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

193 articles found

  • 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.

  • 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

  • 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,

  • 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

  • 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

  • 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

  • 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

  • Plan Name

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

  • 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"

  • Medicare and Provider Selection

    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. However, network problems largely disappear if you

  • FEHB Enrollment Category

    This entry indicates your premium category. Premiums are not the same for GS, FDIC, SEC, and several other types of eligible employees. GS part-time employees pay part of the employer share of the

  • Dental Plan Type

    There are three different plan types. 1. There are "official" benefits in some FEHB plans that go beyond an accidental injury benefit. 2. There are "unofficial" benefits in many FEHB plans that cost

  • Getting Needed Care

    How often was it easy to get an appointment, the care tests, or treatments you thought you needed through your health plan?

  • TRICARE

    Would it be advantageous for me to enroll in TRICARE (I am retired military) rather than remaining with my FEHB plan? In general, TRICARE is a better choice than any FEHB plan, because its benefits

  • Mail Order Drugs

    A "Yes" means that the plan gives you a substantial supply, often with a discount (usually a three month supply for the normal cost of one or two months) if you fill a prescription by mail order.

  • Foreign Service Medicare Advantage

    If you enroll in this FEHB plan, Medicare Parts A and B, and the Foreign Service Medicare Advantage plan, you will receive Medicare Part B premium reimbursements and many eligible medical benefits at

  • Use of Imaging Studies for Low Back Pain

    The percentage of members with an initial diagnosis of low back pain who did not have an imaging study (X-ray, MRI, CT scan) within 28 days of the diagnosis.

  • Claims Processing

    How often did your health plan handle your claims quickly and correctly?

  • Hearing Aids Child and Adult

    Many plans only cover children, not adults. And the age limit for children also differs among plans. We show you the age limit for a child, if present, the coverage amount, and replacement frequency.

  • Hospital Stay

    Some plans have an admission fee for a hospital stay. Some plans charge per day with a total stay maximum, and some plans charge just per stay. Most plans waive these charges for enrollees who have

  • Savings Account

    For Consumer Driven and High Deductible plans with a savings account, we show the savings account contribution, because you will be able to use the savings account before reaching the deductible.

  • Extra Cost of Part B

    The difference between what you will likely pay, including both premiums and out-of-pocket costs, when you have an FEHB plan with both Medicare Parts A and B, compared to the same plan with only Part

  • Deductible

    This is the deductible, if any, that you (or you and your family) will have to pay before the plan will reimburse most medical expenses. Not all payments count against the deductible, so we recommend

  • Overall Rating By Members

    This measure is based on the question, "Using any number from 0 to 10, where 0 is the worst health plan possible and 10 is the best health plan possible, what number would you use to rate your health

  • Regular Benefits Anywhere

    Some HMO plans will let you use partner HMOs elsewhere without paying any extra charges for routine care. All plans pay for emergency care anywhere in the world without substantial penalty.

  • Specialist Visit

    Some plans charge a percentage, most a dollar co-payment, for each visit to a preferred or affiliated specialist physician or provider.

  • Primary Care Visit

    Some plans charge a percentage, most a dollar co-payment, for each visit to a preferred or affiliated primary care physician or provider.

  • Non Preferred Coverage

    All fee for service plans (except BCBS Basic, BCBS FEP Blue Focus, and GEHA Elevate Plus), and some HMOs, let you use physicians and other providers who are not "preferred"; if you are willing to pay

  • Out of Network Benefit

    Most dental plans do provide out-of-network coverage. But that coverage is either lower, costs you more, or both. These plans are good buys only when you plan to make regular use of network providers.

  • Name Brand Drugs

    Most newer drugs are under patent and cost more. Some plans charge a percentage, most a dollar co-payment, for each prescription. In most cases the amount specified allows a one month supply from the

  • Med B Savings Size

    If you want a simpler summary of likely savings from having Parts A and B compared to Part A only, we rate plans as having "large" savings if the savings equal two-thirds or more of the Part B

  • Generic Drugs

    Generic drugs are usually less expensive than name brand drugs still under patent. Some plans charge a percentage, most a dollar co-payment, for each prescription. In most cases, the amount specified

  • Open Formulary

    Many plans use a "formulary" that limits your choice of drugs. You have to pay much more, and sometimes the entire cost, if you choose a name brand drug for your condition that is not on the

  • Self Plus One Cheaper

    Most, but not all plans, charge a lower premium for a Self plus One enrollment than for a Self Family enrollment for a couple or a single parent with one child.

  • Drug Deductible

    Some plans charge a special deductible for drugs. NA means no deductible.

  • Orthodontic

    All of the FEDVIP dental plans have a substantial orthodontic benefit. Orthodontic expenses are the perfect dental expense for combining a dental plan with an FSA account for expenses the plan

  • Hospital Inpatient

    A few plans make you pay for a small percentage of other inpatient hospital charges.

  • Hospital Room & Board

    A few plans make you pay for a small percentage of hospital room and board charges.

  • Hearing Aids

    A "Yes" means that the plan pays part of the cost of a hearing aid for both children and adults. "Some" means that this benefit is available only for children. Most plans will pay for a hearing aid

  • Part B Rebate

    A few plans offer partial Medicare Part B reimbursements for those enrolled in Medicare Part B. These savings are included in our yearly cost estimates with Medicare Parts A & B and in the Extra Cost

  • Vision Care

    All plans cover the cost of medically necessary vision care. A "yes" means that the plan, in addition, will pay for refractions and roughly half or more of the cost of glasses or contact lenses;

  • Dental Cost None

    The standalone dental plans charge an extra premium. However, dental benefits provided by FEHB plans require no extra premium. The amount shown reflects the tax-preferred discount you receive

  • Specialist without referral

    All fee-for-service plans and most HMOs now let you go to any specialist on the preferred provider list without referral by a primary care physician.