December 11 is approaching and your weekend plans do not include spending hours poring over boring and unreadable insurance documents, trying to remember the difference between coinsurance and copayments, trying to translate biweekly premium amounts into annual amounts that you can compare to annual deductibles and annual catastrophic spending limits, or on trying to compare 34 health plans in the Washington DC metro area to each other for every ailment affecting everyone in your family. There are better things to do, like watching football games of teams that have a chance to get into the playoffs (none of them are called “Redskins”), getting some Christmas shopping done in the never-ending “after Black Friday” sales, and following the latest sex scandals among the high and mighty.
But maybe, just maybe, you will be willing to spend an hour to find a money saving insurance deal. CHECKBOOK estimates that the average health care cost—enrollee share of premium plus out of pocket—for an annuitant couple without Medicare Parts A or B will be $8,000 or more next year in the 9 highest cost self-plus-one plans in the DC area FEHBP next year.
What will that same couple spend in the lowest cost plans? There are 7 plans that will cost on average under $6,000 next year and another 6 that are below $6,500. So, 13 plans will save you on average $1,500 to $2,000 (or more) next year than the 9 highest cost plans!
A couple with Medicare Parts A and B will spend $10,000 or more, even after the Medicare wraparound, in the 16 highest cost self-plus-one plans. For this same couple, we estimate that there are 6 plans at or below $8,000 next year, for a saving of $2,000 or more.
Cost Saving Tips
With just a few days left until the December 11 deadline for plan changes, what can you do to grab these kinds of savings without losing your sanity? Just follow this simple advice.
First, put about a dozen plan names into your “possible buys” shopping list.
With or without Medicare, employee or annuitant, it is hard to beat Kaiser Standard, CareFirst HDHP, UnitedHealthcare Choice Plus, CareFirst Standard, or Aetna Open Access Basic among local area plans. And it is hard to beat NALC, APWU, and Aetna Direct CDHP plans, or GEHA Standard, GEHA HDHP, Aetna HealthFund HDHP, or Foreign Service among national plans. Not far behind these are MHBP Standard and HDHP, Blue Cross Basic, and NALC High.
Second, if you are already in any of these plans, you are not throwing away as much money as most. But there is probably more to save.
Regardless, you’ve got to narrow your choices down farther to keep your shopping experience sane and sensible. Some of these plans really stand out for particular groups.
- Any HDHP (high deductible) plan is a great buy for employees at any age who don’t have huge fixed annual doctor or drug expenses. The Health Savings Accounts (HSAs) these plans offer are like IRAs on steroids: money in your personally owned account goes in tax free, grows tax free, comes out tax free if spent on health care, and stays with you the rest of your life regardless of what plan changes you make. These plans have good overview explanations of how they work at the beginning of brochure Section 5. If you are a saver who maxes out thrift plan contribution, focus on the thousands of dollars more you can add tax free to your HSA account.
- Aetna Direct, CareFirst HDHP, Kaiser Standard and High, and Blue Cross Basic really stand out for annuitants with Medicare Parts A and B. If you haven’t been paying attention, you may not know that all of these plans offer a complete or partial Medicare wraparound, with no deductible. The first two also give you a sizeable savings account to help with drug copays or dental. And new this year, buried in the small print of its brochure, Blue Cross Basic (but not Standard) offers a $600 per person Part B rebate for these annuitants. If you are currently in Blue Cross Standard, why aren’t you moving to Basic, for a cost saving close to $2,000 next year?
- Are you an HMO fan or one who wouldn’t consider an HMO? If you are in either group, that could simplify your shopping list.
- You could call your doctors’ offices to see which plan networks they will be in next year.
Third, however you narrow it down, you should look at three or four plans for next year, focusing not only on overall cost but also on how well they serve your family’s health needs. For example, if you have high drug expenses, make sure they have good name brand drug benefits. Make one of them a High Deductible plan and one of them the plan you are in now. If you have Medicare Parts A and B make one of them Aetna Direct.
You can read about each plan’s strong points, check the plan’s drug formulary, and download a brochure at its web site. You can compare plan benefits side-by-side, compare plan quality ratings, and also download brochures at the OPM or CHECKBOOK web sites. You can also compare estimated plan costs for families like yours, and for the DC area see if your doctors are in the plan, at the CHECKBOOK web site. You can even read our advice for employees and annuitants without having to subscribe—for example, to learn the pros and cons enrolling in Medicare Part B, as well as money saving tips.
Fourth, you should now download three or four plan brochures to focus on. Do not print them—keep them as PDF files. These are hundred page documents with lots of small print. You are not going to read every page, let alone study them.
What to do? It is simple. Every brochure has a page (Section 2) describing how its benefits will change for next year. Mouse to that page to see if any of those changes will help or hurt your family. (Example: halfway down that page you will see the bulleted line that tells you about the new $600 Part B rebate in Blue Cross Basic.)
Other pages to scan are the Special Features and non-FEHB benefits pages (starting at Section 5(h)), where you will learn about cash wellness benefits and unofficial dental benefits and lots more. If you are on Medicare, you will want to review the table near the end of Section 9 on whether and how well the plan wraps around Medicare Parts A and B to reduce your costs. And you will want to search for any benefits that particularly matter to you, such as chiropractic, hearing aids, or maternity. (Hint: just type in a word like “hearing” and with a few mouse clicks you will get to the hearing aid benefits.)
Fifth, at this point you should be nearing a decision. Don’t procrastinate further. Breathe a sigh of relief if you are already in one of the top plans and like its service, or bite the bullet and change plans if you have thousands of dollars to save. (Another hint: whatever plan you choose, a two-person family should check to see which premium is lower: self-plus-one or family. You may be surprised.)
To change plans, employees can use an agency resource or in many cases www.employeeexpress.gov. Annuitants should use the OPM web site at https://retireefehb.opm.gov. OPM also offers retiree help at 800-332-9798, but that number sometimes puts callers on hold for very long waits.
Walton Francis is the principal author of CHECKBOOK’s Guide to Health Plans for Federal Employees. Individuals can subscribe to the online version for $9.95 and see a listing of agencies that provide free CHECKBOOK access to employees at www.guidetohealthplans.org.