FEHB Open Season 2019

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AnonJohn
Posts: 261
Joined: Wed Oct 07, 2015 2:45 pm

Re: FEHB Open Season 2019

Post by AnonJohn » Wed Oct 16, 2019 11:30 am

@UAL Flyer - I've read your previous discussions / arguments, and disagree. I'd associate myself with Tdubs here.

Based on 4 years of actual EOB expense analysis, maxing HSA contributions, and a marginal rate of ~30%+, Grabiner's analysis and my analysis is borne out --- a clear win for GEHA HDHP over GEHA standard and BCBS Basic. While scenarios can be concocted to make that fail, the cost of that failure is manageable.

I would agree with what you wrote: if having a HDHP makes you avoid care, it can be a powerfully bad idea.

Finally, the utility of FSAs depend on whether you have predictable expenses. My $0.02 is to paraphrase Fiddler on the Roof. Is there a proper place for FSAs? Yes, far away from me. Have tried them, hated them for lots of reasons.

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BogleFanGal
Posts: 391
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Re: FEHB Open Season 2019

Post by BogleFanGal » Wed Oct 16, 2019 11:43 am

AnonJohn wrote:
Wed Oct 16, 2019 11:21 am
Drain wrote:
Thu Oct 10, 2019 1:31 pm
BogleFanGal wrote:
Thu Oct 10, 2019 12:43 pm
OP: thank you for thread - hoping people keep adding as more info comes to opm site. Does anyone know if GEHA HDHP members gain access to GEHA's discounted dental network rates through its HDHP plan? I'm not talking about the HDHP plan actually paying for any dental work other than preventive cleanings/exam benefit.

I'm just asking whether it gives you access to their negotiated dental rates if/when you need dental work and are paying out of pocket for it. (vs paying full walk-in rate.)

Or do you have to buy the separate GEHA Dental Plan for that?
I've had the dental plan for years but may drop it, given some problems I've experienced.
You have to buy the separate dental coverage to get its rates. The HDHP covers preventive and not much more. What the brochure states is all there is.
That doesn't comport with my experience at the dentist. Preventative service was covered free under HDHP (as in the brochure), and I got the GEHA negotiated rates for fillings. May be an artifact of how they handle insurance / billing, and I note that I had GEHA dental before, so perhaps the practice didn't handle the transition right. Either way, it's a nice feature to have.
UPDATE for anyone who's interested: I actually contacted GEHA to ask about this: after putting me on hold to check, she told me that anyone who just had the HDHP with preventive dental benefits would get the benefit of paying GEHA's lower negotiated dental plan rates on other work (vs the walk-in cash price), even WITHOUT buying the separate GEHA dental plan coverage.

But when I asked her where I could view this in writing, she said I can't. There's no consumer-facing doc that states this - not the plan brochure or anywhere else. And she couldn't put anything in writing. :annoyed

So zero confidence on ditching dental plan based upon that flimsy verbal conversation. To me, negotiated rates are the big dental plan value as I have dental problems: paying cash rates for cleanings, exams and bitewings are not as big a deal.

Someone else upthread also stated that the GEHA dental network is actually different and bigger than the GEHA HDHP dental network...while on past calls, GEHA reps have said it's the same network.
"Life would be infinitely happier if we could only be born at the age of eighty and gradually approach eighteen." Mark Twain

themesrob
Posts: 258
Joined: Fri Jul 15, 2016 1:58 pm

Re: FEHB Open Season 2019

Post by themesrob » Wed Oct 16, 2019 12:17 pm

AnonJohn wrote:
Wed Oct 16, 2019 11:30 am
@UAL Flyer - I've read your previous discussions / arguments, and disagree. I'd associate myself with Tdubs here.

Based on 4 years of actual EOB expense analysis, maxing HSA contributions, and a marginal rate of ~30%+, Grabiner's analysis and my analysis is borne out --- a clear win for GEHA HDHP over GEHA standard and BCBS Basic. While scenarios can be concocted to make that fail, the cost of that failure is manageable.

I would agree with what you wrote: if having a HDHP makes you avoid care, it can be a powerfully bad idea.

Finally, the utility of FSAs depend on whether you have predictable expenses. My $0.02 is to paraphrase Fiddler on the Roof. Is there a proper place for FSAs? Yes, far away from me. Have tried them, hated them for lots of reasons.
We (self + 1) are at (almost) two years of comparison, and find the opposite -- both years, we came out ahead with GEHA standard (ER visits each year, generic prescription meds being the primary drivers). One year was pretty close, the other was not.

I'm with UAL Flyer, I don't think these scenarios are uncommon. and this is aside from the value derived from DW not worrying about whether she should go to the ER for x-rays after a slip and fall because she knows it's 100% covered (which she would absolutely not do if we had the HDHP). YMMV.

AnonJohn
Posts: 261
Joined: Wed Oct 07, 2015 2:45 pm

Re: FEHB Open Season 2019

Post by AnonJohn » Wed Oct 16, 2019 3:46 pm

BogleFanGal wrote:
Wed Oct 16, 2019 11:43 am
AnonJohn wrote:
Wed Oct 16, 2019 11:21 am
Drain wrote:
Thu Oct 10, 2019 1:31 pm
BogleFanGal wrote:
Thu Oct 10, 2019 12:43 pm
OP: thank you for thread - hoping people keep adding as more info comes to opm site. Does anyone know if GEHA HDHP members gain access to GEHA's discounted dental network rates through its HDHP plan? I'm not talking about the HDHP plan actually paying for any dental work other than preventive cleanings/exam benefit.

I'm just asking whether it gives you access to their negotiated dental rates if/when you need dental work and are paying out of pocket for it. (vs paying full walk-in rate.)

Or do you have to buy the separate GEHA Dental Plan for that?
I've had the dental plan for years but may drop it, given some problems I've experienced.
You have to buy the separate dental coverage to get its rates. The HDHP covers preventive and not much more. What the brochure states is all there is.
That doesn't comport with my experience at the dentist. Preventative service was covered free under HDHP (as in the brochure), and I got the GEHA negotiated rates for fillings. May be an artifact of how they handle insurance / billing, and I note that I had GEHA dental before, so perhaps the practice didn't handle the transition right. Either way, it's a nice feature to have.
UPDATE for anyone who's interested: I actually contacted GEHA to ask about this: after putting me on hold to check, she told me that anyone who just had the HDHP with preventive dental benefits would get the benefit of paying GEHA's lower negotiated dental plan rates on other work (vs the walk-in cash price), even WITHOUT buying the separate GEHA dental plan coverage.

But when I asked her where I could view this in writing, she said I can't. There's no consumer-facing doc that states this - not the plan brochure or anywhere else. And she couldn't put anything in writing. :annoyed

So zero confidence on ditching dental plan based upon that flimsy verbal conversation. To me, negotiated rates are the big dental plan value as I have dental problems: paying cash rates for cleanings, exams and bitewings are not as big a deal.

Someone else upthread also stated that the GEHA dental network is actually different and bigger than the GEHA HDHP dental network...while on past calls, GEHA reps have said it's the same network.
Very interesting. Thanks for calling. I agree that the GEHA dental prices are a big part of the value. One approach you could take would be to call your dentist, and ask them what it would cost if you had just the HDHP plan. If they have a good insurance person, they might have some insight, or be able to to a "test billing" for certain services. Mine did that for me.

AnonJohn
Posts: 261
Joined: Wed Oct 07, 2015 2:45 pm

Re: FEHB Open Season 2019

Post by AnonJohn » Wed Oct 16, 2019 4:01 pm

themesrob wrote:
Wed Oct 16, 2019 12:17 pm
AnonJohn wrote:
Wed Oct 16, 2019 11:30 am
@UAL Flyer - I've read your previous discussions / arguments, and disagree. I'd associate myself with Tdubs here.

Based on 4 years of actual EOB expense analysis, maxing HSA contributions, and a marginal rate of ~30%+, Grabiner's analysis and my analysis is borne out --- a clear win for GEHA HDHP over GEHA standard and BCBS Basic. While scenarios can be concocted to make that fail, the cost of that failure is manageable.

I would agree with what you wrote: if having a HDHP makes you avoid care, it can be a powerfully bad idea.

Finally, the utility of FSAs depend on whether you have predictable expenses. My $0.02 is to paraphrase Fiddler on the Roof. Is there a proper place for FSAs? Yes, far away from me. Have tried them, hated them for lots of reasons.
We (self + 1) are at (almost) two years of comparison, and find the opposite -- both years, we came out ahead with GEHA standard (ER visits each year, generic prescription meds being the primary drivers). One year was pretty close, the other was not.

I'm with UAL Flyer, I don't think these scenarios are uncommon. and this is aside from the value derived from DW not worrying about whether she should go to the ER for x-rays after a slip and fall because she knows it's 100% covered (which she would absolutely not do if we had the HDHP). YMMV.
Interesting. What is your marginal rate? How much does the FSA save you each year?

My basic analysis is simple: Assume I spend the full deductible (and never worry about visiting the doctor when needed). After the tax savings, premium pass through, and premium difference, I'm ahead. If, after meeting the deductible, all other things are the same with the plan (YMMV), HDHP comes out ahead. Specifically, in 2018, actual numbers (I didn't include GEHA standard in my 2019 run):

GEHA HDHP Premium = 3560; GEHA Std Premium = 3378

After tax premium: HDHP = 2494; Std = 2366

Premium pass through to HSA: 1500 (went up to $1800)
Tax savings from HSA: 1696

Summing up, net cost for HDHP: -$702 ; net cost for Std: $2366 minus any FSA tax savings.

Deductible: $3000

Cost after deductible:
HDHP: $2298, which is $70 less than standard, but beatable if you make good use of FSA tax savings. But the HSA value will grow over time, if invested, and there are the chances you spend much more or much less than the deductible. In many of those cases HDHP wins.

Again, I'd point out that this is nontrivially dependent on your marginal tax rate.

tj
Posts: 2688
Joined: Thu Dec 24, 2009 12:10 am

Re: FEHB Open Season 2019

Post by tj » Wed Oct 16, 2019 5:34 pm

BogleFanGal wrote:
Wed Oct 16, 2019 11:43 am
AnonJohn wrote:
Wed Oct 16, 2019 11:21 am
Drain wrote:
Thu Oct 10, 2019 1:31 pm
BogleFanGal wrote:
Thu Oct 10, 2019 12:43 pm
OP: thank you for thread - hoping people keep adding as more info comes to opm site. Does anyone know if GEHA HDHP members gain access to GEHA's discounted dental network rates through its HDHP plan? I'm not talking about the HDHP plan actually paying for any dental work other than preventive cleanings/exam benefit.

I'm just asking whether it gives you access to their negotiated dental rates if/when you need dental work and are paying out of pocket for it. (vs paying full walk-in rate.)

Or do you have to buy the separate GEHA Dental Plan for that?
I've had the dental plan for years but may drop it, given some problems I've experienced.
You have to buy the separate dental coverage to get its rates. The HDHP covers preventive and not much more. What the brochure states is all there is.
That doesn't comport with my experience at the dentist. Preventative service was covered free under HDHP (as in the brochure), and I got the GEHA negotiated rates for fillings. May be an artifact of how they handle insurance / billing, and I note that I had GEHA dental before, so perhaps the practice didn't handle the transition right. Either way, it's a nice feature to have.
UPDATE for anyone who's interested: I actually contacted GEHA to ask about this: after putting me on hold to check, she told me that anyone who just had the HDHP with preventive dental benefits would get the benefit of paying GEHA's lower negotiated dental plan rates on other work (vs the walk-in cash price), even WITHOUT buying the separate GEHA dental plan coverage.

But when I asked her where I could view this in writing, she said I can't. There's no consumer-facing doc that states this - not the plan brochure or anywhere else. And she couldn't put anything in writing. :annoyed

So zero confidence on ditching dental plan based upon that flimsy verbal conversation. To me, negotiated rates are the big dental plan value as I have dental problems: paying cash rates for cleanings, exams and bitewings are not as big a deal.

Someone else upthread also stated that the GEHA dental network is actually different and bigger than the GEHA HDHP dental network...while on past calls, GEHA reps have said it's the same network.
All you have to do a search for a dentist in each plan. The results are much different.

Tdubs
Posts: 859
Joined: Tue Apr 24, 2018 7:50 pm

Re: FEHB Open Season 2019

Post by Tdubs » Wed Oct 16, 2019 7:22 pm

UALflyer wrote:
Wed Oct 16, 2019 8:07 am
Tdubs wrote:
Tue Oct 15, 2019 8:13 pm
an FSA has no advantage if you spend little or nothing on medical, which was one of your examples in the original thread ($400 in copays paid from an FSA).
A lot depends on your particular situation. An FSA, while less flexible than an HSA, is still quite flexible and allows you to use it towards various expenses that don't have anything to do with medical co-pays. We know quite a few people, for instance, who get massages on a monthly basis, which are reimbursable from their FSA without a letter of medical necessity. There are quite a few expenses like that, but if none of them work for you, then you just need to factor this into your calculations.
For the basic plans to come out ahead, you have to nail a max spend of your FSA and nothing more in the examples you provide, such as the one where you get free labs, have copays but spend nothing in areas advantaged by a GEHA HDHP. Not much more, not much less.
That's not true either. What is true, however, is that with a non-HDHP plan, the category of your expenses matters. For some people, these expense categories are very stable and predictable, which makes these types of decisions fairly easy. For others, their expense categories and their overall healthcare spend varies a ton year to year, which makes these decisions a lot more difficult.

What is absolutely critical, however, is for people to run the calculations correctly. As I mentioned above, what is very common is for people to run the numbers in a way that, for instance, completely omits the tax advantages of a healthcare FSA (this is what grabiner did in the thread that I linked above, which skewed the numbers in favor of the HDHP's), disregards the fact that with a non-HDHP, a lot of healthcare expenses have very little or no out of pocket impact, etc...
You can carry over $500, but that isn't going to gain you much over an HSA across many years of coverage.
You should never be running these types of calculations over a period that is longer than a year. When you sign up for a health plan, at most, you are signing up for a year. Health plans change as do individual situations, so a health plan that made sense this year may not make sense the following year. This is one of the big advantages that FEHB's have, as a wide selection of those means that people can pick and choose them strategically in a way that maximizes their advantages for each year.
I have two co-workers who had to figure out how to spend down to the $500. They got messages they didn't need, bought extra pairs of reading glasses they didn't need and the like. This is wasted money. In an HSA, you don't have that problem.
This, I completely agree with, as an HSA is significantly more flexible. Prior to the implementation of the $500 carryover, this used to be a much bigger problem. Now, it's not nearly as much of an issue, particularly for families.
I don't think most sports injuries would be enough of an ER visit to tip the scales. Even someone who is a sports enthusiast isn't likely to visit an ER often enough that they should skip an HDHP.
For whatever reason, you make these very broad statements with great conviction, but without really looking into them.

Once again, it all depends on your particular situation. One of our neighbors, for instance, is an avid basketball player (plays 4-5 times a week) and a downhill skier. He averages 1-2 ER visits per year for various sports related injuries, which has been consistent for well over a decade.

I realize that this isn't your situation, but people and their lifestyles are all different, which is the reason that it's so important to run these calculations in a way that factors in your specific situation.
There are scenarios where the basic plan + FSA wins, but it seems like drawing an inside straight from year to year.
You're trying to say that this is the case for you, which is perfectly fine. I think that it's safe to safe that every other person in the country isn't you, so their healthcare needs are going to be different.

There are lots and lots of people out there with very stable healthcare needs, for whom practically all their healthcare spend consists of maintenance medications and office visits with labs. For people like that, a non-HDHP plan will frequently make way more financial sense... or not, as they need to run their specific numbers.
I'd agree that if someone is inclined to avoid seeking care to save money in an HDHP, then a basic plan is best--certainly some insurers are betting people will do exactly that.
The very reason that employers and insurance companies like HDHP's is because they create powerful financial incentives for their participants to delay and avoid incurring medical expenses, which is the way that all these insurance companies and employers save money.

As I've previously mentioned, there are lots and lots of medical conditions that do not manifest themselves in an obvious way. If you have an HDHP and you get a really, really, really bad headache, you have a very powerful financial incentive to delay or avoid going to the ER. No matter how you slice it, an ER visit like that will cost you $1k+ (and, if imaging tests are ordered, you're talking about thousands of dollars), so there aren't a lot of HDHP participants out there who will just go to the ER right away, costs be damned. Instead, they will delay and try to manage it at home (until at least their regular doctor's office opens) as, after all, it's probably nothing. Yet, if it a brain aneurysm or subarachnoid hemorrhage, that delay could cost you your life.

Most people running these financial calculations tend not to pay all that much attention to the above factor. Yet, in practical terms, a person with no medical training already has a lot of trouble differentiating between emergent and non-emergent conditions, and the powerful financial incentive that HDHP's create causes virtually all HDHP participants to delay seeking care in these types of situations. This is the reason that I emphasize the fact that in close cases, people should err on the side of caution and opt for a non-HDHP.
You can go get massages and max your FSA, but then it isn't a low spend year anymore, that was your $400 example where someone only spends on copays, right? Medical expenses are, in these discussions, about cost comparisons of necessity vs. necessity. Massages are usually discretionary spending. If you want to save some money on your monthly massage or six pairs of reading glasses rather than save it in a well-invested HSA, fine, but it isn't apples to apples. Don't compare FSA, indulgent savings to an HSA that can be banked for medical necessities.

To return to your example in the earlier thread, if you spend almost nothing on medically necessary services in a basic plan--about $400, as you argued, on copays for office visits--an HDHP/HSA is better. Year to year, you are putting very little in an FSA to cover the annual planned expenses vs the $7,000 or $8,000 you can put in an HSA with investable dollars. Which is better?

For whatever reason, you make these broad statements about FSAs and ER visits based on anecdotes you collect from your friends. Let's take your athletic neighbor. I can't believe he goes to the ER 1-2 times each year, but if he does, there is something very wrong. Does he plan to blow out his knee every year? In 20 years of active organized sports, I went to the ER once and stayed an afternoon. I'd note that some of those many, many stays for him most certainly had to be serious and required him to stay in the hospital where he would regret very much a basic plan vs. a GEHA HDHP with its superior hospital coverage. Same for the follow up visits to specialists and rehab.

I'm not trying to say this is the case for me. I'm saying that this is the case for most people, and your examples likely total up to a small minority of cases, many of which can't be planned out like a mortgage payment. There is a reason that GEHA's HDHP wins out (per Checkbook) whether you spend nothing, a little, average, or a lot on medical services. Exceptions are possible but improbable enough that most people should not base their insurance choices on them.

Tdubs
Posts: 859
Joined: Tue Apr 24, 2018 7:50 pm

Re: FEHB Open Season 2019

Post by Tdubs » Wed Oct 16, 2019 9:09 pm

tj wrote:
Wed Oct 16, 2019 5:34 pm
BogleFanGal wrote:
Wed Oct 16, 2019 11:43 am
AnonJohn wrote:
Wed Oct 16, 2019 11:21 am
Drain wrote:
Thu Oct 10, 2019 1:31 pm
BogleFanGal wrote:
Thu Oct 10, 2019 12:43 pm
OP: thank you for thread - hoping people keep adding as more info comes to opm site. Does anyone know if GEHA HDHP members gain access to GEHA's discounted dental network rates through its HDHP plan? I'm not talking about the HDHP plan actually paying for any dental work other than preventive cleanings/exam benefit.

I'm just asking whether it gives you access to their negotiated dental rates if/when you need dental work and are paying out of pocket for it. (vs paying full walk-in rate.)

Or do you have to buy the separate GEHA Dental Plan for that?
I've had the dental plan for years but may drop it, given some problems I've experienced.
You have to buy the separate dental coverage to get its rates. The HDHP covers preventive and not much more. What the brochure states is all there is.
That doesn't comport with my experience at the dentist. Preventative service was covered free under HDHP (as in the brochure), and I got the GEHA negotiated rates for fillings. May be an artifact of how they handle insurance / billing, and I note that I had GEHA dental before, so perhaps the practice didn't handle the transition right. Either way, it's a nice feature to have.
UPDATE for anyone who's interested: I actually contacted GEHA to ask about this: after putting me on hold to check, she told me that anyone who just had the HDHP with preventive dental benefits would get the benefit of paying GEHA's lower negotiated dental plan rates on other work (vs the walk-in cash price), even WITHOUT buying the separate GEHA dental plan coverage.

But when I asked her where I could view this in writing, she said I can't. There's no consumer-facing doc that states this - not the plan brochure or anywhere else. And she couldn't put anything in writing. :annoyed

So zero confidence on ditching dental plan based upon that flimsy verbal conversation. To me, negotiated rates are the big dental plan value as I have dental problems: paying cash rates for cleanings, exams and bitewings are not as big a deal.

Someone else upthread also stated that the GEHA dental network is actually different and bigger than the GEHA HDHP dental network...while on past calls, GEHA reps have said it's the same network.
All you have to do a search for a dentist in each plan. The results are much different.
In the HDHP, I have gotten the Connection Dental discounted fees for non-preventive care in 2019. The plan brochure indicates it offers the same dental network as other GEHA medical plans. Here is what it says on page 100 of the GEHA brochure for 2019.

"Free to all GEHA health plan members, Connection Dental® can reduce your costs for dental care. Connection Dental is a network of more than 140,000 provider locations nationwide. Participating providers have agreed to limit their charges to reduced fees for GEHA health plan members. As a GEHA health plan member, you can take advantage of this program in addition to receiving basic dental benefits provided under the GEHA health plan. To find a participating Connection Dental provider in your area, call 800-296-0776 or visit www.geha.com. Please confirm provider participation prior to your visit."

Other than the optional dental plan, is there something else in the standard plan?

tj
Posts: 2688
Joined: Thu Dec 24, 2009 12:10 am

Re: FEHB Open Season 2019

Post by tj » Wed Oct 16, 2019 10:22 pm

yes, it is the same network as other GEHA MEDICAL plans. Not the same network as the GEHA Dental plans, which is the the GEHA Connection Dental Federal® plan. The latter uses CIGNA, which is much larger than the dentists who have contracted directly with GEHA for it's medical plans.

Tdubs
Posts: 859
Joined: Tue Apr 24, 2018 7:50 pm

Re: FEHB Open Season 2019

Post by Tdubs » Thu Oct 17, 2019 4:39 am

tj wrote:
Wed Oct 16, 2019 10:22 pm
yes, it is the same network as other GEHA MEDICAL plans. Not the same network as the GEHA Dental plans, which is the the GEHA Connection Dental Federal® plan. The latter uses CIGNA, which is much larger than the dentists who have contracted directly with GEHA for it's medical plans.
Right, and you get the negotiated rates of the Connection network. So it doesn't matter which medical plan you pick to get the negotiated rates. The optional Dental plans have network and out of network coverage (and high and standard plans). So it would certainly have more provider options. For those who don't choose FEDVIP, the HDHP seems to offer better coverage for preventive and diagnostic services than the basic or high options (see section 5 of the brochure).

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BogleFanGal
Posts: 391
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Re: FEHB Open Season 2019

Post by BogleFanGal » Thu Oct 17, 2019 7:42 am

Tdubs wrote:
Thu Oct 17, 2019 4:39 am
tj wrote:
Wed Oct 16, 2019 10:22 pm
yes, it is the same network as other GEHA MEDICAL plans. Not the same network as the GEHA Dental plans, which is the the GEHA Connection Dental Federal® plan. The latter uses CIGNA, which is much larger than the dentists who have contracted directly with GEHA for it's medical plans.
Right, and you get the negotiated rates of the Connection network. So it doesn't matter which medical plan you pick to get the negotiated rates. The optional Dental plans have network and out of network coverage (and high and standard plans). So it would certainly have more provider options. For those who don't choose FEDVIP, the HDHP seems to offer better coverage for preventive and diagnostic services than the basic or high options (see section 5 of the brochure).
This dental benefits discussion is quite helpful - thank you. Can either of you please correct me if I'm misunderstanding any of the below?

1. GEHA HDHP offers preventive coverage, but with a smaller network of dentists participating.
2. The separate FEDVIP GEHA DENTAL plan offers more provider choices - a bigger network.
3. However, a fed employee that just opts for the GEHA HDHP without buying the separate GEHA dental plan will STILL benefit in two ways, even though they'll pay for all dental care (other than the preventive) out of pocket: (a) they will pay lower GEHA-negotiated fees vs as a walk-in/cash patient and (b) can access the bigger Dental Connections network for care at those preferred negotiated rates.)
"Life would be infinitely happier if we could only be born at the age of eighty and gradually approach eighteen." Mark Twain

UALflyer
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Re: FEHB Open Season 2019

Post by UALflyer » Thu Oct 17, 2019 8:01 am

Medical expenses are, in these discussions, about cost comparisons of necessity vs. necessity. Massages are usually discretionary spending. If you want to save some money on your monthly massage or six pairs of reading glasses rather than save it in a well-invested HSA, fine, but it isn't apples to apples. Don't compare FSA, indulgent savings to an HSA that can be banked for medical necessities.
This point has already been addressed several times. Once again, with a general FSA, if your dental, vision and healthcare copays are running too low for the year, you can easily fill in the gap with other eligible expenses (massages, sunblock, radon detection devices, etc...). The list of those FSA eligible expenses is enormous, and many of them do not require a prescription and are purchased anyway. At the same time, if your other FSA eligible expenses are running high for the year, you can easily defer many of the FSA eligible expenses until the following year.
There is a reason that GEHA's HDHP wins out (per Checkbook) whether you spend nothing, a little, average, or a lot on medical services. Exceptions are possible but improbable enough that most people should not base their insurance choices on them.
I am intentionally not responding to the rest of your post, which can be summarized as "Here is the way that I spend my healthcare dollars, and most people's spending should be just like mine. If it's not, "there is something wrong." Even when presented with actual examples of people's healthcare spending, you respond by stating how it is different from yours. Once again, people and their lifestyles are all different, so the fact that you are finding it difficult to understand their lifestyles is completely irrelevant to the insurance choices that are right for them.

The only reason that I am even responding here is because of the statement that I just quoted above, which is highly misleading. Once again, people (and you) need to understand all the factors that go into these decisions, so that they can run their own individual numbers. If you look at AnonJohn's post directly above yours, who, by the way, prefers the HDHP, you'll see an easy example where once you factor in the FSA tax savings, the GEHA Standard starts out over $600 ahead of the HDHP. For other categories of employees, such as part time employees, that advantage is even larger. I completely agree that this doesn't end the conversation, as this assumes that the participants would spend their maximum FSA contributions, assumes that the HDHP participants wouldn't use a limited purpose FSA, etc...

Hence, the point that I keep trying to make, which is that people need to understand all the factors that go into these calculations and then run the numbers for themselves. It makes absolutely no difference whether their lifestyles and healthcare utilization matches up against your expectations, or whether it fits any of the examples (my examples, by the way, are only intended to illustrate all the cost saving opportunities available to the non-HDHP participants, which are frequently misunderstood by those on the HDHP's) out there. My issue with your posts here is the fact that in your zeal to debate this, you are making it very difficult for people to understand all the factors that go into the calculations. You are also glossing over the powerful financial incentive that the HDHP participants have to postpone and even avoid seeking medical attention in situations that don't clearly call for it, but can be extremely dangerous.

MnD
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Re: FEHB Open Season 2019

Post by MnD » Thu Oct 17, 2019 8:23 am

UALflyer wrote:
Wed Oct 16, 2019 8:07 am

There are lots and lots of people out there with very stable healthcare needs, for whom practically all their healthcare spend consists of maintenance medications and office visits with labs. For people like that, a non-HDHP plan will frequently make way more financial sense... or not, as they need to run their specific numbers.

The very reason that employers and insurance companies like HDHP's is because they create powerful financial incentives for their participants to delay and avoid incurring medical expenses, which is the way that all these insurance companies and employers save money.

As I've previously mentioned, there are lots and lots of medical conditions that do not manifest themselves in an obvious way. If you have an HDHP and you get a really, really, really bad headache, you have a very powerful financial incentive to delay or avoid going to the ER. No matter how you slice it, an ER visit like that will cost you $1k+ (and, if imaging tests are ordered, you're talking about thousands of dollars), so there aren't a lot of HDHP participants out there who will just go to the ER right away, costs be damned. Instead, they will delay and try to manage it at home (until at least their regular doctor's office opens) as, after all, it's probably nothing. Yet, if it a brain aneurysm or subarachnoid hemorrhage, that delay could cost you your life.

Most people running these financial calculations tend not to pay all that much attention to the above factor. Yet, in practical terms, a person with no medical training already has a lot of trouble differentiating between emergent and non-emergent conditions, and the powerful financial incentive that HDHP's create causes virtually all HDHP participants to delay seeking care in these types of situations. This is the reason that I emphasize the fact that in close cases, people should err on the side of caution and opt for a non-HDHP.
A a textbook case of very stable healthcare needs (occasional office visits and limited generic maintenance med) I would second many of UALflyer's points as to why we've been GEHA standard plan for pretty much our entire adult lives. On top of that I really dislike mixing healthcare and insurance with investing which leads to another point - reducing financial complexity. Just reading the threads the various HSA account twists, turns , transfers and and tricks gives me a headache. They remind me of the threads of folks chasing on-line bank rates all the time with their savings, or paying a portion income taxes with pay-pal through a rotating quarterly rewards credit card to "make" $40 or whatever.

We invest and bank at Schwab for decades and likewise with FEHB in GEHA Standard and have a deep understanding of both which enables us to utilize their systems to the fullest. We do invest a lot in our health with regards to diet and exercise and I think that's a better and more straightforward investment than gaming health plans.
70/30 AA, Global market cap equities, TSP G and DODLX FI. Rebalance to AA if FI <25% or >35%. Weighted ER<= 0.10%. 5% of annual portfolio balance SWR, Proportional (to AA) withdrawals.

Tdubs
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Re: FEHB Open Season 2019

Post by Tdubs » Thu Oct 17, 2019 8:49 am

BogleFanGal wrote:
Thu Oct 17, 2019 7:42 am
Tdubs wrote:
Thu Oct 17, 2019 4:39 am
tj wrote:
Wed Oct 16, 2019 10:22 pm
yes, it is the same network as other GEHA MEDICAL plans. Not the same network as the GEHA Dental plans, which is the the GEHA Connection Dental Federal® plan. The latter uses CIGNA, which is much larger than the dentists who have contracted directly with GEHA for it's medical plans.
Right, and you get the negotiated rates of the Connection network. So it doesn't matter which medical plan you pick to get the negotiated rates. The optional Dental plans have network and out of network coverage (and high and standard plans). So it would certainly have more provider options. For those who don't choose FEDVIP, the HDHP seems to offer better coverage for preventive and diagnostic services than the basic or high options (see section 5 of the brochure).
This dental benefits discussion is quite helpful - thank you. Can either of you please correct me if I'm misunderstanding any of the below?

1. GEHA HDHP offers preventive coverage, but with a smaller network of dentists participating.
2. The separate FEDVIP GEHA DENTAL plan offers more provider choices - a bigger network.
3. However, a fed employee that just opts for the GEHA HDHP without buying the separate GEHA dental plan will STILL benefit in two ways, even though they'll pay for all dental care (other than the preventive) out of pocket: (a) they will pay lower GEHA-negotiated fees vs as a walk-in/cash patient and (b) can access the bigger Dental Connections network for care at those preferred negotiated rates.)
I'm going to call GEHA today to verify items 1 & 2. FEDVIP certainly provides a larger "network" by offering out of network benefits, but I'm not sure in network is really different. It would be nice to know. I have extremely expensive bridgework looming in the next few years.

Tdubs
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Re: FEHB Open Season 2019

Post by Tdubs » Thu Oct 17, 2019 9:20 am

UALflyer wrote:
Thu Oct 17, 2019 8:01 am
Medical expenses are, in these discussions, about cost comparisons of necessity vs. necessity. Massages are usually discretionary spending. If you want to save some money on your monthly massage or six pairs of reading glasses rather than save it in a well-invested HSA, fine, but it isn't apples to apples. Don't compare FSA, indulgent savings to an HSA that can be banked for medical necessities.
This point has already been addressed several times. Once again, with a general FSA, if your dental, vision and healthcare copays are running too low for the year, you can easily fill in the gap with other eligible expenses (massages, sunblock, radon detection devices, etc...). The list of those FSA eligible expenses is enormous, and many of them do not require a prescription and are purchased anyway. At the same time, if your other FSA eligible expenses are running high for the year, you can easily defer many of the FSA eligible expenses until the following year.
There is a reason that GEHA's HDHP wins out (per Checkbook) whether you spend nothing, a little, average, or a lot on medical services. Exceptions are possible but improbable enough that most people should not base their insurance choices on them.
I am intentionally not responding to the rest of your post, which can be summarized as "Here is the way that I spend my healthcare dollars, and most people's spending should be just like mine. If it's not, "there is something wrong." Even when presented with actual examples of people's healthcare spending, you respond by stating how it is different from yours. Once again, people and their lifestyles are all different, so the fact that you are finding it difficult to understand their lifestyles is completely irrelevant to the insurance choices that are right for them.

The only reason that I am even responding here is because of the statement that I just quoted above, which is highly misleading. Once again, people (and you) need to understand all the factors that go into these decisions, so that they can run their own individual numbers. If you look at AnonJohn's post directly above yours, who, by the way, prefers the HDHP, you'll see an easy example where once you factor in the FSA tax savings, the GEHA Standard starts out over $600 ahead of the HDHP. For other categories of employees, such as part time employees, that advantage is even larger. I completely agree that this doesn't end the conversation, as this assumes that the participants would spend their maximum FSA contributions, assumes that the HDHP participants wouldn't use a limited purpose FSA, etc...

Hence, the point that I keep trying to make, which is that people need to understand all the factors that go into these calculations and then run the numbers for themselves. It makes absolutely no difference whether their lifestyles and healthcare utilization matches up against your expectations, or whether it fits any of the examples (my examples, by the way, are only intended to illustrate all the cost saving opportunities available to the non-HDHP participants, which are frequently misunderstood by those on the HDHP's) out there. My issue with your posts here is the fact that in your zeal to debate this, you are making it very difficult for people to understand all the factors that go into the calculations. You are also glossing over the powerful financial incentive that the HDHP participants have to postpone and even avoid seeking medical attention in situations that don't clearly call for it, but can be extremely dangerous.
Actually you are misinterpreting my position, as I noted previously. It isn't, "Here is the way that I spend my healthcare dollars, and most people's spending should be just like mine." It is: (1) Analysis (Checkbook) that has nothing to do with my particular situation indicates the HDHP is a better buy in four spending scenarios. That indicates that for most people, that is the best option. You rely on anecdotes, I'm using an independent source. (2) Your low-spend $400 dollar example used previously does not favor a basic plan when considering the value of an HSA. That was Grabiner's original point. In that scenario, you can only improve your position by changing the scenario to include optional spending you don't need to push the FSA savings and tax benefits higher. I'll repeat, if your medical spend is low, the HDHP/HSA wins. You seem to be ignoring that point because it is correct.

Thinking that I have "zeal" and you don't is pretty funny. I've never challenged your point that people should consider all factors, that's obvious. I've agreed with your point that an HDHP can discourage seeking treatment--did you forget already?

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Re: FEHB Open Season 2019

Post by Tdubs » Thu Oct 17, 2019 9:25 am

MnD wrote:
Thu Oct 17, 2019 8:23 am
UALflyer wrote:
Wed Oct 16, 2019 8:07 am

There are lots and lots of people out there with very stable healthcare needs, for whom practically all their healthcare spend consists of maintenance medications and office visits with labs. For people like that, a non-HDHP plan will frequently make way more financial sense... or not, as they need to run their specific numbers.

The very reason that employers and insurance companies like HDHP's is because they create powerful financial incentives for their participants to delay and avoid incurring medical expenses, which is the way that all these insurance companies and employers save money.

As I've previously mentioned, there are lots and lots of medical conditions that do not manifest themselves in an obvious way. If you have an HDHP and you get a really, really, really bad headache, you have a very powerful financial incentive to delay or avoid going to the ER. No matter how you slice it, an ER visit like that will cost you $1k+ (and, if imaging tests are ordered, you're talking about thousands of dollars), so there aren't a lot of HDHP participants out there who will just go to the ER right away, costs be damned. Instead, they will delay and try to manage it at home (until at least their regular doctor's office opens) as, after all, it's probably nothing. Yet, if it a brain aneurysm or subarachnoid hemorrhage, that delay could cost you your life.

Most people running these financial calculations tend not to pay all that much attention to the above factor. Yet, in practical terms, a person with no medical training already has a lot of trouble differentiating between emergent and non-emergent conditions, and the powerful financial incentive that HDHP's create causes virtually all HDHP participants to delay seeking care in these types of situations. This is the reason that I emphasize the fact that in close cases, people should err on the side of caution and opt for a non-HDHP.
A a textbook case of very stable healthcare needs (occasional office visits and limited generic maintenance med) I would second many of UALflyer's points as to why we've been GEHA standard plan for pretty much our entire adult lives. On top of that I really dislike mixing healthcare and insurance with investing which leads to another point - reducing financial complexity. Just reading the threads the various HSA account twists, turns , transfers and and tricks gives me a headache. They remind me of the threads of folks chasing on-line bank rates all the time with their savings, or paying a portion income taxes with pay-pal through a rotating quarterly rewards credit card to "make" $40 or whatever.

We invest and bank at Schwab for decades and likewise with FEHB in GEHA Standard and have a deep understanding of both which enables us to utilize their systems to the fullest. We do invest a lot in our health with regards to diet and exercise and I think that's a better and more straightforward investment than gaming health plans.
I'd agree, if you don't want complexity, don't sign up for an HDHP.

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Re: FEHB Open Season 2019

Post by tj » Thu Oct 17, 2019 9:36 am

Tdubs wrote:
Thu Oct 17, 2019 8:49 am
BogleFanGal wrote:
Thu Oct 17, 2019 7:42 am
Tdubs wrote:
Thu Oct 17, 2019 4:39 am
tj wrote:
Wed Oct 16, 2019 10:22 pm
yes, it is the same network as other GEHA MEDICAL plans. Not the same network as the GEHA Dental plans, which is the the GEHA Connection Dental Federal® plan. The latter uses CIGNA, which is much larger than the dentists who have contracted directly with GEHA for it's medical plans.
Right, and you get the negotiated rates of the Connection network. So it doesn't matter which medical plan you pick to get the negotiated rates. The optional Dental plans have network and out of network coverage (and high and standard plans). So it would certainly have more provider options. For those who don't choose FEDVIP, the HDHP seems to offer better coverage for preventive and diagnostic services than the basic or high options (see section 5 of the brochure).
This dental benefits discussion is quite helpful - thank you. Can either of you please correct me if I'm misunderstanding any of the below?

1. GEHA HDHP offers preventive coverage, but with a smaller network of dentists participating.
2. The separate FEDVIP GEHA DENTAL plan offers more provider choices - a bigger network.
3. However, a fed employee that just opts for the GEHA HDHP without buying the separate GEHA dental plan will STILL benefit in two ways, even though they'll pay for all dental care (other than the preventive) out of pocket: (a) they will pay lower GEHA-negotiated fees vs as a walk-in/cash patient and (b) can access the bigger Dental Connections network for care at those preferred negotiated rates.)
I'm going to call GEHA today to verify items 1 & 2. FEDVIP certainly provides a larger "network" by offering out of network benefits, but I'm not sure in network is really different. It would be nice to know. I have extremely expensive bridgework looming in the next few years.
Out of network benefits doesn't make the network different. The fedvip network is a completely different network with different negotiated pricing.

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Re: FEHB Open Season 2019

Post by UALflyer » Thu Oct 17, 2019 10:26 am

Tdubs wrote:
Thu Oct 17, 2019 9:20 am
I'll repeat, if your medical spend is low, the HDHP/HSA wins. You seem to be ignoring that point because it is correct.
This is all getting very circular, so I am not responding to the same statements that you keep repeating that have already been addressed multiple times.

If your medical spend is nothing or is very low, the HDHP/HSA wins, but only if you are a full time employee (if you are part time, it depends on how part time you are) and/or only if you completely ignore the tax benefits of the healthcare FSA. If you do factor in the tax benefits of the healthcare FSA, and/or you are a part time employee (depends on how part time you are), the HDHP/HSA typically loses.

You keep thinking of the FSA eligible expenses, other than medical co-pays, as "optional spending you don't need," which apparently reflects your individual situation, which, as I keep pointing out, does not need to match up to that of other people. This is the crux of the issue here. Once again, given just how flexible the general healthcare FSA's are and just how many everyday expenses can be reimbursed from it without a letter of medical necessity, it can be very easy for people to maximize their usage without incurring any medical expenses and without "optional spending [they] don't need." Once again, it can be very easy for people, and especially for families with kids, to receive additional tax benefits by incurring the same FSA eligible expenses that they would incur anyway. The fact that a lot of these expenses are not time sensitive gives people a lot of flexibility, so that if their medical expenses are running high, they can defer the other expenses to the following year. If their medical expenses are running low, they can pull some of the expenses into the current year. This flexibility only affects the timing (as in, you can get your contacts in October or in January) and does not mean that any of the expenses are optional and wouldn't be made anyway. At the very minimum, the fact that a $500 portion of the healthcare FSA can be rolled over means that the non-HDHP participants should never have their healthcare FSA election at $0 (unless they anticipate leaving their employment prior to their ability to use up the funds in full).

The biggest benefit of the HDHP's is in the fact that the HSA's (which, for tax purposes, enjoy tax treatment that is identical to that of the FSA's) do not have a "use it or lose it" stipulation of the FSA's. That is certainly a very nice benefit, but what a lot of people do not understand is that to really maximize it, they need to invest the HSA funds, and pay the HSA eligible expenses from other funds. In order to benefit from the investment, it needs to be a long term one. You also should be maxing out your TSP's/401(k)'s/457's, and Roth/backdoor Roth's, as maxing out your HSA and paying expenses from your outside funds, while simultaneously failing to max out your other tax advantaged accounts generally doesn't make much sense. Most employer-based HSA custodians only offer limited investment options that come with higher fees than you can otherwise obtain. If you opt for a non-employer based HSA custodian, you'll avoid these limitations, but pay a penalty in the form of the FICA tax (I've already addressed the situation where you're above the Social Security wage cap for the year). The vast majority of the HDHP participants out there do not actually do all of the above, and just use their HSA funds to pay for various eligible expenses on a regular basis. In those cases, even in situations where the HDHP wins, for FEHB's we are generally talking about pretty small amounts (in AnonJohn's example above, in which he actually favors the HDHP, the win was equal to $70, and that's without counting any tax benefits of a general healthcare FSA paired with a non-HDHP and was for a full time employee), all while subjecting the participants to the risks that I've mentioned above that have to do with them being incentivized to postpone and/or avoid seeking medical attention.
Last edited by UALflyer on Thu Oct 17, 2019 11:27 am, edited 1 time in total.

Tdubs
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Re: FEHB Open Season 2019

Post by Tdubs » Thu Oct 17, 2019 11:17 am

tj wrote:
Thu Oct 17, 2019 9:36 am
Tdubs wrote:
Thu Oct 17, 2019 8:49 am
BogleFanGal wrote:
Thu Oct 17, 2019 7:42 am
Tdubs wrote:
Thu Oct 17, 2019 4:39 am
tj wrote:
Wed Oct 16, 2019 10:22 pm
yes, it is the same network as other GEHA MEDICAL plans. Not the same network as the GEHA Dental plans, which is the the GEHA Connection Dental Federal® plan. The latter uses CIGNA, which is much larger than the dentists who have contracted directly with GEHA for it's medical plans.
Right, and you get the negotiated rates of the Connection network. So it doesn't matter which medical plan you pick to get the negotiated rates. The optional Dental plans have network and out of network coverage (and high and standard plans). So it would certainly have more provider options. For those who don't choose FEDVIP, the HDHP seems to offer better coverage for preventive and diagnostic services than the basic or high options (see section 5 of the brochure).
This dental benefits discussion is quite helpful - thank you. Can either of you please correct me if I'm misunderstanding any of the below?

1. GEHA HDHP offers preventive coverage, but with a smaller network of dentists participating.
2. The separate FEDVIP GEHA DENTAL plan offers more provider choices - a bigger network.
3. However, a fed employee that just opts for the GEHA HDHP without buying the separate GEHA dental plan will STILL benefit in two ways, even though they'll pay for all dental care (other than the preventive) out of pocket: (a) they will pay lower GEHA-negotiated fees vs as a walk-in/cash patient and (b) can access the bigger Dental Connections network for care at those preferred negotiated rates.)
I'm going to call GEHA today to verify items 1 & 2. FEDVIP certainly provides a larger "network" by offering out of network benefits, but I'm not sure in network is really different. It would be nice to know. I have extremely expensive bridgework looming in the next few years.
Out of network benefits doesn't make the network different. The fedvip network is a completely different network with different negotiated pricing.
Yes, that is why I put "network" in quotations. Anyway, I talked to a GEHA dental specialist. In the medical plans, you have access to one network, the GEHA Connection network. This is GEHA's go-to network and has the lowest negotiated prices. In FEDVIP plans, you have access to Connection and three more networks: Cigna, Careington, and Dentamax. However, GEHA may have different negotiated rates for the same procedure between the four "in-network" networks. The best buy will almost always be with a provider in the Connection network vs. one that is only in one of the other three.

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Drain
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Re: FEHB Open Season 2019

Post by Drain » Thu Oct 17, 2019 1:05 pm

Re GEHA HDHP dental vs. the dedicated dental plan: I stand corrected. Yes, I knew the HDHP covered preventive and offered negotiated rates. But I figured the FEDVIP plan would provide additional discounts, like 50% on major procedures, 75% on less-major procedures, etc., or something like that. If it doesn't...wow. Okay. Are the negotiated rates in the plan really that good compared with cash pricing? Or is it just that they prevent "crazy rates"?

Re HDHP (medical) vs. other: Yes, my situation is my own, and that's what I'll address. Here's how I think about it.

First, as noted by others, Checkbook has the HDHP beating the Standard plan at every spend point it examines. It's safe to assume that there are cases in which those cases don't reflect a possible situation, but it would seem like the odds were in your favor unless you had specific and well thought-out reasons to believe otherwise.

Second...after the $1800 employer contribution (note that I am on the Family plan), the deductible is effectively $1200. I contribute the max to the HSA which saves me about another $800 over what I could get with an HCFSA. That leaves an effective deductible of around $400. Heck, I might be willing to pay that much simply to avoid playing the use-it-or-lose-it game. Add in the tax-free compounding I will get within the HSA over the years, and I'm not worried about that $400, which leaves me with just a lower premium compared with the STandard plan.

Now that I think about it, I don't recall the details of the Standard plan, so maybe there are other advantages. But from memory, by and large, the above has been my reasoning. Oh, and I have read before that HDHPs have fewer loopholes with regard to their OOP maximums, on average, than other plans do. But I'm not sure that applies to GEHA Standard or High).
Darin

tj
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Re: FEHB Open Season 2019

Post by tj » Thu Oct 17, 2019 2:32 pm

Drain, I don't know about "additional discounts" but fedvip has coinsurance apply for those other procedures.

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Re: FEHB Open Season 2019

Post by Tdubs » Thu Oct 17, 2019 6:26 pm

Drain wrote:
Thu Oct 17, 2019 1:05 pm
Re GEHA HDHP dental vs. the dedicated dental plan: I stand corrected. Yes, I knew the HDHP covered preventive and offered negotiated rates. But I figured the FEDVIP plan would provide additional discounts, like 50% on major procedures, 75% on less-major procedures, etc., or something like that. If it doesn't...wow. Okay. Are the negotiated rates in the plan really that good compared with cash pricing? Or is it just that they prevent "crazy rates"?

Re HDHP (medical) vs. other: Yes, my situation is my own, and that's what I'll address. Here's how I think about it.

First, as noted by others, Checkbook has the HDHP beating the Standard plan at every spend point it examines. It's safe to assume that there are cases in which those cases don't reflect a possible situation, but it would seem like the odds were in your favor unless you had specific and well thought-out reasons to believe otherwise.

Second...after the $1800 employer contribution (note that I am on the Family plan), the deductible is effectively $1200. I contribute the max to the HSA which saves me about another $800 over what I could get with an HCFSA. That leaves an effective deductible of around $400. Heck, I might be willing to pay that much simply to avoid playing the use-it-or-lose-it game. Add in the tax-free compounding I will get within the HSA over the years, and I'm not worried about that $400, which leaves me with just a lower premium compared with the STandard plan.

Now that I think about it, I don't recall the details of the Standard plan, so maybe there are other advantages. But from memory, by and large, the above has been my reasoning. Oh, and I have read before that HDHPs have fewer loopholes with regard to their OOP maximums, on average, than other plans do. But I'm not sure that applies to GEHA Standard or High).
FEDVIP's advantage is in a wider network of providers and, of course, the coverage they provide in addition to the negotiated rates that all GEHA members enjoy.

The Standard plan's two obvious advantages over the HDHP, better accidental ER coverage and mostly free labs. GEHA HDHP has other advantages.

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motorcyclesarecool
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Re: FEHB Open Season 2019

Post by motorcyclesarecool » Fri Oct 18, 2019 6:29 am

VictoriaF wrote:
Tue Oct 15, 2019 3:56 pm
motorcyclesarecool wrote:
Mon Oct 14, 2019 8:44 pm
VictoriaF wrote:
Mon Oct 14, 2019 3:19 pm

I have recently left GEHA, and now HSA Bank charges me $2/month. What are good options for holding a ~$40k HSA account used as savings (not investments) for ~$3k-$4k annual withdrawals?

Victoria
Fidelity HSA charges no fees and has online bill pay on the website. (The app doesn’t do online bill pay from my HSA). I haven’t tried to do a debit card for my Fidelity HSA. Perhaps someone knows the answer. You can choose FDIC insured options for your cash, or a range of brokered CDs and mutual funds.
I am not interested in an HSA debit card or online bill pay. I prefer to pay my bills using credit cards, claim my expenses online, and get reimbursed as a transfer from the HSA custodian to my bank account. Can I do that with Fidelity?

Victoria
I haven’t done that yet, but I can try it with my next bill and follow-up. At a minimum, I think I can do an online bill pay to myself or to my credit card company.
Understand that choosing an HDHP is very much a "red pill" approach. Most would rather pay higher premiums for a $20 copay per visit. They will think you weird for choosing an HSA.

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Re: FEHB Open Season 2019

Post by LadyGeek » Fri Oct 18, 2019 6:53 am

The discussion is starting to focus on GEHA HDHP dental coverage vs. GEHA FEDVIP plans. Please start a new thread to discuss.

Let's use this thread for a general discussion of the FEHB open season.
Wiki To some, the glass is half full. To others, the glass is half empty. To an engineer, it's twice the size it needs to be.

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Drain
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Re: FEHB Open Season 2019

Post by Drain » Fri Oct 18, 2019 11:35 am

In theory, I shouldn't have to think about features like free labs or better ER rates, as those should already be reflected in the Checkbook estimates. But I have no way of knowing if Checkbook is taking these into account. In particular, the Lab Card is something I could easily imagine them overlooking or intentionally leaving out as a supplementary benefit that won't necessarily be used by the insured.

For my family, those features don't matter. We have been hitting the deductible easily every year we've been on an HDHP, so those savings wind up not being important. But perhaps this will change.
Darin

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Re: FEHB Open Season 2019

Post by UALflyer » Fri Oct 18, 2019 1:08 pm

Drain wrote:
Fri Oct 18, 2019 11:35 am
In theory, I shouldn't have to think about features like free labs or better ER rates, as those should already be reflected in the Checkbook estimates. But I have no way of knowing if Checkbook is taking these into account. In particular, the Lab Card is something I could easily imagine them overlooking or intentionally leaving out as a supplementary benefit that won't necessarily be used by the insured.
Right, while I'm sure that the Checkbook estimates are consistent across different health plans (meaning that they use the same hypothetical expenses and run them through different plans), all the different "usage" labels that they use are not particularly insightful, as they don't tell you what is included in those. There just isn't really a way for them to incorporate all the nuances of different plans into their very simple spreadsheet, nor is there a way to incorporate the tax impact of various scenarios, as it depends on their participants' tax situations and the tax deferral options that they elect.

If you are just completely lost and don't have the time or the inclination to look through the features of various plans, Checkbook is much better than just doing it randomly or asking a co-worker for a recommendation, whose healthcare spend may be totally different from yours. If you are willing to invest a few hours into the process, however, and understand some of the money saving opportunities presented by various plans in the context of your anticipated plan usage, you will frequently find yourself savings thousands of dollars and greatly reducing your frustrations down the road.

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Re: FEHB Open Season 2019

Post by AnonJohn » Mon Oct 21, 2019 10:38 am

As I was quoted, correctly, in my math describing a $70 advantage for the HSA/HDHP approach, which did not include the FSA benefit, I hasten to add a clarification. That $70 advantage is near the worst case scenario for the HDHP, when spending is exactly at the deductible level. And, as others have mentioned, it neglects the potential for a compounded tax advantage.

I say "near" because benefits and services are complicated enough that there may be other scenarios. Certainly Consumers Checkbook considers some scenarios to reach the same recommendation.

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Re: [2018 Open Season] FEHB HDHP options for Federal Employees

Post by Flora » Sun Nov 17, 2019 2:39 pm

[Posts moved into here, see below. --admin LadyGeek]

If you are new to GEHA HDHP for 2020, and open a Fidelity HSA, do you have to wait until February 2020 to start contributing through MyPay to the Fidelity HSA?

Can anyone explain the mechanics? Logging in to MyPay today only shows an option of entering a single (one-time?) amount, effective the next pay period. I was hoping to see an election for 2020.

This is for a single employee, so the maximum is $3,650 - $900 premium credit = $2,650 for 2020.

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motorcyclesarecool
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Re: [2018 Open Season] FEHB HDHP options for Federal Employees

Post by motorcyclesarecool » Sun Nov 17, 2019 3:14 pm

Flora wrote:
Sun Nov 17, 2019 2:39 pm
If you are new to GEHA HDHP for 2020, and open a Fidelity HSA, do you have to wait until February 2020 to start contributing through MyPay to the Fidelity HSA?
No. You can contribute to your Fidelity HSA once you hit Pay Period 1, when your FEHB election takes effect. February is when the first pass-through from GEHA hits HSA Bank.
Flora wrote:
Sun Nov 17, 2019 2:39 pm
Can anyone explain the mechanics? Logging in to MyPay today only shows an option of entering a single (one-time?) amount, effective the next pay period. I was hoping to see an election for 2020.
I’m not familiar with MyPay. In NFC MyEPP, you can set your biweekly HSA allotment once and forget it. It sounds like your payroll processor does something similar, but I defer to someone who’s seen it firsthand. It sounds like you’ll have to ask your payroll POC when to make the election so that it takes effect PP1.
Understand that choosing an HDHP is very much a "red pill" approach. Most would rather pay higher premiums for a $20 copay per visit. They will think you weird for choosing an HSA.

Tdubs
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Re: [2018 Open Season] FEHB HDHP options for Federal Employees

Post by Tdubs » Sun Nov 17, 2019 3:20 pm

Flora wrote:
Sun Nov 17, 2019 2:39 pm
If you are new to GEHA HDHP for 2020, and open a Fidelity HSA, do you have to wait until February 2020 to start contributing through MyPay to the Fidelity HSA?

Can anyone explain the mechanics? Logging in to MyPay today only shows an option of entering a single (one-time?) amount, effective the next pay period. I was hoping to see an election for 2020.

This is for a single employee, so the maximum is $3,650 - $900 premium credit = $2,650 for 2020.
My agency doesn't use MyPay, but I believe that you will wind up with two HSAs by opening with Fidelity. The GEHA HDHP employer pass through goes to HSA Bank. I believe you can transfer that balance to your Fidelity HSA periodically, but that sounds like an unnecessary complication.

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Re: FEHB Open Season 2019

Post by LadyGeek » Sun Nov 17, 2019 3:33 pm

I moved Flora's question and several replies from the 2018 open-season thread into here (2019 open season).
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Re: FEHB Open Season 2019

Post by AznSaver » Sun Nov 17, 2019 4:43 pm

daheld wrote:
Thu Oct 10, 2019 8:26 am
Curious if anyone else here uses APWU. I've been very pleased over the last four years but rarely hear anyone who uses this plan.
I use the MHBP (Mail handler benefits plan) it is an APWU plan but not THE APWU plan, plan id 48 vs 47.
It's a very comparable plan to the one's mentioned, has pros & cons, from GEHA.

Pro - It's has the highest passthrough amount of $1200 (self only), low cost, $15 co-pays after deductible instead of percentage based co-insurance.
Con - I am not a part of the APWU so I pay a yearly $42 associate membership fee annually.

I'll likely stick with my selected plan unless something major happens either with me or the plan requiring a change in my plans.
I like the plan HSA administrator payflex: no fees, good investment choices and only $1k holding requirement.

It seems most on this forum tend to favor the GEHA plans which is probably do to provider availability or some other metric that is not part of my consideration.

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Re: FEHB Open Season 2019

Post by tj » Sun Nov 17, 2019 4:45 pm

AznSaver wrote:
Sun Nov 17, 2019 4:43 pm
daheld wrote:
Thu Oct 10, 2019 8:26 am
Curious if anyone else here uses APWU. I've been very pleased over the last four years but rarely hear anyone who uses this plan.
I use the MHBP (Mail handler benefits plan) it is an APWU plan but not THE APWU plan, plan id 48 vs 47.
It's a very comparable plan to the one's mentioned, has pros & cons, from GEHA.

Pro - It's has the highest passthrough amount of $1200 (self only), low cost, $15 co-pays after deductible instead of percentage based co-insurance.
Con - I am not a part of the APWU so I pay a yearly $42 associate membership fee annually.

I'll likely stick with my selected plan unless something major happens either with me or the plan requiring a change in my plans.
I like the plan HSA administrator payflex: no fees, good investment choices and only $1k holding requirement.

It seems most on this forum tend to favor the GEHA plans which is probably do to provider availability or some other metric that is not part of my consideration.
GEHA pays a lot more towards dental and vision, so I believe it's more cost efficient. Also no minimum to invest with HSA Bank/TDA

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Re: FEHB Open Season 2019

Post by AznSaver » Sun Nov 17, 2019 5:25 pm

tj wrote:
Sun Nov 17, 2019 4:45 pm
GEHA pays a lot more towards dental and vision, so I believe it's more cost efficient. Also no minimum to invest with HSA Bank/TDA
In some respects I agree with that statement, on it's face value it is the most cost effective.
The MHBP like most health plans has no coverage for vision/dental.
The GEHA cost is less, $10 less a month for my specific case and has a $500 lower deductible.
The passthrough difference of $300 more for MHBP negates the $120 increase in cost.
If also considering dental & vision in addition to MHBP, even with the passthrough, GEHA is less expensive within a difference of $100 or less.

The reason I still prefer MHBP is the cost of care when used the $15/$50 copay versus the 5% co-insurance.
While in most cases the GEHA comes out slightly ahead or even vs $15/$50, the cases of high cost events will have a much higher penalty.

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Re: FEHB Open Season 2019

Post by tj » Sun Nov 17, 2019 6:45 pm

AznSaver wrote:
Sun Nov 17, 2019 5:25 pm
tj wrote:
Sun Nov 17, 2019 4:45 pm
GEHA pays a lot more towards dental and vision, so I believe it's more cost efficient. Also no minimum to invest with HSA Bank/TDA
In some respects I agree with that statement, on it's face value it is the most cost effective.
The MHBP like most health plans has no coverage for vision/dental.
The GEHA cost is less, $10 less a month for my specific case and has a $500 lower deductible.
The passthrough difference of $300 more for MHBP negates the $120 increase in cost.
If also considering dental & vision in addition to MHBP, even with the passthrough, GEHA is less expensive within a difference of $100 or less.

The reason I still prefer MHBP is the cost of care when used the $15/$50 copay versus the 5% co-insurance.
While in most cases the GEHA comes out slightly ahead or even vs $15/$50, the cases of high cost events will have a much higher penalty.
What scenarios are you envisioning the co-pays being cheaper than 5% coinsurance? I had to go to the emergency room in Hawaii and they charged $950 before any insurance company negotiated rate discounts. 5% of that would still be less than $50.


Also, consider your exposure when you are out of network with MHBP. According to this document it's 40% coinsurance on almost everything: https://www.mhbp.com/pdf/ConsumerOption ... 034033.pdf

That's higher than GEHA's 25% out of network.

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Re: FEHB Open Season 2019

Post by AznSaver » Sun Nov 17, 2019 8:53 pm

tj wrote:
Sun Nov 17, 2019 6:45 pm
What scenarios are you envisioning the co-pays being cheaper than 5% coinsurance? I had to go to the emergency room in Hawaii and they charged $950 before any insurance company negotiated rate discounts. 5% of that would still be less than $50.

Also, consider your exposure when you are out of network with MHBP. According to this document it's 40% coinsurance on almost everything: https://www.mhbp.com/pdf/ConsumerOption ... 034033.pdf

That's higher than GEHA's 25% out of network.
I do understand what your saying in terms of averages and most occurrences GEHA is marginally less expensive.
In my personal choice for insurance I would rather work with defined numbers and plan for that cost, I understand that life doesn't always respect that choice... The ER co-pay is $50, however it is waived if admitted and out of pocket maximum is wavied as well, to my understanding the underlying deductible is all that needs to be satisified in this situation.

Thankfully I haven't experienced many medical emergencies but with the experiences I have had it has lead me to believe the costs are quit high.
2006 - ER visit total cost was $2350 + $240 medication (walk-in)
2018 - ER + ambulance ride (Unplanned anaphylaxis ): $5840 was admitted.

In both these situations if my math is correct (a lot of times it isn't :? ) I would have been ahead with my current plan would I not?
All of this was in network.

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Re: FEHB Open Season 2019

Post by tj » Sun Nov 17, 2019 9:20 pm

AznSaver wrote:
Sun Nov 17, 2019 8:53 pm
tj wrote:
Sun Nov 17, 2019 6:45 pm
What scenarios are you envisioning the co-pays being cheaper than 5% coinsurance? I had to go to the emergency room in Hawaii and they charged $950 before any insurance company negotiated rate discounts. 5% of that would still be less than $50.

Also, consider your exposure when you are out of network with MHBP. According to this document it's 40% coinsurance on almost everything: https://www.mhbp.com/pdf/ConsumerOption ... 034033.pdf

That's higher than GEHA's 25% out of network.
I do understand what your saying in terms of averages and most occurrences GEHA is marginally less expensive.
In my personal choice for insurance I would rather work with defined numbers and plan for that cost, I understand that life doesn't always respect that choice... The ER co-pay is $50, however it is waived if admitted and out of pocket maximum is wavied as well, to my understanding the underlying deductible is all that needs to be satisified in this situation.

Thankfully I haven't experienced many medical emergencies but with the experiences I have had it has lead me to believe the costs are quit high.
2006 - ER visit total cost was $2350 + $240 medication (walk-in)
2018 - ER + ambulance ride (Unplanned anaphylaxis ): $5840 was admitted.

In both these situations if my math is correct (a lot of times it isn't :? ) I would have been ahead with my current plan would I not?
All of this was in network.
Yes, if you are guaranteed to have $50 co-pays for expensive medical expenses, it would make sense.

Does GEHA not do the waiving that MHBP does for ER admittances?

Anyway, for me, I guess I can afford $5k out of pocket max (but it's really only $3500 after the deductible, and the 5% coinsurance 3500 would require $70k of medical bills), so I'm okay with sticking with GEHA. Certainly nothing wrong with choosing MHBP though.
Last edited by tj on Sat Nov 30, 2019 12:41 pm, edited 1 time in total.

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Re: FEHB Open Season 2019

Post by Barefootgirl » Sat Nov 30, 2019 11:42 am

I'm sticking my neck out to ask an ignorant question.

Posters have discussed that a negative attribute of GEHA HDHP is that it disincentivizes people to seek out health care, even necessary health services.

Does the disincentive lie only in the case where they have not yet met the $1500 upfront deductible within a particular calendar year?

Is that it? or is there some other disincentive that I am missing? if it lies in the HSA, I would use funds from somewhere else to pay that deductible and only use the HSA funds later on down the road.
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Re: FEHB Open Season 2019

Post by Tdubs » Sat Nov 30, 2019 12:25 pm

Barefootgirl wrote:
Sat Nov 30, 2019 11:42 am
I'm sticking my neck out to ask an ignorant question.

Posters have discussed that a negative attribute of GEHA HDHP is that it disincentivizes people to seek out health care, even necessary health services.

Does the disincentive lie only in the case where they have not yet met the $1500 upfront deductible within a particular calendar year?

Is that it? or is there some other disincentive that I am missing? if it lies in the HSA, I would use funds from somewhere else to pay that deductible and only use the HSA funds later on down the road.
Any health plan that requires payment for services--be it deductible, copay, or coinsurance--has some disincentive to seek care. The two areas where the GEHA HDHP clearly has a greater disincentive than the GEHA standard or high option plan is the deductible period and ER treatment after an accident--the latter is a free service on the standard plan vs. the HDHP's deductible and 5% coinsurance after that.

It was interesting to go through a year on the HDHP to see if the plan was really a disincentive. In my family, I've concluded it wasn't. My wife and kids weren't even aware of the HDHP's features and sought treatment as they always would. I, of course, was very aware of the disincentive and consciously made a point of getting services--typical ones for my age.

I also found the HDHP to be an incentive to getting care. Once we hit the deductible, the superior coverage of the HDHP incentivized me to get services and nag my family members to make appointments THIS year.

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Re: FEHB Open Season 2019

Post by Barefootgirl » Sat Nov 30, 2019 1:26 pm

I thought of another possibility - with a regular FSA account, the cost of deductibles is reimbursed through many types of services, but with the HDHP, the cost of deductibles is only reimbursed via dental and vision expenses. (FSA LEX) and last time I checked those are minimal with the GEHA dental and vision plans.
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Re: FEHB Open Season 2019

Post by Cash » Sat Nov 30, 2019 1:38 pm

Tdubs wrote:
Sat Nov 30, 2019 12:25 pm
Barefootgirl wrote:
Sat Nov 30, 2019 11:42 am
I'm sticking my neck out to ask an ignorant question.

Posters have discussed that a negative attribute of GEHA HDHP is that it disincentivizes people to seek out health care, even necessary health services.

Does the disincentive lie only in the case where they have not yet met the $1500 upfront deductible within a particular calendar year?

Is that it? or is there some other disincentive that I am missing? if it lies in the HSA, I would use funds from somewhere else to pay that deductible and only use the HSA funds later on down the road.
Any health plan that requires payment for services--be it deductible, copay, or coinsurance--has some disincentive to seek care. The two areas where the GEHA HDHP clearly has a greater disincentive than the GEHA standard or high option plan is the deductible period and ER treatment after an accident--the latter is a free service on the standard plan vs. the HDHP's deductible and 5% coinsurance after that.

It was interesting to go through a year on the HDHP to see if the plan was really a disincentive. In my family, I've concluded it wasn't. My wife and kids weren't even aware of the HDHP's features and sought treatment as they always would. I, of course, was very aware of the disincentive and consciously made a point of getting services--typical ones for my age.

I also found the HDHP to be an incentive to getting care. Once we hit the deductible, the superior coverage of the HDHP incentivized me to get services and nag my family members to make appointments THIS year.
This has been my experience this year too. Previously, my wife was on her own plan, but she joined mine this year after we had a child. One emergency room visit knocked out the deductible, so I have been encouraging her to make every appointment possible by the end of the year!

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Re: FEHB Open Season 2019

Post by tj » Sat Nov 30, 2019 3:29 pm

Barefootgirl wrote:
Sat Nov 30, 2019 1:26 pm
I thought of another possibility - with a regular FSA account, the cost of deductibles is reimbursed through many types of services, but with the HDHP, the cost of deductibles is only reimbursed via dental and vision expenses. (FSA LEX) and last time I checked those are minimal with the GEHA dental and vision plans.

Ther are no deductibles with the dental nad vision plans. You can use your HSA to reimburse the cost of the medical deductible.

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Re: FEHB Open Season 2019

Post by AznSaver » Sun Dec 01, 2019 2:29 am

Barefootgirl wrote:
Sat Nov 30, 2019 1:26 pm
I thought of another possibility - with a regular FSA account, the cost of deductibles is reimbursed through many types of services, but with the HDHP, the cost of deductibles is only reimbursed via dental and vision expenses. (FSA LEX) and last time I checked those are minimal with the GEHA dental and vision plans.
What you are describing is the Limited Expense Health Care FSA, not a HDHP HSA. If you have an HSA you CANNOT also have a regular FSA account as IRS regulations prohibit you from contributing to both.

The Limited Expense Health Care FSA can be used with an HSA; however it can only be used to reimburse vision and dental expenses as medical reimbursement is provided by the HSA... Also like Tj said with the GEHA HDHP preventative vision/dental are covered by the plan, without a deductibles, so there is nothing to reimburse... only non-preventative or costs exceeding standard coverage would need to be covered/reimbursed.

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Re: FEHB Open Season 2019

Post by AznSaver » Sun Dec 01, 2019 3:09 am

Barefootgirl wrote:
Sat Nov 30, 2019 11:42 am
I'm sticking my neck out to ask an ignorant question.

Posters have discussed that a negative attribute of GEHA HDHP is that it disincentivizes people to seek out health care, even necessary health services.

Does the disincentive lie only in the case where they have not yet met the $1500 upfront deductible within a particular calendar year?

Is that it? or is there some other disincentive that I am missing? if it lies in the HSA, I would use funds from somewhere else to pay that deductible and only use the HSA funds later on down the road.
The disincentive aspect is there because people typically think they have to "pay out the butt" until they receive the benefits of their health ins.

A lot of people misunderstand coverages and costs with health ins and more so with HDHP/HSAs. (Generalization statements warning)
All health ins./plan types will generally cover preventative care, deductibles do not apply...
I am able to see my doctor for my annual physical, do required lab work, and receive recommended immunizations at no cost.
The services you receive beyond preventative care and prescriptions needed you pay at insurance negotiated rates, i.e. cheaper.
The FEHB HDHPs typically cost less and have employer passthroughs that actually pay you just for having the plan.
(Self coverage GEHA HDHP has a $1500 deductible with a $900 passthrough, i.e. NET deductible $600 (1500-900))
Even when you do hit your deductible it's not a free lunch in a HDHP or even a regular health plan, it isn't until you hit your yearly out of pocket maximum.

If you do have health issues that have regular moderate-high costs prescriptions or procedures then a HDHP might have not been the right type of plan to choose in the first place. IMHO, If people are delaying truly necessary health services just to save a few bucks they might want to rethink their priorities... You can always make more money, but you only have one life.

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Re: FEHB Open Season 2019

Post by motorcyclesarecool » Sun Dec 01, 2019 6:38 am

AznSaver wrote:
Sun Nov 17, 2019 4:43 pm

Pro -[...]$15 co-pays after deductible instead of percentage based co-insurance.
Given that our most expensive prescription is an epi-pen at $500 if I can’t find a coupon, that works out to a $25 copay after the deductible under GEHA HDHP. Copay on the occasional amoxicillin is pennies. To me, it hurts more to pay $15 when I could be paying pennies in the marority of cases than it does to pay $25 when I could be paying $15 once.
The scenario where I’d consider MHBP HDHP would be if I expected to hit and significantly exceed the out-of-pocket maximum for the year.
Understand that choosing an HDHP is very much a "red pill" approach. Most would rather pay higher premiums for a $20 copay per visit. They will think you weird for choosing an HSA.

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Re: FEHB Open Season 2019

Post by motorcyclesarecool » Sun Dec 01, 2019 7:04 am

Tdubs wrote:
Sat Nov 30, 2019 12:25 pm
Barefootgirl wrote:
Sat Nov 30, 2019 11:42 am
I'm sticking my neck out to ask an ignorant question.

Posters have discussed that a negative attribute of GEHA HDHP is that it disincentivizes people to seek out health care, even necessary health services.

Does the disincentive lie only in the case where they have not yet met the $1500 upfront deductible within a particular calendar year?

Is that it? or is there some other disincentive that I am missing? if it lies in the HSA, I would use funds from somewhere else to pay that deductible and only use the HSA funds later on down the road.
Any health plan that requires payment for services--be it deductible, copay, or coinsurance--has some disincentive to seek care. The two areas where the GEHA HDHP clearly has a greater disincentive than the GEHA standard or high option plan is the deductible period and ER treatment after an accident--the latter is a free service on the standard plan vs. the HDHP's deductible and 5% coinsurance after that.

It was interesting to go through a year on the HDHP to see if the plan was really a disincentive. In my family, I've concluded it wasn't. My wife and kids weren't even aware of the HDHP's features and sought treatment as they always would. I, of course, was very aware of the disincentive and consciously made a point of getting services--typical ones for my age.

I also found the HDHP to be an incentive to getting care. Once we hit the deductible, the superior coverage of the HDHP incentivized me to get services and nag my family members to make appointments THIS year.
I’ve also concluded that it was not a disincentive. I’ll have been on GEHA HDHP for the past five years in January. I am absolutely clear that paying this way saves me money on an annualized basis, but is slightly less “convenient” than paying a higher premium in exchange for predictable (not necessarily lower) copays.
I come out ahead buying my eggs, bread, and milk at Costco rather than the corner convenience store. I view HDHP as a similarly smarter approach. The supposed convenience of higher premiums for predictable copays is not attractive to me.

One unexpected positive effect is that I appreciate my physicians more than I did with traditional insurance.

I also expect more from them. I’m more willing to seek a second opinion or travel to a different city to see the top practice in that particular field.

Now that I have a decent amount saved in my HSA, I feel like I can hop on a plane to Mayo if a family member needed it, and not bat an eye. An HDHP plus HSA has me feeling almost financially independent regarding medical expenses. I like this feeling. I don’t want to give it up.
Understand that choosing an HDHP is very much a "red pill" approach. Most would rather pay higher premiums for a $20 copay per visit. They will think you weird for choosing an HSA.

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Re: FEHB Open Season 2019

Post by AznSaver » Sun Dec 01, 2019 12:48 pm

motorcyclesarecool wrote:
Sun Dec 01, 2019 6:38 am
AznSaver wrote:
Sun Nov 17, 2019 4:43 pm

Pro -[...]$15 co-pays after deductible instead of percentage based co-insurance.
Given that our most expensive prescription is an epi-pen at $500 if I can’t find a coupon, that works out to a $25 copay after the deductible under GEHA HDHP. Copay on the occasional amoxicillin is pennies. To me, it hurts more to pay $15 when I could be paying pennies in the marority of cases than it does to pay $25 when I could be paying $15 once.
The scenario where I’d consider MHBP HDHP would be if I expected to hit and significantly exceed the out-of-pocket maximum for the year.
While I do understand the sentiment and have acknowledged that GEHA on average is less expensive for routine costs, MHBP HDHP is better for high cost emergency and moderate-high prescription costs. The GEHA "co-pay" for prescription costs is 25% generic costs while MHBP is $10... 25% of $500 is $125... Both plans will have negotiated rates for prescriptions and for me if it is less then the $10 cap I do pay the lesser amount.

After we both hit the deductible, even if your costs were $0 from routine procedures/labs you are only saving $15 in cost from me...
In that same scenario if we both go into the ER, I will only have to pay $50, unless admitted then I pay $0, while you are paying 5% of whatever the cost is and that could be very expensive... On the other hand if I was consistently reaching the out-of-pocket max, I would probably not choose a HDHP but if I had to I would choose the GEHA plan instead as it has a lower out-of-pocket max.

Even with 10 years of experience in the Insurance industry before I became a federal employee I don't purport to be anywhere close to an expert in regards to health insurance: it's an every changing beast with more nuances and intricates than all other insurance combined.
Insurance is a personal and situational choice and I respect your opinion and choice in the matter. I personally would rather possibly save a little less on the routine procedures and have only a specific amount to pay for high costs emergency/catastrophic occurrences.

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Re: FEHB Open Season 2019

Post by AznSaver » Sun Dec 01, 2019 12:59 pm

motorcyclesarecool wrote:
Sun Dec 01, 2019 6:38 am
Given that our most expensive prescription is an epi-pen...
I also require an Epinephrine auto-injector (Epi-Pen), the time I found this out was bad $5k hospital bill, all costs were covered. However that was also the same day they released a few generics on the market.

If you haven't been hitting your deductible where the costs for you might be negligible please look into the Impax auto-injector. It is a generic Epi-pen that is extremely affordable and could possible save you alot over the long term... Cash price i believe was $100 for the two-pack, it could be even less with insurance negotiated rates.

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Re: FEHB Open Season 2019

Post by motorcyclesarecool » Sun Dec 01, 2019 5:30 pm

AznSaver wrote:
Sun Dec 01, 2019 12:48 pm

Both plans will have negotiated rates for prescriptions and for me if it is less then the $10 cap I do pay the lesser amount.
[record scratch] That makes a huge difference! So, on MHBP I could pay LESS than the flat copay? I’ll have to ponder that again.
AznSaver wrote:
Sun Dec 01, 2019 12:59 pm
I also require an Epinephrine auto-injector (Epi-Pen), the time I found this out was bad $5k hospital bill, all costs were covered. However that was also the same day they released a few generics on the market.

If you haven't been hitting your deductible where the costs for you might be negligible please look into the Impax auto-injector. It is a generic Epi-pen that is extremely affordable and could possible save you alot over the long term... Cash price i believe was $100 for the two-pack, it could be even less with insurance negotiated rates.
I have a little one with severe food allergies.
Searching around, Impax looks a lot like Adrenaclick. We had an adrenaclick for a while. If it was for me, I’d go generic in a heartbeat. For my kid, the Mylan EpiPen is what I leave with the babysitter or send to school, as it is more intuitive, delivers the drug more quickly (3 seconds vs 10 with generic). It’s more likely to be administered correctly by a bystander. Once my kid is older, and could be trusted to self-administer, I think the generic could be an option once again.
Understand that choosing an HDHP is very much a "red pill" approach. Most would rather pay higher premiums for a $20 copay per visit. They will think you weird for choosing an HSA.

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Re: FEHB Open Season 2019

Post by TimeRunner » Sun Dec 01, 2019 5:30 pm

Side-subject but instructive: We have GEHA Standard with Caremark mail-order. Two-pack generic Epi-Pen injector is $20, free shipping.
One cannot enlighten the unconscious.

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