FEHBP 2009 Open Season

[XL-entLady]

The 2008 Federal Benefits Open Season for Health (FEHBP), Flexible Spending Accounts (FSAFEDS), Dental and Vision (FEDVIP) Open Season will be conducted from November 10, 2008 through December 8, 2008.


http://www.opm.gov/insure/health/index.asp


My current plan, Blue Cross-Blue Shield Standard Option, will be raising its premium costs by 17.4%. In addition, I take several medications (lots and lots :o), none of which have generic options, and next year my prescription copay will almost double.

So I am going to need to spend a lot of time analyzing data and weighing my health insurance choices this open season. (I have to see doctors in very specialized fields, and it's hard to find one who is a Preferred Provider.) I will also be reviewing my FEDVIP choices from last year to see if it makes economic sense for me to continue those coverages, to switch companies, or to drop the coverage completely.

So, long story short, I thought I'd open this thread and share what I'm finding as I sort through my options. And I'd like to ask you all to do the same, recognizing that we all have different circumstances and live in different areas. As you are developing your own analysis and conclusions about your health care insurance options during the next seven weeks, will you take a moment and share them with us here? Thanks!

Lady

[ChemEng]

Also remember to sign up for Flexible Spending accounts for Health Care and/or Dependent Care if you are eligible. Not using them is turning away free money. In short, they let you pay with pretax dollars, posttax expenses. If anyone has questions about how they work, feel free to ask here or drop me a PM.

[nnuut]

I'm considering switching from BCBS to Mailhandlers and save about $850 a year!:D Still studing the handouts!:notrust:

[ChemEng]

I'm considering switching from BCBS to Mailhandlers and save about $850 a year!:D Still studing the handouts!:notrust:Just a general comment--If you are looking at the HDHP's, make sure to study the plan in detail. They operate very differently from standard HMO/FFS plans. Not saying they are bad choice, just that they pass a certain amount of risk onto the customer that other plans do not while also having certain perks as well.

[nnuut]

I know makes the decision harder, still haven't made up my mind!:confused: Study study:suspicious:

[XL-entLady]

Also remember to sign up for Flexible Spending accounts for Health Care and/or Dependent Care if you are eligible. Not using them is turning away free money. In short, they let you pay with pretax dollars, posttax expenses. If anyone has questions about how they work, feel free to ask here or drop me a PM.
As I'm sure you know, ChemEng, annuitants can't participate in flexible spending accounts (FSAFEDS). But when I was on the active payroll, my tax savings was hundreds of dollars, just from being enrolled in the program. I'll add my nudge to yours.

Folks, it takes just a minute to figure out your expected health costs for the year and then enroll. The savings can be substantial. It pays you a great "dollars per hour" in tax savings! :D

Lady

[XL-entLady]

I'm considering switching from BCBS to Mailhandlers and save about $850 a year!:D Still studing the handouts!:notrust:
Last year I almost switched too. But the spreadsheets said that the drug costs didn't quite make sense. Now this year, a specialist I have to see is not in the Mailhandlers provider directory.

So I, too, will study, study. And I'll mutter to myself. :laugh:

Lady

[XL-entLady]

Here's a caution. Don't use the comparison tool on the OPM website yet. It still has the 2008 information. A lot of the website information has not yet been updated, and a note on the site says that it will be available beginning November 3.

Lady

[Guest2]

One other error noticed. They list some very strange 2008 Biweekly amounts in their new 2009 .Pdf files. They can't get anything right!

[clester]

Anyone have BC/BS basic? if so, how do you like it etc.?

[Guest2]

Anyone have BC/BS basic? if so, how do you like it etc.?

Clester, I had BCBS for several years until 2008. Prescription by mail looked
to be a great deal for quite some time. $35 per 90 day suppply. But I did
a evaluation of out of pocket expense (everyones different) and found that
Aetna (per year) would end up less expensive. I would suggest you look
at how many times you do a regular visit to your Primary Care Physician
and how many Prescriptions you will order for the year. By comparing each
one, you might be surprised of what you'll find. BCBS sends you a
Explanation of Benefits sheet each time you are billed. But only in a
perfect world. I've recieved Eof B's 8 months after a procedure and got
blind-sided because of the Specialists Billing Department. Getting a $800
bill (unexpectedly) 8 months after you paid a large bill already left a nasty
taste in my mouth. After a surgical procedure, I came to find out that in
New Jersey, an assistant anesthesiologist gets paid seperately and they
couldn't even justify the need for a assistant during a simple procedure.
I ended up paying it to keep up with my obligations as dictated by the
"Just Debts" policy. Hope this helps !

[mick504]

Thanks for the tip for BC/BS...as I have them. I knew the premium went up but hadn't checked the co-pay on prescriptions my wife and I need. I'll check it out in the 2009 brochure. I have thought of mailhandlers also but not sure they cover you if you're outside the US and I am currently in Asia and am covered by BC/BS. I have to pay first and then submit bills to the US. Thanks!

[mick504]

I like BC/BS...as it seems everybody DR's accept them. It depends maybe where you live if there is a better policy. I live or at least have residency in Seattle, WA. They BC/BS works good for me and my wife...kids are all grown up and live far away.

[alevin]

Anyone have BC/BS basic? if so, how do you like it etc.?

I've had basic for nearly 20 years. No paperwork, no hassles, other than every now and then, they do weird things, like sometimes they send reimbursement check to me, sometimes they send it to the doctor- same doctor, different visits, same year. Sometimes because I've already paid the doctor (one of my doctors requires upfront full payment), the doctor ends up getting paid twice and I have to either carry it as a credit towards the next office visit or else request the doctor cut ME a check. It's only happened with dental and dermatologist, other bills it doesn't happen. No idea the reason.

I really really like Flex Savings accounts! :laugh:

[CountryBoy]

Anyone have BC/BS basic? if so, how do you like it etc.?

I've had it for 23 years and have liked it. I know that the cost and co-pays are going up this year, but my wife does 99% of the dealing with these folks and she knows how to dicker with them to get them to accept certain payments and not to charge us for certain payments. I guess she knows how to work their system to our advantage, plus with an existing medical condition the last 4 years, you get a little leery switching plans. Also if I go out in 2013, I'm already inside the 5 year membership requirement.

So there is a lot to take into account and sometimes you take a little bad for the devil you know.

CB

[clester]

I have had BC for 16 years and have liked it so far. A couple of years ago they changed from High and standard options to standard and basic options. I stayed with standard because I was leery of the new option. One difference that I am aware of is that if you do not go to a preferred provider they pay nothing, but if you do they pay more or all I think.

[CountryBoy]

The 2008 Federal Benefits Open Season for Health (FEHBP), Flexible Spending Accounts (FSAFEDS), Dental and Vision (FEDVIP) Open Season will be conducted from November 10, 2008 through December 8, 2008.


http://www.opm.gov/insure/health/index.asp


My current plan, Blue Cross-Blue Shield Standard Option, will be raising its premium costs by 17.4%. In addition, I take several medications (lots and lots :o), none of which have generic options, and next year my prescription copay will almost double.

So I am going to need to spend a lot of time analyzing data and weighing my health insurance choices this open season. (I have to see doctors in very specialized fields, and it's hard to find one who is a Preferred Provider.) I will also be reviewing my FEDVIP choices from last year to see if it makes economic sense for me to continue those coverages, to switch companies, or to drop the coverage completely.

So, long story short, I thought I'd open this thread and share what I'm finding as I sort through my options. And I'd like to ask you all to do the same, recognizing that we all have different circumstances and live in different areas. As you are developing your own analysis and conclusions about your health care insurance options during the next seven weeks, will you take a moment and share them with us here? Thanks!

Lady

Lady,

If you can find someone that has the Nov 2008 NARFE Magazine it has a lot of review info on all the various plans offered during this open season.

CB

[Show-me]

I have had BCBS Standard for my entire 7 year career and it has served me well. It is getting expensive, but I am very high maintenance. BCBS has never gave me grief about anything and I make sure to call in before a procedure.

I also have maxed out my FSA 5 years in a row. Like I said, high maintenance and two kid with braces. I ran out of FSA money in June.

[XL-entLady]

I have had BCBS Standard for my entire 7 year career and it has served me well. It is getting expensive, but I am very high maintenance. BCBS has never gave me grief about anything and I make sure to call in before a procedure.

I also have maxed out my FSA 5 years in a row. Like I said, high maintenance and two kid with braces. I ran out of FSA money in June.
Yeah, Show-me. I know what you mean. That's one intangible thing I'm really weighing in my calculations. In my last MRI series I was in the tube for almost 4 hours and the medical bill was a real stomach twister. BCBS paid all but pennies and didn't even blink.

Lady

[ChemEng]

I also have maxed out my FSA 5 years in a row. Like I said, high maintenance and two kid with braces. I ran out of FSA money in June.We have both Health Care and Dependant Care FSAs. The Dependant Care FSA is maxed ($5k) to help offset the cost of daycare. That alone saves a lot of money.

This year our Health Care FSA was at $1500, but next year I am going to raise it significantly to cover the cost of laser eye surgery. The HCFSA is really good about making you plan when you want to perform the large medical expenses. I recommend around the first of each calendar year to maximize the "spend before you pay" feature of the HCFSA.

[CountryBoy]

Yeah, Show-me. I know what you mean. That's one intangible thing I'm really weighing in my calculations. In my last MRI series I was in the tube for almost 4 hours and the medical bill was a real stomach twister. BCBS paid all but pennies and didn't even blink.

Lady

Yep, bypass surgery almost 5 years ago and BCBS paid just about all of it and my annual stress tests, it doesn't cost me a dime. They each have good points and bad.

CB

[Silverbird]

That's why I wear the silver standard BCBS handcuffs - I don't like the lack of choices I get with other programs. :( Here comes the bill :sick:. My only consolation - most people don't get their choice of wristwear, or get none at all.

[XL-entLady]

I'm looking at various options for the FEHBP Open Season, and I'm wondering if any of you have experience or opinions about NALC that you'd like to share?

BTW, the opm.gov "PlanSmartChoice" tool is pretty cool if you're trying to decide where to start comparing plans.

https://www.plansmartchoice.com/registration.aspx

TIA for sharing any info on NALC,
Lady

[XL-entLady]

I'm looking at various options for the FEHBP Open Season, and I'm wondering if any of you have experience or opinions about NALC that you'd like to share?

BTW, the opm.gov "PlanSmartChoice" tool is pretty cool if you're trying to decide where to start comparing plans.

https://www.plansmartchoice.com/registration.aspx

TIA for sharing any info on NALC,
Lady
Never mind re the NALC question. My pain management clinic doesn't take that insurance so I can't consider it. Bummer.

Lady

[XL-entLady]

I mentioned previously on this thread that I wasn't happy with how much my BCBS premiums and out-of-pocket costs are going to go up in 2009 so I was shopping around. I've spent the day asking each of my health care providers for a list of the insurances that they take. Turns out that BCBS is the only one that is on every list. SO-O-O that's the one I'm staying with next year!

It's Silverbird's comment about the silver handcuffs all over again. :rolleyes: But SB also said we should count our blessings that we have our choice of wristwear and she's so right!

Now I just have to do my due diligence on whether to keep or change my dental and vision insurance carriers.

Has anyone else had any blinding flashes of insight this open season? :o

Lady

[Guest2]

Before I start this little tidbit of information, I just want everyone to
know that I'm more then aware of my O.C.D. Please use it to make a
more informed decision.;) I visited the http://PlanSmartChoice.com
website. I went to the estimated "Out of Pocket" tab and calculated
everything being done once except for prescriptions. I entered our
current number of prescriptions using Mail Order and came up with a
fair based "Out of Pocket" estimate. I then rated each which fell under
$2000 and came up with the Top7 Choices. Here are the results that
met my personal criteria;

#01-- Coventry High
#02a- Samba High
#02b- Amerihealth High
#02c- Samba Standard
#03a- NALC PPO
#03b- Keystone High
#04-- GEHA High
#05a- MailHandlers PPO
#05b- Bluecross Basic*
#06-- Amerihealth High
#07-- Bluecross Standard

I then compared the Month Premiums for each and rated the Top7 based
on how expensive they were;

#01-- Bluecross Basic*
#02-- Samba Standard
#03-- NALC PPO
#04-- Mailhandlers PPO
#05-- Bluecross Standard
#06-- GEHA High
#07-- Amerihealth High

I then let the website figure out what preferences met my desires closest
and put them into numerical order and gave them a Top7 rating;

#01-- Samba Standard
#02-- NALC PPO
#03-- Bluecross Basic*
#04-- Mailhandlers PPO
#05-- Amerihealth High
#06-- GEHA High
#07-- Samba High

The conclusion: Based on all of the above, Doctor Preferences and their
locations, It did not make sense to select the cheapest premium, the least
expensive "out of pocket" plan. However, the plan I've chosen was based
on a combination of other factors, as well as expense. The Plan is;
BLUECROSS BLUE SHIELD (BASIC)

[XL-entLady]

Before I start this little tidbit of information, I just want everyone to know that I'm more then aware of my O.C.D. ....The conclusion: Based on all of the above, Doctor Preferences and their locations, It did not make sense to select the cheapest premium, the least expensive "out of pocket" plan. However, the plan I've chosen was based on a combination of other factors, as well as expense. The Plan is;
BLUECROSS BLUE SHIELD (BASIC)
First of all, Squale, don't know if you are kidding or not about that OCD thing. (Need that "tongue in cheek" emoticon again! :cheesy:) My daughter has OCD for real, but sometimes it pays off, such as when she just knew something was wrong with the 4 year old, kept at it until they found the child was going blind in one eye and they fixed it. :)

Thanks for sharing all your hard work, your step by step process and your excellent conclusions! I sit at the feet of the Master! :cool:

Lady

[Frixxxx]

I thought he was just referring to his version of O.C.D.:

One Creative Dude!!!:laugh:

[Guest2]

First of all, Squale, don't know if you are kidding or not about that OCD thing. (Need that "tongue in cheek" emoticon again! ) My daughter has OCD for real, but sometimes it pays off, such as when she just knew something was wrong with the 4 year old, kept at it until they found the child was going blind in one eye and they fixed it.

Thanks for sharing all your hard work, your step by step process and your excellent conclusions! I sit at the feet of the Master!

Lady

For as long as I can remember, both friends and family enjoyed a great
deal of amusement over some of my behavior. Number crunching, my
need to keep items either horizontal or vertical, etc... I've never been
diagnosed with OCD, however, even I recognize my need to have my
environment kept in a manner which I feel comfortable in. Angles are
not in my vocabulary and they must be adjusted should they exist. If
thats one of the symptoms, then I guess I really am. I don't look at it
as a hardship, just fuel to add to my friends fire. They certainly get a
kick out of it all. ;)


I thought he was just referring to his version of O.C.D.:
One Creative Dude!!!

Thanks for the new title, I shall wear it with honor. Also, I wish to thank
you for adding me into your "friend" list. Thats cool beyond words. :)

[XL-entLady]

Good morning, all!

As you all probably know we have less than one week left in our FEHB open season for health insurance. The season ends on December 8, 2009. I don't know how many of you have Blue Cross Standard Option health insurance, but if you do please be aware of the significant changes for 2009!

The following Fedsmith article isn't available through their links anymore, but here it is from my notes:

"Surprise, We're Cutting Your Federal Employee Benefits! (http://www.fedsmith.com/headline/10006/)
More than 4 million federal employees and retirees are having their benefits cut by Blue Cross Blue Shield (BCBS). OPM describes the changes on page 10 of a 137-page document. A policy change increases a patient's out-of-pocket cost up to $7,500.00 for each procedure or surgery when using an out-of-network provider, and it imposes up to a $350.00 out-of-pocket cost for care provided by an out-of-network emergency room doctor.
Posted: November 27, 2008 "

And here's another one:

http://www.washingtonpost.com/wp-dyn/content/article/2008/11/25/AR2008112502576_pf.html

I have BCBS Standard Option but am scrambling to find another choice that all my many health care providers will accept. So far, it looks like Aetna may be my only other choice. But I'm still looking.

We are down to the last days before we're stuck in our plans for another full year. Have you made changes? If so, would you mind sharing your reasons?

Thanks!
Lady

[Guest2]

Good morning, all!

As you all probably know we have less than one week left in our FEHB open season for health insurance. The season ends on December 8, 2009. I don't know how many of you have Blue Cross Standard Option health insurance, but if you do please be aware of the significant changes for 2009!

The following Fedsmith article isn't available through their links anymore, but here it is from my notes:

"Surprise, We're Cutting Your Federal Employee Benefits! (http://www.fedsmith.com/headline/10006/)
More than 4 million federal employees and retirees are having their benefits cut by Blue Cross Blue Shield (BCBS). OPM describes the changes on page 10 of a 137-page document. A policy change increases a patient's out-of-pocket cost up to $7,500.00 for each procedure or surgery when using an out-of-network provider, and it imposes up to a $350.00 out-of-pocket cost for care provided by an out-of-network emergency room doctor.
Posted: November 27, 2008 "

And here's another one:

http://www.washingtonpost.com/wp-dyn/content/article/2008/11/25/AR2008112502576_pf.html

I have BCBS Standard Option but am scrambling to find another choice that all my many health care providers will accept. So far, it looks like Aetna may be my only other choice. But I'm still looking.

We are down to the last days before we're stuck in our plans for another full year. Have you made changes? If so, would you mind sharing your reasons?

Thanks!
Lady

After all the work I did to compare the Plans, I pulled out my trusty "oops,
I changed my mind" card and opted to go with Aetna HMO. I just couldn't
bring myself to get BCBS Notification's (New Jersey) 9 months after I had
a procedure any longer. Double dipping with a Assistant Anestesiologist is
quite aggravating as well. But I understand that this may be, in part, the
blame of the New Jersey and Philadelphia Offices and not a countrywide
problem. Your post simply makes me feel better about my decision. For
that, I wish to thank you.

[XL-entLady]

Congress to hold hearing on BCBS coverage changes

http://www.usnews.com/articles/news/2008/12/02/blue-cross-health-insurance-changes-for-federal-workers-raise-concerns.html



Lady

[felixthecat]

I did some serious research and I'm leaning toward Blue Cross Basic family coverage. However...the only fly in the ointment is that two medications will eat up about $1000 dollars in family plan cost savings between Basic and Standard. Still, I come out 600 dollars ahead on the plan cost, and pay no deductible with Basic. All of our Preferred Providers needs are met. Still, I somehow filled robbed that benefits are decreasing and costs are increasing. Pharmacy drugs can tilt the scales. :(

The two drugs that are costly are Asmanex and Benicar. Level II and Level III drugs.

[XL-entLady]

...the only fly in the ointment is that two medications will eat up about $1000 dollars in family plan cost savings between Basic and Standard. ...I somehow filled robbed that benefits are decreasing and costs are increasing. Pharmacy drugs can tilt the scales. :(

I feel your pain, Felix. I take 8 meds and spouse takes 5. That's lucky 13 total and most don't come in generic. BCBS out of pocket costs will more than double in 2009. :sick:

I'm pouring over spreadsheets and doublechecking preferred provider lists like mad. I've got it narrowed down to (1) keeping BCBS because of preferred provider options or (2) switching to Aetna HDHP for serious cost savings.

Decisions ... decisions! :rolleyes:

Lady

[Frixxxx]

I feel your pain, Felix. I take 8 meds and spouse takes 5. That's lucky 13 total and most don't come in generic. BCBS out of pocket costs will more than double in 2009. :sick:

I'm pouring over spreadsheets and doublechecking preferred provider lists like mad. I've got it narrowed down to (1) keeping BCBS because of preferred provider options or (2) switching to Aetna HDHP for serious cost savings.

Decisions ... decisions! :rolleyes:

Lady
Waddya Got if ya ain't got your health?!?!:nuts:

[XL-entLady]

I'm pouring over spreadsheets and doublechecking preferred provider lists like mad. I've got it narrowed down to (1) keeping BCBS because of preferred provider options or (2) switching to Aetna HDHP for serious cost savings.

Decisions ... decisions!



Waddya Got if ya ain't got your health?!?!:nuts:
Just found out that all my specialists are on Aetna's preferred provider list! Woohoo! FYI, one of my providers wasn't on Aetna's web list of preferred providers, but I phoned the Aetna federal helpline to double-check and the specialist was in the main Aetna database.

So I get the preferred providers AND the cost savings! Score!! :D

And Frixxxx, my buddy, the answer to your question is: "A serious hole in your wallet!" :blink: :cheesy:

Lady

[felixthecat]

I appreciate your thoughts. Well, I live in Louisiana so the Aetna plan is not available here. Decisions decisions.

[roskopfm]

I have Humana HMO for the past four years. Although some doctors are not part of the plan, most are. The payroll deduction is 50% of the Blue Cross amount. THere is no deductable and the co-pays are extremely low. I had surgery and only had to pay a $125 co pay. Office visits cost $25, and drugs are low.

[XL-entLady]

The final day to make FEHB changes is Monday!

I did all my final comparisons and after the yellow haze from the highlighter pen subsided, my final picks are:

- Aetna for my primary insurance (changing from BCBS because of the premium raises and benefit reductions)

- MetLife for my dental

- FEB Blue High Option for my vision

It was all a matter of cost/benefit ratios but everybody is different in their particular needs. I can't believe the kilowatts of computer time and acres of trees that died before I finally had my answer! :rolleyes:

Now I'm going to get the changes done this weekend before the websites get too backed up. Good luck with your decisions! :)

Lady

[MohammadXX]

The final day to make FEHB changes is Monday!



From Federal Soup message board____originally posted by sam8:

Because of the dust-up over BCBS Standard's 2009 change re: non-participating surgeons (the $7,500 out of pocket), OPM has announced, in essence, an extension of Open Season for health plans and an intent to provide additional protection for using out of network surgeons. Please see Breaking News at the OPM site: http://www.opm.gov/news/opm-to-provide-additional-protections-in-2009-for-fehb-enrollees-who-use-outofnetwork-surgeons,1443.aspx and Joe Davidson's Dec. 5 Federal Diary column in the Washington Post: http://www.washingtonpost.com/wp-dyn/content/article/2008/12/05/AR2008120502782.html
RECOMMEND CHECKING FOR DETAILS BEFORE ANYONE DELAYS TAKING OPEN SEASON ACTION, especially as OPM announcement (currently) does not reference retirees.[/QUOTE]rom Federal Soup message board:

[XL-entLady]

For those of you who may not have visited Squale's home thread for a few days (and if you haven't, you're missing out, he's one of the very best) I just wanted to make sure that you get a chance to see this article on the change in coverages that BCBS is proposing for 2009.

Pay special attention to the information at the very bottom of the article that starts out, "Other noteworthy changes...."

http://www.tsptalk.com/mb/showpost.php?p=197651&postcount=2670

Lady

[XL-entLady]

The latest (that I can locate) in the continuing saga:

http://blogs.govexec.com/fedblog/2008/12/staying_open_a_little_longer.php

http://www.opm.gov/news/opm-to-provide-additional-protections-in-2009-for-fehb-enrollees-who-use-outofnetwork-surgeons,1443.aspx

Note that the possibility of late enrollment changes is mentioned:
"Subscribers who want to change carriers after reviewing any additional information about plan benefits will have until the end of January 2009 to select a health plan but must first go to their personnel office and complete an enrollment request form and fill in “belated open season enrollment/change.”

Not sure how retirees like me would accomplish this. Does the extention apply to retirees?

“I am very pleased to see that OPM has heeded our advice and extended the open enrollment period. Federal employees and retirees need this extra time to reevaluate their health plans, and I appreciate that they will be given it,” stated Rep. Elijah Cummings (D-MD)."

Rep. Cummings thinks so.

So am I going to stick with Blue Cross? I DON"T KNOW YET! :worried: If things like doubling the out-of-pocket cost for prescription drugs remains the same for 2009, I'm still switching to Aetna. And I'm still not sure that retirees have the Open Season extension. But I will be scrambling to find out before COB today.

I'll try to keep you all informed. Good luck,

Lady

P.S. If anyone gets any additional information, PLEASE share with us!

[nnuut]

I switched to Mailhandlers this morning, if for no other reason than just to SPITE BCBS. Now they may change the $7,500 penalty to make it more visible or some other BS change. The 13% raise along with the rest of the cuts did it for me. I had Mailhandlers before (after Postmasters raised their prices) but they raised the price back then so I went with BCBS, I've gone 360 now!!:suspicious: Kinda like selling High and Buying Low.:laugh:

[XL-entLady]

http://www.opm.gov/insure/openseason/index.asp

Here is the official OPM notification that Open Season has been extended. It is my impression that this extension applies to employees and retirees alike.

I still switched my insurance over the weekend and I have not switched it back. I don't plan to switch back to BCBS unless they cancel their premium increases and their doubling of out of pocket drug costs and I don't think that will happen.

Interesting Open Season this year. They wait until 3 days before the closing date to start addressing these things? :blink: Ya' think they figured we weren't paying attention? :cheesy:

Well they found out they were wrong! :nuts:

Lady

[ChemEng]

I need to do better on the cost benefit analysis with regards to my health insurance. Right now I use BCBS, but only because I have been since day 1.

I wish there were some online planning tool that took the different expenditure types coupled with the different plan premiums and output the best cost plan for those expenditures.

[EW_ret]

I have had Blue Cross for my entire federal career and for the past three years in retirement. I switched to GEHA standard coverage because its less than 50% Blue standard. I just hope I do not need hospitalization because then I would likely pay more out of pocket.

I could not find the typical cost for semi-private hospital room and and board. I needed this to do a fair comparison. With GEHA I pay 15%, after $350 deductable, and with Blue Cross Standard $200 per admission, and $100X5 for Blue Cross Basic (max $500). I did a GOOGLE on "cost for hospital room semi-private", but cannot find anything.

[XL-entLady]

I need to do better on the cost benefit analysis with regards to my health insurance. Right now I use BCBS, but only because I have been since day 1.

I wish there were some online planning tool that took the different expenditure types coupled with the different plan premiums and output the best cost plan for those expenditures.
https://www.plansmartchoice.com/registration.aspx

This may be what you're looking for. Hope it helps.

Lady

[XL-entLady]

I have had Blue Cross for my entire federal career and for the past three years in retirement. I switched to GEHA standard coverage because its less than 50% Blue standard. I just hope I do not need hospitalization because then I would likely pay more out of pocket.

I could not find the typical cost for semi-private hospital room and and board. I needed this to do a fair comparison. With GEHA I pay 15%, after $350 deductable, and with Blue Cross Standard $200 per admission, and $100X5 for Blue Cross Basic (max $500). I did a GOOGLE on "cost for hospital room semi-private", but cannot find anything.
I wonder if that is because costs vary so wildly from place to place that there is no median cost?

I probably didn't pay as much attention to that as I should have. My medical costs are always prescription drugs and tests (like 3 hours in an MRI tube a couple of times a year :rolleyes:).

Please let us know if you find out anything. Thanks!

Lady

[Guest2]

For those of you who may not have visited Squale's home thread for a few days (and if you haven't, you're missing out, he's one of the very best) I just wanted to make sure that you get a chance to see this article on the change in coverages that BCBS is proposing for 2009.

Pay special attention to the information at the very bottom of the article that starts out, "Other noteworthy changes...."

http://www.tsptalk.com/mb/showpost.php?p=197651&postcount=2670

Lady

Lady, it sounds like good old fashion effective communication and giving
one the ability to make an informed decision has given many of us reason
to step back and take pause. I don't know if you realise the impact you've
had on other peoples lives. If not, let me give you a clue;

You have unselfishly shared such vital information with the membership
that each and everyone of us personally benefited from your kindness.
Whether it gave us reason to look closer at the fine print or gave us a
little more pocket change, when all of us need it the most. Your efforts
deserve so much more then we could possibly repay. I have no doubt
you will hear this from every member who stopped by your thread and
took advantage of its content. From me and my family, I wish to thank
you for creating this thread and showing all of us the power we have
in making a positive difference in the lives of others. :)

[KevinD]

+1 to what SB said.

[ChemEng]

https://www.plansmartchoice.com/registration.aspx

This may be what you're looking for. Hope it helps.

Lady
That is exactly what I was looking for! Although after working through it, the top 3 options were all HDHPs. Maybe I need to look more into those for next year...

[Guest2]

That is exactly what I was looking for! Although after working through it, the top 3 options were all HDHPs. Maybe I need to look more into those for next year...

I found that my need to keep my premiums to a minimum, resulted in the
same HDHP type plans when doing their extensive questionaire. I really
liked their out-of-pocket analysis. When I entered a firm need for three
prescriptions and used (1) under all other entries, it became very clear
that I used answers which leaned towards cost savings within the
questionaire portion. But the Out-Of-Pocket analysis gave me a better
view of what reality would look like, should such emergencies exist.
I also found the SmartChoice website extremely valuable and hope they
keep it in existance for next year. ;)

[alevin]

Lady, it sounds like good old fashion effective communication and giving
one the ability to make an informed decision has given many of us reason
to step back and take pause. I don't know if you realise the impact you've
had on other peoples lives. If not, let me give you a clue;

You have unselfishly shared such vital information with the membership
that each and everyone of us personally benefited from your kindness.
Whether it gave us reason to look closer at the fine print or gave us a
little more pocket change, when all of us need it the most. Your efforts
deserve so much more then we could possibly repay. I have no doubt
you will hear this from every member who stopped by your thread and
took advantage of its content. From me and my family, I wish to thank
you for creating this thread and showing all of us the power we have
in making a positive difference in the lives of others. :)

Adding my 2cents. I sat up and paid attention over the weekend when I read the "fine print" here and on SB's page. Had been snoozing along in BSBC the past 20 years tolerating premium increases. the part about out of network docs got my attention, and surgeries. My dermatologist is currently out of network AND out of town, periodic skin pre-cancer scalpel work and biopsies will count as "surgery" at full cost if I go to see him this coming year (haven't been in the past year, tho would have been a good idea-always got something going on in that arena. Soo, now I get to make informed decision about changing doctors thanks to you, Lady.

My only other out of network provider is my dentist, who I really like. Again, thanks to you, I get to make a concious choice about what's more important-cost or choice. thank goodness I had already bumped up my Flex Savings Account last Friday even before I realized this other stuff was going on. I knew about the premium increase already, just not the other stuff. Thanks again for the whop upside the head. :sick:

[XL-entLady]

Alevin, Squale and KevinD,

Thank you all for taking the time to express your appreciation for the information on this thread!

One of the things I just adore about this MB is the way we so quickly become a family. We all look out for each other and help each other out on a variety of issues, not just (just?!) financial subjects. You just gotta love this site! Tom, you and the moderators provide an invaluable service here!

And Allie, great to see your posts again!

You all take care and thanks again,
Lady

[Guest2]

I'm here "To Protect and Serve" :D

[Guest2]

Extended Enrollment for 2009 FEHB Open Season
December 9, 2008


According to the Office of Personnel Management (OPM), the agency is taking steps to provide additional protections for federal employees participating in the FEHB Program who have non-emergency surgeries performed by out-of-network physicians. The agency has asked FEHB carriers to re-evaluate their benefits for non-emergency surgeries. OPM states they are taking this action in response to concerns over a change in coverage in the Blue Cross Blue Shield out-of-network reimbursement that would have established a $7,500 co-pay for out-of-network surgeries. OPM stated they negotiated this change to address situations where enrollees could be billed tens of thousands of dollars for non-emergency surgeries performed by out-of-network providers, a practice known as balance billing.

What This Means To You

According to OPM, federal employees may make belated Open Season enrollment changes to their FEHB Program, Federal Employees Dental and Vision Insurance Program (FEDVIP) and the Federal Flexible Spending Account Program (FSAFEDS) if FEHB benefit changes affect their enrollment decisions in these programs.

Employees will have an extended enrollment opportunity through January 2009 to make any enrollment changes in these programs.
Also, if employees make a belated Open Season change to their enrollment, the effective dates of the belated change will vary among the programs. Depending on the timing of the change and the employee's pay periods, it may take one or more pay periods for the federal benefits deductions/allotments to be adjusted to match the new election.
Emlpoyees need to know that if they make a belated Open Season change and if they have claims for services incurred in 2009 under their former plan, they and/or their provider may be responsible for reimbursing the former plan for any benefits paid.

Effective Dates OPM states that belated FEHB changes will take effect the first day of the pay period that starts on or after January 1, 2009. Belated FEDVIP changes will take effect January 1, 2009. Belated FSAFEDS changes will take effect on January 1, 2009, or the day after the change is received, whichever is later.

[XL-entLady]

Here is the official BAL (benefits administration letter) on the belated enrollment announcement.

http://www.opm.gov/retire/pubs/bals/2008/08-406.pdf

Lady

[roskopfm]

you really should concern Humana HMO, the cost savings are more than 50%, why not put some of that cash in your pocket for a change. I have had it four years and have had no problems. I have a large choice of doctors and can go to any pharmacy I want. No Deductable and $20 co pay, the per paycheck amount is less than 50% compared to Blue Cross.

[HappyGoLucky]

I, too am unhappy with BCBS. If you don't mind me asking...what did you switch to?

[ChemEng]

you really should concern Humana HMO, the cost savings are more than 50%, why not put some of that cash in your pocket for a change. I have had it four years and have had no problems. I have a large choice of doctors and can go to any pharmacy I want. No Deductable and $20 co pay, the per paycheck amount is less than 50% compared to Blue Cross.
But can they match BCBS vision and dental coverage? ;)

[XL-entLady]

I, too am unhappy with BCBS. If you don't mind me asking...what did you switch to?

http://www.tsptalk.com/mb/showpost.php?p=197559&postcount=39

Here is a post that lists my changes. What was best for me and my circumstances is not going to be the best for everyone. There are lots of links to things like the SmartChoice site on this thread that can help you to make an informed choice.

Good luck!

Lady

[ChemEng]

I think Im moving to Aetna.

Now I just have to figure out how to do it.

Thanks for the help (and prodding) everyone!

[ChemEng]

I think Im moving to Aetna.

Now I just have to figure out how to do it.

Thanks for the help (and prodding) everyone!
I wonder if its past the open season for FSAFEDS. I based my contribution on this year's BCBS costs. With Aetna, my out of pocket costs are going to be totally different (read: MUCH lower).

I probably should have made this change a year or two ago.

[HappyGoLucky]

ChemEng - FSA Open Season is still on - so you should be able to change. It corresponds directly to the extension given for FEHB. I am looking into AETNA now. Thinking I will change....fed up with BC/BS!!

[ChemEng]

ChemEng - FSA Open Season is still on - so you should be able to change. It corresponds directly to the extension given for FEHB. I am looking into AETNA now. Thinking I will change....fed up with BC/BS!!
For me the choice was rather easy. With Aetna, I get $2500 for the family in a health fund + $600 dental. For 2008, I have spent $1400 in combined health and dental costs (to include the costs of having a newborn). Combined with premiums that are nearly 50% off, its a no-brainer.

I was actually worried that I had missed something in my analysis because it is rare to have a situation where one scenario completely dominates another without having to make any tradeoffs. I showed it to another GS officemate and he verified that its a no brainer.

[ChemEng]

So I finally got everything resubmitted and reelected.

This change actually got me back up to the TSP contribution limits (again) since lowering our contribution amounts to have our son. The combination of the reduced premiums and reduced HCFSA needs (plus January's COLA increase) got me back to where I was a year ago this time.

Just hoping there isnt too strong a bounce by the time my contributions kick in!

[XL-entLady]

So I finally got everything resubmitted and reelected.

This change actually got me back up to the TSP contribution limits (again) since lowering our contribution amounts to have our son. The combination of the reduced premiums and reduced HCFSA needs (plus January's COLA increase) got me back to where I was a year ago this time.
ChemEng, congratulations on doing your homework and choosing the health coverage that is best for you. And then using the savings to increase your TSP contribution! Excellent move that will literally pay dividends for years. :cool:

Lady

[XL-entLady]

http://govexec.com/story_page.cfm?articleid=41638&dcn=todaysnews

The latest I can find on BCBS. I'm still going to change to Aetna. I'll know shortly whether that is a good thing or a bad thing. :o

Lady

[KevinD]

http://govexec.com/story_page.cfm?articleid=41638&dcn=todaysnews

The latest I can find on BCBS. I'm still going to change to Aetna. I'll know shortly whether that is a good thing or a bad thing. :o

Lady

I'm with Aetna and they have been very very good to me.

Rheumatologist, Enbrel, Methotrexate, Prednisone, Naproxen, Folic Acid. Yes, I have my issues too. :rolleyes: :D

[Gumby]

I did some serious research and I'm leaning toward Blue Cross Basic family coverage. However...the only fly in the ointment is that two medications will eat up about $1000 dollars in family plan cost savings between Basic and Standard. Still, I come out 600 dollars ahead on the plan cost, and pay no deductible with Basic. All of our Preferred Providers needs are met. Still, I somehow filled robbed that benefits are decreasing and costs are increasing. Pharmacy drugs can tilt the scales. :(

The two drugs that are costly are Asmanex and Benicar. Level II and Level III drugs.

That Benicar is expensive. I take that one also.
I am thinking about changing from BCBS standard to the basic option. The prescriptions will be more expensive but there is no deductible for the rest of the insurance. Our doctors are all on the preferred provider list.
Is anyone else satisfied with the basic option?

[CountryBoy]

That Benicar is expensive. I take that one also.
I am thinking about changing from BCBS standard to the basic option. The prescriptions will be more expensive but there is no deductible for the rest of the insurance. Our doctors are all on the preferred provider list.
Is anyone else satisfied with the basic option?

We have the standard BCBS and are happy with it. We ran the numbers again and standard was just a little better, it was kind of a trade off. In our area we only have GEHA as an alternative, so not much of a choice. The perscriptions was what made the difference, between the standard and basic.

Us oldsters have more meds including benicar also and all the doctors in this area are preferred, so the ER thing wasn't to big of a worry, but I want to thank Lady for posting that link to Gov Exec., any good news always eases the mind. :D

CB

[XL-entLady]

I'm with Aetna and they have been very very good to me.

Rheumatologist, Enbrel, Methotrexate, Prednisone, Naproxen, Folic Acid. Yes, I have my issues too. :rolleyes: :D
KD, I'm happy to hear that you're satisfied with Aetna. Do you have any trouble with getting approval for meds? Among my many meds, I take Lyrica and a monthly injection. It appears from reading Aetna's literature that both of these will require special approval. What has your experience been, if any, with this type of situation?

(And CountryBoy, my friend, glad to help! :))

TIA,
Lady

[KevinD]

KD, I'm happy to hear that you're satisfied with Aetna. Do you have any trouble with getting approval for meds? Among my many meds, I take Lyrica and a monthly injection. It appears from reading Aetna's literature that both of these will require special approval. What has your experience been, if any, with this type of situation?

(And CountryBoy, my friend, glad to help! :))

TIA,
Lady

I haven't had any problems with meds. The Enbrel is delivered by UPS express from the Aetna Specialty Pharmacy with a $25 co-pay. I get all my other meds at Kroger.

[KevinD]

Heres the number if you want to call the Aetna pharmacy to see if your meds are covered.1-866-782-2779

[XL-entLady]

Heres the number if you want to call the Aetna pharmacy to see if your meds are covered.1-866-782-2779
Thanks, KD! Much appreciated!

Lady

[XL-entLady]

Just wanted to report back on my switch from BCBS to Aetna. I found out the hard way this morning that I had no clue what prescription meds cost in today's world.

Aetna is a high deductible plan ($1500) with a health savings account (HSA). My insurance premium is $5 a month after an automatic deposit is rebated to my HSA each month. I can pay the deductible with the savings from my insurance premium. I pay full price for medications until my deductible is reached. .... And that is what has kept me busy this morning!

I got new prescriptions for all my maintenance meds a couple of weeks ago and sent them in to the aetna mail order pharmacy along with my debit card number. Today the payments started hitting my bank account and OMG!! :worried: I've already met my deductible!! :blink:

So I've been scrambling to put more money into my checking account before my mortgage auto-payment hits in a couple of days.

FYI, just in case anyone else switched to Aetna and needs medication.

Lady

[ChemEng]

Grrr... Found out this morning that my TSP transaction didn't "take" on their website. Which means my increased contributions won't start for another 3 weeks. :mad:


So I finally got everything resubmitted and reelected.

This change actually got me back up to the TSP contribution limits (again) since lowering our contribution amounts to have our son. The combination of the reduced premiums and reduced HCFSA needs (plus January's COLA increase) got me back to where I was a year ago this time.

Just hoping there isnt too strong a bounce by the time my contributions kick in!

[ChemEng]

We had that sticker shock too. Wife's birth control was ~$60, but it was absorbed by the health fund. We've never been wasteful with our insurance benefits, but it does have the secondary effect of seeing how much things actually cost outside the BCBS walled garden. Regardless, it was still the right move to make.

We went with the CDHP instead of the HSA. So our experience is a bit different than yours Lady. While I understand the goodness of an HSA, Im not to comfortable with the risk position it would put us in (even both being <30 and healthy).

Scott


Just wanted to report back on my switch from BCBS to Aetna. I found out the hard way this morning that I had no clue what prescription meds cost in today's world.

Aetna is a high deductible plan ($1500) with a health savings account (HSA). My insurance premium is $5 a month after an automatic deposit is rebated to my HSA each month. I can pay the deductible with the savings from my insurance premium. I pay full price for medications until my deductible is reached. .... And that is what has kept me busy this morning!

I got new prescriptions for all my maintenance meds a couple of weeks ago and sent them in to the aetna mail order pharmacy along with my debit card number. Today the payments started hitting my bank account and OMG!! :worried: I've already met my deductible!! :blink:

[roskopfm]

You should really look at the Humana HMO. I live in Chicago and 90% of the doctors appear to be part of the plan. It is one of the cheapest plans, no deductable and small co pays.