Which FEHB Plan Did You Choose And Why?

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tallguy3891
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Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

Just wondering if I'm missing anything regarding choices these days due to relatively recent changes, and also thought it might be helpful to FEHB people newer to the group.

Some examples of why could be: the premium amount, providers, works well with Medicare, use it without Medicare Part B, for the specific Rx coverage, just kept it because had it while working, for overseas coverage, went the Advantage route, etc.

Personal? Yes, I'm on FEHB
Actionable? Yes, could have an effect on my future choice(s) for FEHB.
stan1
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Re: Which FEHB Plan Did You Choose And Why?

Post by stan1 »

I continue on BCBS Standard for several reasons specific to my medical needs (mostly formulary related but a few other things).
I am retired but not on Medicare which is probably an important consideration.
Not able to offer much advice for people on Medicare (yet) as I won't be on Medicare for a few more years.
Nuestroro
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Re: Which FEHB Plan Did You Choose And Why?

Post by Nuestroro »

NALC CDHP. Wife’s employer has a generous plan through Aetna that covers our needs. My employer contributes $80/pp on top of the standard subsidy. So the CDHP is basically a way to capture that in a HRA. Also nice NALC uses Cigna. I’ve had some doctors take Cigna but not other insurers.
cowbman
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Re: Which FEHB Plan Did You Choose And Why?

Post by cowbman »

I'm not retired, so I'm utilizing GEHA HDHP. However, there are numerous discussions on the this topic. If you think you will be impacted by IRMAA for years or decades, these folks tend to say no to Part B, and use something like NALC High, which has a low OOP and reasonable costs. If you don't expect to be impacted by IRMAA for more than a few years, the landscape has changed considerably for FEHB MA plans. I would spend the $12 on Consumers Checkbook.
Last edited by cowbman on Sun Jun 09, 2024 3:57 pm, edited 1 time in total.
HIinvestor
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Re: Which FEHB Plan Did You Choose And Why?

Post by HIinvestor »

We chose the bcbs program that most providers in our home state are familiar, which is based in our state. I like the ability to go to their offices and speak with someone in person when we have coverage challenges. We have the high family option and have had it for over 50 years. We are very happy with it and have been able to see participating & preferred providers all over US.
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

GEHA HDHP since I started 5.5 years ago. I take a look at the other plans every open season, but I've never seen a reason to change.
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tallguy3891
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

cowbman wrote: Sun Jun 09, 2024 3:14 pm I'm not retired, so I'm utilizing GEHA HDHP. However, there are numerous discussions on the this topic. If you think you will be impacted by IRMAA for years or decades, these folks tend to say no to Part B, and use something like NALC High, which has a low OOP and reasonable costs. If you don't expect to be impacted by IRMAA for more than a few years, the landscape has changed considerably for FEHB MA plans. I would spend the $12 on Consumers Checkbook.
Interestingly, when I plugged in info (location, age, healthcare usage) into Consumers' Checkbook as to which FEHB plan to use WITHOUT Medicare Part B, it listed GEHA HDHP as #1. I would have never guessed that, have never heard of anyone doing so, and am still trying to figure out the details as to why. My opinions about choice of plans with Part A only would have been NALC High, MHBP Standard, GEHA Standard, BCBS Basic.
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

tallguy3891 wrote: Sun Jun 09, 2024 6:00 pm
cowbman wrote: Sun Jun 09, 2024 3:14 pm I'm not retired, so I'm utilizing GEHA HDHP. However, there are numerous discussions on the this topic. If you think you will be impacted by IRMAA for years or decades, these folks tend to say no to Part B, and use something like NALC High, which has a low OOP and reasonable costs. If you don't expect to be impacted by IRMAA for more than a few years, the landscape has changed considerably for FEHB MA plans. I would spend the $12 on Consumers Checkbook.
Interestingly, when I plugged in info (location, age, healthcare usage) into Consumers' Checkbook as to which FEHB plan to use WITHOUT Medicare Part B, it listed GEHA HDHP as #1. I would have never guessed that, have never heard of anyone doing so, and am still trying to figure out the details as to why. My opinions about choice of plans with Part A only would have been NALC High, MHBP Standard, GEHA Standard, BCBS Basic.
makes sense to me. For the same reason GEHA HDHP tends to make a lot of sense for people who are not old enough for medicare...
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LonePrairie
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Re: Which FEHB Plan Did You Choose And Why?

Post by LonePrairie »

I'm retired, with original Medicare A and B. I have GEHA dental insurance and GEHA standard health. I'm not sure the dental insurance is worth it, but I'm satisfied with the health insurance and how it coordinates with Medicare and covers prescriptions so I don't have to have Medicare Part D. I am impacted by IRMAA and will be forever.
jaMichael
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Re: Which FEHB Plan Did You Choose And Why?

Post by jaMichael »

Interesting. I never thought about staying with GEHA HDHP after retirement until reading the above posts. Do you continue to make HSA contributions during retirement? Does it make sense to do so? I hadn’t realized that there is no earned income requirement for HSAs as there is for IRAs.
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Re: Which FEHB Plan Did You Choose And Why?

Post by cowbman »

I wonder if the tool is correctly considering that with Medicare it is now an HRA and not an HSA. I guess from a tax standpoint it's not that different, but I MUCH prefer HSAs to HRAs.
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

jaMichael wrote: Sun Jun 09, 2024 6:16 pm Interesting. I never thought about staying with GEHA HDHP after retirement until reading the above posts. Do you continue to make HSA contributions during retirement? Does it make sense to do so? I hadn’t realized that there is no earned income requirement for HSAs as there is for IRAs.
You'd get an HRA instead of an HRA if you take Medicare Part A, which presumably you'd want to take.

Most people take Medicare B, so the idea of taking HDHP post-65 probably doesn't get discussed much.
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tallguy3891
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

jaMichael wrote: Sun Jun 09, 2024 6:16 pm Interesting. I never thought about staying with GEHA HDHP after retirement until reading the above posts. Do you continue to make HSA contributions during retirement? Does it make sense to do so? I hadn’t realized that there is no earned income requirement for HSAs as there is for IRAs.
I think once one is on Medicare, contributions to an HSA are no longer allowed? However, one can still use the $$ in the HSA as per regs.

Once on Medicare, some FEHB plans offer a set HRA amount, but one cannot contribute to it, some of which are quite generous in my opinion.
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Re: Which FEHB Plan Did You Choose And Why?

Post by grabiner »

cowbman wrote: Sun Jun 09, 2024 3:14 pm I'm not retired, so I'm utilizing GEHA HDHP. However, there are numerous discussions on the this topic. If you think you will be impacted by IRMAA for years or decades, these folks tend to say no to Part B, and use something like NALC High, which has a low OOP and reasonable costs. If you don't expect to be impacted by IRMAA for more than a few years, the landscape has changed considerably for FEHB MA plans. I would spend the $12 on Consumers Checkbook.
Note that if you are not yet taking Medicare, Consumer's Checkbook underestimates the benefits of HDHPs. It counts the plan's contribution to your HSA as free money, but ignores the value of your own HSA contribution. If you contribute to your HSA rather than an equal dollar amount to your traditional TSP, you get the benefit of tax-free growth, which is a 22% gain if you retire at a 22% marginal tax rate. If you contribute to your HSA rather than an equal out-of-pocket amount to your Roth TSP or Roth IRA, you have more money growing tax-free, since the Roth contribution would be taxed.

You do not quite get a gain on the full benefit of the HSA contribution, since you could contribute more to an FSA if you use a conventional plan. But the HSA limit is more than the FSA limit, and the FSA is use-or-lose with a small rollover, so you cannot contribute the maximum to an FSA unless you expect enough in medical bills to cover it. In addition, you can use a Limited Expense FSA with the HDHPs, covering dental and vision costs; if you need new glasses every year or know that you will be having dental work, you get some of the FSA benefit even with an HDHP.
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tallguy3891
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

tj wrote: Sun Jun 09, 2024 6:06 pm
tallguy3891 wrote: Sun Jun 09, 2024 6:00 pm
cowbman wrote: Sun Jun 09, 2024 3:14 pm I'm not retired, so I'm utilizing GEHA HDHP. However, there are numerous discussions on the this topic. If you think you will be impacted by IRMAA for years or decades, these folks tend to say no to Part B, and use something like NALC High, which has a low OOP and reasonable costs. If you don't expect to be impacted by IRMAA for more than a few years, the landscape has changed considerably for FEHB MA plans. I would spend the $12 on Consumers Checkbook.
Interestingly, when I plugged in info (location, age, healthcare usage) into Consumers' Checkbook as to which FEHB plan to use WITHOUT Medicare Part B, it listed GEHA HDHP as #1. I would have never guessed that, have never heard of anyone doing so, and am still trying to figure out the details as to why. My opinions about choice of plans with Part A only would have been NALC High, MHBP Standard, GEHA Standard, BCBS Basic.
makes sense to me. For the same reason GEHA HDHP tends to make a lot of sense for people who are not old enough for medicare...
I don't have experience with a HDHP, but in this case I suspect it is ranked #1 in part due to the low 5% coinsurance on many services? This appears much lower than the usual 10%-30% I see on other FEHB plans. This seems difficult to know, since it is 5% of what? Each plan negotiates their "plan allowance" so how would someone know whether that plan's 5%, 10%, or 30% is more or less than another FEHB plan?

However, the premium for GEHA HDHP isn't that low in my opinion, so I'm wondering how it works out when one has to still use up the HRA first, then have a $3200 deductible (as of 2024) for a self+one?
Last edited by tallguy3891 on Sun Jun 09, 2024 7:04 pm, edited 1 time in total.
cowbman
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Re: Which FEHB Plan Did You Choose And Why?

Post by cowbman »

Interesting. I max out everything I can get my hands on, with exception of FSAs. I miss the Mega backdoor Roth IRA. Given federal salaries, there probably isn't a huge push for TSP to offer this. A 457 plan would be nice though.
Last edited by cowbman on Mon Jun 10, 2024 10:33 am, edited 1 time in total.
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

grabiner wrote: Sun Jun 09, 2024 6:52 pm
cowbman wrote: Sun Jun 09, 2024 3:14 pm I'm not retired, so I'm utilizing GEHA HDHP. However, there are numerous discussions on the this topic. If you think you will be impacted by IRMAA for years or decades, these folks tend to say no to Part B, and use something like NALC High, which has a low OOP and reasonable costs. If you don't expect to be impacted by IRMAA for more than a few years, the landscape has changed considerably for FEHB MA plans. I would spend the $12 on Consumers Checkbook.
Note that if you are not yet taking Medicare, Consumer's Checkbook underestimates the benefits of HDHPs. It counts the plan's contribution to your HSA as free money, but ignores the value of your own HSA contribution. If you contribute to your HSA rather than an equal dollar amount to your traditional TSP, you get the benefit of tax-free growth, which is a 22% gain if you retire at a 22% marginal tax rate. If you contribute to your HSA rather than an equal out-of-pocket amount to your Roth TSP or Roth IRA, you have more money growing tax-free, since the Roth contribution would be taxed.

You do not quite get a gain on the full benefit of the HSA contribution, since you could contribute more to an FSA if you use a conventional plan. But the HSA limit is more than the FSA limit, and the FSA is use-or-lose with a small rollover, so you cannot contribute the maximum to an FSA unless you expect enough in medical bills to cover it. In addition, you can use a Limited Expense FSA with the HDHPs, covering dental and vision costs; if you need new glasses every year or know that you will be having dental work, you get some of the FSA benefit even with an HDHP.
I definitely see the value of a HDHP from the financial advantage while working, with a HSA growing, and if one is a low user of healthcare. It is being ranked #1 (here locally anyway) when older and only on Part A Medicare which I'm not so clear about.
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Re: Which FEHB Plan Did You Choose And Why?

Post by cowbman »

tallguy3891 wrote: Sun Jun 09, 2024 6:55 pm
tj wrote: Sun Jun 09, 2024 6:06 pm
tallguy3891 wrote: Sun Jun 09, 2024 6:00 pm
cowbman wrote: Sun Jun 09, 2024 3:14 pm I'm not retired, so I'm utilizing GEHA HDHP. However, there are numerous discussions on the this topic. If you think you will be impacted by IRMAA for years or decades, these folks tend to say no to Part B, and use something like NALC High, which has a low OOP and reasonable costs. If you don't expect to be impacted by IRMAA for more than a few years, the landscape has changed considerably for FEHB MA plans. I would spend the $12 on Consumers Checkbook.
Interestingly, when I plugged in info (location, age, healthcare usage) into Consumers' Checkbook as to which FEHB plan to use WITHOUT Medicare Part B, it listed GEHA HDHP as #1. I would have never guessed that, have never heard of anyone doing so, and am still trying to figure out the details as to why. My opinions about choice of plans with Part A only would have been NALC High, MHBP Standard, GEHA Standard, BCBS Basic.
makes sense to me. For the same reason GEHA HDHP tends to make a lot of sense for people who are not old enough for medicare...
I don't have experience with a HDHP, but in this case I suspect it is ranked #1 in part due to the low 5% coinsurance on many services? This appears much lower than the usual 10%-30% I see on other FEHB plans. This seems difficult to know, since it is 5% of what? Each plan negotiates their "plan allowance" so how would someone know whether that plan's 5%, 10%, or 30% is more or less than another FEHB plan?

However, the premium for GEHA HDHP isn't that low in my opinion, so I'm wondering how it works out when one has to still use up the HRA first, then have a $3200 deductible for a self+one?
The premium isn't that low, but the HSA benefits when maxed out bring the deductible effectively down to $0 if you are 22% or higher. The dental benefits are pretty strong too. Rx benefits aren't the best, so consider that...
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

Perhaps if one had a substantial HSA of $100K, then it could be a good deal to use a plan (with Part A and with or without Part B) like BCBS Focus, which has a very low--in my opinion--premium, or maybe a plan like MHBP HDHP which would, as of this time, still be giving a HRA of $2400 per year for self+one to pad the large HSA? So many FEHB options to work with.
Last edited by tallguy3891 on Sun Jun 09, 2024 8:06 pm, edited 1 time in total.
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

tallguy3891 wrote: Sun Jun 09, 2024 6:55 pm
tj wrote: Sun Jun 09, 2024 6:06 pm
tallguy3891 wrote: Sun Jun 09, 2024 6:00 pm
cowbman wrote: Sun Jun 09, 2024 3:14 pm I'm not retired, so I'm utilizing GEHA HDHP. However, there are numerous discussions on the this topic. If you think you will be impacted by IRMAA for years or decades, these folks tend to say no to Part B, and use something like NALC High, which has a low OOP and reasonable costs. If you don't expect to be impacted by IRMAA for more than a few years, the landscape has changed considerably for FEHB MA plans. I would spend the $12 on Consumers Checkbook.
Interestingly, when I plugged in info (location, age, healthcare usage) into Consumers' Checkbook as to which FEHB plan to use WITHOUT Medicare Part B, it listed GEHA HDHP as #1. I would have never guessed that, have never heard of anyone doing so, and am still trying to figure out the details as to why. My opinions about choice of plans with Part A only would have been NALC High, MHBP Standard, GEHA Standard, BCBS Basic.
makes sense to me. For the same reason GEHA HDHP tends to make a lot of sense for people who are not old enough for medicare...
I don't have experience with a HDHP, but in this case I suspect it is ranked #1 in part due to the low 5% coinsurance on many services? This appears much lower than the usual 10%-30% I see on other FEHB plans. This seems difficult to know, since it is 5% of what? Each plan negotiates their "plan allowance" so how would someone know whether that plan's 5%, 10%, or 30% is more or less than another FEHB plan?

However, the premium for GEHA HDHP isn't that low in my opinion, so I'm wondering how it works out when one has to still use up the HRA first, then have a $3200 deductible (as of 2024) for a self+one?
The low coinsurance but also the pass through which offsets most of the deductible, plus the included preventative dental and vision insurance.


The negotiated rate for procedures with GEHA HDHP, Standard and High should all be the same.

Also the HRA rolls over a certain amount, it's not like it is use or lose.
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Re: Which FEHB Plan Did You Choose And Why?

Post by rich126 »

In retirement (under 65) I still keep BCBS Standard. Maybe out of laziness. Each time I've worked for the government I just select it. I just assume it gives me the largest selection of doctors but I don't know if that is true. I think it is likely true back in Maryland but out west (AZ) it might not be true.
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Re: Which FEHB Plan Did You Choose And Why?

Post by pahkcah »

My wife and I are both retired Federal employees. Once we no longer had a need to cover our children, we switched to individual plans. We were both using FEHB BCBS Standard Option until Medicare kicked in. We stayed with BCBS but switched to BCBS Basic when Medicare became our prime coverage and FEHB became our secondary coverage. This year, BCBS Basic provides a reimbursement of $800 to each of us that helps pay for our Medicare Part B premiums. This is not the least expensive option, but it provides health care that best supports our needs. In our area, every doctor we looked at who accepts Medicare is in-network for BCBS Basic. No need for Part D for us, as the prescription coverage under our FEHB plan is better than using Part D. Due to our CSRS pensions, we will always be subject to some level of IRMAA.

We could change plans and potentially save some money, but peace of mind knowing we have pretty much total coverage for all our medical needs is worth the cost. Our only out of pocket costs besides the premiums are for prescription co-pays. I've had multiple surgeries, extensive diagnostic procedures (including CT scans, MRIs, and ultrasounds), and a lot of physical therapy, but haven't paid a penny out of pocket.
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Re: Which FEHB Plan Did You Choose And Why?

Post by RJC »

GEHA HDHP and am still in the accumulation phase. Is it still the best HDHP option for Feds?
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

RJC wrote: Sun Jun 09, 2024 7:41 pm GEHA HDHP and am still in the accumulation phase. Is it still the best HDHP option for Feds?
Yes.
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Re: Which FEHB Plan Did You Choose And Why?

Post by delamer »

LonePrairie wrote: Sun Jun 09, 2024 6:14 pm I'm retired, with original Medicare A and B. I have GEHA dental insurance and GEHA standard health. I'm not sure the dental insurance is worth it, but I'm satisfied with the health insurance and how it coordinates with Medicare and covers prescriptions so I don't have to have Medicare Part D. I am impacted by IRMAA and will be forever.
We are retired with GEHA Standard, but no Part B. Obviously, we signed up for Part A. Also in IRMAA territory.

It’s been inexpensive but good quality coverage. Claims processing always has been problem-free.

We’re prepared financially to add Part B should one of us develop a condition that makes it necessary. I think I ran into one provider who didn’t accept GEHA Standard, so I went elsewhere.

I’m mistrustful of the Medicare Advantage plans. Maybe those offered under FEHB are better than those available to the general public, but I’m staying away for now based on what I’ve read.
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Re: Which FEHB Plan Did You Choose And Why?

Post by mbres60 »

@tallguy3891 aren't you on Aetna Direct? Are you thinking of switching for next year? We are on Aetna Direct and have no problem. This year we are subject to IRMAA and will probably be for the foreseeable future. We don't want the FEHB advantage plans because I found out that Part D prescription plans will make one of our prescriptions have to be approved every year. Ah, no thank you. We don't need that kind of oversight when the main plans don't do that. This drug has been prescribed to one of us since the late 90's so not changing what works now.

As for paying for Part B with IRMAA, probably not the best financial move but we can afford it and it is easy because of the HRA (and because my former employer gave me a health fund that will run out next year) so far I have never had to pay for Part B. Spouse had the fund too but his ran out so he is now relying on the HRA.
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Re: Which FEHB Plan Did You Choose And Why?

Post by 44west »

I have been enrolled in both the Aetna and Geha HDHP plans from the very beginning of their existence in the FEHB program. In my opinion based on the lower premiums, HSA tax savings contributions , lower or equal to other plans maximum out of pocket expenses, 5% copay after deductible, dental cleanings, eye exams and limited eye glasses every 2 years plus a 250.00 health/ wellness account that required very little work on my part to accomplish to be a no brainer for us. Yes we have had years where we had high medical bills and went over our deductible but we only paid a 5% copay. In my state GEHA used the Aetna network of doctors and this year switched to United Healthcare giving us excellent options. Between the 2 HSA accounts we have well over a $100,000.
This is the year we both turn 65 and my intent was to sign up for Medicare part A and not Medicare part B. If we took Medicare part B costs would exceed $4,000 per year for the 2 of us, our plan alone contributes $2000 to an HRA with a $ 3200 deductible so we need only $1200 more to meet our deductible should we need to. I’m undecided as to what we will do with Part B now that the Postal Service is coming up with their own health program.
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Re: Which FEHB Plan Did You Choose And Why?

Post by Claudia Whitten »

pahkcah wrote: Sun Jun 09, 2024 7:32 pm My wife and I are both retired Federal employees. Once we no longer had a need to cover our children, we switched to individual plans. We were both using FEHB BCBS Standard Option until Medicare kicked in. We stayed with BCBS but switched to BCBS Basic when Medicare became our prime coverage and FEHB became our secondary coverage. This year, BCBS Basic provides a reimbursement of $800 to each of us that helps pay for our Medicare Part B premiums. This is not the least expensive option, but it provides health care that best supports our needs. In our area, every doctor we looked at who accepts Medicare is in-network for BCBS Basic. No need for Part D for us, as the prescription coverage under our FEHB plan is better than using Part D. Due to our CSRS pensions, we will always be subject to some level of IRMAA.
Why do so many people choose FEHB BCBS Basic when Medicare kicks in? That's the option that I hear most often. Have you compared other options/plans and decided that BCBS is best?

And how about Part C with this combo?
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

Claudia Whitten wrote: Mon Jun 10, 2024 9:23 am
pahkcah wrote: Sun Jun 09, 2024 7:32 pm My wife and I are both retired Federal employees. Once we no longer had a need to cover our children, we switched to individual plans. We were both using FEHB BCBS Standard Option until Medicare kicked in. We stayed with BCBS but switched to BCBS Basic when Medicare became our prime coverage and FEHB became our secondary coverage. This year, BCBS Basic provides a reimbursement of $800 to each of us that helps pay for our Medicare Part B premiums. This is not the least expensive option, but it provides health care that best supports our needs. In our area, every doctor we looked at who accepts Medicare is in-network for BCBS Basic. No need for Part D for us, as the prescription coverage under our FEHB plan is better than using Part D. Due to our CSRS pensions, we will always be subject to some level of IRMAA.
Why do so many people choose FEHB BCBS Basic when Medicare kicks in? That's the option that I hear most often. Have you compared other options/plans and decided that BCBS is best?

And how about Part C with this combo?
There is no Part C with that combo...

The risk of the Part B and BCBS Basic combo is that BCBS will cover absolutely nothing if you do to a provider that is not in their network and not in Medicare. A lot of people don't seem to care about that risk, though.
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Re: Which FEHB Plan Did You Choose And Why?

Post by ChrisC »

While working and a few years into retirement, we were on AETNA HDHP. I changed to GEHA HDHP as the coverage was better for a surgical procedure that Aetna viewed as experimental but was covered by GEHA. I continued on GEHA HDHP, self plus 1, as my wife went on Medicare A & B (so I could still make HSA contributions for a family plan plus my catch-up). When I went on Medicare Part A (and decided not to take Part B) two years after my wife enrolled in original Medicare, I switched to GEHA Standard, plus 1. We've been at IRMAA, tier 3, with my CSRS pension, my wife's modest county pension, her SS and my WEP-reduced SS. We generally do Roth conversions up to the 24% tax bracket. With capital gains from the sale of investment real estate last year, we landed in the 35% tax bracket last year and we'll likely be in IRMAA, tier 4 for 2025.

Up until this year, if I had been enrolled in Medicare Part B my Medicare Part B premiums would have far exceeded out-of-pocket medical expenses not covered by FEHB insurance -- and we have been seriously considering dropping Part B coverage for my wife. (Since my wife has been enrolled in Part B, we've paid around $35K in Part B premiums and her out-of pocket expenses not covered by GEHA HDHP or GEHA Standard were probably around $2K the last eight years.) Unfortunately, this year I ran into serious medical issues and I've reached the GEHA out-of-pocket maximum limit of $6500, which is $1300 more than I would have paid for premiums under Medicare Part B, which would have likely covered all of the out-of-pocket expenses I incurred under GEHA standard. If my treatment is successful, I don't expect next year to have significant out-of-pocket expenses under GEHA standard, though I'll be looking to see if I might be better served by a high-option FEHB plan. Next year, IRMAA for us will likely be $5800 for my wife's Part B coverage. Our HSAs cover all our out-of pocket expenses (including insurance premiums post 65 years old) but they will soon be exhausted in a few years after nearly $180K in eligible expenses incurred over the years from 2008 to present.
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Re: Which FEHB Plan Did You Choose And Why?

Post by ChrisC »

Claudia Whitten wrote: Mon Jun 10, 2024 9:23 am
pahkcah wrote: Sun Jun 09, 2024 7:32 pm My wife and I are both retired Federal employees. Once we no longer had a need to cover our children, we switched to individual plans. We were both using FEHB BCBS Standard Option until Medicare kicked in. We stayed with BCBS but switched to BCBS Basic when Medicare became our prime coverage and FEHB became our secondary coverage. This year, BCBS Basic provides a reimbursement of $800 to each of us that helps pay for our Medicare Part B premiums. This is not the least expensive option, but it provides health care that best supports our needs. In our area, every doctor we looked at who accepts Medicare is in-network for BCBS Basic. No need for Part D for us, as the prescription coverage under our FEHB plan is better than using Part D. Due to our CSRS pensions, we will always be subject to some level of IRMAA.
Why do so many people choose FEHB BCBS Basic when Medicare kicks in? That's the option that I hear most often. Have you compared other options/plans and decided that BCBS is best?

And how about Part C with this combo?
Because it's cost-effective, provides for some Medicare Part B reimbursement, has good prescription drug coverage (especially with the Medicare Part D add-on) and fabulous coverage, in tandem with Part B, if you can stay in network! We manage my BIL's medical care and finances, and he's been in assisted living since 2017. He has MS and thus far BCBS has covered all his expensive medical treatments, including durable medical equipment.

What Part C are you talking about? Are you referring to FEHB Medicare Advantage Plans or regular ones offered in general?
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pahkcah
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Re: Which FEHB Plan Did You Choose And Why?

Post by pahkcah »

Claudia Whitten wrote: Mon Jun 10, 2024 9:23 am
pahkcah wrote: Sun Jun 09, 2024 7:32 pm My wife and I are both retired Federal employees. Once we no longer had a need to cover our children, we switched to individual plans. We were both using FEHB BCBS Standard Option until Medicare kicked in. We stayed with BCBS but switched to BCBS Basic when Medicare became our prime coverage and FEHB became our secondary coverage. This year, BCBS Basic provides a reimbursement of $800 to each of us that helps pay for our Medicare Part B premiums. This is not the least expensive option, but it provides health care that best supports our needs. In our area, every doctor we looked at who accepts Medicare is in-network for BCBS Basic. No need for Part D for us, as the prescription coverage under our FEHB plan is better than using Part D. Due to our CSRS pensions, we will always be subject to some level of IRMAA.
Why do so many people choose FEHB BCBS Basic when Medicare kicks in? That's the option that I hear most often. Have you compared other options/plans and decided that BCBS is best?

And how about Part C with this combo?
As far as BCBS versus other FEHB plans, we have been with BCBS for decades. Never had a single issue finding doctors, never an issue being approved for any procedures, not one single piece of documentation to deal with, and never any issues with billing. For us, it's like choosing a car, where we are willing to pay more for reliability. We'd rather have a Toyota product (none of our Toyota or Lexus vehicles ever had any mechanical issues) than one from a manufacturer who sells a less reliable product at a lower cost. We know we could save money choosing some of the other FEHB plans, but this is an area where we aren't willing (and don't need) to skimp.

I'm not saying it wouldn't have happened with another FEHB plan, but I needed major foot surgery a year ago. Within a week, I was able to see a Mass General foot surgeon who is one of the best in the world, and shortly thereafter had surgery performed by this surgeon. We paid nothing, not a single penny for the up-front diagnostic procedures, the surgery, office visits, and subsequent physical therapy. Same thing happened for recent emergency surgery to remove my gallbladder, including emergency room visits and a lot of diagnostic testing.

We changed from Standard to Basic because we learned that all of the doctors we encountered who accepted Medicare were in-network for Basic. Medicare covers 80% of costs and BCBS covers the remaining 20%. The reimbursement covers basically 4 months of the standard cost of Medicare Part B for each of us, which helps a bit.

I haven't really looked in Advantage plans, but there have been a number of Boglehead posts concerning Medicare and FEHB, including this one where some of the comments discuss FEHB Advantage plans: viewtopic.php?t=430585

The good news is that if anyone chooses a plan and decides to change, they can do so during the next open season.
stan1
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Re: Which FEHB Plan Did You Choose And Why?

Post by stan1 »

Recently retired, not on Medicare. I've stayed with BCBS for several reasons, but one is also that in 30 years they have covered everything and never given me a hassle. In maybe five cases over the years where there was a data error or billing error on the part of the medical biller, every time they have resolved it in my favor with one phone call. One time the provider put the wrong code on a pre-authorization request and BCBS told them basically "you get one chance on that, this one's on you".

Formularies are very easy to find these days. It may not be a factor for many of you, but I have a specific name brand drug that works best for me that is on the BCBS formulary but not on GEHA. BCBS Basic does not have a mail order pharmacy for non-Medicare members which is a bit of a hassle.
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tallguy3891
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

mbres60 wrote: Mon Jun 10, 2024 8:13 am @tallguy3891 aren't you on Aetna Direct? Are you thinking of switching for next year? We are on Aetna Direct and have no problem. This year we are subject to IRMAA and will probably be for the foreseeable future. We don't want the FEHB advantage plans because I found out that Part D prescription plans will make one of our prescriptions have to be approved every year. Ah, no thank you. We don't need that kind of oversight when the main plans don't do that. This drug has been prescribed to one of us since the late 90's so not changing what works now.

As for paying for Part B with IRMAA, probably not the best financial move but we can afford it and it is easy because of the HRA (and because my former employer gave me a health fund that will run out next year) so far I have never had to pay for Part B. Spouse had the fund too but his ran out so he is now relying on the HRA.
Yes, Aetna Direct. With new Part D Rx option. Works better for us than BCBS Std and Basic did, more Skilled Nursing Facility days, lower premium, lower Rx costs to us, higher HRA for reimbursement, and because of the $2000 cap on the Part D Rx, my spouse has zero cost for meds the rest of this year.

This is why I started this thread. Wondered if I was missing something, but I don't see it.
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tallguy3891
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

44west wrote: Mon Jun 10, 2024 8:30 am I have been enrolled in both the Aetna and Geha HDHP plans from the very beginning of their existence in the FEHB program. In my opinion based on the lower premiums, HSA tax savings contributions , lower or equal to other plans maximum out of pocket expenses, 5% copay after deductible, dental cleanings, eye exams and limited eye glasses every 2 years plus a 250.00 health/ wellness account that required very little work on my part to accomplish to be a no brainer for us. Yes we have had years where we had high medical bills and went over our deductible but we only paid a 5% copay. In my state GEHA used the Aetna network of doctors and this year switched to United Healthcare giving us excellent options. Between the 2 HSA accounts we have well over a $100,000.
This is the year we both turn 65 and my intent was to sign up for Medicare part A and not Medicare part B. If we took Medicare part B costs would exceed $4,000 per year for the 2 of us, our plan alone contributes $2000 to an HRA with a $ 3200 deductible so we need only $1200 more to meet our deductible should we need to. I’m undecided as to what we will do with Part B now that the Postal Service is coming up with their own health program.
Can you give some examples of how much you had to pay out of pocket with the 5% coinsurance? Seems like a small amount.
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

tallguy3891 wrote: Mon Jun 10, 2024 10:39 am
44west wrote: Mon Jun 10, 2024 8:30 am I have been enrolled in both the Aetna and Geha HDHP plans from the very beginning of their existence in the FEHB program. In my opinion based on the lower premiums, HSA tax savings contributions , lower or equal to other plans maximum out of pocket expenses, 5% copay after deductible, dental cleanings, eye exams and limited eye glasses every 2 years plus a 250.00 health/ wellness account that required very little work on my part to accomplish to be a no brainer for us. Yes we have had years where we had high medical bills and went over our deductible but we only paid a 5% copay. In my state GEHA used the Aetna network of doctors and this year switched to United Healthcare giving us excellent options. Between the 2 HSA accounts we have well over a $100,000.
This is the year we both turn 65 and my intent was to sign up for Medicare part A and not Medicare part B. If we took Medicare part B costs would exceed $4,000 per year for the 2 of us, our plan alone contributes $2000 to an HRA with a $ 3200 deductible so we need only $1200 more to meet our deductible should we need to. I’m undecided as to what we will do with Part B now that the Postal Service is coming up with their own health program.
Can you give some examples of how much you had to pay out of pocket with the 5% coinsurance? Seems like a small amount.
When I surpassed my $1500 deductible, stuff was very very cheap.

Occupational therapy Billed amount $687 - negotiated rate $322, 5% - $16

Doctors appointment billed $207 Negotiated rate $127 5% - $6

I'm assuming the negotated rates are the same for GEHA Standard, but you would be paying the flat co-pays, which are higher.
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tallguy3891
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

tj wrote: Mon Jun 10, 2024 10:47 am
tallguy3891 wrote: Mon Jun 10, 2024 10:39 am
44west wrote: Mon Jun 10, 2024 8:30 am I have been enrolled in both the Aetna and Geha HDHP plans from the very beginning of their existence in the FEHB program. In my opinion based on the lower premiums, HSA tax savings contributions , lower or equal to other plans maximum out of pocket expenses, 5% copay after deductible, dental cleanings, eye exams and limited eye glasses every 2 years plus a 250.00 health/ wellness account that required very little work on my part to accomplish to be a no brainer for us. Yes we have had years where we had high medical bills and went over our deductible but we only paid a 5% copay. In my state GEHA used the Aetna network of doctors and this year switched to United Healthcare giving us excellent options. Between the 2 HSA accounts we have well over a $100,000.
This is the year we both turn 65 and my intent was to sign up for Medicare part A and not Medicare part B. If we took Medicare part B costs would exceed $4,000 per year for the 2 of us, our plan alone contributes $2000 to an HRA with a $ 3200 deductible so we need only $1200 more to meet our deductible should we need to. I’m undecided as to what we will do with Part B now that the Postal Service is coming up with their own health program.
Can you give some examples of how much you had to pay out of pocket with the 5% coinsurance? Seems like a small amount.
When I surpassed my $1500 deductible, stuff was very very cheap.

Occupational therapy Billed amount $687 - negotiated rate $322, 5% - $16

Doctors appointment billed $207 Negotiated rate $127 5% - $6

I'm assuming the negotated rates are the same for GEHA Standard, but you would be paying the flat co-pays, which are higher.
Thanks for the info. Am I correct in understanding that the $1000 per person HRA for retirees would automatically be applied to the first bills owed (or does one pay it and have to request to be reimbursed)? THEN, one has to pay the (currently) remaining $600 of the $1600 deductible out of pocket, then when the deductible is satisfied one pays the 5%?
BattyNatty
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Re: Which FEHB Plan Did You Choose And Why?

Post by BattyNatty »

My family has been covered by Kaiser through FEHB for about six years now and we love it. Having one place to go with every problem and never a need to find a new practice or deal with billing issues is wonderful. We definitely think we take better care of ourselves because of how easy it is to get care—and that when we previously had a high deductible plan we found ourselves delaying or minimizing care to save money we have.

Obviously dependent on location, but if you’re somewhere where they have a good presence I highly recommend it.
44west
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Re: Which FEHB Plan Did You Choose And Why?

Post by 44west »

tallguy3891 wrote: ↑Mon Jun 10, 2024 3:39 pm
44west wrote: ↑Mon Jun 10, 2024 1:30 pm
I have been enrolled in both the Aetna and Geha HDHP plans from the very beginning of their existence in the FEHB program. In my opinion based on the lower premiums, HSA tax savings contributions , lower or equal to other plans maximum out of pocket expenses, 5% copay after deductible, dental cleanings, eye exams and limited eye glasses every 2 years plus a 250.00 health/ wellness account that required very little work on my part to accomplish to be a no brainer for us. Yes we have had years where we had high medical bills and went over our deductible but we only paid a 5% copay. In my state GEHA used the Aetna network of doctors and this year switched to United Healthcare giving us excellent options. Between the 2 HSA accounts we have well over a $100,000.
This is the year we both turn 65 and my intent was to sign up for Medicare part A and not Medicare part B. If we took Medicare part B costs would exceed $4,000 per year for the 2 of us, our plan alone contributes $2000 to an HRA with a $ 3200 deductible so we need only $1200 more to meet our deductible should we need to. I’m undecided as to what we will do with Part B now that the Postal Service is coming up with their own health program.
Can you give some examples of how much you had to pay out of pocket with the 5% coinsurance? Seems like a small amount.
When I surpassed my $1500 deductible, stuff was very very cheap.

Occupational therapy Billed amount $687 - negotiated rate $322, 5% - $16

Doctors appointment billed $207 Negotiated rate $127 5% - $6

I'm assuming the negotated rates are the same for GEHA Standard, but you would be paying the flat co-pays, which are higher.


That is correct. My example. Lab reports on a biopsy after deductible
Billed 1875.00 Allowed amount 1465.78 Geha paid 1392.50 I owed 73.28
tj
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

tallguy3891 wrote: Mon Jun 10, 2024 12:26 pm
tj wrote: Mon Jun 10, 2024 10:47 am
tallguy3891 wrote: Mon Jun 10, 2024 10:39 am
44west wrote: Mon Jun 10, 2024 8:30 am I have been enrolled in both the Aetna and Geha HDHP plans from the very beginning of their existence in the FEHB program. In my opinion based on the lower premiums, HSA tax savings contributions , lower or equal to other plans maximum out of pocket expenses, 5% copay after deductible, dental cleanings, eye exams and limited eye glasses every 2 years plus a 250.00 health/ wellness account that required very little work on my part to accomplish to be a no brainer for us. Yes we have had years where we had high medical bills and went over our deductible but we only paid a 5% copay. In my state GEHA used the Aetna network of doctors and this year switched to United Healthcare giving us excellent options. Between the 2 HSA accounts we have well over a $100,000.
This is the year we both turn 65 and my intent was to sign up for Medicare part A and not Medicare part B. If we took Medicare part B costs would exceed $4,000 per year for the 2 of us, our plan alone contributes $2000 to an HRA with a $ 3200 deductible so we need only $1200 more to meet our deductible should we need to. I’m undecided as to what we will do with Part B now that the Postal Service is coming up with their own health program.
Can you give some examples of how much you had to pay out of pocket with the 5% coinsurance? Seems like a small amount.
When I surpassed my $1500 deductible, stuff was very very cheap.

Occupational therapy Billed amount $687 - negotiated rate $322, 5% - $16

Doctors appointment billed $207 Negotiated rate $127 5% - $6

I'm assuming the negotated rates are the same for GEHA Standard, but you would be paying the flat co-pays, which are higher.
Thanks for the info. Am I correct in understanding that the $1000 per person HRA for retirees would automatically be applied to the first bills owed (or does one pay it and have to request to be reimbursed)? THEN, one has to pay the (currently) remaining $600 of the $1600 deductible out of pocket, then when the deductible is satisfied one pays the 5%?
I have no idea if the HRA is automatic or if one submit requests for reimbursement for each claim.
44west
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Re: Which FEHB Plan Did You Choose And Why?

Post by 44west »

Thanks for the info. Am I correct in understanding that the $1000 per person HRA for retirees would automatically be applied to the first bills owed (or does one pay it and have to request to be reimbursed)? THEN, one has to pay the (currently) remaining $600 of the $1600 deductible out of pocket, then when the deductible is satisfied one pays the 5%?

When you start the HRA ( mine in Feb.) they put 2000.00 family into your account. When the medical provider submits the bill GEHA pays them direct. My 2000.00 HRA was prorated because January they funded my HSA for that month. The unused 2000.00 HRA rolls into the following year providing you stay with them.
Once you use up the 2000.00 HRA you pay full negotiate prices until you meet the 3200.00 family deductible, so 1200.00. After that it’s 5% of negotiated billing.
keystone
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Re: Which FEHB Plan Did You Choose And Why?

Post by keystone »

cowbman wrote: Sun Jun 09, 2024 7:02 pm
tallguy3891 wrote: Sun Jun 09, 2024 6:55 pm
tj wrote: Sun Jun 09, 2024 6:06 pm
tallguy3891 wrote: Sun Jun 09, 2024 6:00 pm
cowbman wrote: Sun Jun 09, 2024 3:14 pm I'm not retired, so I'm utilizing GEHA HDHP. However, there are numerous discussions on the this topic. If you think you will be impacted by IRMAA for years or decades, these folks tend to say no to Part B, and use something like NALC High, which has a low OOP and reasonable costs. If you don't expect to be impacted by IRMAA for more than a few years, the landscape has changed considerably for FEHB MA plans. I would spend the $12 on Consumers Checkbook.
Interestingly, when I plugged in info (location, age, healthcare usage) into Consumers' Checkbook as to which FEHB plan to use WITHOUT Medicare Part B, it listed GEHA HDHP as #1. I would have never guessed that, have never heard of anyone doing so, and am still trying to figure out the details as to why. My opinions about choice of plans with Part A only would have been NALC High, MHBP Standard, GEHA Standard, BCBS Basic.
makes sense to me. For the same reason GEHA HDHP tends to make a lot of sense for people who are not old enough for medicare...
I don't have experience with a HDHP, but in this case I suspect it is ranked #1 in part due to the low 5% coinsurance on many services? This appears much lower than the usual 10%-30% I see on other FEHB plans. This seems difficult to know, since it is 5% of what? Each plan negotiates their "plan allowance" so how would someone know whether that plan's 5%, 10%, or 30% is more or less than another FEHB plan?

However, the premium for GEHA HDHP isn't that low in my opinion, so I'm wondering how it works out when one has to still use up the HRA first, then have a $3200 deductible for a self+one?
The premium isn't that low, but the HSA benefits when maxed out bring the deductible effectively down to $0 if you are 22% or higher. The dental benefits are pretty strong too. Rx benefits aren't the best, so consider that...
And for someone with pretty low maintenance vision needs, the vision benefit is pretty good covering a chunk of the exam and frame/lense replacement.

My family has been on GEHA HDHP for about 7 years now and I think it's a great option. I would just caution anyone to take a second look if they anticipate any out of network expenses, since GEHA treats the out of network deductible as separate from the in network (ie out of network expenses do not count towards in network and vice versa).
44west
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Re: Which FEHB Plan Did You Choose And Why?

Post by 44west »

the dental not only gives you 2 free cleanings and x-rays but you also only pay the Geha negotiated price on other dental work if needed.
tj
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

44west wrote: Mon Jun 10, 2024 2:44 pm the dental not only gives you 2 free cleanings and x-rays but you also only pay the Geha negotiated price on other dental work if needed.
Yep - it also throws some cash at your fillings and pays for 2x fluoride.
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tallguy3891
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

44west wrote: Mon Jun 10, 2024 1:00 pm Thanks for the info. Am I correct in understanding that the $1000 per person HRA for retirees would automatically be applied to the first bills owed (or does one pay it and have to request to be reimbursed)? THEN, one has to pay the (currently) remaining $600 of the $1600 deductible out of pocket, then when the deductible is satisfied one pays the 5%?

When you start the HRA ( mine in Feb.) they put 2000.00 family into your account. When the medical provider submits the bill GEHA pays them direct. My 2000.00 HRA was prorated because January they funded my HSA for that month. The unused 2000.00 HRA rolls into the following year providing you stay with them.
Once you use up the 2000.00 HRA you pay full negotiate prices until you meet the 3200.00 family deductible, so 1200.00. After that it’s 5% of negotiated billing.
I can see where it would be an option for some people. The concern I would have with it if not enrolled in Part B would be the same concern I check into with any FEHB plan without also having Part B; that is, "hospital observation care"-- when not officially admitted to a hospital, but they keep a person for a few days. In that case my understanding is the Medicare allowance limits do not apply and the hospital charges what they charge. I have no way to know how much, nor what the plan allowance of any particular FEHB plan would be (?), but I do seem to remember I have seen bills for my spouse for tens of thousands of dollars per day. I would not want to have to pay 5%, or 15%, or 30% of that amount multiple times a year.

That leads me to believe, in our situation, that I would have to assume paying the catastrophic max out of pocket every year. Why would I risk that when I can enroll in Part B, have total wraparound with my FEHB plan, pay zero out of pocket per year, and the current cost for Part B premiums is about one third less for the both of us than just the catastrophic out of pocket for a HDHP for one of us?

So, to me, a HDHP sounds maybe ok for a younger person, still an employee, but using it with Part A only seems risky to me at a retiree age. If anyone reads carefully what I have just said they might understand why I was surprised by Consumers' Checkbook recommending GEHA HDHP as #1 without Part B (but with Part A only) in our area for our situation. If anyone can clarify it for me I would appreciate it.
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Re: Which FEHB Plan Did You Choose And Why?

Post by tj »

tallguy3891 wrote: Mon Jun 10, 2024 3:16 pm
44west wrote: Mon Jun 10, 2024 1:00 pm Thanks for the info. Am I correct in understanding that the $1000 per person HRA for retirees would automatically be applied to the first bills owed (or does one pay it and have to request to be reimbursed)? THEN, one has to pay the (currently) remaining $600 of the $1600 deductible out of pocket, then when the deductible is satisfied one pays the 5%?

When you start the HRA ( mine in Feb.) they put 2000.00 family into your account. When the medical provider submits the bill GEHA pays them direct. My 2000.00 HRA was prorated because January they funded my HSA for that month. The unused 2000.00 HRA rolls into the following year providing you stay with them.
Once you use up the 2000.00 HRA you pay full negotiate prices until you meet the 3200.00 family deductible, so 1200.00. After that it’s 5% of negotiated billing.
I can see where it would be an option for some people. The concern I would have with it if not enrolled in Part B would be the same concern I check into with any FEHB plan without also having Part B; that is, "hospital observation care"-- when not officially admitted to a hospital, but they keep a person for a few days. In that case my understanding is the Medicare allowance limits do not apply and the hospital charges what they charge. I have no way to know how much, nor what the plan allowance of any particular FEHB plan would be (?), but I do seem to remember I have seen bills for my spouse for tens of thousands of dollars per day. I would not want to have to pay 5%, or 15%, or 30% of that amount multiple times a year.

That leads me to believe, in our situation, that I would have to assume paying the catastrophic max out of pocket every year. Why would I risk that when I can enroll in Part B, have total wraparound with my FEHB plan, pay zero out of pocket per year, and the current cost for Part B premiums is about one third less for the both of us than just the catastrophic out of pocket for a HDHP for one of us?

So, to me, a HDHP sounds maybe ok for a younger person, still an employee, but using it with Part A only seems risky to me at a retiree age. If anyone reads carefully what I have just said they might understand why I was surprised by Consumers' Checkbook recommending GEHA HDHP as #1 without Part B (but with Part A only) in our area for our situation. If anyone can clarify it for me I would appreciate it.

Some people get hit with massive IRMAA such that paying the deductible + coinsurance is going to be cheaper than paying Part B + IRMAA.
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MillennialFinance19
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Re: Which FEHB Plan Did You Choose And Why?

Post by MillennialFinance19 »

GEHA HDHP. By retirement, we should have $250k saved in an HSA which gives great flexibility. Enjoying the lower premiums vs. BCBS also.
VTI and chill until 57...
ChrisC
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Re: Which FEHB Plan Did You Choose And Why?

Post by ChrisC »

tj wrote: Mon Jun 10, 2024 3:24 pm
tallguy3891 wrote: Mon Jun 10, 2024 3:16 pm
44west wrote: Mon Jun 10, 2024 1:00 pm Thanks for the info. Am I correct in understanding that the $1000 per person HRA for retirees would automatically be applied to the first bills owed (or does one pay it and have to request to be reimbursed)? THEN, one has to pay the (currently) remaining $600 of the $1600 deductible out of pocket, then when the deductible is satisfied one pays the 5%?

When you start the HRA ( mine in Feb.) they put 2000.00 family into your account. When the medical provider submits the bill GEHA pays them direct. My 2000.00 HRA was prorated because January they funded my HSA for that month. The unused 2000.00 HRA rolls into the following year providing you stay with them.
Once you use up the 2000.00 HRA you pay full negotiate prices until you meet the 3200.00 family deductible, so 1200.00. After that it’s 5% of negotiated billing.
I can see where it would be an option for some people. The concern I would have with it if not enrolled in Part B would be the same concern I check into with any FEHB plan without also having Part B; that is, "hospital observation care"-- when not officially admitted to a hospital, but they keep a person for a few days. In that case my understanding is the Medicare allowance limits do not apply and the hospital charges what they charge. I have no way to know how much, nor what the plan allowance of any particular FEHB plan would be (?), but I do seem to remember I have seen bills for my spouse for tens of thousands of dollars per day. I would not want to have to pay 5%, or 15%, or 30% of that amount multiple times a year.

That leads me to believe, in our situation, that I would have to assume paying the catastrophic max out of pocket every year. Why would I risk that when I can enroll in Part B, have total wraparound with my FEHB plan, pay zero out of pocket per year, and the current cost for Part B premiums is about one third less for the both of us than just the catastrophic out of pocket for a HDHP for one of us?

So, to me, a HDHP sounds maybe ok for a younger person, still an employee, but using it with Part A only seems risky to me at a retiree age. If anyone reads carefully what I have just said they might understand why I was surprised by Consumers' Checkbook recommending GEHA HDHP as #1 without Part B (but with Part A only) in our area for our situation. If anyone can clarify it for me I would appreciate it.

Some people get hit with massive IRMAA such that paying the deductible + coinsurance is going to be cheaper than paying Part B + IRMAA.
Raises hand. Last 8 years, wife's Part B + IRMAA exceeds any deductible and coinsurance (out-of-pocket) that would have been covered solely by almost any FEHB plan, by a huge factor. I'm not enrolled in Part B so don't have Part B and IRMAA charges -- for this year I hit the catastrophic limit under GEHA standard, plus 1, of $6500 on May 2nd, which is the first time out of 6 years on Medicare (just Part A) that my out-of pocket costs exceeded the amount I would have paid for Part B and IRMAA.

I agree it's risky to use an HDHP with only Part A -- I didn't do it and I thought the coverage under GEHA standard, plus 1, was significantly better than the coverage I previously had under GEHA- HDHP for me with only Part A and for my wife with Part A and B.
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tallguy3891
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

tj wrote: Mon Jun 10, 2024 3:24 pm
tallguy3891 wrote: Mon Jun 10, 2024 3:16 pm
44west wrote: Mon Jun 10, 2024 1:00 pm Thanks for the info. Am I correct in understanding that the $1000 per person HRA for retirees would automatically be applied to the first bills owed (or does one pay it and have to request to be reimbursed)? THEN, one has to pay the (currently) remaining $600 of the $1600 deductible out of pocket, then when the deductible is satisfied one pays the 5%?

When you start the HRA ( mine in Feb.) they put 2000.00 family into your account. When the medical provider submits the bill GEHA pays them direct. My 2000.00 HRA was prorated because January they funded my HSA for that month. The unused 2000.00 HRA rolls into the following year providing you stay with them.
Once you use up the 2000.00 HRA you pay full negotiate prices until you meet the 3200.00 family deductible, so 1200.00. After that it’s 5% of negotiated billing.
I can see where it would be an option for some people. The concern I would have with it if not enrolled in Part B would be the same concern I check into with any FEHB plan without also having Part B; that is, "hospital observation care"-- when not officially admitted to a hospital, but they keep a person for a few days. In that case my understanding is the Medicare allowance limits do not apply and the hospital charges what they charge. I have no way to know how much, nor what the plan allowance of any particular FEHB plan would be (?), but I do seem to remember I have seen bills for my spouse for tens of thousands of dollars per day. I would not want to have to pay 5%, or 15%, or 30% of that amount multiple times a year.

That leads me to believe, in our situation, that I would have to assume paying the catastrophic max out of pocket every year. Why would I risk that when I can enroll in Part B, have total wraparound with my FEHB plan, pay zero out of pocket per year, and the current cost for Part B premiums is about one third less for the both of us than just the catastrophic out of pocket for a HDHP for one of us?

So, to me, a HDHP sounds maybe ok for a younger person, still an employee, but using it with Part A only seems risky to me at a retiree age. If anyone reads carefully what I have just said they might understand why I was surprised by Consumers' Checkbook recommending GEHA HDHP as #1 without Part B (but with Part A only) in our area for our situation. If anyone can clarify it for me I would appreciate it.

Some people get hit with massive IRMAA such that paying the deductible + coinsurance is going to be cheaper than paying Part B + IRMAA.
Excellent point.
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tallguy3891
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Re: Which FEHB Plan Did You Choose And Why?

Post by tallguy3891 »

MillennialFinance19 wrote: Mon Jun 10, 2024 3:31 pm GEHA HDHP. By retirement, we should have $250k saved in an HSA which gives great flexibility. Enjoying the lower premiums vs. BCBS also.
Good point, and also could have Part B as well and thus zero out of pocket with the right FEHB plan, and then reimburse oneself from the HSA for Part B premiums and Rx costs, thus having no healthcare costs, or next to none, ever? Or of course, no Part B and just reimburse for costs as needed.
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