By Stephen Barr
Monday, November 13, 2006
For the next four weeks, federal employees and retirees will select their health insurance coverage for 2007. Many will escape the sticker shock of past years, as federal officials say 63 percent of enrollees in the federal employee health insurance program will see no increase in their premiums next year.
But policy analyst Walton Francis , who tracks premium and benefit changes in the Federal Employees Health Benefits Program, cautions against falling into open-season complacency.
Without the jolt of the usual large premium increase, "the danger is that people won't pay attention," he said. "They are going to yawn and go about their business, and that's a mistake.
"There is a 'change' page in every plan brochure, and people ought to be looking at that page," Francis said.
He added, "There are lots of decisions to be made by each individual subscriber, and there is often a better deal available right now."
Francis is the chief researcher and writer of the annual "Checkbook's Guide to Health Plans for Federal Employees," sponsored by the nonprofit group that publishes Washington Consumers' Checkbook magazine. The guide rates the more than 250 FEHBP plans, taking into account premiums, catastrophic limits and estimated out-of-pocket costs for most medical expenses. The guide also figures in tax savings that employees gain by paying their premiums through pretax payroll deductions.
The 2007 guide, Francis said, shows that:
· Some plans are good buys and can save hundreds or thousands of dollars.
A federal family of four, for example, should check out Blue Cross basic, the American Postal Workers Union consumer-driven plan, the Government Employees Hospital Association standard option, and the Aetna and Mail Handlers high-deductible health plans.
The guide also give high marks to some health maintenance organizations, such as the Kaiser Foundation Health Plan's mid-Atlantic standard and high options, the Aetna Open Access basic option and M.D.-IPA.
A retired federal couple enrolled in Medicare parts A and B should take a look at the annual costs and savings under GEHA standard, Mail Handlers high-deductible, Blue Cross basic and the APWU consumer option, according to the guide.
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.
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