As they approach the midpoint in the federal health insurance hunting season, federal workers in some agencies--especially outside the Washington area--still haven't received official government guidance on next year's health plans and premiums.
Parts of agencies (the Agriculture Department, for example) haven't received the printed information. Others got it late and are just mailing it out to field installations. Without the official guidelines, it will be tough to decide which health plan is best next year. Premiums are going up an average of 9.3 percent, but some increases will be more, a few much less.
The open season began Nov. 8 and ends Dec. 13.
There is still plenty of time to do the homework, but your decision shouldn't depend on a last-minute flip of the coin. Experts say the most asked question is hard to answer: What is the best health plan?
Some people believe there must be one plan that fits everybody, and anybody, best. Experts say there may be one plan that is best for you. But that depends on who you are. To home in on your ideal plan, ask yourself some questions. Some of them, obviously, cannot be answered with any certainty. That is one reason individuals need to consider all options.
For instance, ask yourself:
Are you married or single? Do you have children? If you don't have children, is there a chance that you will become a parent next year? Are there twins (or triplets) in your family?
Are you healthy? How about your spouse and dependents?
Did your parents and grandparents run in marathons in their eighties and nineties, or does your family line start falling apart at 40?
Is your doctor part of the preferred-provider network of any of the available health plans?
What does your dentist think of the coverage offered by the various health plans? Will you like the coverage, and will the dentist get paid?
Do you plan to have any accidents next year?
How much are you prepared to spend on health premiums?
What is the maximum out-of-pocket expense you could handle next year if you or someone in your family is hit with catastrophic medical bills because of illness or accident? Unless you don't mind having to pay a bundle in out-of-pocket medical expenses next year, check out the catastrophic limit for various health plans. Under the Blue Cross standard option, for example, a family of four using preferred providers would be limited to paying about $4,000 next year. The same family in the Postmasters or Mail Handlers standard options could be out $9,800 to $12,000, according to the Consumers' Checkbook guide to federal health plans.
Is it smart or foolish to pick a health plan for a specific benefit, such as good dental coverage?
Remember, if you don't make any changes in your coverage, you will remain in your current health plan next year, assuming it is still part of the federal program. That may be good, but its premiums could be going up while some coverage has been reduced.
If your health plan is leaving the federal program at the end of the year--more than 100 HMOs have dropped out in the past two years--you will be put automatically in the Blue Cross standard option. That's one of the all-around best plans, but it isn't best for everybody. Doing nothing takes the health care decision out of your hands.
Here are some sources of information for health insurance shoppers:
* Checkbook's Guide to Health Insurance Plans for Federal Employees. The guide costs $8.95 at newsstands. Or you can order it by mail ($10.45) by calling 202-347-7283.
* The December issue of Retirement Life magazine. The magazine is published by the National Association of Retired Federal Employees. NARFE members--both active-duty and retired--automatically get the magazine. The number is 1-800-627-1914.
* The Office of Personnel Management's health insurance Web site (which some people have trouble getting to work): www.opm.gov/insure.
* Federal Diary columns on "best buys," as rated by Walton Francis, who wrote the Checkbook guide, and Bill Smith, of Retirement Life. Those columns can be found at washingtonpost.com.
At 9 a.m. tomorrow on WUST radio (1120 AM), Francis will answer questions about "best" and "worst" buys for federal workers and retirees.
Problem Employees What do bosses and co-workers do about a problem employee? At 10 a.m. tomorrow on WUST radio, John Palguta, of the Merit Systems Protection Board, will talk about his agency's detailed study on poor performers.
Mike Causey's e-mail address is firstname.lastname@example.org
Friday, Nov. 19, 1999