Federal Diary Live

Interested in learning about health savings accounts and health reimbursement arrangements? Got questions about how to use a health maintenance organization? Looking for the insurance plan in the Federal Health Benefits Program that best meets your needs?

Tom Bernatavitz, the Aetna executive in charge of its government program, will joined Stephen Barr, who writes The Post's Federal Diary column, for a discussion of the upcoming 2006 FEHBP open season at Wednesday, Nov. 9, at noon ET on Federal Diary Live.

For 2006, Aetna is expanding the Aetna HealthFund consumer-driven option to 46 new markets. The expansion will make the plan available to more than 5.6 million participants in FEHBP in 91 markets. The health insurance company also offers Aetna Open Access HMO. The HMO is available in 20 states, including Maryland and Virginia, and the District of Columbia.

More than 280,000 current federal employees are Open Access enrollees.

The transcript follows.

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Stephen Barr: Thanks to all joining in this discussion today, including our guest from Aetna, Tom Bernatavitz. We'll be talking about the 2006 FEHBP open season, and Tom, to start things rolling, would you give us an overview of what Aetna has planned for next year in the federal program? And thank you for taking time from your busy schedule to take reader questions and comments today.

Tom Bernatavitz: Aetna's 2006 theme is "You asked, we listened." We conducted a number of surveys and focus groups last year to collect the opinions of federal employees.

We received a lot of valuable feedback, but a few things stood out.

First, you said it was a hassle to get referrals. This year, we introduced the Aetna Open Access plan, which requires no referrals. None of our 2006 federal plans require referrals.

You also asked for more dental freedom. We now offer access to more than 70,000 dentists nationwide (about 4,000 in the D.C. area) and out-of-network dental coverage for members of our Open Access plan.

You also asked for more value for your premium dollars and alternative-type health plans. Aetna in 2006 will increase deposits into members' health savings accounts (HSAs) and will lower premiums for the Aetna HealthFund HSA plan.

Aetna is the only FEHBP plan that gives members more HSA money back than they pay in monthly premiums.

Through this account, we provide $1,500 single ($3,000 family) per year to spend on qualified health expenses, including dental.

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Alexandria, Va.: Would you please explain how your HSA works? Would you say it is more appropriate for some ages and not others?

Tom Bernatavitz: The Aetna HealthFund HSA is a simple, four-part plan.

1. It covers preventive care at 100% when you use participating providers. Your HSA is not reduced.

2. You can use money from your HSA to pay for other medical expenses. The HSA grows through the year with automatic monthly deposits of $125 single and $250 family. This gives you an annual amount of $1,500 single and $3,000 family to spend on qualified medical and dental expenses. You can make additional voluntary deposits that are tax-deductible (up to the annual deductible amount).

3. You pay an annual deductible before traditional medical plan coverage begins. You may use money from your HSA to pay for medical and pharmacy expenses.

4. After the deductible is met, you pay coinsurance or pharmacy co-payments for covered expenses. An out-of-pocket maximum limits the amount you pay in a plan year. And no referrals are required.

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Randolph, N.J.: If I join Aetna's HSA Plan, how do I take money out of my account to cover medical or dental expenses?

Tom Bernatavitz: It's simple. You will receive a no-fee Visa debit card, or, if you prefer, you can order optional checks to make withdrawals from your HSA. Those withdrawals are tax-free if used for qualified expenses. You can pay your doctor or pharmacy directly with your Visa debit card.

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Ft. Belvoir, Va.: Can you list the States where the HMO is available? Specifically interested in Florida -- intend to move there soon.

Tom Bernatavitz: Aetna's Open Access HMO is open to federal employees in Arizona, California, Connecticut, Colorado, Washington, D.C., Georgia, Illinois, Indiana, Kansas, Kentucky, Maryland, Missouri, Nevada, New Jersey, New York, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Virginia and Washington.

At this time, we do not offer the plan in Florida, but we continually evaluate expansion opportunities and will look closely at Florida next year.

If you reside in one of the above service areas, and have a dependent in Florida, that dependent can access our HMO plan in Florida.

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Washington, D.C.: What's your most popular plan for feds? Thanks.

Tom Bernatavitz: Our Open Access HMO continues to be the most popular plan among federal employees, with more than 280,000 members nationwide.

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Norfolk, Va.: I see Aetna HealthFund is offered in 91 markets. Is Aetna offered nationwide? If I have dependent children away at college, will they be covered?

Tom Bernatavitz: We are offered in 36 states and the District of Columbia. If a federal employee lives or works in one of our 91 markets, he or she may enroll in either Aetna HealthFund option.

Once enrolled, the employee and family members are covered nationwide through Aetna's PPO, with access to a network of more than 684,000 health care professionals.

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Alexandria, Va.: It looks like the Aetna Health Savings Account Plan is putting the most money into the employee's HSA account in the Washington, DC area. Can you provide more details on this plan?

Tom Bernatavitz: You are right.

For 2006, the plan deposits $125 per month (single) and $250 per month (family). That's $1,500 single and $3,000 family annually.

That's more than any other HSA offered anywhere, and exceeds annual non-postal employee contributions by more than $500 single and more than $750 family per year.

The difference is even greater for postal employees.

Our HSA deposits amount to 60% of the deductible. To make up the difference between the deposit and the deductible, enrollees can choose to make voluntary deposits, which are tax-deductible.

Your HSA can be used to pay for charges that would apply to your deductible, and can be withdrawn tax-free for any qualified expenses you may have. These are the same types of expenses for which you would use a flexible spending account.

But unlike FSAs, which are "use it or lose it," voluntary HSA deposits can be used only if you need it to meet your deductible or want it for an additional deduction at tax time.

For a complete list of qualified expenses, go to www.irs.gov and look under Publication 502. You also can get the information at http://custom.aetna.com/fehbp/index.shtml.

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Washington, D.C.: Your premiums seemed to have jumped higher than some other plans. And more than last year. Am I correct?

Tom Bernatavitz: Aetna's premiums did increase for our Open Access "high option" plan, but the plan still provides superior value with enhancements such as:

1. The elimination of referrals to in-network specialists

2. Access to all types of care with small co-payments

3. A reduction in the copay for out-patient surgery

4. Vision exam coverage through a copay, and a $100 eyewear allowance

5. Access to a dental PPO option at no additional premium charge

If you're interested in another Aetna plan option with a lower premium, we have three of the five lowest-cost options for federal employees in the D.C. area.

Our Basic Open Access HMO plan is very similar to our High Open Access HMO plan, but at a lower cost.

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Stephen Barr: Tom, a couple of readers have sent in questions expressing concern about doctors dropping out of their fee-for-service plans/networks. I assume this is an across-the-board issue in today's competitive marketplace and in areas where companies try to hold down costs. Am I on the right track or wrong track here?

Tom Bernatavitz: Aetna has a large and stable network of contracted doctors and hospitals. In the D.C. Metro area, we enjoy strong relationships with hospitals and physicians, and our network has been growing in recent years.

There has been some network volatility in the area, but that is due largely to consolidation among some of the health plans that compete with Aetna.

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Oklahoma City, Okla.: Does Aetna's High Deductible Health Plan with HSA pay interest on the money in my account?

Tom Bernatavitz: HSA account holders earn interest tax-free through a fixed interest account that currently is paying 2.75 percent interest.

In 2006, account holders who exceed a minimum HSA balance of $2,000 will have eight different investment options.

Participation will be entirely optional, and the eight funds are distributed through J.P. Morgan Chase.

Three are asset allocation funds, two are fixed income funds, two are U.S. equity funds and one is an international equity fund.

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Baltimore, Md.: I've heard that Aetna is offering a dental PPO option under their Open Access Plan. How does it work and can you tell us what this will mean for the employee?

Tom Bernatavitz: Employees have asked for more dentist to choose from. For 2006, Aetna is offering a dental PPO, with access to more than 70,000 dentists nationwide.

The dental PPO option allows you to receive care in or out of network. It covers the same dental services that it does now, but instead of an office visit co-pay, each member pays an annual $20 deductible.

If they use an in-network dentist, members' exams, X-rays, cleanings and fillings are covered at 100%.

Members also have access to the same discounted rates that Aetna negotiates for all services from participating dentists.

For out-of-network care, Aetna pays 50% of our normal, negotiated rate for the same services.

The dental PPO option is available for no additional premium. To sign up, you must call customer service at 800-537-9384 by Jan. 31, 2006.

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Hyattsville, Md.: I'm a federal employee with family coverage; I've been with a HMO for 20 plus years, but now my youngest child is a freshman in college --in another state, where this HMO has no coverage. I think I'm going to have to change plans, but which one? And how do I go about finding a doctor for myself? I've got several health issues, unfortunately, and this HMO has all my medical records - well, at least 20 plus years of them! But I do need to make sure that my son is able to see a doctor where he goes to college (in New Jersey). Thank you!

Tom Bernatavitz: A great option for you might be Aetna's Open Access HMO, which is available at a low premium ($72.71 biweekly for a family).

The plan is available throughout the entire states of Maryland and New Jersey. To select a doctor, go to www.aetnafeds.com and use our DocFind utility.

With Aetna's Open Access HMO plan, neither you nor your son need to select a primary care physician.

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Washington, D.C.: Do retirees in Aetna need to take Medicare Part D? If not, what's your view on Part B? Does it matter which Aetna plan you are in? Thank you.

Tom Bernatavitz: No, you don't need to take Medicare Part D.

OPM determined that all FEHBP plans qualify as creditable coverage, which means the benefits provided under federal plans are as good or better than those available under Medicare Part D.

If this should change, you can enroll in Part D without a premium penalty or surcharge.

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Arlington, Va.: Do you think drug prices have moderated, and if so, what is now driving your premium increases? Thank you.

Tom Bernatavitz: For two of Aetna's plan options, premiums have actually decreased for 2006. These are the Aetna HealthFund HSA Plan and the Aetna HealthFund Consumer-Directed Plan.

Rising medical costs, including prescription drug costs, continue to put cost pressures on insurers working to keep premiums affordable.

Aetna continues to seek creative solutions, such as our HSA and consumer-directed plans, to offer federal employees affordable alternatives that deliver value to them.

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Family plan and kids in college: At what age are kids no longer eligible to be covered by a parent?

Tom Bernatavitz: When an unmarried child turns 23, he or she is no longer eligible for FEHBP dependent coverage.

Steve tells us we're out of time.

Thanks for all of your great questions and interest in Aetna's plans.

For more information, you can check out your options at http://custom.aetna.com/fehbp/index.shtml or call 1-800-537-9384.

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Editor's Note: Washingtonpost.com moderators retain editorial control over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.