Federal employee health benefits (FEHB)

I was invited to a support group in the Ridgecrest area, and a week later for caregivers and seniors in the Tehachapi area. In both cases, one of the hotline’s many concerns was with retired FEHB employees and Medicare. For this article, I did some more research and was amazed to learn of the many options available to retirees, called “annuitants”.

My first achievement was the variety of plans offered to retirees and dependent spouses. Listening to questions from participants on the phone call, I realized that some people had restrictions on which doctor they could use. While investigating, I learned that limiting access to doctors, when they probably weren’t aware of it, was of their own choosing. There are many plans to choose from, and as is often the case with many consumers, they buy by price and don’t look at the perks they buy.

Consider purchasing a new television. The cheapest might just have an on / off switch and little to no features. It can have a small screen and the picture quality can be just passable. It can be a great buy for a spare bedroom, but it’s clearly not a good choice for normal family viewing. At the other end is a big screen with a phenomenal picture, a large number of HDMI and other input jacks, great sound, etc. You have different requirements and you will make a decision on the benefits of on-screen TVs.

Health plans should work the same way. People who complained about access to doctors probably chose “small screen TV”. It may be affordable, but the policy has not met their needs. While researching options, I found 64 plans available in California. Some of these plans were only available to retirees, while others included either spouse or family. Monthly costs ranged from $ 91.01 per month to $ 2,300.50 per month for a family plan. For the purposes of this article, I will focus only on plans for individual annuitants.

Company options. In California, there are six insurance companies to choose from: Aetna (18), Anthem Blue Cross (3), Blue Shield of California (3) Health Net (15) Kaiser Permanente (21) and United Healthcare (3).

What I mean here is that when asked what plan you have, answering “FEHB” or “Kaiser” is not a very precise description of your coverage. Kind of like saying you drive a Chevrolet. Do you drive a Corvette or a pickup?

The above list offers PPO type plans and HMO type plans. For this exercise, I will focus on PPO style plans, as they offer the widest choice of vendors.

By eliminating the HMO plans and selecting only plans for “me” (no dependents), I was able to narrow down Aetna’s choices (2). I was disappointed to learn that all the other plans were HMOs. This calls into question the fact that the people who told me they have a PPO and a few doctors to choose from are probably in an HMO and don’t realize it. Pity!

The “Aetna Medicare Advantage” (Z24) plan for a single person is $ 125 per month and the “Aetna Direct” (N61) is $ 153.96 in 2021. It requires enrollment in Medicare Parts A and B and acts as a supplement to Medicare. * This plan pays you back $ 900.00 per year, making it a great deal for those who qualify. The two plans have a difference other than the premium. The Z24 plan reads to me like a private Medicare Advantage plan, very common nationwide, but not available in Kern County from any of the private companies. Plan N61 reads like a traditional PPO. I advise anyone to buy any of these plans or the HMO plans offered by other companies. As in my previous analogy, look behind the TV and make sure all the “bells and whistles” you need are covered.

The FEHB program has an annual enrollment period, so as your health benefits and your wallet change over the years, you have the option of switching plans. Once you quit the program, think twice as you may not be allowed to return.

If you have any questions about the FEHB program, contact the program, the Internet or the carriers. I do not sell, service, or offer research on this topic beyond what I hope is accurate information here.

* These rates do not apply to all registrants. If you are in a special enrollment category, please refer to the FEHB program website or contact the tribal agency or employer that maintains your enrollment for health benefits.

REMEMBER: If you have a Medicare F supplemental plan, call me 30 days before your birthday and no more than 60 days after. We save an average of $ 800 to over $ 1,000 per year by researching alternatives. Free of charge, all conversations are over the phone.

Call me, the “Medicare Guru” 760-376-2100 for a no-obligation consultation.