FEHB Blue Cross Basic vs. Blue Focus

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JerryB
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FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Thu Nov 29, 2018 6:19 pm

I almost missed seeing the new option in my Blue Cross literature. I use Basic Self Plus One and have been satisfied mainly since our medical care is limited to annual check ups (fingers crossed). Blue Focus will cost about $1,400 less in annual premiums (less the new $600 Medicare Part B Reimbursement). The annual maximum would increase by $2,000 to $13,000 with Blue Focus. All our providers are in network and that would not change with Blue Focus. Coverages for various services would change, but it is not clear by how much as Blue Focus uses a 30% of their Allowance for major services like hospital, doctor. I am an annuitant.

Seems like a no brainer to switch unless I am missing something. Has anyone looked at this new option?

retiredjg
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by retiredjg » Thu Nov 29, 2018 6:25 pm

I don't know the answer, but It might be helpful to know if BC is your primary provider or secondary to Medicare. I guess (not sure) this depends on whether you are still working or not.

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JerryB
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Thu Nov 29, 2018 6:31 pm

retiredjg wrote:
Thu Nov 29, 2018 6:25 pm
I don't know the answer, but It might be helpful to know if BC is your primary provider or secondary to Medicare. I guess (not sure) this depends on whether you are still working or not.
Yes, BC is secondary to Medicare for myself, not my wife. Not working.

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HueyLD
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by HueyLD » Thu Nov 29, 2018 6:43 pm

https://media.fepblue.org/-/media/PDFs/ ... e_Book.pdf

I think the major difference is in prescription drug coverage especially for the more expensive tiers 3,4 and 5. The link provides very good side by side comparison.

Also, if you have two people on Medicare, you can get $1,200 reimbursement from BCBS and that will reduce the difference in premiums to about $200.

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JerryB
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Sat Dec 01, 2018 8:27 am

With only one of us on Medicare B, the premium savings of $1,400 on Blue Focus exceeds the $600 reimbursement under Basic.

stan1
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by stan1 » Sat Dec 01, 2018 9:29 am

HueyLD wrote:
Thu Nov 29, 2018 6:43 pm

I think the major difference is in prescription drug coverage especially for the more expensive tiers 3,4 and 5. The link provides very good side by side comparison.
Right, if you have prescriptions you need to look at the Blue Focus formulary closely. Blue Focus has a very different formulary than Basic.

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JerryB
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Sat Dec 01, 2018 11:00 am

stan1 wrote:
Sat Dec 01, 2018 9:29 am
HueyLD wrote:
Thu Nov 29, 2018 6:43 pm

I think the major difference is in prescription drug coverage especially for the more expensive tiers 3,4 and 5. The link provides very good side by side comparison.
Right, if you have prescriptions you need to look at the Blue Focus formulary closely. Blue Focus has a very different formulary than Basic.
Definitely. Fortunately I only take a generic statin that is cheaper than candy.

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HueyLD
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by HueyLD » Sat Dec 01, 2018 12:35 pm

If your wife is not on Medicare, you need to also review this plan summary for those under the age of 65:

https://media.fepblue.org/-/media/PDFs/ ... ryBook.pdf

There are quite a few other changes including higher copays, higher deductibles, fewer allowed visits for certain treatments, no dental coverage, etc.

There is no free lunch, as they say. I think the new Blue Focus targets younger folks who rarely need medical attention.

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JerryB
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Sat Dec 01, 2018 1:36 pm

Thanks. They have so many brochures, there is Benefits at a Glance, Summary Book, and finally the detailed benefits books.

https://media.fepblue.org/-/media/PDFs/ ... ochure.pdf

https://media.fepblue.org/-/media/PDFs/ ... ochure.pdf

Yooper16
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by Yooper16 » Sun Dec 02, 2018 9:55 am

We were/are in a similar spot for Medicare and FEHB as far as eligibility for Medicare B signup.

Don't know about the Blues, but Aetna Direct and Rural Letter Carriers(who we presently have) are no deductiblbe, copays or co-insurance (except drugs) if you also have part B and in network and provider excepts assignment. Is Focus that way?

Our original thought was to "risk" the much higher deductible on Aetna Direct until June as we both are pretty healthy. Direct provides a $900 per year per person fund and is about $35 per month less on premiums but has a significantly higher deductible and copays for the non-Medicare period. Aetna Direct premium for self plus 1 is $305 vs $338(?) for Rural Carriers.

We have decided to either stick with Rural Carriers for the full year and switch to Direct for 2020 or consider using the QLE to change in June.

FYI-- for reasons Aetna can't explain most of their policies are listed as HMOs on the OPM website. They are not HMOs, so give it look.

tj
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by tj » Sun Dec 02, 2018 10:08 am

Take a look at mhbp consumer driven as well, they waive all the copays, deductibles with Medicare and give $1200 per person HRA which can be used for the Medicare premiums

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JerryB
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Mon Dec 03, 2018 11:47 am

Blue Focus does not include the $2,500 hearing aid benefit that is included in Basic.

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HueyLD
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by HueyLD » Mon Dec 03, 2018 1:16 pm

JerryB wrote:
Mon Dec 03, 2018 11:47 am
Blue Focus does not include the $2,500 hearing aid benefit that is included in Basic.
There you go. The devil is in the detail.

I did scan the Blue Focus brochure (the legal contract) and concluded that it is designed for younger folks who do not use much health care benefits.

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JerryB
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Mon Dec 03, 2018 1:23 pm

HueyLD wrote:
Mon Dec 03, 2018 1:16 pm
JerryB wrote:
Mon Dec 03, 2018 11:47 am
Blue Focus does not include the $2,500 hearing aid benefit that is included in Basic.
There you go. The devil is in the detail.

I did scan the Blue Focus brochure (the legal contract) and concluded that it is designed for younger folks who do not use much health care benefits.
I like to think of ourselves as older folks that don't use much health care benefits :)
But I might need that hearing aid next time.

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HueyLD
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by HueyLD » Mon Dec 03, 2018 1:30 pm

Yes siree, Jerry. You may be an iron man who participates in triathlon, but I have seen more than a few older folks who were healthy but went downhill fast by one illness.

Good luck to you as good health is the best wealth.

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JerryB
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Mon Dec 10, 2018 10:13 am

Last day of open season, so I switched to Blue Focus. Catastrophic loss limit goes up by $2,000 so I will take the bet. I'll give a report in a year.

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Nestegg_User
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by Nestegg_User » Mon Dec 10, 2018 3:50 pm

JerryB wrote:
Sat Dec 01, 2018 11:00 am
stan1 wrote:
Sat Dec 01, 2018 9:29 am
HueyLD wrote:
Thu Nov 29, 2018 6:43 pm

I think the major difference is in prescription drug coverage especially for the more expensive tiers 3,4 and 5. The link provides very good side by side comparison.
Right, if you have prescriptions you need to look at the Blue Focus formulary closely. Blue Focus has a very different formulary than Basic.
Definitely. Fortunately I only take a generic statin that is cheaper than candy.
you might even check if it’s cheaper without the insurance; enough antibiotics and other type drugs are sold (almost like loss leaders) by wally world and the like.
I’ve also seen that enough times that the store pickup is actually cheaper than the mail delivery (and there’s differences between Rx’s enough times, as well)... check on your meds

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JerryB
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Thu Jun 27, 2019 7:58 am

Followup: My plan to switch to Blue Focus based on our good health backfired. DW had unexpected minor surgery and a 3 day hospital stay. All providers were in network. Sticker price was about $40,000. Blue paid about $13,000, I paid about $6000. 30% of very low allowances add up fast.

retiredjg
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by retiredjg » Thu Jun 27, 2019 8:28 am

Did Medicare Part A pay for the rest?

I have not used Medicare Part A and am unclear on how much it covers. Would it be correct that if you had stayed on BC Basic the bill would have been near $0 for you and your wife to pay? Or maybe that is something you don't know until it happens?

It's always a gamble, isn't it? :(

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JerryB
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by JerryB » Thu Jun 27, 2019 8:48 am

Under Basic, we might have paid 1 or 2 thousand, but it is hard to figure exactly. It would have been fine if I had gotten sick since I have Medicare, but DW does not.

retiredjg
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by retiredjg » Thu Jun 27, 2019 9:22 am

JerryB wrote:
Thu Jun 27, 2019 8:48 am
Under Basic, we might have paid 1 or 2 thousand, but it is hard to figure exactly. It would have been fine if I had gotten sick since I have Medicare, but DW does not.
Oh. Forgot that DW was not yet on Medicare. That does make a difference!

mrc
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Re: FEHB Blue Cross Basic vs. Blue Focus

Post by mrc » Thu Jun 27, 2019 11:03 am

JerryB wrote:
Thu Jun 27, 2019 8:48 am
Under Basic, we might have paid 1 or 2 thousand, but it is hard to figure exactly. It would have been fine if I had gotten sick since I have Medicare, but DW does not.
Probably closer to $1K. Our share of a liver surgery with 2 nights in hospital ran ~$750. The hospital submitted chargers were $36K. We paid the hospital $350, the surgeon $200, the anesthesiologist $0, labs $0. The remainder was for GP and specilist CoPays getting past the entire thing. We think BASIC is the best thing since sliced bread.
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