Search results for deductibles copayments and coinsurance in the fehb program

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  • Deductibles, Copayments, and Coinsurance in the FEHB Program

    You can use cost sharing details to assist you in choosing a plan by pinpointing strengths and weaknesses for items of particular importance. If you are especially concerned about a broad area of

  • How to Get FEHB Plan Information

    The OPM website has plan brochures and a great deal of other useful information. There are three additional ways to get brochures: Attend health fairs Call the plan Visit the plan website You change

  • How the FEHB Program Works

    The Federal Employees Health Benefits Program (FEHB) is an unconventional government program. Instead of giving you one "take it or leave it" choice, the government authorizes plans to compete for

  • How to Coordinate a FEHB Plan with Other Insurance

    You cannot use our cost rankings directly if you have health insurance coverage from another source. The best FEHB plan for you depends on the cost and benefit structure of the other plan, though

  • 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

  • What Part-Time Employees Need to Know About the FEHB Program

    Many career Federal employees work part-time schedules. In these cases, most government agencies do not pay the regular share of the premium. Instead, employees receive a pro rata amount based on

  • Should Federal Annuitants Stay Enrolled in the FEHB program after Age 65?

    You could drop FEHB coverage once you enroll in Parts A and B. But this would be a bad decision. Medicare Part B requires you to pay 20 percent of the cost of doctors’ fees, and deductibles, with no

  • Nursing Care Benefits in the FEHB Program

    There are four kinds of nursing care: Skilled care while in a hospital. Skilled care in a special extended or skilled care facility. Care in your own home provided by visiting nurses. Custodial care

  • Hearing Aid Benefits in the FEHB Program

    All plans cover medical problems, such as infections, that affect any part of your body, including your ears. All plans cover routine hearing testing for children. Almost all will pay most of the

  • Outpatient Mental Benefits in the FEHB Program

    OPM has long required that plans pay the same benefits for physician visits or hospital stays whether due to either physical or mental illness. This requirement is called "parity," and, at face

  • 2024 FEHB Program Changes

    The average 2024 premium will increase 7.7% for enrollees. This is considerably higher than historical experience in the FEHB, but is similar to most private employer cost increases and largely

  • Should I Join an HMO in the FEHB Program?

    HMO plans provide not just insurance, but also a different approach to health care delivery from traditional fee-for-service medicine. Therefore, although cost and benefit comparisons are the key

  • Expect to see Improved Fertility Coverage from FEHB Plans in 2024

    OPM released their annual carrier call letter that outlines the goals and initiatives federal employees can see from FEHB plans in 2024. One of the biggest changes is fertility coverage. From the OPM

  • What You Need to Know About Dental Care in the FEHB Program

    Plans' dental benefits differ widely in details, and many of the brochures use technical terminology such as "gingival" (gum, in English), "alveolar" (the part of the jawbone that holds teeth in

  • Should I Join a High Deductible Plan in the FEHB Program?

    Over a dozen national and some local carriers offer High Deductible plans (HDHP), with at least two or three of these plans available to most enrollees. HDHPs offer spectacular savings opportunities

  • Why Every Federal Employee Should Have a Flexible Spending Account (FSA)

    Flexible Spending Accounts (FSAs) provide a way to shelter even more health care spending from taxes. FSAs allow you to shelter the out-of-pocket costs that you incur for copayments, coinsurance,

  • What You Need to Know About Vision Care in the FEHB Program

    All FEHB plans pay for medically necessary care of your eyes, such as cataract surgery. Many pay for annual refractive examinations to determine your prescription for eyeglasses or contact lens, and

  • Flexible Spending Accounts

    For most employees, Health Care Flexible Spending Accounts (FSAs) provide a way to shelter even more health care spending from taxes. FSAs allow you to shelter the out-of-pocket costs for copayments,

  • What You Need to Know About the FEHB Program and Health Savings Accounts (HSA)

    Both Health Reimbursement Arrangements (HRAs) and Health Savings Accounts (HSAs) provide significant tax advantages, beyond those available through Premium Conversion and FSAs. The simpler case

  • Are Consumer Driven Health Plans the Right FEHB Plan Type for You?

    Consumer Driven Health Plans (CDHPs) have been around for a while, but we still get a lot of questions about them. Here’s why they’re one of the lowest-cost plans in FEHB. How CDHPs work CDHPs have

  • Clinical Quality of Care for FEHB Plans

    We also report ratings from OPM on how plans compared for clinical quality of care. These data are from the Healthcare Effectiveness Data and Information Set (HEDIS), which are standardized

  • Should I Use Non-Preferred Providers With My FEHB Plan?

    You face far higher costs if you use non-preferred providers in most plans, though many plans remove this cost if you have Medicare Parts A & B. Plans not only charge you more for deductibles,

  • What's New in FEHB for 2024

    Every year it’s important to review what’s new in FEHB. As in previous years, there are significant premium, benefit, and plan availability changes that will affect both active and retired federal

  • 13 FEHB Open Season Tips

    Getting "Free" Health Insurance—Some Consumer-Driven and High Deductible FEHB plans provide you a savings account larger than your actual premium cost after taxes. You can end the year with more

  • Should I suspend FEHB coverage and just have Medicare Advantage?

    If you join a commercial MA plan, not FEHB Medicare Advantage plans, you can temporarily suspend your FEHB enrollment and stop paying two sets of premiums. Under the suspend option, you pay the Part

  • A Closer Look at 2024 FEHB Premiums

    Federal employees and annuitants will, on average, pay 7.7% more in FEHB premiums next year. OPM cites increased cost and use of prescription drugs, emergency room care, and outpatient care as the

  • What Federal Annuitants Need to Know about Medicare Part D for 2024

    Federal annuitants will have higher healthcare costs in 2024. The enrollee share for FEHB premiums is rising 7.7%, and the standard Medicare Part B premium is increasing 5.9%, or $9.80, to

  • Reasons Why You Shouldn't Enroll in Medicare Part B

    Here are a few scenarios why retirees should consider not taking Part B. High Income Couples and Individuals that pay IRMAA—If you fall into one of the high-income categories (more than $103,000

  • Big Changes in How Federal Annuitants Receive Prescription Drug Benefits in 2024 and Beyond

    Major Medicare Part D reforms were enacted in the Inflation Reduction Act of 2022 (IRA). Some of the legislation’s provisions seek to lower prescription drug costs for both Medicare beneficiaries and

  • Are High Deductible Health Plans the Right FEHB Plan Type for You?

    For most federal employees, High Deductible Health Plans (HDHPs) will be the cheapest FEHB plan type. Here’s how they work. HDHP Overview HDHPs have much higher deductibles than traditional HMO and

  • FEHB Plan Brochures

    You can download PDF copies of plan brochures at the Checkbook, OPM, and plan websites, and either use them online or as print copies. Plan brochures are necessary to determine what benefits each

  • What Federal Employees Need to Know About FEHB Premium Conversion

    Federal employees shelter their share of the FEHB plan premium from income taxes through what is called "Premium Conversion." Employees have the right to opt out of this program. This increases very

  • Limitations on FEHB Enrollment

    Many plans are open to all employees. However, HMOs require that you live or work in their service area, and a few plans require that you work for a particular agency or join a specific union. Most

  • How Much Money Can I Save by Switching FEHB Plans?

    Whether your family's circumstances are "average" or unusual, some HMOs, some national plans such as Blue Cross Basic and GEHA Standard option, and several High-Deductible plans offer big savings

  • How to Choose the Best FEHB Plan For You and Your Family

    There are three important steps to follow to narrow down the selection of plans: Use the Guide's yearly cost comparisons, which are personalized based on the information you tell us, to find the

  • FEHB Plan Quality

    For traditional fee-for-service insurance plans, service quality used to be a minor issue. The main service concerns were how easily you could get help from plan representatives regarding coverage

  • FEHB Plan Catastrophic Limits

    The most important reason for buying health insurance is to protect you against financial catastrophe. You may, therefore, wish to approach plan selection by comparing plans based on potential

  • Why FEHB Premiums Vary

    The General Schedule (GS) employee and retiree share of the annual premium varies widely among plans. In national plans it ranges from about $1,400 to almost $4,000 for individuals, and from about

  • How to Save Money on FEHB Coverage and Healthcare Costs

    With the average enrollee share of FEHB premium increasing 7.7% next year, most federal employees will pay more for health insurance in 2024. We’ll analyze this premium hike and walk you through

  • What the End of the COVID-19 Public Health Emergency Means for FEHB Coverage

    On May 11, 2023, the Department of Health and Human Services ended the COVID-19 Public Health Emergency (PHE). As a result, some FEHB benefit provisions enacted by OPM will change going forward. OPM

  • When is the 2024 FEHB Open Season?

    The 2024 FEHB Open Season will run from November 13, 2023 through December 11, 2023. Open Season starts every year on the Monday of the second full work week in November and ends on the Monday of the

  • Reasons Why You Should Enroll in Medicare Part B

    The most common question we receive every Open Season from retirees and soon-to-be retirees is whether to take Part B and pay the extra premium. Given that there is a penalty if you delay Part B

  • FEHB Tax Savings for Federal Employees

    There are major tax advantages for health insurance. The employer share of health insurance—paid by agencies for employees and by OPM for retirees—is part of employee compensation but by law is

  • When is the 2025 FEHB Open Season?

    The 2025 FEHB Open Season will run from November 11, 2024 through December 9, 2024. Open Season starts every year on the Monday of the second full work week in November and ends on the Monday of the

  • FEHB Plan Accreditation

    We report whether or not plans are accredited by NCQA, URAC, or AAAHC. These organizations have procedures to determine whether plans meet the organizations accreditation standards. The standards

  • Can you Save Money by Enrolling in FEHB Self Plus One?

    Married couples with no children to cover, and single parents with one child to cover, can enroll as self plus one rather than as a family and, depending on the plan, usually save two or three

  • Disputed Claims for FEHB Plans

    Along with the customer satisfaction survey results, we have another indicator of service quality for fee-for-service plans. We checked disputed claims on file at OPM. A disputed claim is a case in

  • Why Every Federal Employee Should Consider a Health Savings Account

    High Deductible Health Plans (HDHP), which include Health Savings Accounts (HSA), are one of the cheapest health plan options available to federal employees. With an increase in HSA contributions for

  • 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

  • High Deductible Health Plans

    I am confused regarding the difference between a consumer directed health plan with a health reimbursement account and a high deductible health plan that can have a health savings account. What sets