Open Season starting points from the pros

Tuesday - 11/9/2010, 4:42pm EST

Walton Francis, editor, Checkbook Guide to Health Plans for Federal Employees

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November 10, 2010 -- Although most of the open season attention is focused on the Federal Employee Health Benefit Program plans, you will also be able to sign up for a flexible spending account, and vision and dental insurance options through December 13. The federal life insurance option (FEGLI) and the federal long-term-care insurance plan are NOT participating in this open season.

Federal News Radio continues its coverage of open season by speaking with Walton Francis, editor of the "Checkbook Guide to Health Plans for Federal Employees." Many federal agencies have subscribed to the guide which workers can use for free.

The "Checkbook Guide" offers recommendations but people with unique situations -- if you are getting a hip replacement surgery or having a child -- should also consult with their health care providers, Francis said.

Blue Cross Blue Shield basic is the leading national plan. Good options for consumer or high-deductible plans are AETNA or APWU. And the best buy for an HMO is the Kaiser standard option.

Consumer-driven and high-deductible plans

Both consumer and high-deductible plans allow you to accumulate money in a savings account. Physicals are free. So if you only have a couple of doctor's visits annually, you will end up with the money, about $1-2,000 a year.

The high-deductible plan uses a health savings account, which is "money in your name," Francis said. If you leave the health plan, the money goes with you.

However, the consumer plan uses a health reimbursement account that does not stay with you if you leave the plan.

"Anyone who's not considering one of these two kinds of plans is not doing due diligence during open season," Francis said.

Do you need Medicare?
A married couple with Medicare Part B and the Blue Cross standard plan will have to pay $7,500 annually in premiums alone.

"The question is, Do you benefit from Medicare sufficiently for it to be worth the premium?" Francis said. "If you expect to or want to go out of network, Medicare Part B is a really helpful buy and there's some people for whom that's extremely important."

Other options are less expensive than the Part B and Blue Cross standard combination.

All plans except for Blue Cross basic guarantee you pay nothing out of pocket for hospitals or doctors if you have Medicare Part B.

"In that sense, it's a good deal," Francis said.

Having both a FEHB plan and Medicare is also "political insurance" under a new Congress where the fate of federal pay and benefits is uncertain.

"Suppose Congress ... does something bad to one program or the other. If you have both it's a little insurance you can maneuver," Francis said.

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