Study Health-Plan Options Carefully This Open Season

The retired couple also might reduce medical costs by enrolling in an HMO, such as Kaiser's standard option, Aetna basic and the Aetna Health Fund consumer-driven option.

· Some benefits are changing, and sometimes for the better.

The Mail Handlers standard and high options have dropped their prescription-drug deductible -- a change that helps enrollees regardless of how much or how little they use prescription medicines. (Co-payments continue at Mail Handlers, such as a $10 co-pay for generic medications from in-network retail pharmacies.)

· Enrollees hold down their medical costs when they stay in-network.

Double-check to make sure your doctor and dentist accept reimbursement from federal plans. Dental and vision benefits, in particular, are based on preferred providers.

· Attention to premiums is especially important when deciding whether to enroll in the dental and vision program, which starts for the first time Dec. 31.

Regular health insurance typically covers annual checkups and teeth cleaning, and almost all health insurance plans provide coverage for accidental dental or vision injuries.

The stand-alone dental plans can cost several hundred dollars a year in premiums, and Francis suggests that they may make the most sense for people who anticipate moderately high dental expenses, want some protection against unexpected bills and like the predictability of paying a regular premium.

The vision plans also should be seen as a way to prepay routine costs for eye exams, glasses, contact lens and related services. They are not true insurance plans, Francis said.

Employees who are uncertain about whether to enroll for dental-vision coverage have the option of setting up a flexible spending account. FSAs help limit out-of-pocket costs by providing what the Consumers' Checkbook guide estimates as one-third savings on health-care expenses because payments are made in pretax dollars.

Stephen Barr's e-mail address isbarrs@washpost.com.