By Stephen Barr
Thursday, March 20, 2008

After teeth and eyes, it's time for ears.

The federal employee health insurance program yesterday urged health insurance companies to strengthen their coverage for adults who need hearing aids or have problems hearing.

The health insurance program rolled out enhanced benefits for dental and vision services to federal employees in 2006, and Linda M. Springer, director of the Office of Personnel Management, said hearing benefits are "an area where we need to do more," starting in 2009.

The federal workforce has a large number of aging baby boomers who will be in need of professional services to help them cope with hearing loss and the sense of isolation that often accompanies it, Springer said.

"This is an area that has not gotten the attention it deserves," she said.

Last year, OPM asked insurance companies to increase coverage of hearing benefits for newborns and children, noting that hearing loss is one of the most common congenital birth defects. Some companies increased those benefits, at little or no additional cost to enrollees, OPM said.

Springer's request for improved hearing benefits for adults came at the start of a two-day meeting of health insurance representatives from companies that participate in the Federal Employees Health Benefits Program, which is administered by OPM. FEHBP, as the program is known, provides medical insurance and health coverage to about 8 million government employees and their family members. It permits federal employees to purchase coverage from national health carriers, such as Blue Cross and Blue Shield, from health maintenance organizations, such as Aetna and Kaiser Permanente, and from groups representing government employees, such as postal unions.

Democratic presidential contenders Hillary Rodham Clinton and Barack Obama have used the federal employee program, which also covers members of Congress, as a model for their promises to put health insurance within reach of any American who needs coverage. John McCain, the all-but-certain Republican presidential nominee, has called for broad changes in the nation's health insurance system that include features of the federal program.

In her remarks yesterday, Springer noted that presidential candidates have talked of "opening up" the federal employee health program to the public but said OPM is steering clear of campaign politics. "Our job is to ensure the federal plan is the best it can be," she said.

OPM outlined its goals for 2009 in a "call letter" sent March 11 to the health insurance companies. The letter, made public yesterday, informed the companies that OPM wants to wrap up contract negotiations for next year's health benefits package by mid-August.

The letter also asks the insurance companies to submit proposals for a pilot program to see if there are better ways to coordinate coverage between the FEHBP and Medicare.

For most federal retirees who are 65 and older, Medicare serves as their first payer on insurance claims. FEHBP plans usually waive their hospital and medical deductibles and co-insurance for federal retirees who pay the Medicare premium for doctors and outpatient services, known as Part B.

By proposing a pilot program, OPM hopes that insurance companies will come up with other ideas on how to combine or coordinate coverage between the FEHBP and Medicare, other than just waiving co-payments.

The call letter suggests that the insurance companies consider setting up accounts so that a part of each retiree's FEHBP premium could be passed along to pay for Medicare premiums. That might lower overall premium costs for retirees but also might require insurance companies to accept more financial risk.

The National Association of Active and Retired Federal Employees said yesterday that it was troubled by the proposal because creating a pilot for Medicare-eligible federal retirees could open the door for establishing a separate FEHBP plan based on retirement status or age. That has never been done before in the program and might result in higher premiums for retirees, the association said.

But Nancy H. Kichak, an associate director at OPM, said retirees would pay the same premium in any Medicare pilot as they would in a counterpart FEHBP plan. Under the proposed pilot, retirees "are not going to lose benefits by doing this," she said.

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