75th Air Base Wing Public Affairs

3 Things To Do This Open Season

A checklist for considering your health coverage options.

This week, the Office of Personnel Management made its annual announcement about premiums under the Federal Employees Health Benefits Program. The good news is the average premium increase, 1.5 percent, is the lowest since 1996. The bad news is if your plan is increasing its premium by $500 per month, then the average means nothing to you.

If you’re eligible to participate in FEHBP, then you’re eligible to change your health plan, and your supplemental dental and vision coverage, during the upcoming open season that runs from Nov. 12 to Dec. 10. Current employees also can sign up for a flexible spending account for 2019.

Although many FEHBP participants will maintain the same health coverage for 2019 as they carry this year, everybody should do three things before they make a decision about their this open season.

Look at how your existing plan will change in 2019. The front cover of every FEHBP plan brochure will show the page references for your plan changes for the upcoming year. You should review the following factors that will determine your total out of pocket cost for health care:

  • Premium
  • Plan contribution to a health fund or medical account, health savings account, health reimbursement account, or Medicare reimbursement
  • Deductible
  • Copays and coinsurance for inpatient and outpatient services
  • Catastrophic out of pocket maximums
  • Prescription drug coverage
  • Plan provider network changes for health care and prescription drug providers

Look at how you have changed or will change in 2019. The two largest expenses for health care are inpatient hospital stays and name brand or specialty drug costs. If you will need either of these services, knowing their out of pocket cost will help you choose the best health plan for 2019. Consider your current health care needs and those you know you’ll have next year:

  • Do you have any surgeries coming up? Some health plans have zero out of pocket costs for inpatient care in a network hospital, while others require that you pay 15 percent of the plan allowance up to the catastrophic cap.
  • What do you pay out of pocket for prescriptions? Look at plan formularies on the FEHBP website for two or three other plans to see how they compare with your existing plan.
  • You also can contact your plan (or potential plans) by phone to ask specific questions about costs of certain procedures, medical equipment, supplies and medications.
  • If you or a family member will turn 65 next year, review how your plan will coordinate with Medicare Parts A and B.

Look for the key differences for your situation. Although the main purpose of health insurance is to avoid catastrophic expenses for medical emergencies and costly health care, there are other factors that make some health plans better than others. This is especially true if you are enjoying mostly good health. Here are some things that can separate a good plan from a better plan for you and your family:

  • Tax savings of a high deductible health plan with a health savings account. HDHPs allow healthy participants to save tax-free dollars to put away for future health care costs. HSA accounts belong to you and you decide when to spend the money. HRA account balances continue in future years as long as you stay in the same HDHP. There are 17 HDHP choices in 2019. OPM has removed a restriction for 2019 regarding the premium pass-through amounts allowed to be contributed to a member’s HSA or HRA. The pass-through amount will no longer be limited to 50 percent of the plan deductible.
  • There will be 28 low-cost consumer-driven health plans to choose from in 2019. These plans provide a medical fund or health fund for you to spend before any out of pocket costs are incurred. If you don’t spend the dollars provided in 2019, they will carry over into 2020 as long as you stay in the plan. These are especially attractive when your only health care needs are preventative. Preventative care has zero out of pocket costs and will not use your health fund dollars.
  • Health maintenance organization plans offer the convenience of coordinated health care—and in the case of Kaiser Permanente, one-stop-shopping with all of your health care under one roof. HMOs stress preventative care and well-being, so you may find incentives to maintain your health in HMO plans.
  • Certain FEHBP plans provide some coverage for preventative dental, vision and other services that may be important to you. For example, massage therapy is covered by the Foreign Service Benefit Plan.
  • Some FEHBP plans offer innovations such as reduced cost sharing when members take action to manage chronic conditions, like cancer and diabetes. According to OPM, 88 percent of plans will have this in place in 2019, compared to 82 percent this year.

There are 18 new FEHBP plan options for 2019 and 27 plans offering three options—including a variation of a high option, standard option and a value option. Unfortunately, the names of these types of plans are not uniform. For example, the Blue Cross Blue Shield Service Benefit plan will offer Standard Option, Basic Option and a new Focus Option. NALC offers High Option, CDHP Option and Value Option.

Although details about the new BC/BS Focus option are scarce, it will be the new default FEHBP plan for 2019. It will have the lowest premiums ($53.14 biweekly for self only coverage) of any plan except the NALC Value Option ($44.84). Because NALC has a membership fee, it can’t serve as the default plan. The default plan is used when a participant does not select a new plan when their plan leaves FEHBP.

Plans leaving the program in 2019 include Healthnet of Arizona, UnitedHealthcare of California, United Healthcare of the River Valley (covering eastern and central Iowa and west central Illinois), and Physicians Plus Insurance Corporation (covering south central Wisconsin).

For 2019, biweekly employee premiums will range from less than $50 for self only coverage to more than $500. For self plus one and family enrollments, the low end is around $100 and the high is more than $1,000. For federal retirees, the range on a monthly basis is a low of around $100 month for self only coverage to a high of over $1,000. Remember, the premium does not reflect the quality of the plan, but the cost of administering the program and the overall health of the plan participants. The best plan for you may be one that is less expensive.

Looking at differences in premiums is just the beginning of your homework to determine the best health plan for you in 2019. Stay tuned for additional open season information and consider attending a local or virtual health fair this open season. Start planning now, so you can go to the health fair with a list of specific questions to help you make your decision.

X
This website uses cookies to enhance user experience and to analyze performance and traffic on our website. We also share information about your use of our site with our social media, advertising and analytics partners. Learn More / Do Not Sell My Personal Information
Accept Cookies
X
Cookie Preferences Cookie List

Do Not Sell My Personal Information

When you visit our website, we store cookies on your browser to collect information. The information collected might relate to you, your preferences or your device, and is mostly used to make the site work as you expect it to and to provide a more personalized web experience. However, you can choose not to allow certain types of cookies, which may impact your experience of the site and the services we are able to offer. Click on the different category headings to find out more and change our default settings according to your preference. You cannot opt-out of our First Party Strictly Necessary Cookies as they are deployed in order to ensure the proper functioning of our website (such as prompting the cookie banner and remembering your settings, to log into your account, to redirect you when you log out, etc.). For more information about the First and Third Party Cookies used please follow this link.

Allow All Cookies

Manage Consent Preferences

Strictly Necessary Cookies - Always Active

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data, Targeting & Social Media Cookies

Under the California Consumer Privacy Act, you have the right to opt-out of the sale of your personal information to third parties. These cookies collect information for analytics and to personalize your experience with targeted ads. You may exercise your right to opt out of the sale of personal information by using this toggle switch. If you opt out we will not be able to offer you personalised ads and will not hand over your personal information to any third parties. Additionally, you may contact our legal department for further clarification about your rights as a California consumer by using this Exercise My Rights link

If you have enabled privacy controls on your browser (such as a plugin), we have to take that as a valid request to opt-out. Therefore we would not be able to track your activity through the web. This may affect our ability to personalize ads according to your preferences.

Targeting cookies may be set through our site by our advertising partners. They may be used by those companies to build a profile of your interests and show you relevant adverts on other sites. They do not store directly personal information, but are based on uniquely identifying your browser and internet device. If you do not allow these cookies, you will experience less targeted advertising.

Social media cookies are set by a range of social media services that we have added to the site to enable you to share our content with your friends and networks. They are capable of tracking your browser across other sites and building up a profile of your interests. This may impact the content and messages you see on other websites you visit. If you do not allow these cookies you may not be able to use or see these sharing tools.

If you want to opt out of all of our lead reports and lists, please submit a privacy request at our Do Not Sell page.

Save Settings
Cookie Preferences Cookie List

Cookie List

A cookie is a small piece of data (text file) that a website – when visited by a user – asks your browser to store on your device in order to remember information about you, such as your language preference or login information. Those cookies are set by us and called first-party cookies. We also use third-party cookies – which are cookies from a domain different than the domain of the website you are visiting – for our advertising and marketing efforts. More specifically, we use cookies and other tracking technologies for the following purposes:

Strictly Necessary Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Functional Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Performance Cookies

We do not allow you to opt-out of our certain cookies, as they are necessary to ensure the proper functioning of our website (such as prompting our cookie banner and remembering your privacy choices) and/or to monitor site performance. These cookies are not used in a way that constitutes a “sale” of your data under the CCPA. You can set your browser to block or alert you about these cookies, but some parts of the site will not work as intended if you do so. You can usually find these settings in the Options or Preferences menu of your browser. Visit www.allaboutcookies.org to learn more.

Sale of Personal Data

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Social Media Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.

Targeting Cookies

We also use cookies to personalize your experience on our websites, including by determining the most relevant content and advertisements to show you, and to monitor site traffic and performance, so that we may improve our websites and your experience. You may opt out of our use of such cookies (and the associated “sale” of your Personal Information) by using this toggle switch. You will still see some advertising, regardless of your selection. Because we do not track you across different devices, browsers and GEMG properties, your selection will take effect only on this browser, this device and this website.