Few members of the federal family have a tougher time during a health insurance hunting season than retirees or their survivors.
Statistically, retirees are much more likely to have costly health problems than younger civil servants. And retirees must buy the same health insurance packages, and pay the same premiums, often on half the income of active workers.
Retirees and federal workers have until Dec. 11 to select their 1988 health insurance plan, and unlike employes who get help at the office, retirees often must depend on the media or the grapevine of fellow retirees for information.
For the benefit of the 100,000 federal retirees in the Washington area, here are some tips from Gordon Brown, secretary of the National Association of Retired Federal Employees, taken from his column in NARFE's Retirement Life magazine:
All the plans offered in the federal health program cover hospital care, surgery, diagnostic testing and office visits. Most also cover prescription drugs, and some cover special care such as dental, chiropractic or home health care. The plan comparison chart that retirees should have received from the Office of Personnel Management shows what is covered and the percentage of payment each plan will make. Brochures can be obtained from each plan.
Retirees, in many cases, should consider health maintenance organizations because many of them are cutting premiums in 1988.
Low-cost plans often offer comparable or nearly equal benefits to what many retirees now get from high-option (more costly) plans. Brown says that higher premiums often reflect a difference of only $50 or $100 in the deductible and 5 percent in the coinsurance (80 percent instead of 75 percent). That means that you might have to pay slightly more out of pocket if you are enrolled in a low-option plan, but the difference often is slight and doesn't justify the higher premiums of a more costly option.
Catastrophic illness protection is the most important benefit of any plan for retirees, Brown says. The catastrophic illness benefit puts a dollar limit on the amount of money you must pay out of pocket in the form of either coinsurance or deductibles in some plans. Once you've paid out the limit, the plan pays all other covered expenses that year in full.
Brown says that many single retirees can purchase good health insurance for about $25 a month, with family coverage running about $60 a month. Among those plans, he suggests that retirees consider: National Alliance standard option; Mail Handlers (both standard and high option); National Association of Government Employees standard option; National Federation of Federal Employees standard option; National Treasury Employees standard option; Postmasters standard option and the Blue Cross-Blue Shield standard option. Most of the union-backed plans charge a nonmember fee in addition to premiums.
A final word to retirees, and anyone shopping for health insurance: Nobody can pick a plan for you. Your needs, family situation and finances are unique. When you narrow down your choices, read all the brochures carefully. If you have questions about what is covered, call the plan. Remember that for some benefits, such as dental, you must be a member of the plan for one to three years, in some cases, before it will pay any benefits.