If you haven't started your federal health plan hunt, don't panic. You still have nine working days. On the other hand, there is every reason to sweat a little.
You can't order the insurance off the Internet and shouldn't have a friend pick your plan. If your designated shopper gets a plan that fits him--not you--you will live with the mistake every day of next year.
There are health plan brochures that you (and your doctor) should read. And if you decide to change plans, there are forms to fill out.
Premiums will rise an average 9.3 percent next year.
But as many federal workers and retirees have discovered, averages are deceptive. One fee-for-service plan, Alliance, will cut its biweekly premiums next year. Those who buy the self-only policy will pay $6.77 per pay period less next year than they are paying this year in the same plan. Alliance premiums for family coverage will drop $15.58 biweekly next year.
GEHA, one of the best-rated plans in the program, is increasing its biweekly premiums by $9.47, for self-only coverage, and $19.46, for family coverage. That's more than the average increase.
All fee-for-service health plans (except the excellent, but expensive Postmasters plan) will require everybody to make co-payments for prescription drugs by mail. Currently many retirees get the drugs (which can be very costly) free if ordered by mail.
Generic drug-by-mail co-payments will range from $7 in the American Postal Workers Union and Kaiser Permanente plans to $20 in the Aetna US Healthcare standard-option plan, according to Walton Francis. He wrote the Consumers' Guide to Year 2000 Health Plans for Federal Employees.
Although mail-order drugs will still be a major bargain (providing a 90-day supply of drugs that otherwise could cost hundreds of dollars), co-payments will be a hardship for many lower-income retirees.
Previous columns have dealt with "best buys" for groups of people with particular medical needs. Upcoming columns will review some of those best buys--as rated by Checkbook and Bill Smith, of the National Association of Retired Federal Employees.
For people who are still undecided, here's a rundown of premium changes for the fee-for-service plans that cover most federal workers and the vast majority of retirees. The numbers show next year's premium cost to active-duty employees and the change (up or down) from this year.
* Alliance, self-only, $55.59 biweekly, down $6.77; family, $109.00, down $15.58.
* American Postal Workers Union, self only, $39.72, up $3.02; family, $84.20, up $5.91.
* Blue Cross high-option, self-only, $66.29, up $2.72; family, $134.35, up $4.73. Standard-option, self-only, $30.04, up $2.22; family, $66.78, up $4.46.
* GEHA, self-only, $45.72, up $9.47; family, $92.67, up $19.46.
* Mail Handlers high-option, self-only, $45.43, up $6.54; family, $86.13, up $12.50. Standard-option, self-only $21.08, up $1.91; family, $45.76, up $4.16.
* National Association of Letter Carriers, self-only, $46.87, up $3.73; family, $92.66, up $6.87.
* Postmasters high-option, self-only, $122.15, up $6.38; family, $257.67, up $12.79. Standard-option, self-only, $43.61, up $1.77; family, $88.89, up $2.90.
Five-Year Rule In yesterday's column, I made a big mistake in writing about the importance of the five-year rule on health insurance coverage. The issue is the ability to carry federal health insurance into retirement. Unlike private-sector types (who usually lose their health coverage in retirement when they turn age 65), feds can keep coverage for life--if they satisfy the five-year requirement.
To have coverage in retirement, a fed must have been covered by any one of the federal health plans for "the five years of service immediately before retirement, or the full period or periods of service between first eligibility to enroll and the date he becomes an annuitant, if less than five years." That's from 5 U.S.C 8906 (b).
Thanks to readers Bonnie Rose, Darryl Ann Cherry, Lee S. Gale, Teresa C. Hagans and Dean D. Legacy--among others--who spotted the error and diplomatically urged us to correct it.
Health Plan Seminar There will be two federal health insurance forums in Montgomery County on Monday: a 9:30 a.m. session at the National 4-H Center in Chevy Chase and a 7:30 p.m. session at the Nuclear Regulatory Commission in Bethesda. For details call 202-225-5341.
Mike Causey's e-mail address is firstname.lastname@example.org
Wednesday, Dec. 1, 1999