As the national debate on health care continues, it's important to remember how fortunate those of us who are federal employees and retirees are. We've all heard about private sector plans that drop members who have become sick. We've heard tales of plans not accepting employees or family members due to pre-existing conditions. Most shocking to me is the fact that many employees lose their health insurance when they retire from their private sector jobs.
Federal enrollees have not had to face such issues since 1960, when FEHBP was created. Yes, some of the premiums in the plan will spike next year, but that's why there's an open season: You have the option to switch. Are you prepared for that possibility?
Weighing a Switch
If you haven't changed health plans for a few years, it's probably time to evaluate your coverage. Here are some things to look at:
- Cost of premiums compared to similar plans.
- How your plan's standard option compares to the other options.
- Type of coverage (fee-for-service with preferred provider option, health maintenance organization, or other).
- How well your plan covers the specific types of care you and your family members need.
- How costs and coverage compare for the plans in your area. The Office of Personnel Management offers an online comparison tool. You also can check out Consumer's Checkbook Guide to Federal Health Plans and PlanSmartChoice.
You also might have to educate yourself about newer types of options available, such as high-deductible health plans. Most agencies hold health benefits fairs during open season that provide information on options. If you're retired, you might find a health fair sponsored by your local chapter of the National Active and Retired Federal Employees Association or by one of your local elected representatives. And OPM's Web site is always a good source of information.
During the upcoming open season you also might have to think about flexible spending accounts. There are three types of such accounts:
- A general purpose Health Care FSA reimburses eligible health care expenses not covered by FEHBP, the Federal Employees Dental and Vision Insurance Program, or any other insurance. Eligible expenses include co-payments, co-insurance, deductibles, over-the-counter medicines, medical supplies, prescription drugs, vision and dental care, and shipping charges for mail-order prescriptions.
- A Limited Expense Health Care FSA is designed for individuals who are enrolled in a high-deductible health plan. Reimbursement is limited to eligible dental and vision expenses.
- A Dependent Care FSA reimburses eligible day care expenses for children under 13 and tax dependents of any age who are incapable of self-care. These expenses must be necessary to allow you and your spouse (if you're married) to work, look for work, or attend school full-time.
Check out the FSA Web site for more information.
If you are 65 or older, you are eligible for Medicare. Your initial enrollment period is three months on either side of your 65th birthday (including the month of your birthday). If you missed your initial enrollment, an open enrollment is held every year from January through March. If you are currently employed and carrying FEHBP as an employee, you probably only need to be enrolled in Medicare Part A hospital insurance. There is no premium for this coverage if you've paid the Medicare tax. (All federal employees have paid it since 1983). You also have qualified your spouse for Medicare by paying this tax.
If you are retired, you also should consider enrolling in Medicare Part B. Many of the federal plans will provide waivers of deductibles, co-payments and coinsurance when Medicare is your primary coverage. Check out your health plan's Web site for more information about Medicare and your FEHBP plan.
Vision and Dental
In addition to looking at your FEHBP coverage, you can make changes to your Federal Employees Dental and Vision Insurance Program benefits during open season. The place to start is the official FEDVIP Web site. OPM also offers a useful tool for comparing dental and vision plans. And you also can listen to interviews with several FEDVIP carriers on Federal News Radio.
Long-Term Care Insurance There is not an official open season for the Federal Long-Term Care Insurance Program, but due to the new version 2.0 that now is available, along with the rate increase for many of the original policies, employees and retirees also should take a fresh look at this kind of insurance. I've written about it twice lately: Long-Term Care Considerations (Oct. 9) and Buying Long-Term Care Insurance (Oct. 16).
Tammy Flanagan is the senior benefits director for the National Institute of Transition Planning Inc., which conducts federal retirement planning workshops and seminars. She has spent 25 years helping federal employees take charge of their retirement by understanding their benefits.
For more retirement planning help, tune in to "For Your Benefit," presented by the National Institute of Transition Planning Inc. live on Monday mornings at 10 a.m. ET on federalnewsradio.com or on WFED AM 1500 in the Washington metro area.