Search results for our methods and data sources

156 articles found

  • Our Methods and Data Sources

    We compare plans in terms of their likely dollar cost to you, including both the “for sure” expense of the premium and the out-of-pocket (OOP) expenses you face for costs the plan does not pay. We

  • 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

  • Medicare and Provider Selection

    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. However, network problems largely disappear if you

  • Prenatal and Postpartum Care

    Do pregnant women receive care in the first trimester?

  • Hearing Aids Child and Adult

    Many plans only cover children, not adults. And the age limit for children also differs among plans. We show you the age limit for a child, if present, the coverage amount, and replacement frequency.

  • 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

  • What's the Difference Between a HSA and a HRA?

    There are two different savings accounts associated with HDHP and CDHP plans, HSA and HRA. Here's how they compare:

  • Weight Loss Drug Coverage from FEHB Plans and Medicare

    Weight-loss drug popularity has skyrocketed. Between 2020 to 2022, the number of prescriptions has risen to around 9 million in the U.S. With celebrity attention, positive clinical trials, and even

  • 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

  • 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

  • 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

  • Miscellaneous

    I'm not very healthy and could easily have expenses of many thousands of dollars next year. So I don't think that your rankings based on average costs are what I should use. What should I do? A good

  • 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

  • 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

  • How can Checkbook's Guide to Health Plans for Federal Employees help me?

    Checkbook's Guide to Health Plans for Federal Employees gives you vital shopping information that you cannot get from any other source. It tells you how much money you can save by changing—or by

  • Customer Satisfaction Ratings of FEHB Plans

    Our Guide shows plan-by-plan customer satisfaction ratings reported by OPM. These ratings come from a 2023 survey in which a standardized questionnaire was sent to a sample of each plan’s members.

  • 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 Purchase a FEDVIP Dental or Vision Plan?

    The Federal government offers standalone "FEDVIP" dental and vision plans, separate and distinct from the FEHB program. The FEDVIP program shares the same Open Season dates as the FEHB program, but

  • 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

  • How Health Insurance Works

    Individuals and families buy automobile, life, fire, and health insurance policies to protect themselves from catastrophic financial harm from rare events. No one buys "food insurance" because food

  • Will My FEHB Plan Pay for That?

    Most plans limit reimbursement for most of the following services. Current employees can cover any of them through a Flexible Spending Account. Dental care—Only some plans cover dental care. We

  • 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

  • How to Balance Risk When Choosing a FEHB Plan

    Since you do not know in advance how high your medical bills will be, there is no way to know which plan will leave you with the lowest total cost. You must gamble just as you do with any insurance,

  • How to use Checkbook's Guide to Health Plans for Federal Employees

    We prepared the Guide because we know that choosing the right plan can be difficult, even if you have time to read hundreds of pages in plan brochures. The coverage details are hard to understand and

  • Dental Care

    I am a new employee and I have the Blue Cross Basic plan. I've reviewed the plan and it seems to cover dental as well as medical. But I have always thought I needed separate dental and vision. Others

  • Surgical Procedures & Disease Management

    If someone is going to have major surgery, say a hysterectomy, is there a better plan for this and managing any care/complications? In the case of planned surgery, we recommend four things. First, if

  • 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

  • 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

  • High Cost Year

    Our High Cost year estimates the out-of-pocket amounts you are likely to pay for a major hospital visit along with heavier use of primary care and specialist physicians, outpatient services, drugs,

  • Low Cost Year

    Our Low Cost year estimates the out-of-pocket amounts you are likely to pay for a number of doctor visits (one of which is an annual checkup), modest prescription drug and lab test spending, minor

  • Average Cost Year

    Your costs for health care include more than just insurance premiums. Our "Estimated average yearly costs for families like yours" also includes what you have to pay for the part of costs not covered

  • Deductible

    This is the deductible, if any, that you (or you and your family) will have to pay before the plan will reimburse most medical expenses. Not all payments count against the deductible, so we recommend

  • Most You Can Pay

    Insurance plans have a stated limit on what you might have to pay in a year for premium, hospital, doctor, drug, and other medical costs. But some plans have loopholes that may leave you paying

  • 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,

  • Part B Rebate

    A few plans offer partial Medicare Part B reimbursements for those enrolled in Medicare Part B. These savings are included in our yearly cost estimates with Medicare Parts A & B and in the Extra Cost

  • Profile Coverage

    Health costs vary with family size; we take this into account in rating plans. We do not have ratings for families larger than 5 (or for Medicare beneficiaries with covered children) but ratings for

  • International Health Coverage

    I am recently retired, looking to select a health plan that will work for my wife and I. Both of us have selected Medicare A and B. The past 10 years we have had our health plan with Kaiser. However

  • Prescription Drug Coverage

    I take a number of prescription drugs and I would like to find out which plan would cost me the least out of pocket cost. Is there a way to do this? Our results comparing plans include substantial

  • Maternity Care

    What plan offers the best maternity benefits? Most plans offer low or no cost maternity coverage. Check brochures for this, and check network lists online to make sure you will have a good selection

  • Plan Type

    Health Maintenance Organizations, or HMOs, are almost all local plans and have a closed set of doctors. A few HMOs allow you to use providers outside the plan's network, a variation called

  • 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

  • FEHB & Medicare Advantage

    Federal retirees have Medicare Advantage (MA) plans to consider joining. Our analysis shows that some of these offerings are an outstanding value. Aetna, APWU, Compass Rose, Kaiser, GEHA, MHBP, Rural

  • 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

  • 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

  • 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

  • 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

  • Plan Name

    This is the name of the plan. In some cases, we abbreviate the name to make our tables clearer.

  • Types of FEHB Plans

    Plans are of three main types: Preferred Provider Organization (PPO) and Fee-for-Service (FFS) plans, High Deductible (HDHP) and Consumer-Driven (CDHP) plans Health Maintenance Organization (HMO)

  • 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