Gravity is typically a science term associated with the downward force that draws an object or living thing to earth. Because health insurance premiums aren’t an object or living thing – they aren’t subject to gravity’s force and tend to go up each year. So what can you do to create your own gravity and hold your health care costs down?
The average FEHB premium will increase 7.2% this year on top of last year’s 8.8% increase. While premiums are usually the first thing a federal employee or retiree looks at when choosing a health plan, paying attention to overall costs such as deductibles, co-pays for office visits and prescription drugs, and other out-of-pocket expenses can actually lower your overall healthcare expenses.
Choosing the right plan for your health situation and the services you actually use is a good start. But most federal employees simply stay in the same plan each year, because they don’t know where to even begin in comparing plans. Only 8% of federal employees switch health plans in any Open Season, although if costs continue to increase at this pace, we may see more and more people looking for other less expensive options.
Federal employees say that it’s the plan brochure, also known as the outline of coverage or plan document, that keeps them in the same plan. Ranging from 140 to 160 pages, it can seem a daunting task to dive into that brochure to find out what it really covers and whether it’s a good fit for you and your family.
OPM has done you a favor in this regard.
They require every FEHB provider to organize their plan brochure in the same sequence. With a little guidance, you’ll discover that you don’t need to read the entire 150 pages – you can simply go to the sections that are important to you. (The brochures for the plans available in your state are available online. Just select your state and the brochures for each plan available are available in pdf format.)
Here’s a cheat sheet to help you get started:
- General Features – § 1 – Starts on Page 6 or 7 – overview of how the plan operates
- Plan Changes – § 2 – Starts on Page 9 or 10 – even if you aren’t changing plans, you should review this section to learn about any changes that could affect you
- Costs/Deductibles/Co-pays/Maximum Out-of-pocket limits – § 4 –Starts between Pages 16 and 20 – everything related to costs is included in this section
- Detailed Benefits – § 5 – Starts between Pages 22 and 26 – the details of how the plan covers specific conditions are laid out extensively in this section. This is the largest part of the plan brochure.
- Summary of FEHB Benefits – § 11 – Last few pages of brochure
There are several great web-based tools, such as Consumer’s Checkbook and Plan Smart Choice you can access to help you make FEHB comparisons. But before you use these tools, you may want to narrow down your options so you’re comparing only two or three plans.
Armed with the right tools, good questions, and an understanding of your healthcare needs, you can use gravity to hold your healthcare costs down.