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

182 articles found

• 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"

• 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

• 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

• 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?

• Claims Processing

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

• 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

• 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

• 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.

• 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.

• 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

• 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

• 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.

• Profile Age

  Health costs vary even more by age than by family size.

• Medicare Cost Waiver

  An increasing number of plans provide a Medicare wraparound that covers your hospital, physician, and other medical expenses (but not prescription drugs) at no cost to you whether or not you use

• Published Premium

  This shows the premium you pay, even if you have no health care bills. It does not reflect the tax-preferred discount you receive (approximately one third) if you participate in "premium conversion".

• Gynecologist

  All fee-for-service plans and almost all HMOs now let women get their regular OB-GYN checkups with preferred providers without requiring referral by a primary care physician.

• Accredited

  We report whether plans are accredited by NCQA or by URAC or AAAHC, two smaller accrediting organizations. "Yes" means that the plan is accredited by one or more of these organizations.

• GEHA Medicare Advantage

  If you enroll in this GEHA FEHB plan, have Medicare Parts A & B, and in enroll in GEHA's special Medicare Advantage plan, you will receive both better benefits and a Medicare Part B premium

• United Medicare Advantage

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

• Aetna Medicare Advantage

  If you enroll in this FEHB plan, Medicare Parts A & B, and Aetna Medicare Advantage, you will receive Medicare Part B premium reimbursements and many eligible medical benefits at little to no

• CDPHP Medicare Advantage

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

• Followup Mental Illness

  Follow-up appointment within 30 days of discharge.

• MHBP Medicare Advantage

  If you enroll in this MHBP FEHB plan, have Medicare Parts A & B, and in enroll in MHBP's special Medicare Advantage plan, you will receive both better benefits and a Medicare Part B premium