2025 FEHB and PSHB Rates Posted

[tallguy3891]

Some significant changes in my opinion. Other articles online too but here is OPM link posted online:

My overall opinion: Wow.

Will it change anybody's choice? Other comments? Will have to wait maybe a few weeks for details in the brochures to see what else has changed, if anything.

https://www.opm.gov/healthcare-insuranc ... l=Premiums

[HausaPain]

My premiums will go up 15.9%! Just a guess, but I’ll bet my COLA isn’t going to increase by 15.9%.

Mike

[THY4373]

Per a family member who is a board member on an FEHB plan he said this was coming to me a few months ago. A large driver is the GLP-1 weight loss drugs which are both very popular and very expensive. At my Federal adjacent org (we don't have FEHB) our plans are up about 10% across the board though we pay a lot less than true FEHB plans.

[tallguy3891]

Update to my initial post: As of today the info is posted at the regular OPM.gov site, look for Public Use files for 2025 and scroll through. It gives more details regarding deductibles, Rx costs, etc.

https://www.opm.gov/healthcare-insuranc ... use-files/

[tallguy3891]

My premiums will go up 15.9%! Just a guess, but I’ll bet my COLA isn’t going to increase by 15.9%.

Mike

I saw one or more plan premiums go up more than $100 per month!

My opinion is that this year (and every year!) especially is a good time for enrollees to review their plan due to possible changes because of the recent changes in regulations.

[tallguy3891]

Looks like some GEHA plans will be offering Part D Rx option in 2025?

[tj]

My premiums will go up 15.9%! Just a guess, but I’ll bet my COLA isn’t going to increase by 15.9%.

Mike

People always say stuff like this, but it's insane, your biweekly salary is drastically higher than your biweekly premiums. You don't need the salary to gup 15.9% to cover the 15.9% increase in premiums. If it's 15.9%, it probably makes sense to re-evaluate which FEHB plan is best.

[stan1]

From GovExec:
https://www.govexec.com/pay-benefits/20 ... a%20decade.

Cost drivers:

OPM and the White House on Wednesday announced that beginning next year, multiple national—and often several regional—FEHBP and PSHBP insurance carriers offer comprehensive IVF coverage to the tune of $25,000 or more. Also new in 2025 are requirements that all FEHB carriers cover at least GLP-1 class anti-obesity drug, such as Ozempic or Wegovy, for weight loss treatments, alongside two additional oral anti-obesity drugs. Carriers must also offer “comprehensive behavioral therapy,” including diet and exercise regimens, to those prescribed those drugs.

Will need to read the brochures in detail and review formularies. There are actually a lot of differences when you get into prescription benefits, formularies, chiropractic care, international benefits, etc.

What are people's best practices for working around the lack of a mail order pharmacy in BCBS Basic (non-Medicare)? Using local CVS within walking distance of house but keep hoping for something more convenient.

[nps]

My premiums will go up 15.9%! Just a guess, but I’ll bet my COLA isn’t going to increase by 15.9%.

Mike

People always say stuff like this, but it's insane, your biweekly salary is drastically higher than your biweekly premiums. You don't need the salary to gup 15.9% to cover the 15.9% increase in premiums. If it's 15.9%, it probably makes sense to re-evaluate which FEHB plan is best.

I agree. I never understand why people make these statements

[Weathering]

If I’m reading things correctly, GEHA HDHP for self+family goes up ~$300 per year. Seems manageable but hopefully does not become the norm year-after-year.

[delamer]

My premiums will go up 15.9%! Just a guess, but I’ll bet my COLA isn’t going to increase by 15.9%.

Mike

People always say stuff like this, but it's insane, your biweekly salary is drastically higher than your biweekly premiums. You don't need the salary to gup 15.9% to cover the 15.9% increase in premiums. If it's 15.9%, it probably makes sense to re-evaluate which FEHB plan is best.

I agree. I never understand why people make these statements

Same here. Unless your entire income goes to paying your health insurance premium, it’s just wrong.

(And if that’s true about your income, then it’s time to reevaluate your lifestyle. )

Looks like our premium will be up around 14%, or about $565/year. Even just looking at my pension alone, that’s an extremely small portion of it. And in the big picture of our entire income, it doesn’t even register.

But I will be interested to see if the premium increase is accompanied by a reduction in benefits also. It is always worth examining the options.

EDIT: A quick calculation — if your premium goes up $75/month, that’s $900/year. Say your 2024 expenses are $75,000/year. Then the $900 adds 1.2% to 2025 expenses. How that affects you depends on 2024 income, 2025 COLAs (or other 2025 income increases/decreases), and changes in other expenses in 2025.

[tallguy3891]

I took that post about the 15.9% premium increase versus COLA as humor.

Either way, it makes a point. A 15.9% premium increase may not be a huge deal, but if it is combined with a 15.9% increase in gas, energy, food, clothing, rent, home insurance, property taxes, etc., every year, now that could get one's attention. IF all that were to happen. And some of it did the past few years.

I for one do not assume that everyone who is on this group is wealthy. For some here, a $100, or $200, or $300 a month increase in costs could be a problem. Especially if every year. For many here, it is not.

[KellyT]

Once the 2025 benefit plan books are available, I’ll have a better idea of the increases to the plan and how that will impact me. I looked at Compass Rose, but one of my providers is not in the plan. I called MHBP to try and understand their plan, but their customer service wasn’t able to assist as the plan booklet wasn’t out and this crs was new. I got a better answer from the chat feature. I will end up staying with BCBS standard however because all of their copays are a flat fee versus 10% of plan allowance prior to meeting the deductible that I see in the other plans. I was having a hard time validating a much cheaper Premium over unknown costs that I would pay out of pocket.

[delamer]

I took that post about the 15.9% premium increase versus COLA as humor.

Either way, it makes a point. A 15.9% premium increase may not be a huge deal, but if it is combined with a 15.9% increase in gas, energy, food, clothing, rent, home insurance, property taxes, etc., every year, now that could get one's attention. IF all that were to happen. And some of it did the past few years.

I for one do not assume that everyone who is on this group is wealthy. For some here, a $100, or $200, or $300 a month increase in costs could be a problem. Especially if every year. For many here, it is not.

While I understand your general point, it needs to be said that there hasn’t been an annual increase in the total CPI of over 15% since the decade of the 1910’s. The highest number since 2000 — by a huge margin — was 8.0% in 2022. Here’s a link: https://www.minneapolisfed.org/about-us ... ndex-1913-

But the bottom line is that an additional $900/year spent on health insurance, using my example, is $900 that can’t be spent on something else or saved.

[tallguy3891]

Once the 2025 benefit plan books are available, I’ll have a better idea of the increases to the plan and how that will impact me. I looked at Compass Rose, but one of my providers is not in the plan. I called MHBP to try and understand their plan, but their customer service wasn’t able to assist as the plan booklet wasn’t out and this crs was new. I got a better answer from the chat feature. I will end up staying with BCBS standard however because all of their copays are a flat fee versus 10% of plan allowance prior to meeting the deductible that I see in the other plans. I was having a hard time validating a much cheaper Premium over unknown costs that I would pay out of pocket.

BCBS Standard as of now does not have flat copays for most treatments, but rather usually 15%. BCBS Basic does have mostly flat copays at this time. The other important mitigating factor which I look at is the catastrophic out of pocket max for the year. This, along with the premium, Rx costs, Skilled Nursing days, etc., are all worth taking a look at in my opinion. In addition, if one is on Medicare it can change the equation dramatically. Checkbook.org does a nice job of many various scenarios for the working and annuitants.

[tallguy3891]

I took that post about the 15.9% premium increase versus COLA as humor.

Either way, it makes a point. A 15.9% premium increase may not be a huge deal, but if it is combined with a 15.9% increase in gas, energy, food, clothing, rent, home insurance, property taxes, etc., every year, now that could get one's attention. IF all that were to happen. And some of it did the past few years.

I for one do not assume that everyone who is on this group is wealthy. For some here, a $100, or $200, or $300 a month increase in costs could be a problem. Especially if every year. For many here, it is not.

While I understand your general point, it needs to be said that there hasn’t been an annual increase in the total CPI of over 15% since the decade of the 1910’s. The highest number since 2000 — by a huge margin — was 8.0% in 2022. Here’s a link: https://www.minneapolisfed.org/about-us ... ndex-1913-

But the bottom line is that an additional $900/year spent on health insurance, using my example, is $900 that can’t be spent on something else or saved.

Indeed. And $1200 more spent per year on food, and $2400 more per year on rent, and $600 more per year on gas, and 25% more on car insurance, and so on. Also, I think those here understand that the CPI does not probably reflect the real inflation rate and loss of buying power.

[dukeblue219]

Looks like Carefirst HDHP family went from $215 down to $205 biweekly. Shrug.

[Dottie57]

Per a family member who is a board member on an FEHB plan he said this was coming to me a few months ago. A large driver is the GLP-1 weight loss drugs which are both very popular and very expensive. At my Federal adjacent org (we don't have FEHB) our plans are up about 10% across the board though we pay a lot less than true FEHB plans.

FYI,

GLP-1 drugs were created for diabetes type 2. They are also helpful for weight loss.

I have diabetes and use one - dulaglutide. It has been fabulous in controlling my blood glucose.

[tallguy3891]

Per a family member who is a board member on an FEHB plan he said this was coming to me a few months ago. A large driver is the GLP-1 weight loss drugs which are both very popular and very expensive. At my Federal adjacent org (we don't have FEHB) our plans are up about 10% across the board though we pay a lot less than true FEHB plans.

FYI,

GLP-1 drugs were created for diabetes type 2. They are also helpful for weight loss.

I have diabetes and use one - dulaglutide. It has been fabulous in controlling my blood glucose.

We aren't allowed to speak about health issues but from a strictly financial standpoint, I read a couple of the weight loss GLP-1 Rx are going to be included in the next round of Medicare price negotiations for 2026.

[Tdubs]

Not all premium increases have been extreme.

Been looking at UHC FEHB Medicare Advantage plans for a couple years now, and with my retirement at the end of the year, I finally have to make a decision whether to sign up for one of their base plans.

Amazingly, their plan premiums (AS3 and Y83) have hardly changed at all in price from last year. Unless there is a significant change in services, I think my decision has gotten easier.

[delamer]

I took that post about the 15.9% premium increase versus COLA as humor.

Either way, it makes a point. A 15.9% premium increase may not be a huge deal, but if it is combined with a 15.9% increase in gas, energy, food, clothing, rent, home insurance, property taxes, etc., every year, now that could get one's attention. IF all that were to happen. And some of it did the past few years.

I for one do not assume that everyone who is on this group is wealthy. For some here, a $100, or $200, or $300 a month increase in costs could be a problem. Especially if every year. For many here, it is not.

While I understand your general point, it needs to be said that there hasn’t been an annual increase in the total CPI of over 15% since the decade of the 1910’s. The highest number since 2000 — by a huge margin — was 8.0% in 2022. Here’s a link: https://www.minneapolisfed.org/about-us ... ndex-1913-

But the bottom line is that an additional $900/year spent on health insurance, using my example, is $900 that can’t be spent on something else or saved.

Indeed. And $1200 more spent per year on food, and $2400 more per year on rent, and $600 more per year on gas, and 25% more on car insurance, and so on. Also, I think those here understand that the CPI does not probably reflect the real inflation rate and loss of buying power.

You can’t count me in the group that believes that “the CPI does not probably reflect the real . . .”

I’ll agree that since every household has different items/services that they purchase, that the CPI does not capture any specific household’s inflation rate. It’s a national average, by definition and design.

[tallguy3891]

Not all premium increases have been extreme.

Been looking at UHC FEHB Medicare Advantage plans for a couple years now, and with my retirement at the end of the year, I finally have to make a decision whether to sign up for one of their base plans.

Amazingly, their plan premiums (AS3 and Y83) have hardly changed at all in price from last year. Unless there is a significant change in services, I think my decision has gotten easier.

Apparently if one opts into the Medicare Advantage option in those plans they get $150 per month (or each if couple on the MA option) as a Medicare Part B reimbursement. Most plans I have seen do not give that high of an amount as of now. That further mitigates the premium amount.

[44west]

It’s interesting that the PSHB Geha HDHP costs more than the FEHB Geha HDHP plan when the intent for breaking away from the FEHB was to save the postal service money. Not sure why this plan might be the only one that is higher.

[Jim180]

I'm in the APWU High Option self-only plan so it looks like my premium will drop $32 per month. I'll be going on Medicare in December so I'll probably get into their Medicare Advantage plan with United Healthcare.

[Tdubs]

Not all premium increases have been extreme.

Been looking at UHC FEHB Medicare Advantage plans for a couple years now, and with my retirement at the end of the year, I finally have to make a decision whether to sign up for one of their base plans.

Amazingly, their plan premiums (AS3 and Y83) have hardly changed at all in price from last year. Unless there is a significant change in services, I think my decision has gotten easier.

Apparently if one opts into the Medicare Advantage option in those plans they get $150 per month (or each if couple on the MA option) as a Medicare Part B reimbursement. Most plans I have seen do not give that high of an amount as of now. That further mitigates the premium amount.

Yes, I've not seen another one with such a generous rebate. It would mean for a +1 plan in my state that my spouse and I will pay about $400-450/mo for the policy and Medicare premiums combined. With copays waived, our retirement medical costs would be very predictable.

[AnonJohn]

If I’m reading things correctly, GEHA HDHP for self+family goes up ~$300 per year. Seems manageable but hopefully does not become the norm year-after-year.

Agree. $331.24 was what I calculated. 6.7% increase. Nothing to sneeze at, and frustrating in a lot of ways (hello, 2% COLA). But manageable. I'll also reserve a little judgment until I see what the pass through is? Unlikely to increase but one can dream!

[delamer]

Not all premium increases have been extreme.

Been looking at UHC FEHB Medicare Advantage plans for a couple years now, and with my retirement at the end of the year, I finally have to make a decision whether to sign up for one of their base plans.

Amazingly, their plan premiums (AS3 and Y83) have hardly changed at all in price from last year. Unless there is a significant change in services, I think my decision has gotten easier.

Apparently if one opts into the Medicare Advantage option in those plans they get $150 per month (or each if couple on the MA option) as a Medicare Part B reimbursement. Most plans I have seen do not give that high of an amount as of now. That further mitigates the premium amount.

Yes, I've not seen another one with such a generous rebate. It would mean for a +1 plan in my state that my spouse and I will pay about $400-450/mo for the policy and Medicare premiums combined. With copays waived, our retirement medical costs would be very predictable.

There is a lot of dissatisfaction with Medicare Advantage plans available to the general public.

While it is certainly possible that the MA plans under FEHB are a superior product, caveat emptor.

I always recommend reviewing the information in the Consumers’ Checkbook, especially when making the initial choice in retirement: https://www.checkbook.org/newhig2/hig.cfm

Our plan premium is going up over 14% in 2025 and I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

[tj]

If I’m reading things correctly, GEHA HDHP for self+family goes up ~$300 per year. Seems manageable but hopefully does not become the norm year-after-year.

Agree. $331.24 was what I calculated. 6.7% increase. Nothing to sneeze at, and frustrating in a lot of ways (hello, 2% COLA). But manageable. I'll also reserve a little judgment until I see what the pass through is? Unlikely to increase but one can dream!

It's not increasing.

[Dottie57]

Per a family member who is a board member on an FEHB plan he said this was coming to me a few months ago. A large driver is the GLP-1 weight loss drugs which are both very popular and very expensive. At my Federal adjacent org (we don't have FEHB) our plans are up about 10% across the board though we pay a lot less than true FEHB plans.

FYI,

GLP-1 drugs were created for diabetes type 2. They are also helpful for weight loss.

I have diabetes and use one - dulaglutide. It has been fabulous in controlling my blood glucose.

We aren't allowed to speak about health issues but from a strictly financial standpoint, I read a couple of the weight loss GLP-1 Rx are going to be included in the next round of Medicare price negotiations for 2026.

Sorry you are right. I just hate it when the GLP-1 agonists are referred to as weight loss drugs.

[stan1]

I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

The plan formularies are very important for anyone who must take a non-generic drug. You can look to see when it comes off-patent to see how long you'll have to wait for that. However, for some chronic conditions managed long term by prescription drugs it seems like there is always a new and improved drug that comes out right as the old one goes off-patent.

[delamer]

I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

The plan formularies are very important for anyone who must take a non-generic drug. You can look to see when it comes off-patent to see how long you'll have to wait for that. However, for some chronic conditions managed long term by prescription drugs it seems like there is always a new and improved drug that comes out right as the old one goes off-patent.

What a coincidence!

I just did a quick check, and it looks like I’ve got 7 years until mine is off patent. Thanks for the tip.

[tallguy3891]

I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

The plan formularies are very important for anyone who must take a non-generic drug. You can look to see when it comes off-patent to see how long you'll have to wait for that. However, for some chronic conditions managed long term by prescription drugs it seems like there is always a new and improved drug that comes out right as the old one goes off-patent.

What a coincidence!

I just did a quick check, and it looks like I’ve got 7 years until mine is off patent. Thanks for the tip.

Hopefully the new $2000 oop cap will help if you choose to opt-in on one of the plans which covers the Rx. My spouse had to use an expensive specialty med this year (approx $21000.00 each fill) but since we had opted into the Part D option with our plan, the max oop each time was $250 until reaching the $2000 cap (our plan already had it for 2024). As a result, the oop max was reached in May so no further cost for any Rx since then. And as you probably know, there is supposed to be an opt-in "smoothing" of the $2000 max starting 2025 to divide it by 12 if one wants to have a set monthly cost.

[delamer]

I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

The plan formularies are very important for anyone who must take a non-generic drug. You can look to see when it comes off-patent to see how long you'll have to wait for that. However, for some chronic conditions managed long term by prescription drugs it seems like there is always a new and improved drug that comes out right as the old one goes off-patent.

What a coincidence!

I just did a quick check, and it looks like I’ve got 7 years until mine is off patent. Thanks for the tip.

Hopefully the new $2000 oop cap will help if you choose to opt-in on one of the plans which covers the Rx. My spouse had to use an expensive specialty med this year (approx $21000.00 each fill) but since we had opted into the Part D option with our plan, the max oop each time was $250 until reaching the $2000 cap (our plan already had it for 2024). As a result, the oop max was reached in May so no further cost for any Rx since then. And as you probably know, there is supposed to be an opt-in "smoothing" of the $2000 max starting 2025 to divide it by 12 if one wants to have a set monthly cost.

We chose not to enroll in Part B or Part D. And we were not auto-enrolled in Part D by our FEHB plan (GEHA Standard).

So I think the above does not apply, but I admit to not being well-informed on all this.

[Tdubs]

Not all premium increases have been extreme.

Been looking at UHC FEHB Medicare Advantage plans for a couple years now, and with my retirement at the end of the year, I finally have to make a decision whether to sign up for one of their base plans.

Amazingly, their plan premiums (AS3 and Y83) have hardly changed at all in price from last year. Unless there is a significant change in services, I think my decision has gotten easier.

Apparently if one opts into the Medicare Advantage option in those plans they get $150 per month (or each if couple on the MA option) as a Medicare Part B reimbursement. Most plans I have seen do not give that high of an amount as of now. That further mitigates the premium amount.

Yes, I've not seen another one with such a generous rebate. It would mean for a +1 plan in my state that my spouse and I will pay about $400-450/mo for the policy and Medicare premiums combined. With copays waived, our retirement medical costs would be very predictable.

There is a lot of dissatisfaction with Medicare Advantage plans available to the general public.

While it is certainly possible that the MA plans under FEHB are a superior product, caveat emptor.

I always recommend reviewing the information in the Consumers’ Checkbook, especially when making the initial choice in retirement: https://www.checkbook.org/newhig2/hig.cfm

Our plan premium is going up over 14% in 2025 and I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

Agree, that's been my biggest hangup on it. I subscribe to Checkbook every year (though it hasn't really revealed problems with the plan), and when the plan information comes out, I need to review that too. Unfortunately, I don't think the part that concerns me most--preauthorization hurdles--will be obvious until I'm in the plan.

The plan's network doesn't seem to be an issue since I can go to anyone who takes Medicare. Hard to know the pitfalls until I try it.

[delamer]

Not all premium increases have been extreme.

Been looking at UHC FEHB Medicare Advantage plans for a couple years now, and with my retirement at the end of the year, I finally have to make a decision whether to sign up for one of their base plans.

Amazingly, their plan premiums (AS3 and Y83) have hardly changed at all in price from last year. Unless there is a significant change in services, I think my decision has gotten easier.

Apparently if one opts into the Medicare Advantage option in those plans they get $150 per month (or each if couple on the MA option) as a Medicare Part B reimbursement. Most plans I have seen do not give that high of an amount as of now. That further mitigates the premium amount.

Yes, I've not seen another one with such a generous rebate. It would mean for a +1 plan in my state that my spouse and I will pay about $400-450/mo for the policy and Medicare premiums combined. With copays waived, our retirement medical costs would be very predictable.

There is a lot of dissatisfaction with Medicare Advantage plans available to the general public.

While it is certainly possible that the MA plans under FEHB are a superior product, caveat emptor.

I always recommend reviewing the information in the Consumers’ Checkbook, especially when making the initial choice in retirement: https://www.checkbook.org/newhig2/hig.cfm

Our plan premium is going up over 14% in 2025 and I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

Agree, that's been my biggest hangup on it. I subscribe to Checkbook every year (though it hasn't really revealed problems with the plan), and when the plan information comes out, I need to review that too. Unfortunately, I don't think the part that concerns me most--preauthorization hurdles--will be obvious until I'm in the plan.

The plan's network doesn't seem to be an issue since I can go to anyone who takes Medicare. Hard to know the pitfalls until I try it.

In the non-FEHB world, I believe there are restrictions on getting out of Medicare Advantage and back to regular Medicare if you are unhappy with your MA plan.

I don’t know if that is true for the FEHB MA plans.

There is a lot to evaluate. Good luck with your decision; these choices are anxiety-producing.

[tj]

Apparently if one opts into the Medicare Advantage option in those plans they get $150 per month (or each if couple on the MA option) as a Medicare Part B reimbursement. Most plans I have seen do not give that high of an amount as of now. That further mitigates the premium amount.

Yes, I've not seen another one with such a generous rebate. It would mean for a +1 plan in my state that my spouse and I will pay about $400-450/mo for the policy and Medicare premiums combined. With copays waived, our retirement medical costs would be very predictable.

There is a lot of dissatisfaction with Medicare Advantage plans available to the general public.

While it is certainly possible that the MA plans under FEHB are a superior product, caveat emptor.

I always recommend reviewing the information in the Consumers’ Checkbook, especially when making the initial choice in retirement: https://www.checkbook.org/newhig2/hig.cfm

Our plan premium is going up over 14% in 2025 and I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

Agree, that's been my biggest hangup on it. I subscribe to Checkbook every year (though it hasn't really revealed problems with the plan), and when the plan information comes out, I need to review that too. Unfortunately, I don't think the part that concerns me most--preauthorization hurdles--will be obvious until I'm in the plan.

The plan's network doesn't seem to be an issue since I can go to anyone who takes Medicare. Hard to know the pitfalls until I try it.

In the non-FEHB world, I believe there are restrictions on getting out of Medicare Advantage and back to regular Medicare if you are unhappy with your MA plan.

I don’t know if that is true for the FEHB MA plans.

There is a lot to evaluate. Good luck with your decision; these choices are anxiety-producing.

^ It's not. You can change any FEHB plan any Open Season. There is a lot less risk in choosing Advantage with FEHB as it's much easier to "undo". Also the Advantage plans in FEHB are generally better than the junk sold in the individual market.

Some people still might prefer to avoid Advantage altogether though.

[JustAnotherProf]

I saw one or more plan premiums go up more than $100 per month!

My opinion is that this year (and every year!) especially is a good time for enrollees to review their plan due to possible changes because of the recent changes in regulations.

Thank you for starting this thread. I'll be one of those doing a deeper review this year. We are in the NALC family high option and seeing a $134.66 x 12 = $1615.92 annual premium increase which is 28.0%. The new premium is about 9.5% of our total regular household income, and the increase alone represents about 2.1% of our total regular household income. So the increase is not tremendous, but not trivial. That's a good Costco trip every month taken back. Our house and car insurance also went up like this. We are fortunate to have saved assets to draw on that ameliorate the impact, but when you say "Wow", OP - I hear you.

Besides hitting lower income households harder on a relative basis, I observe a couple of other things about the increases:

(1) The "Gov't Pays" amount is capped. If you sort the spreadsheet, it appears that self = $645.84, Self + One = $1408.33, and Self & Family = $1547.50 are the maximums, respectively, that the Gov't pays. I don't know if this is a new feature (the cap), but I never noticed it before. A non-negligible part of our $100+ monthly increase is because the % covered by the Feds has decreased in the capped plans.

(2) This is not a one-off thing. Sure, medical costs go up faster than CPI, but the FEHB announcement says: "Federal employees and retirees share of 2025 FEHB premiums will increase — on average — by 13.5%. This is the largest increase in a decade, following a 7.7% increase for 2024, and an 8.7% increase in 2023." A big theme in advising early retirees is looking out for those health care costs. That advice seems to be on target.

[Tdubs]

Apparently if one opts into the Medicare Advantage option in those plans they get $150 per month (or each if couple on the MA option) as a Medicare Part B reimbursement. Most plans I have seen do not give that high of an amount as of now. That further mitigates the premium amount.

Yes, I've not seen another one with such a generous rebate. It would mean for a +1 plan in my state that my spouse and I will pay about $400-450/mo for the policy and Medicare premiums combined. With copays waived, our retirement medical costs would be very predictable.

There is a lot of dissatisfaction with Medicare Advantage plans available to the general public.

While it is certainly possible that the MA plans under FEHB are a superior product, caveat emptor.

I always recommend reviewing the information in the Consumers’ Checkbook, especially when making the initial choice in retirement: https://www.checkbook.org/newhig2/hig.cfm

Our plan premium is going up over 14% in 2025 and I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

Agree, that's been my biggest hangup on it. I subscribe to Checkbook every year (though it hasn't really revealed problems with the plan), and when the plan information comes out, I need to review that too. Unfortunately, I don't think the part that concerns me most--preauthorization hurdles--will be obvious until I'm in the plan.

The plan's network doesn't seem to be an issue since I can go to anyone who takes Medicare. Hard to know the pitfalls until I try it.

In the non-FEHB world, I believe there are restrictions on getting out of Medicare Advantage and back to regular Medicare if you are unhappy with your MA plan.

I don’t know if that is true for the FEHB MA plans.

There is a lot to evaluate. Good luck with your decision; these choices are anxiety-producing.

Fortunately, FEHB allows switching in and out of its MA plans.

[tallguy3891]

I started taking a fairly expensive drug in 2024 that I’ll be on indefinitely (and probably forever). So time for us to review too.

The plan formularies are very important for anyone who must take a non-generic drug. You can look to see when it comes off-patent to see how long you'll have to wait for that. However, for some chronic conditions managed long term by prescription drugs it seems like there is always a new and improved drug that comes out right as the old one goes off-patent.

What a coincidence!

I just did a quick check, and it looks like I’ve got 7 years until mine is off patent. Thanks for the tip.

Hopefully the new $2000 oop cap will help if you choose to opt-in on one of the plans which covers the Rx. My spouse had to use an expensive specialty med this year (approx $21000.00 each fill) but since we had opted into the Part D option with our plan, the max oop each time was $250 until reaching the $2000 cap (our plan already had it for 2024). As a result, the oop max was reached in May so no further cost for any Rx since then. And as you probably know, there is supposed to be an opt-in "smoothing" of the $2000 max starting 2025 to divide it by 12 if one wants to have a set monthly cost.

We chose not to enroll in Part B or Part D. And we were not auto-enrolled in Part D by our FEHB plan (GEHA Standard).

So I think the above does not apply, but I admit to not being well-informed on all this.

From what I've seen, it looks like GEHA Standard might be offering a Part D Rx plan in 2025 to opt into or out of. Will have to see what the official brochure says coming soon. Will also have to see if one is required to be in both Parts A and B or if Part A only is allowed too. That being said, the Part D options in the FEHB plans have varied widely in their copays/coinsurance for Rx from what I have seen so that is another thing to watch for.

[delamer]

The plan formularies are very important for anyone who must take a non-generic drug. You can look to see when it comes off-patent to see how long you'll have to wait for that. However, for some chronic conditions managed long term by prescription drugs it seems like there is always a new and improved drug that comes out right as the old one goes off-patent.

What a coincidence!

I just did a quick check, and it looks like I’ve got 7 years until mine is off patent. Thanks for the tip.

Hopefully the new $2000 oop cap will help if you choose to opt-in on one of the plans which covers the Rx. My spouse had to use an expensive specialty med this year (approx $21000.00 each fill) but since we had opted into the Part D option with our plan, the max oop each time was $250 until reaching the $2000 cap (our plan already had it for 2024). As a result, the oop max was reached in May so no further cost for any Rx since then. And as you probably know, there is supposed to be an opt-in "smoothing" of the $2000 max starting 2025 to divide it by 12 if one wants to have a set monthly cost.

We chose not to enroll in Part B or Part D. And we were not auto-enrolled in Part D by our FEHB plan (GEHA Standard).

So I think the above does not apply, but I admit to not being well-informed on all this.

From what I've seen, it looks like GEHA Standard might be offering a Part D Rx plan in 2025 to opt into or out of. Will have to see what the official brochure says coming soon. Will also have to see if one is required to be in both Parts A and B or if Part A only is allowed too. That being said, the Part D options in the FEHB plans have varied widely in their copays/coinsurance for Rx from what I have seen so that is another thing to watch for.

Thanks; I’ll keep an eye on this.

[tallguy3891]

I saw one or more plan premiums go up more than $100 per month!

My opinion is that this year (and every year!) especially is a good time for enrollees to review their plan due to possible changes because of the recent changes in regulations.

Thank you for starting this thread. I'll be one of those doing a deeper review this year. We are in the NALC family high option and seeing a $134.66 x 12 = $1615.92 annual premium increase which is 28.0%. The new premium is about 9.5% of our total regular household income, and the increase alone represents about 2.1% of our total regular household income. So the increase is not tremendous, but not trivial. That's a good Costco trip every month taken back. Our house and car insurance also went up like this. We are fortunate to have saved assets to draw on that ameliorate the impact, but when you say "Wow", OP - I hear you.

Besides hitting lower income households harder on a relative basis, I observe a couple of other things about the increases:

(1) The "Gov't Pays" amount is capped. If you sort the spreadsheet, it appears that self = $645.84, Self + One = $1408.33, and Self & Family = $1547.50 are the maximums, respectively, that the Gov't pays. I don't know if this is a new feature (the cap), but I never noticed it before. A non-negligible part of our $100+ monthly increase is because the % covered by the Feds has decreased in the capped plans.

(2) This is not a one-off thing. Sure, medical costs go up faster than CPI, but the FEHB announcement says: "Federal employees and retirees share of 2025 FEHB premiums will increase — on average — by 13.5%. This is the largest increase in a decade, following a 7.7% increase for 2024, and an 8.7% increase in 2023." A big theme in advising early retirees is looking out for those health care costs. That advice seems to be on target.

I was disappointed to see NALC High increase so much for 2025. It was a backup choice for us because I consider it an excellent option, but they have priced the plan out of my interest in it. Same goes for BCBS Standard and Basic, both of which we had in the past. It would be nice if they would create some cheaper supplement plans within FEHB since it is secondary to Medicare and from what I have seen pays a very small % of bills after Part B.

[chalet]

The plan's network doesn't seem to be an issue since I can go to anyone who takes Medicare.

Is it anyone who takes medicare ........ AND ...... agrees to accept your insurance?

just an example, from GEHA: "You can see any out-of-network doctor or health care provider that participates in Medicare and accepts the plan. "

https://retiree.uhc.com/geha/find-a-provider

[Tdubs]

The plan's network doesn't seem to be an issue since I can go to anyone who takes Medicare.

Is it anyone who takes medicare ........ AND ...... agrees to accept your insurance?

just an example, from GEHA: "You can see any out-of-network doctor or health care provider that participates in Medicare and accepts the plan. "

https://retiree.uhc.com/geha/find-a-provider

UHC has interesting language on that issue. "Flexibility to see any provider—in-network or out-of-network—at the same cost share, as long as they accept Medicare and are willing to bill UnitedHealthcare."

I wondered, what provider wouldn't bill UHC? My spouse has one essential provider who is out of network. While I knew they take Medicare, I asked them if they would bill UHC. They were just very confused about why I was even asking them the question. It took a long time before I got someone who, after I read them UHC language, finally said "yes."

For our other local providers, it looks like they are (at least in 2024) in network.

[tallguy3891]

The plan's network doesn't seem to be an issue since I can go to anyone who takes Medicare.

Is it anyone who takes medicare ........ AND ...... agrees to accept your insurance?

just an example, from GEHA: "You can see any out-of-network doctor or health care provider that participates in Medicare and accepts the plan. "

https://retiree.uhc.com/geha/find-a-provider

UHC has interesting language on that issue. "Flexibility to see any provider—in-network or out-of-network—at the same cost share, as long as they accept Medicare and are willing to bill UnitedHealthcare."

I wondered, what provider wouldn't bill UHC? My spouse has one essential provider who is out of network. While I knew they take Medicare, I asked them if they would bill UHC. They were just very confused about why I was even asking them the question. It took a long time before I got someone who, after I read them UHC language, finally said "yes."

For our other local providers, it looks like they are (at least in 2024) in network.

There are now quite a few FEHB plans offering Advantage (MA) plans, a nice perk being the Medicare Reimbursement, but some regular plans do this too. Several of the MA plans do not show our providers as being "in-network" so I pursued them no further as my spouse uses a lot of healthcare and I did not want to be wondering all the time if there was going to be a coverage issue, even though the plans stated one could see any provider who accepts Medicare and who is willing to treat. However, the UHC MA plans I looked at do at this time have all our providers in-network so I was interested in the GEHA Standard MA option.

However, our current plan currently (Aetna Direct) will be a lower premium for 2025, also has Medicare Reimbursement, great Rx coverage with the Part D option, and since we are still considered "Original" Parts A and B with the FEHB plan as secondary, can see almost any provider almost anywhere.

[Tdubs]

The plan's network doesn't seem to be an issue since I can go to anyone who takes Medicare.

Is it anyone who takes medicare ........ AND ...... agrees to accept your insurance?

just an example, from GEHA: "You can see any out-of-network doctor or health care provider that participates in Medicare and accepts the plan. "

https://retiree.uhc.com/geha/find-a-provider

UHC has interesting language on that issue. "Flexibility to see any provider—in-network or out-of-network—at the same cost share, as long as they accept Medicare and are willing to bill UnitedHealthcare."

I wondered, what provider wouldn't bill UHC? My spouse has one essential provider who is out of network. While I knew they take Medicare, I asked them if they would bill UHC. They were just very confused about why I was even asking them the question. It took a long time before I got someone who, after I read them UHC language, finally said "yes."

For our other local providers, it looks like they are (at least in 2024) in network.

There are now quite a few FEHB plans offering Advantage (MA) plans, a nice perk being the Medicare Reimbursement, but some regular plans do this too. Several of the MA plans do not show our providers as being "in-network" so I pursued them no further as my spouse uses a lot of healthcare and I did not want to be wondering all the time if there was going to be a coverage issue, even though the plans stated one could see any provider who accepts Medicare and who is willing to treat. However, the UHC MA plans I looked at do at this time have all our providers in-network so I was interested in the GEHA Standard MA option.

However, our current plan currently (Aetna Direct) will be a lower premium for 2025, also has Medicare Reimbursement, great Rx coverage with the Part D option, and since we are still considered "Original" Parts A and B with the FEHB plan as secondary, can see almost any provider almost anywhere.

So you steered clear of Aetna's Advantage Plan?

[HoneyBee]

tallguy3891:
"Same goes for BCBS Standard and Basic, both of which we had in the past. It would be nice if they would create some cheaper supplement plans within FEHB since it is secondary to Medicare and from what I have seen pays a very small % of bills after Part B."

Agree 100%. I have had Medicare and BCBS Basic for three years now. I had a few outpatient procedures, but mostly routine medical care and preventative care. No expensive medications. The vast majority of the expenses are paid by Medicare and BCBS just covers the deductible and the coinsurance, after the huge write down. So BCBS has paid very little in 3 years. While I appreciate the $800 annual reimbursement for the Medicare premium, I wonder if it is worth paying for both Medicare and FEHB.

And my Medicare premium is going to increase by one or two IRMAA tiers for 2025 because of the capital gains I realized on a property sale in 2023. I thought about dropping Medicare for one year but then will be hit with the 10% lifetime penalty.
[Waiting for IRMAA tiers to be released later this month.]

[tj]

[Waiting for IRMAA tiers to be released later this month.]

https://thefinancebuff.com/medicare-irm ... ckets.html

[tallguy3891]

The plan's network doesn't seem to be an issue since I can go to anyone who takes Medicare.

Is it anyone who takes medicare ........ AND ...... agrees to accept your insurance?

just an example, from GEHA: "You can see any out-of-network doctor or health care provider that participates in Medicare and accepts the plan. "

https://retiree.uhc.com/geha/find-a-provider

UHC has interesting language on that issue. "Flexibility to see any provider—in-network or out-of-network—at the same cost share, as long as they accept Medicare and are willing to bill UnitedHealthcare."

I wondered, what provider wouldn't bill UHC? My spouse has one essential provider who is out of network. While I knew they take Medicare, I asked them if they would bill UHC. They were just very confused about why I was even asking them the question. It took a long time before I got someone who, after I read them UHC language, finally said "yes."

For our other local providers, it looks like they are (at least in 2024) in network.

There are now quite a few FEHB plans offering Advantage (MA) plans, a nice perk being the Medicare Reimbursement, but some regular plans do this too. Several of the MA plans do not show our providers as being "in-network" so I pursued them no further as my spouse uses a lot of healthcare and I did not want to be wondering all the time if there was going to be a coverage issue, even though the plans stated one could see any provider who accepts Medicare and who is willing to treat. However, the UHC MA plans I looked at do at this time have all our providers in-network so I was interested in the GEHA Standard MA option.

However, our current plan currently (Aetna Direct) will be a lower premium for 2025 (for self+one anyway), also has Medicare Reimbursement, great Rx coverage with the Part D option, and since we are still considered "Original" Parts A and B with the FEHB plan as secondary, can see almost any provider almost anywhere.

So you steered clear of Aetna's Advantage Plan?

In my opinion the plan looks great, the premium is amazing and actually is lower in 2025 (self+ one anyway), and the HRA is great, but yes, I couldn't risk the network issue in our situation. Maybe I don't understand how it truly works, but I wasn't comfortable with it. In other locations perhaps it would be more fitting?

[tallguy3891]

tallguy3891:
"Same goes for BCBS Standard and Basic, both of which we had in the past. It would be nice if they would create some cheaper supplement plans within FEHB since it is secondary to Medicare and from what I have seen pays a very small % of bills after Part B."

Agree 100%. I have had Medicare and BCBS Basic for three years now. I had a few outpatient procedures, but mostly routine medical care and preventative care. No expensive medications. The vast majority of the expenses are paid by Medicare and BCBS just covers the deductible and the coinsurance, after the huge write down. So BCBS has paid very little in 3 years. While I appreciate the $800 annual reimbursement for the Medicare premium, I wonder if it is worth paying for both Medicare and FEHB.

And my Medicare premium is going to increase by one or two IRMAA tiers for 2025 because of the capital gains I realized on a property sale in 2023. I thought about dropping Medicare for one year but then will be hit with the 10% lifetime penalty.
[Waiting for IRMAA tiers to be released later this month.]

Have you looked at BCBS Focus as a secondary to Medicare? I've been wondering about it and now with the Part D option cap of $2000 beginning 2025 it looks like an option for us. However, like Basic, as of now it does not offer extra Skilled Nursing days. I personally would not use it if I still had a non-Medicare spouse or children on my plan though. Just my opinion.

[tallguy3891]

I noticed on the BCBS FEHB site they already have the Rx 2025 formularies for all 3 plans online.

They also have 2025 changes for Basic plan copays, etc.