FEHBP 2009 Open Season

[CountryBoy]

Yeah, Show-me. I know what you mean. That's one intangible thing I'm really weighing in my calculations. In my last MRI series I was in the tube for almost 4 hours and the medical bill was a real stomach twister. BCBS paid all but pennies and didn't even blink.

Lady

Yep, bypass surgery almost 5 years ago and BCBS paid just about all of it and my annual stress tests, it doesn't cost me a dime. They each have good points and bad.

CB

 

[Silverbird]

That's why I wear the silver standard BCBS handcuffs - I don't like the lack of choices I get with other programs. Here comes the bill . My only consolation - most people don't get their choice of wristwear, or get none at all.

 

[XL-entLady]

I'm looking at various options for the FEHBP Open Season, and I'm wondering if any of you have experience or opinions about NALC that you'd like to share?

BTW, the opm.gov "PlanSmartChoice" tool is pretty cool if you're trying to decide where to start comparing plans.

https://www.plansmartchoice.com/registration.aspx

TIA for sharing any info on NALC,
Lady

 

[XL-entLady]

I'm looking at various options for the FEHBP Open Season, and I'm wondering if any of you have experience or opinions about NALC that you'd like to share?

BTW, the opm.gov "PlanSmartChoice" tool is pretty cool if you're trying to decide where to start comparing plans.

https://www.plansmartchoice.com/registration.aspx

TIA for sharing any info on NALC,
Lady

Never mind re the NALC question. My pain management clinic doesn't take that insurance so I can't consider it. Bummer.

Lady

 

[XL-entLady]

I mentioned previously on this thread that I wasn't happy with how much my BCBS premiums and out-of-pocket costs are going to go up in 2009 so I was shopping around. I've spent the day asking each of my health care providers for a list of the insurances that they take. Turns out that BCBS is the only one that is on every list. SO-O-O that's the one I'm staying with next year!

It's Silverbird's comment about the silver handcuffs all over again. But SB also said we should count our blessings that we have our choice of wristwear and she's so right!

Now I just have to do my due diligence on whether to keep or change my dental and vision insurance carriers.

Has anyone else had any blinding flashes of insight this open season?

Lady

 

[Guest2]

Before I start this little tidbit of information, I just want everyone to
know that I'm more then aware of my O.C.D. Please use it to make a
more informed decision. I visited the http://PlanSmartChoice.com
website. I went to the estimated "Out of Pocket" tab and calculated
everything being done once except for prescriptions. I entered our
current number of prescriptions using Mail Order and came up with a
fair based "Out of Pocket" estimate. I then rated each which fell under
$2000 and came up with the Top7 Choices. Here are the results that
met my personal criteria;

#01-- Coventry High
#02a- Samba High
#02b- Amerihealth High
#02c- Samba Standard
#03a- NALC PPO
#03b- Keystone High
#04-- GEHA High
#05a- MailHandlers PPO
#05b- Bluecross Basic*
#06-- Amerihealth High
#07-- Bluecross Standard

I then compared the Month Premiums for each and rated the Top7 based
on how expensive they were;

#01-- Bluecross Basic*
#02-- Samba Standard
#03-- NALC PPO
#04-- Mailhandlers PPO
#05-- Bluecross Standard
#06-- GEHA High
#07-- Amerihealth High

I then let the website figure out what preferences met my desires closest
and put them into numerical order and gave them a Top7 rating;

#01-- Samba Standard
#02-- NALC PPO
#03-- Bluecross Basic*
#04-- Mailhandlers PPO
#05-- Amerihealth High
#06-- GEHA High
#07-- Samba High

The conclusion: Based on all of the above, Doctor Preferences and their
locations, It did not make sense to select the cheapest premium, the least
expensive "out of pocket" plan. However, the plan I've chosen was based
on a combination of other factors, as well as expense. The Plan is;
BLUECROSS BLUE SHIELD (BASIC)

 

[XL-entLady]

Before I start this little tidbit of information, I just want everyone to know that I'm more then aware of my O.C.D. ....The conclusion: Based on all of the above, Doctor Preferences and their locations, It did not make sense to select the cheapest premium, the least expensive "out of pocket" plan. However, the plan I've chosen was based on a combination of other factors, as well as expense. The Plan is;
BLUECROSS BLUE SHIELD (BASIC)

First of all, Squale, don't know if you are kidding or not about that OCD thing. (Need that "tongue in cheek" emoticon again! :cheesy:) My daughter has OCD for real, but sometimes it pays off, such as when she just knew something was wrong with the 4 year old, kept at it until they found the child was going blind in one eye and they fixed it.

Thanks for sharing all your hard work, your step by step process and your excellent conclusions! I sit at the feet of the Master!

Lady

 

[Frixxxx]

I thought he was just referring to his version of O.C.D.:

One Creative Dude!!!:laugh:

 

[Guest2]

First of all, Squale, don't know if you are kidding or not about that OCD thing. (Need that "tongue in cheek" emoticon again! ) My daughter has OCD for real, but sometimes it pays off, such as when she just knew something was wrong with the 4 year old, kept at it until they found the child was going blind in one eye and they fixed it.

Thanks for sharing all your hard work, your step by step process and your excellent conclusions! I sit at the feet of the Master!

Lady

For as long as I can remember, both friends and family enjoyed a great
deal of amusement over some of my behavior. Number crunching, my
need to keep items either horizontal or vertical, etc... I've never been
diagnosed with OCD, however, even I recognize my need to have my
environment kept in a manner which I feel comfortable in. Angles are
not in my vocabulary and they must be adjusted should they exist. If
thats one of the symptoms, then I guess I really am. I don't look at it
as a hardship, just fuel to add to my friends fire. They certainly get a
kick out of it all.

I thought he was just referring to his version of O.C.D.:
One Creative Dude!!!

Thanks for the new title, I shall wear it with honor. Also, I wish to thank
you for adding me into your "friend" list. Thats cool beyond words.

 

[XL-entLady]

Good morning, all!

As you all probably know we have less than one week left in our FEHB open season for health insurance. The season ends on December 8, 2009. I don't know how many of you have Blue Cross Standard Option health insurance, but if you do please be aware of the significant changes for 2009!

The following Fedsmith article isn't available through their links anymore, but here it is from my notes:

"Surprise, We're Cutting Your Federal Employee Benefits!
More than 4 million federal employees and retirees are having their benefits cut by Blue Cross Blue Shield (BCBS). OPM describes the changes on page 10 of a 137-page document. A policy change increases a patient's out-of-pocket cost up to $7,500.00 for each procedure or surgery when using an out-of-network provider, and it imposes up to a $350.00 out-of-pocket cost for care provided by an out-of-network emergency room doctor.
Posted: November 27, 2008 "

And here's another one:

http://www.washingtonpost.com/wp-dyn/content/article/2008/11/25/AR2008112502576_pf.html

I have BCBS Standard Option but am scrambling to find another choice that all my many health care providers will accept. So far, it looks like Aetna may be my only other choice. But I'm still looking.

We are down to the last days before we're stuck in our plans for another full year. Have you made changes? If so, would you mind sharing your reasons?

Thanks!
Lady

 

[Guest2]

Good morning, all!

As you all probably know we have less than one week left in our FEHB open season for health insurance. The season ends on December 8, 2009. I don't know how many of you have Blue Cross Standard Option health insurance, but if you do please be aware of the significant changes for 2009!

The following Fedsmith article isn't available through their links anymore, but here it is from my notes:

"Surprise, We're Cutting Your Federal Employee Benefits!
More than 4 million federal employees and retirees are having their benefits cut by Blue Cross Blue Shield (BCBS). OPM describes the changes on page 10 of a 137-page document. A policy change increases a patient's out-of-pocket cost up to $7,500.00 for each procedure or surgery when using an out-of-network provider, and it imposes up to a $350.00 out-of-pocket cost for care provided by an out-of-network emergency room doctor.
Posted: November 27, 2008 "

And here's another one:

http://www.washingtonpost.com/wp-dyn/content/article/2008/11/25/AR2008112502576_pf.html

I have BCBS Standard Option but am scrambling to find another choice that all my many health care providers will accept. So far, it looks like Aetna may be my only other choice. But I'm still looking.

We are down to the last days before we're stuck in our plans for another full year. Have you made changes? If so, would you mind sharing your reasons?

Thanks!
Lady

After all the work I did to compare the Plans, I pulled out my trusty "oops,
I changed my mind" card and opted to go with Aetna HMO. I just couldn't
bring myself to get BCBS Notification's (New Jersey) 9 months after I had
a procedure any longer. Double dipping with a Assistant Anestesiologist is
quite aggravating as well. But I understand that this may be, in part, the
blame of the New Jersey and Philadelphia Offices and not a countrywide
problem. Your post simply makes me feel better about my decision. For
that, I wish to thank you.

 

[XL-entLady]

Congress to hold hearing on BCBS coverage changes

http://www.usnews.com/articles/news...anges-for-federal-workers-raise-concerns.html



Lady

 

[felixthecat]

I did some serious research and I'm leaning toward Blue Cross Basic family coverage. However...the only fly in the ointment is that two medications will eat up about $1000 dollars in family plan cost savings between Basic and Standard. Still, I come out 600 dollars ahead on the plan cost, and pay no deductible with Basic. All of our Preferred Providers needs are met. Still, I somehow filled robbed that benefits are decreasing and costs are increasing. Pharmacy drugs can tilt the scales.

The two drugs that are costly are Asmanex and Benicar. Level II and Level III drugs.

 

[XL-entLady]

...the only fly in the ointment is that two medications will eat up about $1000 dollars in family plan cost savings between Basic and Standard. ...I somehow filled robbed that benefits are decreasing and costs are increasing. Pharmacy drugs can tilt the scales.

I feel your pain, Felix. I take 8 meds and spouse takes 5. That's lucky 13 total and most don't come in generic. BCBS out of pocket costs will more than double in 2009.

I'm pouring over spreadsheets and doublechecking preferred provider lists like mad. I've got it narrowed down to (1) keeping BCBS because of preferred provider options or (2) switching to Aetna HDHP for serious cost savings.

Decisions ... decisions!

Lady

 

[Frixxxx]

I feel your pain, Felix. I take 8 meds and spouse takes 5. That's lucky 13 total and most don't come in generic. BCBS out of pocket costs will more than double in 2009.

I'm pouring over spreadsheets and doublechecking preferred provider lists like mad. I've got it narrowed down to (1) keeping BCBS because of preferred provider options or (2) switching to Aetna HDHP for serious cost savings.

Decisions ... decisions!

Lady

Waddya Got if ya ain't got your health?!?!:nuts:

 

[XL-entLady]

I'm pouring over spreadsheets and doublechecking preferred provider lists like mad. I've got it narrowed down to (1) keeping BCBS because of preferred provider options or (2) switching to Aetna HDHP for serious cost savings.

Decisions ... decisions!

Waddya Got if ya ain't got your health?!?!:nuts:

Just found out that all my specialists are on Aetna's preferred provider list! Woohoo! FYI, one of my providers wasn't on Aetna's web list of preferred providers, but I phoned the Aetna federal helpline to double-check and the specialist was in the main Aetna database.

So I get the preferred providers AND the cost savings! Score!!

And Frixxxx, my buddy, the answer to your question is: "A serious hole in your wallet!" :blink: :cheesy:

Lady

 

[felixthecat]

I appreciate your thoughts. Well, I live in Louisiana so the Aetna plan is not available here. Decisions decisions.

 

[roskopfm]

I have Humana HMO for the past four years. Although some doctors are not part of the plan, most are. The payroll deduction is 50% of the Blue Cross amount. THere is no deductable and the co-pays are extremely low. I had surgery and only had to pay a $125 co pay. Office visits cost $25, and drugs are low.

 

[XL-entLady]

The final day to make FEHB changes is Monday!

I did all my final comparisons and after the yellow haze from the highlighter pen subsided, my final picks are:

- Aetna for my primary insurance (changing from BCBS because of the premium raises and benefit reductions)

- MetLife for my dental

- FEB Blue High Option for my vision

It was all a matter of cost/benefit ratios but everybody is different in their particular needs. I can't believe the kilowatts of computer time and acres of trees that died before I finally had my answer!

Now I'm going to get the changes done this weekend before the websites get too backed up. Good luck with your decisions!

Lady

 

[MohammadXX]

The final day to make FEHB changes is Monday!

From Federal Soup message board____originally posted by sam8:

Because of the dust-up over BCBS Standard's 2009 change re: non-participating surgeons (the $7,500 out of pocket), OPM has announced, in essence, an extension of Open Season for health plans and an intent to provide additional protection for using out of network surgeons. Please see Breaking News at the OPM site: http://www.opm.gov/news/opm-to-prov...llees-who-use-outofnetwork-surgeons,1443.aspx and Joe Davidson's Dec. 5 Federal Diary column in the Washington Post: http://www.washingtonpost.com/wp-dyn/content/article/2008/12/05/AR2008120502782.html
RECOMMEND CHECKING FOR DETAILS BEFORE ANYONE DELAYS TAKING OPEN SEASON ACTION, especially as OPM announcement (currently) does not reference retirees.[/QUOTE]rom Federal Soup message board: