New Federal employee ... Choosing Healthcare

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inthearena
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New Federal employee ... Choosing Healthcare

Post by inthearena » Wed Jun 12, 2019 7:54 am

I'm converting to a gov't civilian in the coming weeks and am starting to dive into the benefits. There seem to be an incredible diverse set of options for health insurance. Anyone have any tips or suggestions for selecting the best option for a family of 4 (children are 3 years old and 3 months old) with no major health issues?
"Whatever you do in life, surround yourself with smart people who'll argue with you." | -John Wooden

daheld
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Re: New Federal employee ... Choosing Healthcare

Post by daheld » Wed Jun 12, 2019 8:07 am

I'm a federal employee of a little more than 4 years. Others with more experience can and probably will chime in, but I have to say that I've been pleased with the APWU Consumer Driven option. The structure of the plan is a little different than others I've used, but I really like it. For a family option, they fund a $2400 Personal Care Account (PCA) each year. You can keep a maximum of $10,000 in PCA funds to be used for health care expenses. Your deductible on a family plan is $1600, but you can use the PCA funds that THEY'RE FUNDING. Once you've met your deductible, the plan kicks in and they pay 85%, you pay 15%. In terms of premiums, it's one of the more affordable options.

Certainly do your research to figure out what's best for your specific situation, but my anecdotal experience has been positive.

RJC
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Re: New Federal employee ... Choosing Healthcare

Post by RJC » Wed Jun 12, 2019 8:10 am

We have Blue Cross Blue Shield Basic Option. It seems to have the best benefits for the price.

Swansea
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Re: New Federal employee ... Choosing Healthcare

Post by Swansea » Wed Jun 12, 2019 8:24 am

Washington Consumer Checkbook has an excellent guide to federal health plans. I think the cost is about $15.
I was a federal HR Officer for years, and found it to be an excellent source. A trip to the OPM site, opm.gov would also be helpful...

donheff
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Re: New Federal employee ... Choosing Healthcare

Post by donheff » Wed Jun 12, 2019 8:38 am

I am retired from Federal service and have GEHA. For my first twenty years of service I had BC/BS but after studying Consumer Checkbook I switched to GEHA Standard since it has similar coverage for a lot less. I live in DC and the GEHA UHC network is pretty much coextensive with BC/BS's network. The nice thing is you can switch every November during open season so if you conclude that other options (like an HMO or another PPO) are better you can switch.

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dm200
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Re: New Federal employee ... Choosing Healthcare

Post by dm200 » Wed Jun 12, 2019 9:08 am

Not a federal employee myself, but know a lot of folks who are.

If you are located in an area where you have a choice of Kaiser - such as Washington DC area - suggest you seriously consider Kaiser. I think the costs tend to be low (relatively) and the quality is good. In addition, there are many good and convenient options (such as free virtual housecalls).

themesrob
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Re: New Federal employee ... Choosing Healthcare

Post by themesrob » Wed Jun 12, 2019 9:11 am

I think it's a bit area-specific. You might ask your new colleagues what they use, especially those with similar family situations. We use GEHA, which in our area at least is part of the Aetna network, so we can go to any of the really good hospitals in our area. Most of my colleagues have it or BCBS for the same reason. Some of the more esoteric federal options aren't as widely accepted here -- they might be in your area, though.

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dm200
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Re: New Federal employee ... Choosing Healthcare

Post by dm200 » Wed Jun 12, 2019 9:16 am

themesrob wrote:
Wed Jun 12, 2019 9:11 am
I think it's a bit area-specific. You might ask your new colleagues what they use, especially those with similar family situations. We use GEHA, which in our area at least is part of the Aetna network, so we can go to any of the really good hospitals in our area. Most of my colleagues have it or BCBS for the same reason. Some of the more esoteric federal options aren't as widely accepted here -- they might be in your area, though.
"Family" considerations (both cost and quality/convenience) can be important. The good news for federal employees is the choice of many plans, as well as the ability to switch every year. So, for example, if you try Kaiser for a year - and you do not like the doctors or other features - you can switch in a year.

Windylotus
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Re: New Federal employee ... Choosing Healthcare

Post by Windylotus » Wed Jun 12, 2019 9:43 am

GEHA (HDHP) for the family. They contribute $150 per month to your HSA account.

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dm200
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Re: New Federal employee ... Choosing Healthcare

Post by dm200 » Wed Jun 12, 2019 9:53 am

dm200 wrote:
Wed Jun 12, 2019 9:08 am
Not a federal employee myself, but know a lot of folks who are.
If you are located in an area where you have a choice of Kaiser - such as Washington DC area - suggest you seriously consider Kaiser. I think the costs tend to be low (relatively) and the quality is good. In addition, there are many good and convenient options (such as free virtual housecalls).
Over the decades, we went back and forth to and from Kaiser - depending on employer insurance. Our son was young at some of the time with Kaiser. One feature that was great with a small child was the 24x7 advice hotline. On several occasions, we called that with issues with our then young son - and the nurse helped figure out whether we needed to seek quick attention. And it was "no charge". In this area (Washington DC) - there are 24x7 Kaiser Urgent care centers (almost equivalent to Emergency Department) with full access to all records, etc. Often (from our experience) they will call in a specialist. While you must see Kaiser Physicians, you have a choice pf primary care physicians - and you can switch at any time for any (or no) reason. There is a variety of Physicians in Primary Care - Pediatricians, Internal medicine, family practice. Some are older, some younger, men, women. Many backgrounds from many other countries - as well as a lot from the US. I really like and get along with my Primary Care Phisician (Internal medicine), but I am nearly certain that my wife would not like her at all. So, my wife has a Family Practice physician that she is very happy with. Today, Kaiser offers (no charge) email exchange (may take 1-2 days), telephone appointments and "virtual" housecalls (two way audio and video via smart phones, etc.)

Most regular prescription drugs can be refilled by mail.

While we had only one child, good longtime friends of ours have many, many children - one is Type 1 diabetic - and they have been very, very pleased with Kaiser over the decades. After being in the military, the husband is a longtime federal employee - now retired. They still swear by Kaiser.

Kaufmanrider
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Re: New Federal employee ... Choosing Healthcare

Post by Kaufmanrider » Wed Jun 12, 2019 9:58 am

Windylotus wrote:
Wed Jun 12, 2019 9:43 am
GEHA (HDHP) for the family. They contribute $150 per month to your HSA account.
I agree, after over 20 years of BC/BS I switched. They fund 1800 a year (150 a month. Family deductable is 3000. After that they pay 95%. Preventative dental and eye exams included in plan.

delamer
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Re: New Federal employee ... Choosing Healthcare

Post by delamer » Wed Jun 12, 2019 10:46 am

Swansea wrote:
Wed Jun 12, 2019 8:24 am
Washington Consumer Checkbook has an excellent guide to federal health plans. I think the cost is about $15.
I was a federal HR Officer for years, and found it to be an excellent source. A trip to the OPM site, opm.gov would also be helpful...
Seconding this recommendation.

As a first step, you really need to decide if you are comfortable with an HDHP or prefer traditional coverage. For a healthy family like yours, an HDHP is a good option. But you don’t want to avoid medical care because you don’t want to spend the largish deductible.

If you decide on a traditional plan, we are happy with GEHA Standard Option. Price is low and coverage is good.

You should check with any key providers — like your kids’ pediatrician — to make sure they accept an insurance that you are considering.

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dm200
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Re: New Federal employee ... Choosing Healthcare

Post by dm200 » Wed Jun 12, 2019 11:19 am

delamer wrote:
Wed Jun 12, 2019 10:46 am
Swansea wrote:
Wed Jun 12, 2019 8:24 am
Washington Consumer Checkbook has an excellent guide to federal health plans. I think the cost is about $15.
I was a federal HR Officer for years, and found it to be an excellent source. A trip to the OPM site, opm.gov would also be helpful...
Seconding this recommendation.

As a first step, you really need to decide if you are comfortable with an HDHP or prefer traditional coverage. For a healthy family like yours, an HDHP is a good option. But you don’t want to avoid medical care because you don’t want to spend the largish deductible.
If you decide on a traditional plan, we are happy with GEHA Standard Option. Price is low and coverage is good.
You should check with any key providers — like your kids’ pediatrician — to make sure they accept an insurance that you are considering.
Alternately, consider or decide how important keeping any or all of your current providers. With 20/20 hindsight over the years - this was never a big issue or problem. We have always been able to find competent replacements - often better!

I would also take into account your spouse's values, opinions, priorities. "Family relations" can often be as (or more) important than objective evaluation or financial advantage. :sharebeer

retiredjg
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Re: New Federal employee ... Choosing Healthcare

Post by retiredjg » Wed Jun 12, 2019 11:34 am

The larger plans like BC/BS and GEHA are likely to be good choices anywhere in the US. But locally there may be something better. If you have little time to choose, just pick one of these. You can change each year - in November if I recall correctly.

After you get on the job, ask your co-workers about who they use and how they like it.

InvisibleAerobar
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Re: New Federal employee ... Choosing Healthcare

Post by InvisibleAerobar » Wed Jun 12, 2019 11:51 am

themesrob wrote:
Wed Jun 12, 2019 9:11 am
I think it's a bit area-specific. You might ask your new colleagues what they use, especially those with similar family situations. We use GEHA, which in our area at least is part of the Aetna network, so we can go to any of the really good hospitals in our area. Most of my colleagues have it or BCBS for the same reason. Some of the more esoteric federal options aren't as widely accepted here -- they might be in your area, though.
that's the key point

I lived in NoVA previously and currently live outside of DC (though still working for the same agency). Care First standard was quite good when I was in DC, and it has one of the lowest (if not the lowest) max out-of-pocket expense. That mattered to me, b/c I'm a cyclist, and cycling injuries could get severe. After I moved out of the area, it's been BC/BS Basic and GEHA HDHP. That said, amongst the HDHP plans, GEHA HDHP seems to be the best of the bunch, even compared to the other options offered in the DC area.

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dm200
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Re: New Federal employee ... Choosing Healthcare

Post by dm200 » Wed Jun 12, 2019 1:54 pm

retiredjg wrote:
Wed Jun 12, 2019 11:34 am
The larger plans like BC/BS and GEHA are likely to be good choices anywhere in the US. But locally there may be something better. If you have little time to choose, just pick one of these. You can change each year - in November if I recall correctly.

After you get on the job, ask your co-workers about who they use and how they like it.
Depending on the details, that may or may not be helpful, on balance. I am acquainted, for example, with several people who believe, from their experience, that my PCP is awful, terrible, etc. Yet, for me - both objectively and subjectively - I am extremely happy and judge her to be an excellent Physician. I often look at the Checkbook patient reviews of physicians. Some of the high patient reviews of physicians are physicians I have a low opinion of.

wassabi
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Re: New Federal employee ... Choosing Healthcare

Post by wassabi » Wed Jun 12, 2019 5:45 pm

dm200 wrote:
Wed Jun 12, 2019 9:08 am
Not a federal employee myself, but know a lot of folks who are.

If you are located in an area where you have a choice of Kaiser - such as Washington DC area - suggest you seriously consider Kaiser. I think the costs tend to be low (relatively) and the quality is good. In addition, there are many good and convenient options (such as free virtual housecalls).
:thumbsup
I selected Kaiser partly because my wife was already with them and wanted to stay with them, and partly because of your strong endorsement. We live near a Kaiser compound so it's very convenient. I had CareFirst for 15+ years and really liked the flexibility of a PPO; however, it was a pain to have my physician in one city, then a specialist potentially in another, then a blood lab somewhere else. With Kaiser, everything is right there. Your records are online and doctors respond to online messages. Couldn't be more convenient. So far so good.

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dm200
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Re: New Federal employee ... Choosing Healthcare

Post by dm200 » Thu Jun 13, 2019 9:16 am

wassabi wrote:
Wed Jun 12, 2019 5:45 pm
dm200 wrote:
Wed Jun 12, 2019 9:08 am
Not a federal employee myself, but know a lot of folks who are.
If you are located in an area where you have a choice of Kaiser - such as Washington DC area - suggest you seriously consider Kaiser. I think the costs tend to be low (relatively) and the quality is good. In addition, there are many good and convenient options (such as free virtual housecalls).
:thumbsup I selected Kaiser partly because my wife was already with them and wanted to stay with them, and partly because of your strong endorsement. We live near a Kaiser compound so it's very convenient. I had CareFirst for 15+ years and really liked the flexibility of a PPO; however, it was a pain to have my physician in one city, then a specialist potentially in another, then a blood lab somewhere else. With Kaiser, everything is right there. Your records are online and doctors respond to online messages. Couldn't be more convenient. So far so good.
Glad Kaiser worked out well for you!

I was reminded recently of a common "hidden cost" we avoid now with Kaiser. Many doctors now have their practice where you have to pay for parking. I suspect it may have gone up, but ever visit to our PCPs and eye doctors cost us $5 for parking. Free parking here at all Kaiser facilities :)

One common factor I notice about folks we know who do not like Kaiser is that they tend to not utilize a lot of the features of Kaiser - such as online appointment scheduling, email with their Physicians, checking lab results online, ordering drug refills online and mail delivery, using Kaiser urgent care instead of Hospital ED - and so on. They tend to not be aware of new features when Kaiser adds them. They also tend to have unrealistic expectations of Kaiser Physicians - for example, one friend said she hated Kaiser because Kaiser doctors would not get her late husband (who was an alcoholic) to quit drinking! My wife and I (especially me) usually take advantage of the full array of Kaiser benefits. For example, I always review, in detail, all lab results and do my best to understand them. If I don't understand something - I email the Physician and ask. The other thing I do (not automatic with Kaiser) is email one of my specialists when a test (relevant to that specialty) is run by my PCP. I just had a lot of tests run by my PCP in relation to my annual health assessment. One test was OK as far as my PCP was concerned, but I emailed a specialist and asked about this test. She looked at the record and advised me to change the dosage of a drug I take. All this was done by email and the cost for the change of dosage from the specialist was zero :) I am also noticing that several of the specialists I see regularly are tending to not want or need to see me as regularly. As long as this is medically correct (I assume it is) - saves me time and money. In our cases, Kaiser rarely makes any billing errors. We check everything (especially me) though - and in the rare case of an error, Kaiser corrects it quickly. Because they are both the insurer and provider - there can never be a fight between the provider and the insurance company. Except for hospitalization and things (like some surgery) done at non-Kaiser facilities - everything is done by Kaiser folks - so you do not get into the "out of network" mess. In this area, most surgery is done at a Kaiser facility. More and more such surgery is done without an overnight stay - and Kaiser recently added some surgeries that required one overnight stay. On my Kaiser medicare plan, such surgeries only cost $250 - all included.

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inthearena
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Re: New Federal employee ... Choosing Healthcare

Post by inthearena » Fri Jun 14, 2019 8:13 am

Thank you all for the valuable insight! This has made life much simpler. After reviewing everything I've decided to go with the GEHA - HDHP (for this year at least!) It seems to be the right fit for my family and I like the access to an HSA as a perk.
"Whatever you do in life, surround yourself with smart people who'll argue with you." | -John Wooden

BackOfTheNet
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Re: New Federal employee ... Choosing Healthcare

Post by BackOfTheNet » Fri Jun 14, 2019 8:34 am

I think GEHA HDHP is a great deal. These are some rough numbers I used when thinking about which plan for my family.

$3,770 Annual premium cost for family (This is pre tax with premium conversion)
-$829 tax savings on premiums (22% tax bracket)
-$1,500 Credit to HSA
==
~$1450 annual cost

Plus you get basic Vision and dental coverage which is extra in many of the other plans. Plus you get to contribute to the family HSA max for additional tax savings. Plus it's pretty easy to earn $175 per adult with the "GEHA health balance" program.

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