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Last-Minute Shopping Tips for Open Season

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NASA and Edwards Air Force Base employees attend a federal health fair in 2014. NASA and Edwards Air Force Base employees attend a federal health fair in 2014. Air Force photo by Rebecca Amber

Are you a procrastinator like me? If so, you may be waiting until the last minute to review your open season options under the Federal Employees Health Benefits Program, Federal Employees Dental and Vision Insurance Program. And if you’re a current employee, you should be thinking about your annual flexible spending account allotments for health and dependent care.

The order of business during open season should be to first select your health plan, then add dental or vision supplemental coverage if needed. The icing on the cake is to select the amount to allocate to an FSA account.

If you’re confused about choosing the best health plan for you and your family, consider the following tips that might help you determine if you should switch to a different plan.

Use the OPM Plan Comparison tool and the Consumer’s Checkbook Guide to Health Plans for Federal Employees. They’re a good first step to help you narrow down the plans available in your zip code and see the monthly premiums, catastrophic limits, out of pocket expenses for deductibles, copayments and coinsurance—and generally assess how the plans stack up against each other.

Narrow down your choices to three or four plans, one of which should be the plan you are enrolled in this year. It’s easier to dig deeper when you’re comparing a limited number of plans.

If you’re 65 and retired, pay close attention to how the plans you’re considering will coordinate benefits with Medicare Parts A and B. Some plans will waive their deductibles, copayments and coinsurance when Medicare A and B are the primary payer.

If you’re in generally good health, then basic, consumer-driven, and value health plans will offer you low premiums, excellent preventive care benefits and wellness incentives such as discounted gym memberships and cash payouts for biometric screenings. A self only low option health plan should cost between $50 and $75 biweekly.

If you have a special health concern, review Section 5 of your FEHBP plan brochure to find out how the plans you are considering will cover the cost to diagnose and treat your condition. This review will show you if the plan covers out of network benefits or if you will need to pay a higher coinsurance or copayment when you use out of network providers.

If you fill a lot of name-brand prescriptions, consider a plan that limits the copayment for name-brand drugs to $80 or $150, rather than coinsurance that might require you to pay a percentage of the drug cost that can run as high as 50 percent. Also, some plans will charge little to nothing to fill generic medications if you use the preferred pharmacy associated with the health plan or the mail order refill service.

Find out whether the health plans you’re considering for 2019 also provide dental and vision coverage. If so, are you required to see a network provider? Is the coverage for more than preventative care? f you need orthodontic services or other major dental work, you may need to consider a supplemental dental plan.

Consider funding a health savings account by using a high deductible health plan if you want to get the tax advantage of putting money in such accounts.  If you are enrolled in a self only health plan, the limit for contributions to an HSA for 2019 is $3,500. If you are enrolled in a self plus one or family plan, the limit for contributions is $7,000.

Even if you’re a procrastinator, the time is now to assess your options for next year.

Tammy Flanagan has spent 30 years helping federal employees take charge of their retirement by understanding their benefits. She runs her own consulting business at www.retirefederal.com and provides individual counseling as well as online training for the National Active and Retired Federal Employees Association, Plan Your Federal Retirement and the Federal Long Term Care insurance Program. She also serves as the senior benefits director for the National Institute of Transition Planning Inc., which conducts federal retirement planning workshops and seminars.

For more retirement planning help, tune in to "For Your Benefit," presented by the National Institute of Transition Planning Inc. live on Federal News Radio on Mondays at 10 a.m. ET on WFED AM 1500 in the Washington-metro area. Archived shows are available on NITPInc.com.

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