TOPICS
TOPICS
Review Time
Open season is in full swing. There are only 24 days left to choose your health plan, decide on dental and vision coverage, and figure out how much to put away in a flexible spending account. If you haven't done so already, you need to set aside some time to review your options.
After spending a couple of hours looking at my family's situation, I think I've decided on a new health plan for us for 2009. I'll walk you through the process I used in the hope that it might help you make your selections.
First, here are some of the overall factors I used to narrow my choices. My family wants a plan that:
- Lets us keep the same doctors we use now.
- Puts a reasonable limit on catastrophic expenses.
- Allows us the freedom to use doctors of our choice from a large network.
- Includes other features, such as customer satisfaction reports, dental and vision coverage and options for our son, who will be turning 22 a year from now.
- Saves us some money because we are -- thankfully -- in good health.
- Has an above-average prescription benefit, since we fill several prescriptions intermittently and one regularly.
If you're not sure exactly what is important for you or even what options are available, you can use one of several online tools to help narrow your choices:
- PlanSmartChoice
- Consumer's Checkbook Guide to Health Plans
- Office of Personnel Management open season site
Conclusions
Based on the comparisons I made among the plans available in my area, I found a plan that will:
- Save us $1,500 in premiums in 2009.
- Have a deductible and co-payment not much different from those in our current plan.
- Include all our current doctors and local hospitals in its preferred provider network.
- Offer a benefit for our son after age 22 that will be useful, because he still will be in school.
- Include excellent inpatient benefits (this is where costs can start to add up). If one of us needs inpatient care, we pay only a $200 co-pay per admission to a network hospital.
- Cover preventative care and diagnostic services on par with our current coverage.
- Include a pharmacy benefit under which prescriptions will cost $15, $30 or $45, depending on the type of drug (generic, formulary name brand or nonformulary). This is not as good a benefit as in our current plan, but since we fill only one regular prescription and it is a generic, the overall savings still make this plan a winner.
To make comparisons between plans, I used the brochure that our current health plan sent and linked to the online version of the brochure of the other plan I was considering. That way, it was easy to do side-by-side comparisons on the things that were important for our family. You can find 2009 plan brochures on OPM's Web site. Just locate the plans available in your area and click on the plan brochure link.
Now all you need is an hour or two, and you may find that you can save yourself some money next year.
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.
COMMENTS
- Tammy - First, let me thank you for two services you've rendered me: suggesting an optimal retirement date (it worked out fine) and suggesting SAMBA a an FEHB provider for their optional 'Dependent Chilren Health Benefit Plan'.Motivated by your suggestion, and BC/BS's recent coverage degration, I switched and applied for DCHBP for my 24 yr old daughter. Thanks! One quibble - you indicate above that 'there is no underwriting for pre-existing conditions' but the Summary Plan Description I just received from SAMBA says "DHBP has a 12-month pre-existing condition exclusion which limits or denies benefits..." This seems to me to conflict with your claim.. maybe you should clarify? Thanks for your columns - they're certainly the most FED-useful stuff around! Tony Zack Posted December 11, 2008 3:02 PM
- Ha! I caught some of you commenters not reading my past columns! Look back at my column on August 22 titled Opening SAMBA. SAMBA offers coverage for your "children" age 22 - 27. SAMBA Dependent Children Health Benefit Plan can be found on SAMBAPLANS Web Site or the link at OPM's Web Site. 2009 Premium Rates - The premium for each child covered under the Dependent Children Health Benefit Plan is $99 biweekly or $214.50 monthly. This may sound high, but there is no underwriting for pre-existing conditions and it is much less expensive than the FEHB temporary continuation of coverage rates. It is comprehensive coverage for your children over 22 years old. Tammy Flanagan Posted November 14, 2008 12:45 PM
- The FEHB plan in question is SAMBA which has a supplemental plan for children over age 22. The child would no longer be an eligible family member on your self and family enrollment but would enroll on an individual plan with SAMBA. Larry Scanlan Posted November 14, 2008 12:00 PM
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