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I promise, this is the last open season column from me until next year. This year’s annual opportunity to make changes to your health coverage runs through Dec. 12. Most federal employees don’t make any changes during open season. Even if you don’t think you need to switch plans, there are three things you should do before midnight eastern time on Monday.
Look at how your plan will change in 2023. Consider the premiums, but also examine prescription drug formularies, network providers, deductibles, copayments, coinsurance and catastrophic coverage. The front page of every Federal Employee Health Benefits plan brochure will provide references to 2023 rates, changes for the new plan year, and a summary of benefits.
Premiums shouldn’t be the driver of your final decision, however. If you find two or three plans with similar benefits, the lower-priced plan could provide you with better coverage in some cases. Remember that a plan that gets a higher volume of claims may have higher premiums. This is why some “value” plans may not always have the lowest premiums and some “standard” option plans provide better benefits than a “high” option plan. And some “basic” option plans may provide more generous coverage than “standard” options. It’s not the name of the plan that counts, but what it offers.
Compare your options based on your age, health and family needs. There are 271 plans and plan options for 2023. In your zip code, you may have 15 to 40 plans and plan options to choose from. If you’re looking for a nationwide plan with lower cost sharing, then you can reduce your choices to seven or eight options. Or if you would prefer a health maintenance organization, then you may have fewer choices, especially outside major metropolitan areas.
To narrow your choices, use the Consumers’ Checkbook Guide to Health Plans for Federal Employees or the Office of Personnel Management’s plan comparison tool.
You can also attend the virtual health benefits fair. Remember to check plan websites and brochures to make sure your providers are in their network.
Do you take prescription medications? Check the plan formularies, call the plan’s toll-free number and compare out of pocket drug costs between the plans you are considering.
Do the plans you are considering cover dental, vision, alternative care (such as massage therapy, chiropractic and acupuncture) and other forms of treatment?
Consider FEDVIP and FSAFEDS, which are also open now. Employees and annuitants should assess the need for supplemental dental and vision benefits through the Federal Employees Dental and Vision Insurance Program. Use the tools to compare plans and options in your zip code. When you visit a provider who participates with both your FEHB plan and your FEDVIP plan, the FEHB plan will pay benefits first. The FEDVIP plan allowance will be the prevailing charge in these cases. You are responsible for the difference between the FEHB and FEDVIP benefit payments and the FEDVIP plan allowance.
Employees can take advantage of tax savings by using flexible spending accounts for health care and dependent care expenses. With FSAFEDS, you can save up to 30% on your eligible health care, prescription, dental, vision and child or adult day care costs:
- A Health Care FSA is a pre-tax benefit account used to pay for eligible medical, dental, and vision care expenses not covered by your insurance plan or elsewhere.
- A Dependent Care FSA is used to pay for eligible dependent care services, such as preschool, summer day camp, before or after school programs and child or adult day care.
- A Limited Expense Health Care FSA is for those who are enrolled in an HSA-qualified high-deductible health plan and have a health savings account. This helps save on eligible out-of-pocket dental and vision care expenses while taking advantage of the long-term savings power of an HSA.
Why are insurance considerations important in retirement planning? Because federal employees who are eligible for immediate retirement can continue their health insurance into retirement. And like currently employed workers, they can realize savings (and enjoy more retirement income) if they make their health coverage choices wisely.