Search results for how can checkbooks guide to health plans for federal employees help me

176 articles found

  • What the End of the COVID-19 Public Health Emergency Means for FEHB Coverage

    On May 11, 2023, the Department of Health and Human Services ended the COVID-19 Public Health Emergency (PHE). As a result, some FEHB benefit provisions enacted by OPM will change going forward. OPM

  • Clinical Quality of Care for FEHB Plans

    We also report ratings from OPM on how plans compared for clinical quality of care. These data are from the Healthcare Effectiveness Data and Information Set (HEDIS), which are standardized

  • International Health Coverage

    I am recently retired, looking to select a health plan that will work for my wife and I. Both of us have selected Medicare A and B. The past 10 years we have had our health plan with Kaiser. However

  • Should I Join an HMO in the FEHB Program?

    HMO plans provide not just insurance, but also a different approach to health care delivery from traditional fee-for-service medicine. Therefore, although cost and benefit comparisons are the key

  • Deductibles, Copayments, and Coinsurance in the FEHB Program

    You can use cost sharing details to assist you in choosing a plan by pinpointing strengths and weaknesses for items of particular importance. If you are especially concerned about a broad area of

  • What You Need to Know About Vision Care in the FEHB Program

    All FEHB plans pay for medically necessary care of your eyes, such as cataract surgery. Many pay for annual refractive examinations to determine your prescription for eyeglasses or contact lens, and

  • FEHB & Medicare Part D

    The Medicare Part D prescription drug program benefits millions of Americans. It fills a major hole in Medicare that lasted 50 years. But, historically, it would rarely benefit federal retirees who

  • Types of FEHB Plans

    Plans are of three main types: Preferred Provider Organization (PPO) and Fee-for-Service (FFS) plans, High Deductible (HDHP) and Consumer-Driven (CDHP) plans Health Maintenance Organization (HMO)

  • Limitations on FEHB Enrollment

    Many plans are open to all employees. However, HMOs require that you live or work in their service area, and a few plans require that you work for a particular agency or join a specific union. Most

  • Big Changes in How Federal Annuitants Receive Prescription Drug Benefits in 2024 and Beyond

    Major Medicare Part D reforms were enacted in the Inflation Reduction Act of 2022 (IRA). Some of the legislation’s provisions seek to lower prescription drug costs for both Medicare beneficiaries and

  • Will My FEHB Plan Pay for That?

    Most plans limit reimbursement for most of the following services. Current employees can cover any of them through a Flexible Spending Account. Dental care—Only some plans cover dental care. We

  • Why FEHB Premiums Vary

    The General Schedule (GS) employee and retiree share of the annual premium varies widely among plans. In national plans it ranges from about $1,400 to almost $4,000 for individuals, and from about

  • Restricted Plans

    Compass Rose is open to active employees and annuitants of the Intelligence Community, State Dept, Department of Defense, VA, and U.S. Coast Guard. Foreign Service Benefit plan is open to active

  • Advice for Persons Who Pay Full FEHB Premiums

    The FEHB program also provides coverage for former spouses, former employees, children turning age 26, and others. In each of these cases, the covered enrollee must pay the full premium without

  • Mental Health

    All plans cover low-cost mental outpatient care provided that the plan approves both the provider and the number of visits. Rarely are many visits approved. This entry indicates the amount

  • FEHB & Medicare Advantage

    Federal retirees have Medicare Advantage (MA) plans to consider joining. Our analysis shows that some of these offerings are an outstanding value. Aetna, APWU, Compass Rose, Kaiser, GEHA, MHBP, Rural

  • Surgical Procedures & Disease Management

    If someone is going to have major surgery, say a hysterectomy, is there a better plan for this and managing any care/complications? In the case of planned surgery, we recommend four things. First, if

  • How to Get FEHB Plan Information

    The OPM website has plan brochures and a great deal of other useful information. There are three additional ways to get brochures: Attend health fairs Call the plan Visit the plan website You change

  • What You Need to Know About Dental Care in the FEHB Program

    Plans' dental benefits differ widely in details, and many of the brochures use technical terminology such as "gingival" (gum, in English), "alveolar" (the part of the jawbone that holds teeth in

  • FEHB Plan Brochures

    You can download PDF copies of plan brochures at the Checkbook, OPM, and plan websites, and either use them online or as print copies. Plan brochures are necessary to determine what benefits each

  • Expected Health Care Usage

    We present ratings by average, low, or high expected health care use. Unless you are quite sure that your health care situation is unusual, we strongly recommend selecting "average". However, if you

  • Health Alliance Medicare Advantage

    If you enroll in this FEHB plan, Medicare Parts A and B, and the Health Alliance Medicare Advantage plan, you will receive Medicare Part B premium reimbursements and lower out-of-pocket costs for

  • Dental Care

    I am a new employee and I have the Blue Cross Basic plan. I've reviewed the plan and it seems to cover dental as well as medical. But I have always thought I needed separate dental and vision. Others

  • Flexible Spending Accounts

    For most employees, Health Care Flexible Spending Accounts (FSAs) provide a way to shelter even more health care spending from taxes. FSAs allow you to shelter the out-of-pocket costs for copayments,

  • FEHB Plan Quality

    For traditional fee-for-service insurance plans, service quality used to be a minor issue. The main service concerns were how easily you could get help from plan representatives regarding coverage

  • FEHB Eligibility

    Non-career USPS employees are eligible to enroll in FEHB plans after one year of service. However, in the vast majority of cases you'll pay the full premium in FEHB plans with no USPS contribution.

  • Medicare Basics - The Four Parts of Medicare - A, B, C, D

    Medicare Part A—Hospital Insurance—When you become eligible to join Medicare, you'll be enrolled in Part A. Most people don't pay an extra premium as you've been paying for Part A through paycheck

  • Nursing Care Benefits in the FEHB Program

    There are four kinds of nursing care: Skilled care while in a hospital. Skilled care in a special extended or skilled care facility. Care in your own home provided by visiting nurses. Custodial care

  • No Cost Year

    This shows the yearly cost to you for premium (adjusted for the benefits of premium conversion if eligible, a savings of 33%), applicable health savings accounts in Consumer Driven and High

  • Plan Type

    Health Maintenance Organizations, or HMOs, are almost all local plans and have a closed set of doctors. A few HMOs allow you to use providers outside the plan's network, a variation called

  • Medicare Advantage Plan

    Medicare-eligible enrollees can leave FEHB for a Medicare Advantage plan and then come back to an FEHB plan the next open season. Some companies offer FEHB and Medicare Advantage plans. With these

  • Average Cost Year

    Your costs for health care include more than just insurance premiums. Our "Estimated average yearly costs for families like yours" also includes what you have to pay for the part of costs not covered

  • Zip Code

    The FEHB program has both national plans and plans that serve only particular states or cities. You can choose the Zip code where you live or work. If you live outside a plan's official enrollment

  • Most You Can Pay

    Insurance plans have a stated limit on what you might have to pay in a year for premium, hospital, doctor, drug, and other medical costs. But some plans have loopholes that may leave you paying

  • Should I Use Non-Preferred Providers With My FEHB Plan?

    You face far higher costs if you use non-preferred providers in most plans, though many plans remove this cost if you have Medicare Parts A & B. Plans not only charge you more for deductibles,

  • Yearly Cost Estimate - Medicare Part A only

    Your yearly estimated costs include your FEHB premium and what you have to pay for your share of hospital, doctor, prescription, and other costs. We calculate typical costs for someone like you for

  • FEDVIP Eligibility

    Non-career USPS employees that have worked 130 hours per month for the last 90 days are eligible to enroll in FEDVIP dental and vision plans.

  • High Cost Year

    Our High Cost year estimates the out-of-pocket amounts you are likely to pay for a major hospital visit along with heavier use of primary care and specialist physicians, outpatient services, drugs,

  • Low Cost Year

    Our Low Cost year estimates the out-of-pocket amounts you are likely to pay for a number of doctor visits (one of which is an annual checkup), modest prescription drug and lab test spending, minor

  • Doctors in Plan

    This shows whether the doctor(s) you selected were found by Checkbook the last time we looked at the health plans' online physician directory. Even when a doctor appears in a plan's directory, they

  • Doctors

    My doctors are not preferred providers in any plan. What should I do? Set up an FSA account for about half the amount you expect to spend on those doctors. Then pick one of the top ranked plans that

  • What's a Point of Service FEHB Plan?

    Some HMOs provide a Point of Service (POS) option under which you may, by paying a deductible and coinsurance, use any doctor or hospital. This benefit is essentially identical to the fee-for-service

  • Yearly Cost Estimate

    Your costs for health care include more than just your insurance premiums. "Estimated yearly costs" include not only your premiums but also what you have to pay for the part of costs not covered by

  • Profile Coverage

    Health costs vary with family size; we take this into account in rating plans. We do not have ratings for families larger than 5 (or for Medicare beneficiaries with covered children) but ratings for

  • FEHB Plan Accreditation

    We report whether or not plans are accredited by NCQA, URAC, or AAAHC. These organizations have procedures to determine whether plans meet the organizations accreditation standards. The standards

  • Maternity Care

    What plan offers the best maternity benefits? Most plans offer low or no cost maternity coverage. Check brochures for this, and check network lists online to make sure you will have a good selection

  • Should I suspend FEHB coverage and just have Medicare Advantage?

    If you join a commercial MA plan, not Medicare Advantage plans offered by FEHB plans, you can temporarily suspend your FEHB enrollment and stop paying two sets of premiums. Under the suspend option,

  • Should I Use Preferred Providers With My FEHB Plan?

    We rate plan costs based on the assumption that you will always or almost always want to use preferred providers, also known as staying in network. Your cost is always lower, usually far lower, when

  • Plan Code

    This is a code assigned by OPM, unique to each plan in each geographic area. Use it to be sure you have the right plan and to enroll. Codes ending in a "1" or a "4" are for individuals, and in a "2"

  • Plan Name

    This is the name of the plan. In some cases, we abbreviate the name to make our tables clearer.