Calling all Federal employees - Let's talk health insurance

junebugrbig · November 2014

I've had BCBS standard self + family forever. I've always been pretty pleased until the last couple of years. Feel like I am paying way more out of pocket than ever and the premiums are getting really expensive. Considering switching to BCBS Basic. Anyone have that coverage and how does it compare to standard? Any other plans out there that you are happy with??

jlaOK · November 2014

We have had BCBS standard for the last 5 years. I've always been really happy with it and haven't noticed any increase in premiums. I have a friend who's family is on basic. I don't know details but she's been happy with the coverage. They are on a tight budget so assume it works well for their finances.

Hijacking your post a bit - We've used GEHA because they were the only plan that had our current dentist on it but always feel like we pay a lot out of pocket for general dental work. Does anyone have dental recommendations?

RachelandEduardo · November 2014

I have BCBS Standard self + family as well and have been happy with it. I've only been a federal employee for about 8 months though. My previous health insurance as a graduate student was AMAZING (as in I paid $0 to have a baby) so this coverage doesn't even hold a candle to that but it seems ok so far.

For dental BCBS covers preventive and then we have United concordia. The only snag I have run into so far is that I had to have two fillings replaced today and the cost for silver was $34 and the cost for white fillings was $300. My dentist said its unusual for a plan to have this much of a price difference between the two.

Mustardseed2007 · November 2014

So we've been on my H's Basic BCBS since we were married and since we had kids we also were on that. It's been good for us. My concern with having to go to preferred providers only has always been that I might go to someone thinking they are a preferred provider and they aren't, or have some medical record or image or something be reviewed without my knowledge by someone who isn't a preferred provider. But since becoming a user of the BCBS basic in 2008, that has never happened to me.

What has always scared me off of the standard was that several things have a % coinsurance under the standard plan, whereas under the basic plan they are only a copay. Also, although copays generally are a bit more expensive on the basic than the standard, it's only like 5 dollars more. And since all preventative is covered under both, all things being equal I figured the monthly savings in premium are worth the commitment to use preferred providers only.

Just a detail on the coverage for pregnancies that may be helpful under the basic:

Pregnancy is basically covered apart from your hospital admission and a 25 dollar copay at the first OB visit. For ordinary care for your baby in the hospital, it's all covered at 100% except for a copay for a circumcision (in 2011 I paid 80 dollars).

To have my baby girl in march, it cost me a co pay for each hospital admission. In your normal pregnancy this means you pay for 1 admission but for me I had 2 so I paid 150 for when I was admitted in 2013 and 175 when I was admitted in 2014 (the copay went up). It also covered my high risk OB, weekly ultrasounds and my MRI I had to have - no cost to me.

However, for my baby's NICU stay I was charged as if it was a general hospital admission. So that was 175 per day up to 875 maximum. Since we were in for 2.5 weeks I paid 875.

I believe general hospital admissions under the standard plan are limited to the one time copay so it could be much cheaper to be admitted to the hospital under the standard plan. But again, there is a % coinsurance for certain procedures and imaging (I don't remember exactly what things) so again, we decided to stick with the basic this year.

MommyAtty · November 2014

I'm OCD about insurance. DH is a federal employee, and I used to be. We get our insurance through FEHB.

We do a high deductible health plan (Aetna), and running the numbers, including the HSA, we can't find a better deal. BCBS has always had the worst numeric outcome for us. FWIW, I do a total out of pocket calculation, assuming a number of scenarios, including a major accident with broken limb, a pregnancy, and emergency appendectomy. BCBS always loses because (1) we have very few medical expenses beyond preventive care, which is covered at 100% by all plans, (2) their premiums are so high, and (3) they seem to offer fewer perks than other plans (Aetna covers vision and dental, for example). I always thought the high deductible plans would be the worst option, so I was surprised when they turned out to be the best. Shocked, in fact.

Mustardseed2007 · November 2014

MommyAtty said:

I'm OCD about insurance. DH is a federal employee, and I used to be. We get our insurance through FEHB.

We do a high deductible health plan (Aetna), and running the numbers, including the HSA, we can't find a better deal. BCBS has always had the worst numeric outcome for us. FWIW, I do a total out of pocket calculation, assuming a number of scenarios, including a major accident with broken limb, a pregnancy, and emergency appendectomy. BCBS always loses because (1) we have very few medical expenses beyond preventive care, which is covered at 100% by all plans, (2) their premiums are so high, and (3) they seem to offer fewer perks than other plans (Aetna covers vision and dental, for example). I always thought the high deductible plans would be the worst option, so I was surprised when they turned out to be the best. Shocked, in fact.

Now that is very interesting. I'll have to look into that.

itsmevkb · November 2014

I've worked for the feds for 15 years now and have done a few different plans. When it was just me I liked the consumer driven plans but those aren't realistic for us now given the size of your family. I tried a high-deductible plan one year but mainly because it offered IVF coverage. For the most part, I've had BCBS basic. I think the thing is to check the coverage for docs in your area. For me, I believe easily 90% of the docs, hospitals, clinics, etc. in my metro area take BCBS so using a preferred provider hasn't really been an issue.

What I've always been told is that the BCBS standard option is best if you have a specialist who is out of network or if you take a lot of prescriptions as they offer the mail option for three months supplies.

As for dental, BCBS now covers cleanings. I've always found the offered dental plans to have way to high of a premium so for the last two years I've bought a dental discount plan online and pay around $100 a year for my whole family to receive discounted rates about equal to what I'd pay with insurance.

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