FEHB plans?

[Mountainbug]

So the search function is not working for me, please excuse this post if this topic has been discussed already.

Husband and I are starting new jobs, both with fed gov, coming out of military service. After having Tricare for so long, I don't know where to start with health plans. We just had a baby, but otherwise rarely go to the doctor. Husband has free VA care due to some injuries sustained while deployed, but must travel over 100 miles to access it due to there being "no space" at the local VA clinic. I am reading over the plans and trying to do a comparison, but I'm not really sure what we will need. The baby will be having a lot of preventative care appointments in the next few years, so I'm not sure if a HDHP would be the best option. Does anyone have any experience with service levels of different fed healthcare plans? Obviously I'd like to go with the most frugal plan, but with a baby I want to risk being underinsured... Any advice is appreciated.

[MyCircus, MyMonkeys]

Not sure how much help, but as a federal employee, I've always had BCBS Basic (the cheaper option).  Most of my co-workers use BCBS, the only exception is one guy who chose GEHA, because he could choose any doctor (in or out of network, I guess the benefits are the same? I don't know), specifically because his wife's family has a history of breast cancer.  This guy wanted the option to pick any oncologist he wanted, and not settle (for example) any doctor in-network.

The only other coverage I had was Foreign Service Benefit, and that was when we moved overseas with my job (easier claims, although I hear BCBS offers similar services).

Every year, I consider a HDHP, but until I have the deductible limit saved ($5k), I'm leery (clumsy kids, etc.).

[charis]

I  have an HDHP and the plans pays into your HSA, so you don't necessary have to have the entire deductible saved up.  My family HDHP pays half (1500) of my deductible (3000) into my HSA.  I have a more math-oriented friend who calculated several scenarios and figured out that in most of them, you come out ahead with an HDHP with an HSA.

[MyCircus, MyMonkeys]

I have no doubt HDHP is more efficient; and long-term, I plan to switch over. 

But I'm thinking I will wait until my daughter is off of my insurance.  Right now its worth my peace of mind to not have to worry about a potential large medical deductible because some jack-off T-bones me. But my situation may be different from yours Jezebel, in that I will (like next week) have finished paying off loads of debt (totaling $29k over two years, woot woot!), and right now, my focus is my emergency fund before any potential for HSA.

Although, I've been in debt so long, I only just realized that this December might be the time to consider switching over.  I would feel comfortable considering the same $5k as an emergency fund and an emergency HDHP deductible.

[Catbert]

I've always had Kaiser HMO (40 years) but that's available only in certain areas.  If you live in California I would definitely recommend it.  Advantage to Kaiser is no paperwork to file a claim and no fights between your physician and the insurance company.  No ugly surprises when you file for something you thought was covered only to find out your insurance company has a different take.

[fattest_foot]

I had the same question about 4 years ago. I suggest you talk to your coworkers to see what they use, and try to gauge their familial situations to find people comparable to you. You have a grace period to figure out what you want to go with.

Personally, I use BCBS in California, but do know a few who went with GEHA.

[kimmarg]

I've been very very happy with BCBS.  I tried GEHA one year and they were absolutely awful. BCBS is more but I've never had any issue and pretty much every doctor around takes it.  There was a website we had access to one year where you could type in what you think you will use and it would calculate the total costs for you. "Plan smart choice" or something similar. It counted deductable etc (BCBS has no deductible)

Also check out the Eyecare and dentist plans. I have both. The dental is a wash vs just paying for cleanings but it makes me go since I've already paid for it so I do it.  eyecare plans are usually not worth it unless you have a lot of family members with a low perscription.

[SomedayStache]

Due to Obamacare rules, all children's preventative visits are covered 100% under all plans.  Therefore you should pay nothing for well-child visits under either a PPO or a HDHP.  (Sick child visits are another matter.  With the GEHA PPO plan we paid our copay for a sick child visit <$15 or $20> and now with the GEHA HDHP plan we pay the full bill until meeting our deductible.  The last sick child visit bill was $70).

For years I had GEHA Standard and I was very satisfied.  I went through maternity and births of children and paid nothing out of pocket (maternity covered at 100%).   One of my children had a two-day hospital stay and we paid less than $500 out of pocket for all of that.  I've had coworkers say that they had difficulty with GEHA, but I never experienced it.  I will say that all the receptionists are very familiar with BCBS and mostly haven't heard of GEHA.

This year I ran the numbers and decided that with my family history and our approach to medical care it probably made sense to go with the GEHA HDHP plan.  I made some excel graphs comparing the GEHA PPO plan that we'd been on and the GEHA HDHP plan before coming to this conclusion.  I'm maxxing out the HSA contributions and knowing that pot of money is growing is reassuring.

Do talk to your co-workers.  My personal experience, however, is that my coworkers seem to want to choose the cushiest plan.  They seem terrified of paying any bills out of pocket and don't run the numbers.

There were a couple of relevant forum threads over on the Bogleheads website.  I would link you, but their forum seems down at the moment.

[SomedayStache]

So the search function is not working for me, please excuse this post if this topic has been discussed already.

Search function hasn't worked here in ages (if ever).

Pro tip: use google.  Search the forum like this

"forum.mrmoneymustache.com: fehb"
"forum.mrmoneymustache.com: federal health plans"
"forum.mrmoneymustache.com: HDHP"

[SomedayStache]

Also, do your research on how the VA benefits might make you ineligible for an HSA. 
http://www.bernardhealth.com/woofstreetjournal/bid/140978/HSA-Questions-Can-I-Accept-VA-Benefits-and-Open-an-HSA

"An employee must wait at least 3 months after last receiving VA benefits before they are eligible to open an HSA.  So, ask your employee if they have received VA benefits in the last 3 months. 

1.If they have, then they cannot open an HSA until 3 months have passed since they last received benefits. 


2.If they have not, then they actually can open an HSA.  The catch is that if they ever receive VA benefits in the future, then they are NOT entitled to contribute to their account for another 3 months.  This goes for accepting any employer contribution, as well.  However, the employee is still able to use the funds built up in their account to pay for a qualified medical expense during this 3 month period."

[Cellista]

I've had BCBS standard (higher level than basic) for 24 years. 

I've been very happy with it.  I do not recall any fights with them over billing.

My only complaint is that they are slow to reimburse - like six weeks. 

[SimplyMarvie]

I had an HDHP for our family when I was in the private sector and had kids. It did NOT turn out to be a budget-friendly choice for us, but was also a pretty lousy plan overall. The thing to think about with kids is that even if you feed them all organic food, keep them in a bubble and sanitize everything they touch, they're going to get sick. They're going to get sick A LOT -- because that's how they build the immunity they need in later life. So they're going to get ear infections and rashes and fifth's disease and the other four potentially dangerous viral infections that every kid gets and ringworm and all sorts of stuff. So plan you are going to have sick-kid visits as well as well kid visits, at least until they get into elementary school. If you figure that into your calculations, it makes it easier to decide if an HDHP is a good plan. (I'd guess we had 4-6 sick kid visits per year while the kids were pre-Kindergarten, if you need a number. I'm sure other families can chime in.)

Plans-wise, We have the Foreign Service plan because we're Foreign Service. They're an absolute dream overseas (and rarely deny anything, but since we're all getting most of our care through the health unit in the Embassy, they're making out like freakin' bandits in claims...) but they're an enormous pain in the neck if you're domestic. I'd pass.

GHEA has the highest level of disputed claims of any of the non-HMO/PPO plans available in the federal program (I don't know about the HMO/PPO ones, because they're mostly not an option for us). They have great benefits if you're the kinds of people who are willing to fight your insurance company and if paperwork and bureaucracy makes your little heart go pitter-patter. Not judging -- I'd hesitate to recommend them to non-MMM folk, but for the savvy and determined, it might be worth it.

Everyone else I know uses BCBS and are overall pretty happy with them.

[Cellista]

Don't forget dental.  I have MetLife's most expensive plan.  Really good if you need lots of dental work.

I can't speak to the vision insurance which I never had.

[enigmaT120]

I've always had Kaiser HMO (40 years) but that's available only in certain areas.  If you live in California I would definitely recommend it.  Advantage to Kaiser is no paperwork to file a claim and no fights between your physician and the insurance company.  No ugly surprises when you file for something you thought was covered only to find out your insurance company has a different take.

That's what I have here in Oregon.  I don't have the high option that includes dental, I just pay that with a Flexible Spending Account.  Kaiser is cheaper than any of the other plans, though I'm mad that self + one costs the same as self + family.  The high deductable plans weren't any cheaper, last time I checked.