Question about Signing up for FEHB

[SIXTY-NINE]

Hey guys I'd like to ask you some questions about FEHB-


There are some procedures that I'd like to get checked out while I'm enrolled in a plan (that are hopefully not recurring expenses)

- I'd like to get my knee thoroughly looked at (surgery being the worst case option)
- I'd like to get LASIK/LASEK (doubt this will be covered but want to make sure)
- I'd like to get Eustachian Tube Balloon Dilation for my hearing.
-I'd like to get dental aligners (and maybe get a tooth that is misaligned removed from my mouth).
-I'd also like to get some acne/burn scars lasered off my face (doubt this will be covered as well)

I'm looking through the plans but everything is insanely confusing- at the moment I live in California- what do you guys recommend I read through to understand these plans?

Healthcare Plan Information For California - OPM.gov

Welcome to opm.gov

www.opm.gov

Reading through this site at the moment.

Should I get a plan with a low out-of-pocket expense and go for the plan with the most coverage?
These all seem to be one-off costs so should I go with a healthcare plan with the highest premium for a year?



Thanks!

Signed, a guy in his 20s who never learned to do this stuff

 

[Robert_Boucher]

Are you already at a facility? In general FEP Blue Basic or Standard are good plans. I had basic for 3 years and one child under it and only had 1 small issue. This past year I switched to GEHA elevate plus, and like it so far. The reason I switched was they have free virtual DR visits and with 2 kids it comes in handy, and they offer up to $500 per person to use towards expenses for completing things. I did have a knee MRI $200 co-pay, specialist visit was $40 and a knee x-ray was like $7. All in all I'm happy with them and probably will stay with them until they give me a reason to leave.

Edit to add.

If you know you're going to need things done Id look for a plan that going to cost you the least out of pocket each time you go to a Dr office. Also look into FSA feds to help offset some of your out of pocket expenses.

 

[SIXTY-NINE]

Are you already at a facility? In general FEP Blue Basic or Standard are good plans. I had basic for 3 years and one child under it and only had 1 small issue. This past year I switched to GEHA elevate plus, and like it so far. The reason I switched was they have free virtual DR visits and with 2 kids it comes in handy, and they offer up to $500 per person to use towards expenses for completing things. I did have a knee MRI $200 co-pay, specialist visit was $40 and a knee x-ray was like $7. All in all I'm happy with them and probably will stay with them until they give me a reason to leave.

Edit to add.

If you know you're going to need things done Id look for a plan that going to cost you the least out of pocket each time you go to a Dr office. Also look into FSA feds to help offset some of your out of pocket expenses.

I'm not at a facility yet- just recently on-boarded as a trainee.
I have some money saved up so the low pay isn't an issue, and I'd rather get these issues solved now before they get worse. I'll look into those plans and look at the cheapest out of pockets- thanks!

I think my biggest concern is not getting charged thousands for a surgical procedures (without fair reason).

 

[Mike Kilo]

Those plans are never easy to understand and that’s the way they like it. I’ve had Blue standard and just switched to the cheaper basic and haven’t found it lacking.

Also to note, every year around November is open season to change plans so if one doesn’t cut it you’ll be able to change soon lol.

 

[SIXTY-NINE]

Those plans are never easy to understand and that’s the way they like it. I’ve had Blue standard and just switched to the cheaper basic and haven’t found it lacking.

Also to note, every year around November is open season to change plans so if one doesn’t cut it you’ll be able to change soon lol.

Thanks!
0 doubt that companies make way more by burying the explanations in legalese....
Any vision/dental plans that you've had good experience with? Thanks for your input!

 

[GMX]

The whole health benefits thing can be complicated. Some people really like PPOs and some people like the high deductible HMOs with a HSA. I've had the Blue Cross PPO since 2002. At times I've had Standard for certain benefits but am currently using the cheaper Basic. Lots of research required and it's easy to get into the weeds. I do recommend setting up the FSA Feds account to put pre-tax dollars into an account to pay for co-pays and/or authorized products. If you do $100 per PP ($2600/year) you will save several hundred dollars (depending on tax rate) per year using it to pay for co-pays and authorized products (ONLY IF you'll use that though). FSAs are use it or lose it (they allow $500 to carry over to the new year), and HSAs continue to accumulate as you put cash in; some people have multiple thousands in HSAs.

As far as proper dental/vision insurance? I got the dental once to cover braces, but I'm going to do braces again in a few years and will NOT get the insurance for it. I'll max out my FSA and just pay cash. I haven't really seen that dental/vision insurance is really worth the premiums. I think cash plus tax advantaged FSAs are the way to go.

If you're really healthy or really sick go with a High Deductible Health Plan. If you barely go to doctors then the lower premiums will benefit you. If you or someone in family is sick as hell, then once you pay that $10K or whatever in deductibles, then the major $100K shit should be covered 100%.

If you're in the middle and your family has reason to visit the doctor several times a year for various ailments but no long term serious problems, get the PPO and just pay the higher premiums and co-pays each time.

All the things you mentioned except maybe the knee seem pretty elective and probably won't be covered either way, so you pay out of pocket and maybe recoup some cost through the FSA.

YMMV.

 

[SIXTY-NINE]

The whole health benefits thing can be complicated. Some people really like PPOs and some people like the high deductible HMOs with a HSA. I've had the Blue Cross PPO since 2002. At times I've had Standard for certain benefits but am currently using the cheaper Basic. Lots of research required and it's easy to get into the weeds. I do recommend setting up the FSA Feds account to put pre-tax dollars into an account to pay for co-pays and/or authorized products. If you do $100 per PP ($2600/year) you will save several hundred dollars (depending on tax rate) per year using it to pay for co-pays and authorized products (ONLY IF you'll use that though). FSAs are use it or lose it (they allow $500 to carry over to the new year), and HSAs continue to accumulate as you put cash in; some people have multiple thousands in HSAs.

As far as proper dental/vision insurance? I got the dental once to cover braces, but I'm going to do braces again in a few years and will NOT get the insurance for it. I'll max out my FSA and just pay cash. I haven't really seen that dental/vision insurance is really worth the premiums. I think cash plus tax advantaged FSAs are the way to go.

If you're really healthy or really sick go with a High Deductible Health Plan. If you barely go to doctors then the lower premiums will benefit you. If you or someone in family is sick as hell, then once you pay that $10K or whatever in deductibles, then the major $100K shit should be covered 100%.

If you're in the middle and your family has reason to visit the doctor several times a year for various ailments but no long term serious problems, get the PPO and just pay the higher premiums and co-pays each time.

All the things you mentioned except maybe the knee seem pretty elective and probably won't be covered either way, so you pay out of pocket and maybe recoup some cost through the FSA.

YMMV.

This is great advice, thank you.

I'm generally very healthy, work out and have good habits about these things but I have these procedures that I want to get done..

I have a question about aging in the field- what common ailments do you see? I assume high blood pressure from the stress?
Is suicide from stress common among US ATCs?
What else?

 

[32andBelow]

This is great advice, thank you.

I'm generally very healthy, work out and have good habits about these things but I have these procedures that I want to get done..

I have a question about aging in the field- what common ailments do you see? I assume high blood pressure from the stress?
Is suicide from stress common among US ATCs?
What else?

A lot of people wind up being diagnosed with fat

 

[JackTBP]

FEP Blue Basic is what I've had my entire career. Prior to that, my parents had FEP Blue Standard since I was born. Through countless major medical issues in my family, it's reliable insurance that is widely accepted and generally pays what it's supposed to with minimal issues. I spent weeks trying to explain to my parents why - in their situation - having Blue Cross Standard was not the most optimal for them financially. It's insane how complicated insurance is. They finally switched to Basic this year and seem to be saving money with no issues. Everyone is in a different situation, of course, so do your research.

 

[SIXTY-NINE]

FEP Blue Basic is what I've had my entire career. Prior to that, my parents had FEP Blue Standard since I was born. Through countless major medical issues in my family, it's reliable insurance that is widely accepted and generally pays what it's supposed to with minimal issues. I spent weeks trying to explain to my parents why - in their situation - having Blue Cross Standard was not the most optimal for them financially. It's insane how complicated insurance is. They finally switched to Basic this year and seem to be saving money with no issues. Everyone is in a different situation, of course, so do your research.

Yep, I don't mind doing the research but this is probably the most complicated decision I've made in my life so far lol- I'm honestly willing to spend extra money at it for the peace of mind but I don't even know what the hell I'm throwing money at in this case

 

[32andBelow]

Yep, I don't mind doing the research but this is probably the most complicated decision I've made in my life so far lol- I'm honestly willing to spend extra money at it for the peace of mind but I don't even know what the hell I'm throwing money at in this case

You can switch every year. And moving to your facility is a qualifying event to change.