Best health plan for the 'average' person

Tuesday - 10/4/2011, 2:01am EDT

If you want to see grown men and women cheering, or blubbering, at the same event you have three choices:

  • Go to a football game between the Washington Redskins and the Dallas Cowboys.

  • Go to a baseball game between the Philadelphia Phillies and any other team.

  • Watch a group of federal workers and retirees receive the news about their health insurance premiums for the upcoming year.

At any of the above a certain percentage will jump for joy while an equal number will be screaming that life isn't fair.

The good news, for many federal workers and retirees, is that health insurance premiums ON AVERAGE will rise only 3.8 percent next year. That's an interesting figure and an accurate one. But not so helpful if the plan you are in is going up 40 to 50 percent next year, which some are.

The "average" doesn't always tell you much. Consider:

  • The average American male is now 5 feet, 9 1/2 inches tall and weighs 191 pounds. That's an inch taller and about 30 lbs. heavier than it was in 1960.

  • The average American woman is 5 feet, 3 inches tall and weighs 163 lbs. Also up.
If that's you, fine. Nothing wrong with average.

But most people are either taller or shorter than that, and most either weigh less or more. In some cases a lot less or a lot more.

There are more than 200 federal health plans. Most of them are HMOs, which cover workers or retirees in specific geographic regions — like southern Florida, or parts of Arizona. California has a ton of HMOs participating in the Federal Employee Health Benefits Program. HMOs tend to have lower premiums than fee-for-service plans. But that has been changing over time for a variety of reasons, including the risk pool. That's especially true in areas where many of the HMO members are older and have higher medical costs and use more prescription drugs.

When we reported on the 2012 health premiums last week, we got a lot of reaction in two waves. Immediately after the column and news stories appeared, we got emails from feds and retirees who were delighted at the relative small increase. Almost everyone was happy.

Then people stopped looking at the average and started looking at their health plan. Feds, particularly retirees in HMOs, were horrified. For example, Jerry D wrote:

  • " As a federal retiree living in South Florida, I was pleasantly surprised to read your column stating that the average increase in 2012 premiums for local health maintenance organizations were only increasing 6.7 percent. My pleasantness changed when I actually went to the rate tables. My premiums with Av-Med will increase over 41 percent — yes, I said over 41 percent. I guess it's time to shop for another plan. Thanks for letting me vent."
Another in Arizona said he envied his Florida counterpart. His HMO, he said, is going up more than 50 percent. He's also going shopping.

The good news is that federal and postal workers and retirees have lots of choices, options and time. The open season runs from mid-November to early December. Health insurance expert Walton Francis says all of the FEHBP plans are good but some are too expensive. During the open season he'll help us with a series of "best buys" column and radio shows.

In the meantime check out the premiums for next year. Pick three plans you can live with. Then we'll ask the experts which are best for you.


NEARLY USELESS FACTOID

By Jack Moore

They say you catch more flies with honey than vinegar. But one 1950s doctor wanted to have it both ways. According to Life magazine, Dr. DeForest C. Jarvis invented a substance called "honegar," a mixture of both substances, which was designed to cure aches and pains, although it never really took off.


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