Picking a FEHB health insurance plan

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Picking a FEHB health insurance plan

Post by Anonymous User » Wed Aug 05, 2020 9:29 pm

This might be too far afield for this forum, but I'm a bit overwhelmed by the amount of different plans available, and was hoping to get some input on what other clerks chose. I'm in my 20s, no dependents etc., which I imagine is the norm for clerks. Some form of dental coverage is a must. I've also been advised that a PPO is preferable to an HMO, which makes sense to me, but I've never had to choose a health insurance plan before. In fact, I've literally never even used my health insurance before.

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polareagle

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Re: Picking a FEHB health insurance plan

Post by polareagle » Thu Aug 06, 2020 12:25 am

You may already know this, but to see the list of plans available to you, go to this website, enter your court's zip code, choose federal employee (non-postal), and choose bi-weekly. That site has a comparison tool that lets you compare plans.

If you're healthy (sounds like you are), you may consider going with a high deductible health plan ("HDHP"), which will carry a lower premium and provide you with a tax-advantaged health savings account (but which will require you to pay out of pocket for most things aside from routine checkups until you hit your deductible).

I personally used the GEHA HDHP when I was clerking and never had a problem (but also went to the doctor ~1 time over the course of two years).

Another consideration, if you have a particular doctor in mind, is to check if they're part of a preferred provider network. Some doctors will take Blue Cross but not United. Many will take anything but prefer one type over another. (A note about GEHA, which is government employee only--they partner with different provider networks like United or Blue Cross in different parts of the country, so you'll want to figure out who they're partnering with in your area--you'll never see a doctor say they accept "GEHA" itself.)

As for dental, it actually isn't part of the FEHB program, it's a separate thing that you sign up for on the separate benefeds website. Some of the FEHB plans do include a small dental component, but unless you're *really* sure that would cover you, you should sign up for separate dental. Use the same process I outlined above to find a dental plan--start with a dentist and then work backwards.

Finally, if you're still totally lost, there is a dedicated forum for federal employees that has a subforum about FEHB--the career feds there will be far, far more knowledgeable than most of us on this website.

Good luck!

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Wild Card

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Re: Picking a FEHB health insurance plan

Post by Wild Card » Thu Aug 06, 2020 1:36 am

I wasted a ton of time agonizing about this. Just do BCBS Basic. I think it covers two dental checkups per year or something, unlike Standard and unlike that specially discounted plan exclusively for federal employees.

Of course, if you have a chronic illness and see specialists, make sure everyone whom you need to see will accept BCBS Basic.

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Re: Picking a FEHB health insurance plan

Post by Quichelorraine » Thu Aug 06, 2020 11:54 am

I used Blue Cross basic, as did most everyone else I know. In my area (NE metro), nearly everyone accepted it, the premiums were reasonable-ish, and the short-term nature of the plan meant that any inefficiency wouldn't be long lived anyway. High deductible plans can be more efficient if you're young and healthy, but they can also be far more paperwork-intensive and, if you're like me, you'll then spend tons of time worrying about what will happen if you get sick (as then you're suddenly out the deductible). Standard didn't seem to give you much more of anything.

I don't remember the details of dental coverage, but I think it covered at least two basic office visits per year.

Anyway, it's absolutely overwhelming and you're not alone in thinking so. Blue Cross Basic is not the most efficient/bespoke choice, in all likelihood, but it's not a wrong choice, and you won't live with the consequences that long anyway. You can safely treat it as the default.

ETA: I forgot about the Benefeds aspect. Lots of dental insurance isn't too hot, frankly, but I don't remember the details of what the courts offered; I think I was satisfied with the coverage under basic Blue Cross, but I didn't have to go in for any major work. The vision plan, however, was both pretty good and pretty cheap in my area. I also thiiiink I signed up for an FSA, but most of my co-clerks didn't bother funding one (it's a bit more valuable now that over-the-counter stuff is included again).

Again: this is all overwhelming and awful and I remember exactly how I felt when I needed to make these Adult Decisions nobody had ever explained to me. Just imagine how much fun you'd be having if you were part of the Thrift Savings Plan too!

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Re: Picking a FEHB health insurance plan

Post by Anonymous User » Thu Aug 06, 2020 12:11 pm

+1 on BCBS basic. Even though it's "basic" (and relatively cheap), it's very very good insurance. I clerked in two different cities, and basically anyone took it both places. I didn't have tons of medical visits, but I had a few, including an unexpected ER trip and a couple specialist visits, and was always pleasantly surprised by the coverage.

For dental/vision (BENEFEDS), I think I did GEHA and it was good (but I just had like a basic dental cleaning and annual eye exam for new contacts-- nothing extra-- so if it *wasn't* good, that would be pretty bad).

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Re: Picking a FEHB health insurance plan

Post by Anonymous User » Thu Aug 06, 2020 12:45 pm

For what its worth, I ended up needing a fairly substantial surgery while clerking, and GEHA was a huge pain and bureaucratic nightmare to work with.

The coverage/terms of the plan itself were okay, and the premiums not terribly expensive, but man having to actually submit the claims and get them to provide the coverage was like pulling teeth.

I'm particularly bitter that it took them about four weeks to approve a mobility scooter, which I obviously needed as I couldn't put any weight on one leg. So yeah, don't use GEHA.

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Re: Picking a FEHB health insurance plan

Post by Anonymous User » Tue Aug 11, 2020 12:59 pm

Two cents from someone with higher healthcare usage: I needed coverage for myself and my wife, and pre-existing conditions meant we knew our healthcare usage could/would be pretty high. I did pretty extensive cost comparison and GEHA Standard was the most economical by far - assuming you would pay the entire deductible (IIRC it was about $500 per person or $1000 for the family), the overall expected cost was still less than higher premium plans with no deductible. Also, it's one of the least expensive plans with 100% prenatal coverage.

Did not have a bad experience like the above anon, but we did not have huge surgery or anything that would have required special submissions while we were on the plan. Worst thing was some providers were confused about the nature of the beast as a government program that piggy-backs on private carrier networks, and we had some confirmation-of-benefits hiccups where we kept getting told we'd have to pay for prenatal care that we knew was covered.

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Re: Picking a FEHB health insurance plan

Post by IWorkedHarderThanYou » Fri Aug 28, 2020 10:31 pm

Anonymous User wrote:
Thu Aug 06, 2020 12:11 pm
+1 on BCBS basic. Even though it's "basic" (and relatively cheap), it's very very good insurance. I clerked in two different cities, and basically anyone took it both places. I didn't have tons of medical visits, but I had a few, including an unexpected ER trip and a couple specialist visits, and was always pleasantly surprised by the coverage.

For dental/vision (BENEFEDS), I think I did GEHA and it was good (but I just had like a basic dental cleaning and annual eye exam for new contacts-- nothing extra-- so if it *wasn't* good, that would be pretty bad).
BCBS Basic is definitely the best. Pretty much everything is copay (not coinsurance) based. I had a surgery and it cost $250 ($150 copay for surgeon and $100 for facility). I still don't understand why it's cheaper than BCBS Standard.

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polareagle

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Re: Picking a FEHB health insurance plan

Post by polareagle » Sat Aug 29, 2020 10:20 am

IWorkedHarderThanYou wrote:
Fri Aug 28, 2020 10:31 pm
Anonymous User wrote:
Thu Aug 06, 2020 12:11 pm
+1 on BCBS basic. Even though it's "basic" (and relatively cheap), it's very very good insurance. I clerked in two different cities, and basically anyone took it both places. I didn't have tons of medical visits, but I had a few, including an unexpected ER trip and a couple specialist visits, and was always pleasantly surprised by the coverage.

For dental/vision (BENEFEDS), I think I did GEHA and it was good (but I just had like a basic dental cleaning and annual eye exam for new contacts-- nothing extra-- so if it *wasn't* good, that would be pretty bad).
BCBS Basic is definitely the best. Pretty much everything is copay (not coinsurance) based. I had a surgery and it cost $250 ($150 copay for surgeon and $100 for facility). I still don't understand why it's cheaper than BCBS Standard.
It's cheaper because you *must* see a preferred provider. With BCBS Standard, you have the option of going to any doctor in the U.S.--your reimbursement will just be different. This difference probably won't be relevant to a group of mostly 20-somethings who are moving to a new city anyway. If you had a long-term relationship with a set of providers, or if you had niche medical issues that require special knowledge, it could be a bigger concern.

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***0123L

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Re: Picking a FEHB health insurance plan

Post by ***0123L » Sat Aug 29, 2020 12:00 pm

For me there are three BCBS plans - the basic is the midrange plan and the FEP Blue Focus is the cheapest plan. The FEP Focus is about $45/month cheaper. Main difference is a $500/year deductable - but preventitive care I don't think counts toward that. Has anyone chosen between FEEP Blue Focus and BCBS Basic and have tips? I maybe go in for a checkup once a year - but that's preventitive care that will be covered under either. No other regular doctor's visits.

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Re: Picking a FEHB health insurance plan

Post by cjm2018 » Mon Aug 31, 2020 2:22 pm

***0123L wrote:
Sat Aug 29, 2020 12:00 pm
For me there are three BCBS plans - the basic is the midrange plan and the FEP Blue Focus is the cheapest plan. The FEP Focus is about $45/month cheaper. Main difference is a $500/year deductable - but preventitive care I don't think counts toward that. Has anyone chosen between FEEP Blue Focus and BCBS Basic and have tips? I maybe go in for a checkup once a year - but that's preventitive care that will be covered under either. No other regular doctor's visits.
I found helpful this link from BCBS when I recently made the decision: https://www.fepblue.org/benefit-plans/c ... plans-2020

I found that the Focus plan is a good, cheap option for those without any underlying conditions who just go to the doctor a couple of times a year. But it seemed to me that the Focus was more of a bet that you would not suffer from any other significant or catastrophic issues (e.g., inpatient care and ER non-accidental is 30% of allowance with a $6,500 out-of-pocket expenses cap, compared to Basic plan's $175/day up to $875 for inpatient and $125 for ER non-accidental). That's a normal bet to be made with many health insurance plans. It's a personal preference as to whether you'd like to pay more per month and likely face a lower bill if you had a major incident, or pay less per month with the understanding that a major incident could require a bigger lump-sum cash payment.

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