Five Open Season Tips
If you’re currently employed, you surely know by now that you’re not getting a salary adjustment in January -- and if you’re retired, the cost-of-living allowance on your retirement benefit will be only 1.7 percent. You actually might be losing a little money if your health plan premiums are increasing, although most plans are not going up significantly this year.
Would you like to see more money in your paycheck? It’s possible to find some savings during Federal Employee Health Benefits Program open season (which runs through Dec. 10) if you use a strategy of comparing premiums, deductibles, co-insurance, catastrophic limits and co-payments along with considering supplemental dental coverage and flexible spending account plans.
Take some time to consider your needs for 2013. Will you be better off under a nationwide fee-for-service plan open to all eligible individuals, a fee-for-service plan open to specific groups, a consumer-driven health plan, a high-deductible health plan, or a health maintenance organization?
Here are five tips for answering these questions.
Read Section 2 of your plan brochure to see the changes in your current plan for 2013.
You can download your plan’s brochure here. You will notice additional coverage for 2013 for some preventive care, and individual plans may have increased coverage for some services or decreased coverage for others. These changes may or may not affect you, depending on whether the change involves something you typically use, such as prescription drug benefits.
Review your medical, dental and vision expenses from 2012 and look ahead to any changes likely to happen with your family’s health in 2013.
This will help you determine if you will need special coverage for next year or whether you are over-insured this year. Has anyone been diagnosed with a chronic illness? Did anyone qualify for Medicare in 2012, or are they turning 65 in 2013? Are there any foreseen dental or vision expenses coming in 2013?
Taking an inventory of your medical statements and bills from this past year can be very revealing.
- How much did you spend out of pocket on health care?
- What dental expenses were covered by your current insurance?
- Did you use providers that were part of your plan’s network of preferred or participating providers?
- Did you incur medical expenses that were not covered by your insurance?
Giving some serious thought to your health care expenses can help you understand where you might have to make a change or add an additional benefit to lower your out-of-pocket costs.
Don’t fall prey to indecision.
Studies have shown when people are given too many choices, they often fail to make any decision. Did you ever wonder why the Thrift Savings Plan limits investment options? Too many choices would be overwhelming for many employees and actually would result in fewer employee participants. The same thing can happen when the annual FEHBP open season rolls around, with more than 200 health plans in the program.
The answer to the problem of potentially being overwhelmed with choices is to narrow your options. Here’s what to do:
- Find out which plans are available in your area by clicking on your state on this map.
- Cross out the plans that are too expensive to even consider and also the ones that are not available to you. Here are the premiums for 2013.
- Consider the differences between fee for service, HMO, consumer-driven and high-deductible health plans. If one or more of these types do not appeal to you, then cross them out too.
Now you might have a more manageable list of choices. Try to narrow your options to fewer than five plans. Do you have doctors that you don’t want to lose? Check to see which plans they participate in. Take some time to look at the plans’ websites and brochures. This may help you trim your list even further.
Take advantage of tools to help you choose the best plan.
Here are some of the key ones:
- Office of Personnel Management Plan Comparison site
- OPM’s PlanSmartChoice site
- Consumers’ Checkbook Guide to Health Plans for Federal Employees and Annuitants
Consider specific issues for special groups.
Medicare-eligible enrollees should check Section 9 of your FEHBP plan brochure. Here you will find information about coordinating your health plan coverage with Medicare Parts A and B. Many plans will waive their deductibles, co-payments and co-insurance when Medicare becomes the primary payer. This is generally true when you are older than 65, retired and no longer covered by health insurance through current employment. Consider a less expensive FEHBP plan if you are retired and older than 65 to supplement coverage under Medicare A and B.
If you are employed, older than 65 and continue to be covered by your FEHBP plan (or you are retired and covered by the health insurance of your spouse who is still employed), then you may decide to delay enrollment in Medicare Part B until you retire. You will have an eight-month special enrollment period. If you enroll while you are employed, or during the special enrollment period, there will not be a penalty for late enrollment in Part B.
Medicare Part C or Medicare Advantage plans can be used instead of FEHBP coverage. As a retiree, you can suspend your FEHBP coverage to use a Medicare Advantage Plan.
If you are retired from the military you might find that you are entitled to TRICARE, TRICARE for Life, or CHAMPVA, as well as FEHBP. And when you turn 65, you might be adding Medicare to your insurance coverage.
Finally, if you’re close to retirement, in 2011 I wrote about the 10 Things to Remember About Health Insurance and Retirement.