How to find the best health plan during the open season
Finding the right health plan is always tricky. Costs and benefits can change from year to year and needs are often unpredictable. But in 2022, there is a change to health coverage, including the Federal Employee Health Benefit Program, that could positively impact almost all beneficiaries. Last year, Congress passed the Law without surprise, which comes into effect on January 1. Under the new law, surprise billing is prohibited for emergency services. This means that patients will not pay more for emergency care than they would have paid to receive networked care. The law also prohibits prior authorization requirements for emergency services, whether the provider is networked or not.
This increased predictability of costs in an emergency should be good news for all feds. To better prepare for the inevitable surprises in healthcare, there are six questions federal employees should ask themselves each year.
- Is my plan still available? Several HMO plans left the FEHB program in 2022, and a national plan, United Advantage, will not be available this year.
- Are there any new projects to consider? There are a handful of newly available HMO plans for federal employees in 2022, including HealthKeepers HDHP offered in parts of Virginia.
- Are my doctors still on the network and are my prescriptions still listed on the form? It’s always a good idea to check to receive the lowest possible disbursements under your plan.
- How much has my premium increased? The share of enrollment bonuses for federal employees increased by 3.8% on average. However, some plan premiums have remained the same, and some have even decreased. Be sure to check out how you will be impacted in 2022.
- Are the same benefits available in my plan for the same reimbursable costs? Plan benefits may change each year, new benefits may be added, and existing benefits may be removed or cost you more. Consult section 2 of the official FEHB scheme brochure to see if any important benefits have changed in your current scheme.
- What type of registration should I choose? Couples and other two-person families should check if Self and Family registration is cheaper than Self Plus One registration. There are 98 FEHB plan options this year where family car registration is cheaper.
Federal authorities looking to save money on their health insurance have several options:
Change plan: The easiest way to save money is to find another plan, and a cheaper plan may very well be just as good or better than what you currently have. About 5% of federal employees will change health plans during the open season. We know, advising thousands of them over the years, that many stay in expensive plans when better and cheaper options are available.
Our 2022 Health Plans Guide ranks plans based on estimated annual cost, combination of known expense (premium), and expected out-of-pocket expense based on user profile. Below, we show that a family of four in the Washington, DC area, with average expenses, could save about $ 3,700 in annual costs by switching from Blue Cross Standard to GEHA Elevate. There are other great deals on the plans and it only takes a few minutes to see how your existing plan compares to other options.
Consider a high deductible health plan: In most cases, an HDHP plan is the cheapest option available, but far too few federal employees are signing up for it. No one likes a high deductible or knows what you will pay for a health expense before the deductible. But keep in mind that HDHP plans tend to have lower premiums than popular PPO options and you can find out the cost of any health expense by calling the health plan.
HDHP plans have a pre-funded health savings account (HSA), and the key to maximizing the plan’s full potential is to try and maintain or even increase the contribution to the plan each year.
There are two ways to do this. First, if you are switching from a more expensive PPO plan to an HDHP plan, contribute the premium savings to the HSA instead of pocketing them. All the money you invest in the HSA has a triple tax advantage: you pay no tax, investments grow tax-free, and withdrawals are tax-free when used for eligible health expenses. In 2022, the maximum contribution to an HSA is $ 3,650 for individuals and $ 7,300 for families. Second, sign up for a Limited Spend Healthcare Flexible Spending Account (LEX HCFSA). This specific FSA is licensed while having an HSA and can be used for any dental or vision expenses. Covering these expenses will increase your chances of not fully utilizing the plan’s HSA contribution.
If you can keep the HSA plan contribution invested, it can grow quickly. A family that is able to maintain the GEHA HDHP contribution of $ 1,800 and each year thereafter may have saved $ 25,000 or more after 10 years.
Sign up for a flexible spending account: Every active federal employee should have an FSA. Everyone will usually have at least some predictable medical expenses over the next year or so, so why not save 30% on those expenses? The only good reason for not having an FSA is if you are enrolled in an HDHP / CDHP plan, and even then you are still allowed to have an expense limited FSA for dental and vision expenses.
Retirees and future retirees should consider the Medicare Advantage options available to them. United Choice Retiree Advantage plans available in about half of the country have the lowest expected annual costs for retirees. These plans offer generous reimbursement of Medicare Part B premiums ($ 148.50 per month) and have no out-of-pocket expenses for covered medical services other than prescription drug co-pay.
There are also three national Medicare Advantage options open to all employees next year: Aetna Advantage, APWU-High, and MHBP Standard.
Enrolling in Medicare Advantage plans is a three-step process.
- Register for Medicare Part B. This step can take the longest, so it makes sense to start here. The Medicare open season ends one week before the FEHB open season on December 7, so you’ll need to act quickly to join a Medicare Advantage plan.
- Sign up for the FEHB plan that matches the Medicare Advantage plan you want to join.
- Call the carrier to sign up for the Medicare Advantage plan. You will need to be on the FEHB plan list before you can do so, so wait a few days after registering with OPM.
Other factors to consider
FEHB plans continue to increase health and wellness benefits. Many plans offer smoking cessation programs. Some offer discounts on dental care, vision, hearing aids and LASIK. The Kaiser Prosper DC plan offers up to $ 425 for the plan member and registered spouse to complete a total health assessment, biometric screenings and get vaccinated against COVID-19. United Health Plans offer the Peloton app for free to members. If you can’t decide between several different plans, be sure to consider the wellness benefits of each to help you make a final decision. We’ve included the most important of these benefits in the online version of the 2022 Health Plan Guide.
Kevin Moss is Editor-in-Chief at Consumers’ Checkbook. Checkbook’s 2022 Guide to Health Plans for Federal Employees will be available on the first day of the Open Season, November 8. here to see if your agency offers free access. The Guide is also available for purchase. Government executive readers can save 20% by entering promo code GOVEXEC at checkout. Dallen Haws, Financial Planner and YouTube Host “Plan Your Federal Benefits” channel, contributed to this piece.