Solving the Health Plan Puzzle

The FEHBP will be available from November 11 to December 9 in 2019. You don’t have a lot of time for ensuring that you’ve chosen the right healthcare plan that will take care of your requirements for 2020. It isn’t too early for people to start looking at their options. Recently, major changes have been made to the health program. New options are now available.
FEHBP healthcare plans offer these benefits: laboratory services; emergency services; mental health disorder services (which includes behavioral health care); prescription drugs; substance abuse and newborn and maternity care & pediatric services (which includes vision and oral care); hospitalization; habilitative and rehabilitative devices and services; chronic disease treatment; wellness and preventive services.
Cost Factors
One of the primary health plan cost drivers is coverage for prescription drugs. Twenty-seven percent of FEHBP premiums went for prescription medications for the year 2017. Expenses are expected to go higher as expensive drugs enter the market.
Inpatient hospitalization is another area to be considered. Over 70% of hospital-related expenses in the US are accounted for by the 35 expensive conditions as per Business Insider reports. These include heart arrhythmias, diverticulitis, pneumonia, and pancreatic disorders. Some health plans may have better coverage compared to others for such expenses. Due to this however, their premiums are likely to be even higher.
Selecting the Right Health Plan
The healthcare plan you choose may be depend on what stage of life you’re in. Here are a few characteristics of certain plans, which may work for you at certain stages in life.
Healthy and Young (Ages 20 to 35)
• Consider consumer drive health plans. Value or basic plan options like GEHA Elevate and FEP Blue Focus have extremely low premiums.
• If these plans do not include vision and basic dental coverage, add a low-cost FEDVIP plan.
• A lot of health plans provide incentives and rewards for being healthy.
• Contribute to a spending account, which can be used for out-of-pocket costs like prescription copays, allergy shots, and physical therapy.
Mid-Career (Ages 40-55)
• Look for plans that have low cost sharing and premiums like Aetna HealthFund HDHP & UnitedHealthcare HDHP, and GEHA HDHP. Go for high deductible health plans that come with a health savings account, which offer tax savings.
• Go for a low-cost sharing plan with in-network health benefits, like the ones offered in MHBP Standard, BC/BS Standard or Basic Option. Standard plans are also good for this age group as people belonging to this age range may have several ongoing health issues.
Pre-Retirement (Age Group 55+)
• Look for plans that provide low cost sharing and comprehensive medical facilities like BS/BC Basic and NALC High Option
• People in this age group can also go for HDHP plans, provided enrollees also have HSAs and do not have any other insurance like a partner’s private sector health plan or TRICARE.
• Look for plans that provide coverage for chronic conditions that you may be suffering from. The OPM website happens to be a great place for starting your hunt to obtain the best health plans for your family. Best of luck with your search!