Author Topic: Federal Health Insurance Options- Pregnancy  (Read 5505 times)

meh123

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Federal Health Insurance Options- Pregnancy
« on: May 17, 2017, 01:10:02 PM »
Me (private employee) and my husband (federal employee) were just married.  We want to switch me over to the federal health insurance, because my company plans just suck.  We plan to start trying for children this fall.

Any federal employees here have any opinions on health insurance options, especially as it pertains to pregnancy and childbirth?  We are in the DC area, if that makes any difference.

Catbert

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Re: Federal Health Insurance Options- Pregnancy
« Reply #1 on: May 17, 2017, 01:42:09 PM »
Is Kaiser available in your area?  Good coverage for everything.  No paperwork and no after-the-fact declinations.  You are restricted,of course, to their doctors and facilities.

P.S.  I think (it's been a long time since I retired) that while marriage will allow him to go from "self" to "self and family" but it won't let him change providers.  IIRC to change providers you'll need to wait for open season which goes into effect next January.
« Last Edit: May 17, 2017, 01:44:55 PM by mary w »

Blonde Lawyer

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Re: Federal Health Insurance Options- Pregnancy
« Reply #2 on: May 17, 2017, 01:50:38 PM »
I can't answer specifically to pregnancy but I think my advice applies to all medical issues.  Where I live, Fed Blue Cross - Basic provides BETTER coverage than Fed Blue Cross - Standard even though Standard is a higher premium.  Standard allows you to go out of network.  However, everything around me is in-network so there is no issue.  Basic gives me more chiropractor visits than Standard.  It also does not have a co-insurance aspect. 

meh123

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Re: Federal Health Insurance Options- Pregnancy
« Reply #3 on: May 17, 2017, 02:42:50 PM »
Kaiser is available in my area, and I have (non-fed) friends who use their insurance and are happy with it.  I will have to look into this option.  I also need to check if we can change providers mid-year- he currently has a high-deducible plan which I don't want during a pregnancy year.

Blue Cross is accepted almost everywhere around here.  I currently have a Blue Cross plan- the Fed Blue Cross plan is just better in terms of coverage and pricing!  I will look into Fed Blue Cross Basic as well.

SKL-HOU

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Re: Federal Health Insurance Options- Pregnancy
« Reply #4 on: May 17, 2017, 05:47:32 PM »
P.S.  I think (it's been a long time since I retired) that while marriage will allow him to go from "self" to "self and family" but it won't let him change providers.  IIRC to change providers you'll need to wait for open season which goes into effect next January.

Unless this is a specific rule to federal, when you have a life qualifying event, you can change it any way you want.

firelight

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Re: Federal Health Insurance Options- Pregnancy
« Reply #5 on: May 17, 2017, 06:16:47 PM »
Kaiser is available in my area, and I have (non-fed) friends who use their insurance and are happy with it.  I will have to look into this option.  I also need to check if we can change providers mid-year- he currently has a high-deducible plan which I don't want during a pregnancy year.

Blue Cross is accepted almost everywhere around here.  I currently have a Blue Cross plan- the Fed Blue Cross plan is just better in terms of coverage and pricing!  I will look into Fed Blue Cross Basic as well.
Regarding high deductible plans, make sure you run the numbers before you opt for non high deductible plans. For my insurance (non fed), I found that I came out ahead with high deductible plan even with pregnancy and multiple procedures in a single year.

MsPeacock

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Re: Federal Health Insurance Options- Pregnancy
« Reply #6 on: May 17, 2017, 07:15:21 PM »
BCBS FEP (federal employee plan) is accepted by just about everyone in the DC area. I've been really happy with it and have had no problems with it whatsoever in 9 years.

ysette9

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Re: Federal Health Insurance Options- Pregnancy
« Reply #7 on: May 17, 2017, 07:31:56 PM »
Another vote for kaiser. I can't be happier with them and hear horror stories all the time from friends and family with traditional health insurance/care providers.

LateToTheParty

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Re: Federal Health Insurance Options- Pregnancy
« Reply #8 on: May 17, 2017, 07:57:24 PM »
+ 1 for Kaiser. I have been so pleased with my care there.

JJsfr

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Re: Federal Health Insurance Options- Pregnancy
« Reply #9 on: May 17, 2017, 09:38:35 PM »
We have GEHA standard. Math works or to generally be cheaper than BCBS for self+1 even factoring in the$700 deductible as BCBS premiums are$1500 higher or something.

Both GEHA and BCBS cover routine maternity 100%, no deductible, no copay. 

GEHA also has a hdhp with a great hsa provider if you leave that way, but does not cover maternity.

Lila8

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Re: Federal Health Insurance Options- Pregnancy
« Reply #10 on: May 17, 2017, 09:40:47 PM »
Not sure about fed v. private, but generally....
I was very happy with my BCBS. It gets my vote.
I've also heard good things about Kaiser.
I now have Aetna and it is an absolute nightmare. You don't need the added stress of haggling with Aetna to cover routine, basic care when you're pregnant. That's where I am now. I took a look at their facebook page yesterday and found this is standard operating practice for Aetna, across the board, with life-threatening implications.

This thread may be helpful: https://forum.mrmoneymustache.com/mini-money-mustaches/hospital-bill-for-new-baby/

doggyfizzle

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Re: Federal Health Insurance Options- Pregnancy
« Reply #11 on: May 17, 2017, 10:17:03 PM »
We have GEHA standard. Math works or to generally be cheaper than BCBS for self+1 even factoring in the$700 deductible as BCBS premiums are$1500 higher or something.

Both GEHA and BCBS cover routine maternity 100%, no deductible, no copay. 

GEHA also has a hdhp with a great hsa provider if you leave that way, but does not cover maternity.

+1 for GEHA.  My family is covered by GEHA Standard (was High last year) and incurred literally no cost for the birth of my son other than my normal bi-weekly premiums.  So far I haven't been able to tell the difference between Standard vs. High other than the $125 savings on each paycheck.  If either my wife or myself had routine prescriptions, we'd probably still be on High.  And for the first three years a I'd Federal Service I was on BCBS, and I have to say I order GEHA much better for network coverage, premium cost, deductible, and customer support.

kimmarg

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Re: Federal Health Insurance Options- Pregnancy
« Reply #12 on: May 18, 2017, 09:56:53 AM »
Me (private employee) and my husband (federal employee) were just married.  We want to switch me over to the federal health insurance, because my company plans just suck.  We plan to start trying for children this fall.

Any federal employees here have any opinions on health insurance options, especially as it pertains to pregnancy and childbirth?  We are in the DC area, if that makes any difference.

I'm on FEP Blue (Blue cross blue shield the basic, aka cheaper one). Total cost for kiddo was $175 hospital copay for delivery.  Never had any troubles, nothing denied. Tried GEHA one year and it was awful. everything I submitted was denied and they wanted me to drive 2.5 hours for an MRI.  Have multiple coworkers who don't like it either. I don't know of anyone who is unhappy with Blue Cross. It is a bit pricier than some but especially if you're considering pregnancy I would sign up.

EDIT: I would ask people in your area. Here (not DC) everyone takes BCBS.  I have heard of people in other areas liking GEHA but not here.

If you do use Blue Cross sign up for their pregnancy program. You get $100 towards copays, a bunch of free stuff, info and a nurse line you can call anytime with questions. It's free. Basically it's cheaper for them if you have a healthy pregnancy so they want to help.
« Last Edit: May 18, 2017, 10:00:27 AM by kimmarg »

kimmarg

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Re: Federal Health Insurance Options- Pregnancy
« Reply #13 on: May 18, 2017, 10:02:25 AM »
Also note marriage is a qualifying life even to enroll in other services like FSAFEDS, life insurance etc as is the birth of a child.

Also there's a stupid loophole in FSAFEDS which means you cannot INCREASE your election after Oct 1 (Nov 1? about then can't rememeber) even if you have a qualifying life event (like a new baby) which would otherwise allow you to.

meh123

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Re: Federal Health Insurance Options- Pregnancy
« Reply #14 on: May 18, 2017, 11:19:31 AM »
Thank you to all who answered with their experiences.  It looks like several of the available options have worked out well for people, so I will need to do some more research for my specific needs.

One more question: It is advisable to not switch insurance during pregnancy?  For example, I could wait for the open enrollment period this fall to switch over to the fed insurance, which would be effective Jan 1 2018.  If I am already pregnant and seeing a doctor, would this cause headaches? 

kimmarg

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Re: Federal Health Insurance Options- Pregnancy
« Reply #15 on: May 18, 2017, 11:19:07 PM »
If I am already pregnant and seeing a doctor, would this cause headaches?

Maybe. If the doc took both old and new it would probably be fine but if not it would be a huge pain. If it was me I would just switch now. The Fed insurance is very good!

Can't Wait

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Re: Federal Health Insurance Options- Pregnancy
« Reply #16 on: May 19, 2017, 05:58:46 AM »
If you're in the DC area, the Federal Aetna open access HMO plan and the BCBS plan are pretty much the best, in my opinion. Neither one have deductibles; you just pay the copay and go about your day. My wife is pregnant now and we don't even have to pay the copay for the prenatal OB visits. Another member wrote about problems with Aetna, but we haven't had any problems with their federal plan. According to their brochure, you pay nothing for inpatient maternity services at the hospital- so you don't pay anything for the delivery and nursing care. No copays for prenatal care or the first postpartum care visit.

Kaiser is good, but I don't like that you have to use their facilities and doctors. Having to drive all the way to their facility for every single visit would be a complete pain and their plan doesn't offer anything that is better than the Aetna HMO plan or BCBS plan to make it worth that extra effort.