Author Topic: Fed Employee HDHP Experiences  (Read 28074 times)

mrigney

  • Stubble
  • **
  • Posts: 163
    • Running of the Fools
Fed Employee HDHP Experiences
« on: November 02, 2017, 09:40:38 AM »
Open season is about to be upon us. I'm wanting to switch from my BCBS Basic to a HDHP. Looks like the best choice might be the GEHA PPO HDHP? I"m hoping that some folks here have used it and have opinions. Any drawbacks to the plan? Any feds use other HDHPs? Experiences with those?

doggyfizzle

  • Bristles
  • ***
  • Posts: 380
Re: Fed Employee HDHP Experiences
« Reply #1 on: November 02, 2017, 09:59:13 AM »
I'm presently insured through the GEHA Standard Plan (and was on the High plan in 2016); my experience with GEHA so far has been stellar - their customer service has been fantastic whenever I had an issue with physician billing, and because they use the AETNA Signature network, I've never come across a doctor or pharmacy who doesn't accept their insurance.  I also use GEHA for dental.  Once my kid gets a little bit older I will probably switch over to the GEHA HDHP.  I think GEHA kicks in $1200/year in premium passthrough to the HSA.  Check and see what other HDHPs are offered in your area, as a couple plans are a bit more generous with premium passthrough (I think AETNA is up to $1800/year in some cases).

mrigney

  • Stubble
  • **
  • Posts: 163
    • Running of the Fools
Re: Fed Employee HDHP Experiences
« Reply #2 on: November 02, 2017, 10:10:47 AM »
Yeah...Aetna has a HMO HDHP available in my area....I'm always leery of HMOs. There is also a MHBP - consumer Option HDHP available. The MHBP provides $1800 (vs $1500 on the GEHA) as a pass through, but is offset by having a ~$500 higher premium for the year (and a higher deductible, higher out of pocket maximum). Looks like the advantage of the MHBP plan is that you pay a flat fee for office visits ($15) vs 5% on the GEHA HDHP. Same for emergency care. The MHBP is a flat $50 fee for emergency care, $0 for inpatient surgery, room & board charges, etc, whereas you pay 5% on the GEHA.

Actually, I'll have to scroll through, but the flat fees on all care on the MHBP plan make it pretty attractive. Obviously doesn't matter if you don't hit your deductible (which we probably wouldn't most years). Here's a link comparing some plans if anybody wants to look and offer some thoughts: https://www.opm.gov/healthcare-insurance/healthcare/plan-information/compare-plans/fehb/PlanDetails?zipcode=35803&FFSSearch=on&Medicare=False&oldPlans=112AL342ALLS2AL&empType=a&payPeriod=c&rateCoverage=Self%20%26%20Family&plans=225AL112AL342AL482AL

kendallf

  • Handlebar Stache
  • *****
  • Posts: 1068
  • Age: 57
  • Location: Jacksonville, FL
Re: Fed Employee HDHP Experiences
« Reply #3 on: November 02, 2017, 10:52:46 AM »
Yeah...Aetna has a HMO HDHP available in my area....I'm always leery of HMOs. There is also a MHBP - consumer Option HDHP available. The MHBP provides $1800 (vs $1500 on the GEHA) as a pass through, but is offset by having a ~$500 higher premium for the year (and a higher deductible, higher out of pocket maximum). Looks like the advantage of the MHBP plan is that you pay a flat fee for office visits ($15) vs 5% on the GEHA HDHP. Same for emergency care. The MHBP is a flat $50 fee for emergency care, $0 for inpatient surgery, room & board charges, etc, whereas you pay 5% on the GEHA.

Actually, I'll have to scroll through, but the flat fees on all care on the MHBP plan make it pretty attractive. Obviously doesn't matter if you don't hit your deductible (which we probably wouldn't most years). Here's a link comparing some plans if anybody wants to look and offer some thoughts: https://www.opm.gov/healthcare-insurance/healthcare/plan-information/compare-plans/fehb/PlanDetails?zipcode=35803&FFSSearch=on&Medicare=False&oldPlans=112AL342ALLS2AL&empType=a&payPeriod=c&rateCoverage=Self%20%26%20Family&plans=225AL112AL342AL482AL

I'm currently on the MHBP HDHP, and it's been excellent for us for the past 3-4 years.  I picked it primarily because of the high premium pass-through into the HSA.  The Aetna coverage here in Jacksonville is good, and we haven't had any problems with it at all, basically.  I hit the deductible a couple of years due to shoulder surgeries my daughter and wife each had to go through, and running the numbers against BCBS we're still ahead.  I like the Health Equity HSA which has decent investment options, and I'm currently maxing out the HSA each year and investing it all.

doggyfizzle

  • Bristles
  • ***
  • Posts: 380
Re: Fed Employee HDHP Experiences
« Reply #4 on: November 02, 2017, 04:29:36 PM »
I had very high (for me) health care usage this year, and determined that I actually paid less than I would have under the traditional 80/20 BCBS plan...Once I hit the $1500 deductible, I was only paying 5% out of pocket. So I even had an ER visit that cost me less than $100 total.

Overall, I think it's the best HDHP/HSA option for Feds.

Is your responsibility 5% of what the provider bills or 5% of what GEHA "allows" for the service?  I always get a statement from GEHA with  "allow" and "disallow" breakdowns for charges, and then a patient responsibility amount.

kimmarg

  • Pencil Stache
  • ****
  • Posts: 750
  • Location: Northern New England
Re: Fed Employee HDHP Experiences
« Reply #5 on: November 02, 2017, 08:31:23 PM »
I'm presently insured through the GEHA Standard Plan (and was on the High plan in 2016); my experience with GEHA so far has been stellar - their customer service has been fantastic whenever I had an issue with physician billing, and because they use the AETNA Signature network, I've never come across a doctor or pharmacy who doesn't accept their insurance.  I also use GEHA for dental.  Once my kid gets a little bit older I will probably switch over to the GEHA HDHP.  I think GEHA kicks in $1200/year in premium passthrough to the HSA.  Check and see what other HDHPs are offered in your area, as a couple plans are a bit more generous with premium passthrough (I think AETNA is up to $1800/year in some cases).

I had the 100% opposite experience to this with GEHA standard plan. Their customer service was awful - they denied the few claims I submitted and I had to do battle. They wanted me to try a perscription medication that hadn't worked in the past before they covered the one that did work. Despite having lots of options listed on the website they wanted me to travel 2+ hours for an MRI when there are at least 4 options within 20min.  Basically I hated them so much I went back to BCBS which has been flawless. I like the theory of a HDHP but I'm unexcited about GEHA. 

crimwell

  • Stubble
  • **
  • Posts: 101
Re: Fed Employee HDHP Experiences
« Reply #6 on: November 04, 2017, 12:44:38 AM »
I'm presently insured through the GEHA Standard Plan (and was on the High plan in 2016); my experience with GEHA so far has been stellar - their customer service has been fantastic whenever I had an issue with physician billing, and because they use the AETNA Signature network, I've never come across a doctor or pharmacy who doesn't accept their insurance.  I also use GEHA for dental.  Once my kid gets a little bit older I will probably switch over to the GEHA HDHP.  I think GEHA kicks in $1200/year in premium passthrough to the HSA.  Check and see what other HDHPs are offered in your area, as a couple plans are a bit more generous with premium passthrough (I think AETNA is up to $1800/year in some cases).

A heads up: GEHA's standard basic insurance refuses to cover certain "automated" lab expenses associated with hospital stays and serious illnesses

I had an experience about 5 years ago where this added up to the mid tens of thousands of dollars. I didn't have to personally pay it because it was covered by other means (not GEHA) but it was an eye opener.  nothing that I could control, since they were routine and required lab tests at an in network hospital. I decided it was a rare occurrence and stuck with GEHA and then got hit with the same issue for an unrelated set of occurrences the next year. After that I decided it was too risky. Your mileage may vary...

mrigney

  • Stubble
  • **
  • Posts: 163
    • Running of the Fools
Re: Fed Employee HDHP Experiences
« Reply #7 on: November 06, 2017, 06:21:15 AM »
Quote
A heads up: GEHA's standard basic insurance refuses to cover certain "automated" lab expenses associated with hospital stays and serious illnesses

I had an experience about 5 years ago where this added up to the mid tens of thousands of dollars. I didn't have to personally pay it because it was covered by other means (not GEHA) but it was an eye opener.  nothing that I could control, since they were routine and required lab tests at an in network hospital. I decided it was a rare occurrence and stuck with GEHA and then got hit with the same issue for an unrelated set of occurrences the next year. After that I decided it was too risky. Your mileage may vary...

This is one of those things that "scares" me about health insurance in general (not just GEHA). I consider myself pretty savvy compared to the average consumer (as are most folks on the forum, I think). You probably had no real way of knowing about this particular quirk of GEHA before it happened. Likewise, there are probably quirks like this with BCBS, Aetna, etc that you wouldn't know about until it happened. It is almost (completely?) impossible for consumers to know everything that their insurance does/doesn't cover in advance.

The GEHA is not paying for commission fees nor are they waived for GEHA members.  Vanguard ETFs are on a list of commission free ETFs at TD Ameritrade until the 21st of this month.  You may want to look at the other ETFs right now, or you will pay a trading fee on every Vanguard ETF pretty soon (Vanguard is no longer on the commission free list as of the 21st).

Sorry, I meant there are no monthly fees for the HSA bank account, not that GEHA was paying commission fees. I think there are monthly fees if you move an HSA account to them without having a connected plan
But thanks for the heads up on the ETF commission switch too!

The investing mechanisms with HSAs have always seemed a bit clunky, at least from the outside looking in. @Imustacheyouaquestion -- what do you mean/how are you sweeping your HSA funds into the TD Ameritrade account? If you don't do that, what are your investment options?

« Last Edit: November 06, 2017, 06:50:39 AM by mrigney »

Fomerly known as something

  • Handlebar Stache
  • *****
  • Posts: 1627
  • Location: CA
Re: Fed Employee HDHP Experiences
« Reply #8 on: November 07, 2017, 05:45:42 AM »
I have the AETNA HDHP, I've been happy with it, but I'm healthy and haven't really ever tried to "use it."  My yearly sick visits come out to a couple of hundred dollars so I just don't bother.

Hopper

  • 5 O'Clock Shadow
  • *
  • Posts: 41
Re: Fed Employee HDHP Experiences
« Reply #9 on: June 06, 2018, 05:19:09 AM »
I currently have the GEHA HDHP and am happy with it. Really only used it so far for pediatrician visits.  I made the switch years ago from BCBS to Kaiser, and then (after pregnancies and other expenses I thought might be high) made the switch to GEHA.  No complaints with GEHA but I wish we had more options.  I like Kaiser, because the service model is so easy/streamlined and costs were not bad.  But apparently Kaiser won't be offering an HDHP anytime soon.   A self-proclaimed 30+ year member of the Kaiser Federal team was at my agency for a presentation yesterday .  After the presentation, I went up to her and asked if Kaiser was going to be offering any Federal HDHP plans because I really liked their service, but financially HDHPs are a no-brainer for me.  She told me that "Oh well, you may not know this, but OPM picks the plans Fed employees get to choose."  I told her I was aware that OPM selects the final health insurance offerings and asked if she was saying that Kaiser had given a HDHP plan to OPM but that it was not chosen.  She admitted that they hadn't, and then said "You know, we have found that Fed Employees do not want HDHPs."   Bah.   

Loretta

  • Pencil Stache
  • ****
  • Posts: 800
Re: Fed Employee HDHP Experiences
« Reply #10 on: November 06, 2018, 07:19:49 PM »
Hi, resurrecting this thread for open season...is the GEHA HDHP still a good choice for 2019?  I’m debating between GEHA and United Healthcare’s HDHP plans.  I would love to hear firsthand experiences.  I’m 40 with an autoimmune eye disease but reasonably healthy other than that. 

ThatGuy

  • Stubble
  • **
  • Posts: 186
Re: Fed Employee HDHP Experiences
« Reply #11 on: November 06, 2018, 07:56:32 PM »
Since the "pass through" feature was brought up in this thread I'll ask a question that's been bugging me.  Does the pass through amount count towards your contributions or is it in addition to?  In other words for 2019 the limits are $3500/$7000, if your HDHP passes through $1200 will you be able to contribute a total of $4700/$8200?

Fomerly known as something

  • Handlebar Stache
  • *****
  • Posts: 1627
  • Location: CA
Re: Fed Employee HDHP Experiences
« Reply #12 on: November 07, 2018, 08:05:07 PM »
Hi, resurrecting this thread for open season...is the GEHA HDHP still a good choice for 2019?  I’m debating between GEHA and United Healthcare’s HDHP plans.  I would love to hear firsthand experiences.  I’m 40 with an autoimmune eye disease but reasonably healthy other than that.

I'd look at what state you are in.  I'm in a state where GEHA uses the AETNA network; my other choice was the AETNA HDHP but with GEHA I have a slightly cheaper plan with a better pass through and the same network.

doggyfizzle

  • Bristles
  • ***
  • Posts: 380
Re: Fed Employee HDHP Experiences
« Reply #13 on: November 08, 2018, 09:34:04 AM »
Hi, resurrecting this thread for open season...is the GEHA HDHP still a good choice for 2019?  I’m debating between GEHA and United Healthcare’s HDHP plans.  I would love to hear firsthand experiences.  I’m 40 with an autoimmune eye disease but reasonably healthy other than that.

I'd look at what state you are in.  I'm in a state where GEHA uses the AETNA network; my other choice was the AETNA HDHP but with GEHA I have a slightly cheaper plan with a better pass through and the same network.

My GEHA Standard rate jumped about $18 per pay period this year, and coupled with the increase in max out of pocket to $13k, I think I'm going to jump to the GEHA HDHP next year.  Also, I believe GEHA increased the premium pass-through amount as well.  I might look into the MHBP HDHP as well, since it also provides coverage through the Aetna network, and has a $2400 premium pass-through.

the_fixer

  • Handlebar Stache
  • *****
  • Posts: 1252
  • Location: Colorado
  • mind on my money money on my mind
Re: Fed Employee HDHP Experiences
« Reply #14 on: November 13, 2018, 09:39:26 AM »
I am trying to help my wife (a Fed) figure out her insurance, way too many options it is insane.

When she started we ended up just picking the Blue Cross high plan but would like to see about a high deductible to qualify for the HSA.

Where are you seeing the money that they are giving you towards the HSA?

She went to the fair that they had but any question she had the just told her to call or look at the website.

Thanks!

Sent from my Pixel 2 XL using Tapatalk


marion10

  • Bristles
  • ***
  • Posts: 390
Re: Fed Employee HDHP Experiences
« Reply #15 on: November 13, 2018, 11:57:01 AM »
Consumers Checkbook publishes an FEHB guide every year. Google it. Many Federal agencies also provide access to employees. Worth checking out or buying a copy for yourself.

kendallf

  • Handlebar Stache
  • *****
  • Posts: 1068
  • Age: 57
  • Location: Jacksonville, FL
Re: Fed Employee HDHP Experiences
« Reply #16 on: December 12, 2018, 06:29:41 AM »
https://www.opm.gov/healthcare-insurance/healthcare/plan-information/plans/

This link will give you all of the plans and from there you can see the links to their brochures.  The premium rate charts are at these links, first one is regional/HMOs, second is national:

https://www.opm.gov/healthcare-insurance/healthcare/plan-information/premiums/2019/non-postal-rates-hmo.pdf

https://www.opm.gov/healthcare-insurance/healthcare/plan-information/premiums/2019/non-postal-rates-ffs.pdf

If you want to know what the premium pass-through is (what the plan will contribute to your HSA out of your premium) I think you'll have to check that specific plan's brochure.  I haven't found a general reference for that.  In my case in Florida, the max seems to be Mail Handler's $2400 pass-through.


Loretta

  • Pencil Stache
  • ****
  • Posts: 800
Re: Fed Employee HDHP Experiences
« Reply #17 on: December 13, 2018, 05:14:16 AM »
I went with the GEHA HDHP, hope it doesn’t suck.

marion10

  • Bristles
  • ***
  • Posts: 390
Re: Fed Employee HDHP Experiences
« Reply #18 on: December 13, 2018, 08:49:10 AM »
We have had it for several years and been satisfied.

Loretta

  • Pencil Stache
  • ****
  • Posts: 800
Re: Fed Employee HDHP Experiences
« Reply #19 on: April 20, 2019, 02:56:03 PM »
Does anyone have their GEHA HSA in a Devenir account they like?  I had never heard of Devenir until reading about them on the hsabank site.  I appreciate any thoughts and recommendations.  I had 2 trips to the hospital early this year so I’ve been using the $ vice stashing it. 

aaahhrealmarcus

  • 5 O'Clock Shadow
  • *
  • Posts: 72
  • Location: Missouri
  • Declutter. Decommodify. Denerdify.
    • Minimally Nerdy
Re: Fed Employee HDHP Experiences
« Reply #20 on: April 28, 2019, 04:31:50 PM »
I'm in GEHA/HSA Bank, and am currently sitting on close to $5k in my account. I'm trying to figure out when to start investing, and how much... I've seen different numbers thrown around - some sources say you need to keep a minimum of $1k in your account, others say as much as $5k - or else you pay a penalty. The FAQ on their website is no help. Does anyone know?

SomedayStache

  • Pencil Stache
  • ****
  • Posts: 924
  • Live Long and Prosper
Re: Fed Employee HDHP Experiences
« Reply #21 on: May 02, 2019, 10:18:05 AM »
If you have GEHA there are no monthly fees or minimum balance requirements for investment accounts with HSA Bank/TD Ameritrade.

If you were to stop having GEHA but keep your HSABank account then you would have to look into the minimum required cash balance to avoid fees, but as long as you have GEHA it's not a worry. 

Sugaree

  • Handlebar Stache
  • *****
  • Posts: 1667
Re: Fed Employee HDHP Experiences
« Reply #22 on: July 31, 2019, 09:38:30 AM »
I understand that GEHA uses other companies' networks.  So, I live in a state that uses the United network.  My closest trauma center and cancer center just announced that they will stop taking UHC tomorrow.  I assume that means that those centers are now out of network for GEHA as well?  Unfortunately, that particular hospital system also doesn't accept Aetna, which is the other HDHP option here.

We don't currently use any of their doctors, but two years ago I watched first hand how quickly ICU bills can rack up when my best friend's husband was lifeflighted there.  The thought of being balance billed on something like that is terrifying.  But then again, if we're talking about something like that, we're probably looking at a bankruptcy anyway. 

doggyfizzle

  • Bristles
  • ***
  • Posts: 380
Re: Fed Employee HDHP Experiences
« Reply #23 on: July 31, 2019, 11:10:50 AM »
I understand that GEHA uses other companies' networks.  So, I live in a state that uses the United network.  My closest trauma center and cancer center just announced that they will stop taking UHC tomorrow.  I assume that means that those centers are now out of network for GEHA as well?  Unfortunately, that particular hospital system also doesn't accept Aetna, which is the other HDHP option here.

We don't currently use any of their doctors, but two years ago I watched first hand how quickly ICU bills can rack up when my best friend's husband was lifeflighted there.  The thought of being balance billed on something like that is terrifying.  But then again, if we're talking about something like that, we're probably looking at a bankruptcy anyway.

I believe that GEHA (and many other FEHB plans) have both in-network and out-of-network our of pocket maximum costs, that once reached, you don’t pay the costs beyond that point.  Let me see if I can dig up a link to the GEHA EOB, since a change in network is something I’ve also worries about periodically.  My GEHA network is Aetna Premier, which may or may not change depending on the new corporate strategy of CVS now that they own the insurance company.

doggyfizzle

  • Bristles
  • ***
  • Posts: 380
Re: Fed Employee HDHP Experiences
« Reply #24 on: July 31, 2019, 11:22:36 AM »
https://www.geha.com/docs/default-source/medical/2019-geha-hdhp-summary-of-benefits-and-coverage.pdf?sfvrsn=26e12467_13

Looks like the out-of-pocket max is $14k for out of network services in a calendar year.

Sugaree

  • Handlebar Stache
  • *****
  • Posts: 1667
Re: Fed Employee HDHP Experiences
« Reply #25 on: July 31, 2019, 12:04:00 PM »
https://www.geha.com/docs/default-source/medical/2019-geha-hdhp-summary-of-benefits-and-coverage.pdf?sfvrsn=26e12467_13

Looks like the out-of-pocket max is $14k for out of network services in a calendar year.


It's not the OOP max that worries me.  It's being ballance-billed for the difference between what the hospital "charges" and what the allowable amount is.  That doesn't count towards the OOP max.



For example, when I had my kid, the hospital charged somewhere in the neighborhood of $40k (c-section and 4 days in the hospital).  My insurance paid ~$5k.  If the hospital had been out of network, they could have come back to me and said "you owe us the $35k difference between our charge and what your insurance paid."
« Last Edit: July 31, 2019, 12:06:03 PM by Sugaree »

doggyfizzle

  • Bristles
  • ***
  • Posts: 380
Re: Fed Employee HDHP Experiences
« Reply #26 on: August 05, 2019, 07:43:25 PM »
Ah, I did not know that!  And now looking up “balance billing” I have become aware of yet another unnerving aspect of the US healthcare industry, although it looks like in some states this is illegal or at least being scrutinized by state legislatures for some sort of regulation?

Sugaree

  • Handlebar Stache
  • *****
  • Posts: 1667
Re: Fed Employee HDHP Experiences
« Reply #27 on: August 05, 2019, 08:07:13 PM »
Yeah, it's scary.  It looks like UAB and United have come to some sort of agreement, so that's reassuring.

Loretta

  • Pencil Stache
  • ****
  • Posts: 800
Re: Fed Employee HDHP Experiences
« Reply #28 on: October 17, 2020, 01:46:56 PM »
Hi, does anyone know about any scoop on upcoming changes to GEHA that I should know about before open season?  OPM's website is down of course.  The reason I ask is that I tried to make an appointment with a new OBGYN and the person on the phone asked me for my insurance card info like normal.  But when I said GEHA she told me they were no longer accepting patients with United Healthcare, which is who administers my GEHA. 

In truth the whole HSA concept is probably not right for my lifestyle as I've been using it to help pay for my pricey gastro meds which cost $500 every 40 days. 

The GEHA experience has been okay as a Fed. 

Sugaree

  • Handlebar Stache
  • *****
  • Posts: 1667
Re: Fed Employee HDHP Experiences
« Reply #29 on: October 19, 2020, 11:50:13 AM »
Hi, does anyone know about any scoop on upcoming changes to GEHA that I should know about before open season?  OPM's website is down of course.  The reason I ask is that I tried to make an appointment with a new OBGYN and the person on the phone asked me for my insurance card info like normal.  But when I said GEHA she told me they were no longer accepting patients with United Healthcare, which is who administers my GEHA. 

In truth the whole HSA concept is probably not right for my lifestyle as I've been using it to help pay for my pricey gastro meds which cost $500 every 40 days. 

The GEHA experience has been okay as a Fed.

If you use the health rewards benefits at all then you might want to look into how they are changing that program.  The way I understand it, they look like they are going to be offering more opportunities to earn credits, but with an HSA those credits can only be used for vision and/or dental costs until after the deductible is met.

 

Wow, a phone plan for fifteen bucks!