Waiting For The Next FEHBP Surprise

Wednesday - 10/6/2010, 4:00am EDT

Now that feds know the size of their 2011 health plan premiums, many are waiting for the other shoe to drop. Or should be...

As in what changes are coming in benefits, deductibles, copayments and reimbursement at the mysterious "reasonable and customary" rate.

Premiums next year are going up an "average" of 7.2 percent. That means some plans will go up more than that, some less. That increase is better than the average 8.8 percent premium rise in the FEHBP this year. And it's a lot less than premium increases in many private sector, and state and local government plans.

But premiums are only part of the health coverage equation.

Two equally important factors are these:

  • Catastrophic Coverage: The catastrophic coverage limit in your health plan is the maximum amount you would have to pay out of pocket next year in the event of a catastrophic accident or illness before your insurance takes over. (The maximum amount you will have to pay in the event of a catastrophic accident or illness before your insurance takes over). Catastrophic coverage is (or should be) the primary reason people buy health insurance. It's to keep you from going bankrupt because of a major medical problem.

  • Copayments/Prescriptions: What you will pay out of pocket (if anything) before satisfying your plan's deductible. A growing number of FEHBP plans offer high deductibles as a trade off for lower premiums. Health insurance expert Walton Francis, author of Checkbooks' Guide to Health Plans, says that all of the FEHBP plans "have such good coverage that you are well protected from most catastrophic expenses." Currently, that limit on what you pay out of pocket ranges from as little as around $4,000 for a self-only plan to about $15,000 for a family plan.

Paying For Insurance: White collar (nonpostal) federal workers are on track for a 1.4 percent pay raise in January. But retirees are facing their second year without a cost of living adjustment.

Shopping during this upcoming open season ( November 8 through Dec. 13) will be more complicated than ever, especially for retirees. So we called in the cavalry...

This morning at 10 a.m. (EDT) David Snell, insurance expert for the National Active and Retired Federal Employees is our guest on the Your Turn with Mike Causey radio show. He will talk about what active and retired feds should look for (and avoid) in a health plan. And explain how copayments work (and may change), how plans handle prescription drugs, and how to avoid paying too much for coverage you don't need.

Listen if you can. You can listen anywhere in the world on your computer. Go to www.federalnewsradio.com and hit the Listen Live button, or if you are in the DC area and are near a radio, at WFED 1500 AM. You can e-mail questions (mcausey@federalnewsradio.com) or call in during the show at: 202.465.3080.

It's your money and your health.

Political Junkies

The election is less than a month away. Would you like a before-and-after peek at Congress?

The Council of Former Federal Executives has invited all interested parties to its October 25th luncheon ($25 at The Holiday Inn, Westpark in Rosslyn) to hear American University's Dr. James A. Thurber. He's an expert on Congress and will talk about what kind of reforms are needed and, more importantly, feasible?

Then on November 22nd, Dr. Thomas Mann of the Brookings Institution will talk about what the new shaken-but-not-stirred Congress might do over the next two years, and what impact that will have on the 2012 election.

For reservations/information email: ewormser@erols.com

To reach me: mcausey@federalnewsradio.com


Nearly Useless Factoid
by Suzanne Kubota

Thanks to MentalFloss, we now know why surgical scrubs are the colors they are: "Green and greenish-blue surgical linens make looking at the inside of a human body easier on the eyes, since they're opposite red on the color wheel."


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