged to weigh a switch in health plans
-
63906
I have Aetna Basic Open Access. It's not amazing but it isn't bad. I have to select from their list of doctors online, so I try to read reviews of these doctors before I make an appt. So far so good. I'm thinking about switching to Kaiser Standard HMO since it is much cheaper, but I'm afraid it will be a bad idea...any advice?? I am a healthy (knock on wood) young Fed who rarely goes to the dr. Thanks!!
-
63108
Becareful with BCBS. They are now cancelling providers with no warning and backdating the cancellation. So if you a patient and go see your Dr, you may get an EOB stating you owe the full amount. You may think that it cant happen, but it hapned to me, and I am fighting it, but OPN has said there is not much they can do about it. I thought they were supposed to be there for us, not for the insurance companies. It makes me wonder why BCBS premiums can rise so much when there benefits are deteriorating. If you work in a very rural area, like I do--middle of nowhere, and none of the anesthesiologists take BCBS, nor some of the surgeons, BCBS wants you to pay an enormous cost before they will cover anything--and that IS on their high option, where they are supposed to cover out-of-network. Funny, this article says 6 or 7 disputed claims per 10000 employees, well, I had about 10 myself last year. Needless to say, time to giv them the boot.
-
37598
I too am a proponent of the HDHP heath plans - especially Aetna. Did anybody else notice the numbers for 2008 changed significantly? The premium pass through was reduced by 50% ($125 to $66.50 per month), the annual deductible was reduced by 40% ($2500 to $1500), and the premium was reduced by 15% (948 to 804 per year). I sure am disappointed to see the premium pass through drop. That was a nice extra 1500 dollars a year.
-
37594
The commentor who favors Aetna offers creative use of health and flex spending accounts. They are good savings tools for these expenses. However, while Aetna may be a great plan (I do not know), my point is that its NOT just about costs and premiums. BCBS Carefirst is a non-profit, other companies are in it for the profit and many can tell you that certain companies have internal quotas of 10% or more to reach for Denials of Claims. This is something to be careful of. When it comes to the bottom line for many companies and building incentives for executives, they will use Denial of Claim percentages to determine who gets paid more.
To these carriers, your claim for health care provided is viewed as an expense or a loss. Again, Feds - do your research and be careful. I'm going to learn more about these SHA's as I already use an FSA to some degree.
I would never consider a so-called High-deductible plan for certain reasons and calculations, but thats just me. Everyone must figure out what is best for their family - this is not always a "no-brainer" decision. Do not be rushed.
-
37568
It seems this must be reiterated to Feds - especially those with families. Beware the degraded health benefits you may suffer if switching to a new plan just for a smaller premium. Another commentor thinks the math is always simple and Feds should jump on that low premium plan. The math is NOT always simple and you and your family can get burned. Calculate several different scenarios before taking a major step that might affect your life or someone in your family.
Also, bear in mind that when you switch insurance companies, you start from scatch including a pre-existing condition disclosure statement. If you make one mistake on that disclosure, a crafty carrier can cancel your coverage on those grounds alone...if they find you to be a sick person (an expense). This is sad, but it happens everyday in this country. Be careful.
Also, while Flexible Spending Accounts are a useful tool...remember that you lose any cash you pay in for the year that is not spent in that year. That fact must be included in any honest calculations or comparisons.
I say again, think carefully before contracting out your family's healthcare to the lowest bid. Good luck.
-
37478
Here's the common sense approach for those contemplating a change from BCBS to the AETNA HDHP. Take the extra $2000 you'd spend on the BCBS premium and through payroll deduction have that $78 per pay period go into your HSA. At the end of the year you will have contributed the $2000 you would have spent on BCBS premiums plus the $1500 in premium pass through. That's $3500 in your HSA for the year, $500 over the yearly deductible and whatever you don't spend is yours forever no matter if you change plans or leave the gov't. There's free money on the table feds. HELLO
Oh yeah, contrary to what most believe, the AETNA HDHP is not an HMO. You go to whatever doctor/specialist you want whenever you want, no referrals. Do your prescription costs with BCBS count towards your yearly deductible? I didn't think so. They do under AETNA's HDHP.
-
37438
Well if you live in NE Florida you don't have an HMO plan available. This is ridiculous! Everyone always says how the Fed gov has lots of plans or how great the Fed health benefits are, well i have to say that the last two companies i worked for were 1000% better. I pay $28 more per paycheck, and have paid hudrends of dollars more for under this BCBS FFS plan vs my Cigna HMO or Aetna HMO that i've had previously. Why does our area not offer an HMO, and why are our premiums going up?
-
37384
It's the same old tune every open season. Most feds sit back and complain about the rise in premiums, but do nothing in terms of comparing plans and getting out of those ridiculously high premium plans like BCBS Standard. The HDHPs are the way to go for most folks. I like to compare Aetna's HDHP with BCBS Standard. Simple question, "why pay $2000 more in premiums to save $1500 in deductible. With Aetna you get $1500 in premium pass through so technically you're out of pocket risk is $1500. The deductible is $3000 in '08. After you reach the deductible the plan pays 90%. Very similar coverage to BCBS after satisfying the yearly deductible. With FEDFLEX you can now put pre-tax dollars into your HSA (not to be confused with the FSA) through payroll deduction. The beautiful thing about FEDFLEX is you can change your allotment anytime you want (unlike the FSAs). In 2008 you can put $4300 into your HSA. With the $1500 in premium pass through that's $5800 in the HSA for the year and it's yours forever. It's a no brainer FEDs. This is basic kindergarten math. Quit complaining about the rise in premiums and start shopping. $67 per pay period or $145? Hmmmm
-
37383
It's the same old tune every open season. Most feds sit back and complain about the rise in premiums, but do nothing in terms of comparing plans and getting out of those ridiculously high premium plans like BCBS Standard. The HDHPs are the way to go for most folks. I like to compare Aetna's HDHP with BCBS Standard. Simple question, "why pay $2000 more in premiums to save $1500 in deductible. With Aetna you get $1500 in premium pass through so technically you're out of pocket risk is $1500. The deductible is $3000 in '08. After you reach the deductible the plan pays 90%. Very similar coverage to BCBS after satisfying the yearly deductible. With FEDFLEX you can now put pre-tax dollars into your HSA (not to be confused with the FSA) through payroll deduction. The beautiful thing about FEDFLEX is you can change your allotment anytime you want (unlike the FSAs). In 2008 you can put $4300 into your HSA. With the $1500 in premium pass through that's $5800 in the HSA for the year and it's yours forever. It's a no brainer FEDs. This is basic kindergarten math. Quit complaining about the rise in premiums and start shopping. $67 per pay period or $145? Hmmmm
-
37211
Feds must remember some pertinent facts before being swayed on health care decisions. Number one - don't trust cost comparisons from health care companies...they are in it for the profit. You must calculate several different scenarios and at least one should be "catestrophic". Bad thinkgs sometimes happen to good people.
Number two - Bear in mind that large HMO's and political appointees at OPM are trying to steer feds away from traditional plans like BCBS Standard. They'd much prefer if the employee paid more fo the bills and leapt at the lower HMO and "bare bones plan" premiums.
Number three - Research the healthcare company thoroughly. Are they in it for a profit? BCBS Care First is a non-profit organization and I am very happy with them for my familie's health (though the premiums is higher than most). In the end, I think we come out ahead and we are allowed to change doctors or hospitals if we are dissatisfied with either. That type of freedom is not good for business. The powers that be and healthcare lobbyists would like to "starve" the better health plans.
My advice, research thoroughly and be realistic about care. DO NOT make your familie's health a low-bid contract!
-
37209
It certainly is commendable that Agencies have purchased access to Checkbook's annual guide for current employees who have access to Agency PC's. Unfortunately, this is neglecting retirees of those Agencies, who have fewer resources, and less available help, than do the employees.
-
37181
After 22 yrs w/GEHA, I'm unfortunatly having to re-evaluate, & most likely will change provider to BCBS. It's not that GEHA is a bad company, but they have a third party network (PCHS)that no one in my area has heard of, uses, or is willing to join. Only two hospitals in the Louisville area accept the network, ones of course that my physicians aren't using. Although my doctors are PPO, the third party network causes me to pay more out of pocket expenses, as doctors are out out of network. This situation of hospital & doctor out of network cost me plenty this year, a mistake I'm not willing to make again. My advice to all is to not only check if your doctors & hospitals are PPO, but also if they are a part of whatever network your insurance provider uses. There may be a significant & costly difference should you have a serious health issue or needed surgery.
-
37180
After 22 yrs w/GEHA, I'm unfortunatly having to re-evaluate, & most likely will change provider to BCBS. It's not that GEHA is a bad company, but they have a third party network (PCHS)that no one in my area has heard of, uses, or is willing to join. Only two hospitals in the Louisville area accept the network, ones of course that my physicians aren't using. Although my doctors are PPO, the third party network causes me to pay more out of pocket expenses, as doctors are out out of network. This situation of hospital & doctor out of network cost me plenty this year, a mistake I'm not willing to make again. My advice to all is to not only check if your doctors & hospitals are PPO, but also if they are a part of whatever network your insurance provider uses. There may be a significant & costly difference should you have a serious health issue or needed surgery.
-
37171
There is no mention of the struggles for retirees, who on the average are older and more likely to need coverage, to select plans they can afford and that are available to them. Working employees, no matter what their age or medical condition, have the advantages of selecting a plan in their area of residence OR area of employment. Retirees have ther field narrowed. They can only select from their area of residence. Also the FEHB payments are pre-tax dollars for the employed but not for the retiree, who makes substantially less ($). Also, married retirees usually need to select the family plans even though in the majority of cases, there are only two people using the plan. There needs to be some revamping of the FEHB system to take into consideration of the retirees.
-
37160
Forget FSAs you don't have to worry about spending all the money at the end of the year. Go with High Deductable Health Plans like Aetna. This is my 3rd full year and cost have gone DOWN every year. Caution: only use this type if you DON'T need a lot of GENERAL doctor visits. There's a $1500 deductible you have to satisfy first then all payments kick in. It's great for those younger employees. You also get to contribute $2150 of your own money - tax free. This year the cost goes DOWN 11%
-
37155
The Open Season Health Guru's all say enroll in FSAFEDS- the Flexible Spending Account for instant savings.
Here are some pitfalls that you won't hear about if you're new to this program:
This year, was my first time enrolling in FSAFEDS. I thought this would be a good way to pay for the bulk of my medical bills (my kids orthodontics) tax free. Unfortunately since I had already entered into a contract with the Dentist for monthly deductions - - I was unwilling to have the orthodontics bill paid late (i.e. the 2-3weeks wait after receipt of the bill to receive the FSA-reimbursement).
Same goes for Doctor's co-pays and pharmacy Rx. We All pre-pay these items when service is rendered so the reimbursement will be after-the-fact. As a result I'm now asking myself - -What is the real benefit of FSA-FEDS when I pay for these items anyway?
So, actually I've ended up paying $3,000++ twice. Once, when my payroll takes it out bi-weekly ($2,000+++ divided by 26 payperiods) and then again during the year when I actually accrue each charge. Hence, I don't see the benefit of enrolling in FSA-FEDs. The final straw will be if, after reviewing these idiocyncracies, my accountant says that I can't use these medicals bills when I file my taxes. I'll want to know Why Not, when I paid it twice and only got reimbursed once.
-
37118
No, I am not the Union President but I still found it insulting that the lack of movement during open season was attributed to "lethargy or sloth" on behalf of the federal workers. The FEHB and the carriers have made the programs so confusing it paralyzes employees from making health care decisions. It relays a lack of confidence on the employees' part that their best interest is a primary consideration in any of the plans. Many of the clients I work with say they cannot understand what is actually covered under each plan anyway. It appears to be a crap shoot to many. Then when they think they understand and sign up for a plan, suprise expenses appear the first time they use the coverage.
The comparison book helps but the carriers always having the "yes,if" clause leaves it open to discretion.
-
37096
As someone who was a Kaiser subscriber for 10 years and who is running to Blue Cross this open season, I would tell people who have any history of even minor illness to be aware that Kaiser is great as long as you and your family are well. At the first sign of a serious illness, you will learn the terrible price of "saving a buck now" -- if you are faced with a terminal illness, you can guarantee that every request you make will be turned down. Your loved ones will not receive the options for care that they would under a plan you manage yourself.
-
37092
Noman's predicament (in-plan facility, out-of-plan MD) is not at all unusual. If you've got BCBS as an insurer, you can appeal those situations as good-faith attempts to utilize in-plan providers, especially in an emergency. In my experience, BCBS will cover it eventually - but you have to be persistent.
-
37070
It has been noted in this article that employees should sign up for flexible spending accounts. There are only 10 percent of eligible employees enrolled in this program and not 90 percent because of the FSA's annual forfeiture provision. Many people fear the loss of monies contributed because they cannot accurately predict what their medical expenses are going to be. Plus, retirees currently are not eligible for the FSA.
-
37035
This is nice, but why are half the OPM health plan guides I look at still showing 2007 data? Aslo, it's pretty hard to predict savings/costs...for example, a few months ago, I took my daughter to what I thought was an accepted provider emergency room for stitches. Come to find out, the emergency room was accepted, but not the only doctor on duty there that day, so I got two bills from the visit...one in network, and one for out of network. It's supposed to be something like $150 for emergency room visits, but I paid more along the lines of $400-$500 for the visit.
PROMO RIGHT: EVENTS
UPCOMING WEBINARS
NOVEMBER 18
Speed bumps for Teleworking: What are they and how to avoid them?
DECEMBER 3
Achieve Program Success: Unlock the Management Information in Your Data
DECEMBER 10
Practical Transparency: Applying Exchange Networks for Mission Results
PROMO RIGHT: DIRECTORIES
Post a Comment
To post a comment, you must provide a name and a valid e-mail address. Messages must be limited to 400 words. By using this Service you agree not to post material that is obscene, harassing, defamatory, or otherwise objectionable. Although Government Executive does not monitor comments posted to this site (and has no obligation to), it reserves the right to delete, edit, or move any material that it deems to be in violation of this rule.