Reality check: Shop or drop this Open Season

For most federal workers and retirees, going over the fiscal cliff in January isn’t the problem du jour.

Sequestration will happen or not (probably not) and there is little — other than worry — you can do about it.

Six months from now, we will most likely have forgotten what a hot topic the tax and spend issue was. But…

If you or a family member gets really sick or has a serious accident in the new year, that is reality. That, rightly so, will be your No. 1 problem. And whether you come out of it alive and kicking or financially strapped could depend on what you do between now and next Monday. Doing nothing is an option, but not a good one.


When it comes to shopping for the best health insurance deal, most federal and postal retirees have the same strategy: They do nothing. Although the health insurance Open Season ends at COB next Monday, the vast majority of retirees made their decision years ago. Stay the course!

Year after year, the vast majority of federal retirees stick with the same health plan that they had while working even though for most their medical expenses have increased while their income — annuity vs. salary — has dropped.

For the majority of retirees, the plan of choice is Blue Cross-Blue Shield’s standard, which expert Walton Francis calls “the gold standard” of the federal health program’s plans. Francis edits CHECKBOOK’s Guide to Federal Health Plans. Many federal agencies subscribe to the online version so their employees can compare plans at work. Members of the AFGE and NTEU unions also have access to it as part of their membership perks.

Whether you are a 100-year-old retiree or a super-healthy 25-year-old, it pays to shop around. Francis says individuals can save $1,000 a year in 2013 by picking the right plan. Couples even more.

Many retirees assume that with Medicare Part A (which is free), most of their medical bills will be taken care of. Many with Part A and B know it. Or think they do. But while they are the primary payers, retirees have more aches, pains and problems than younger and middle-aged feds. According to Francis, people older than 65 have a 12 percent chance of having high-cost ($25,000 or more) medical bills next year. Younger employees have only a 4 percent chance of hitting or exceeding that number. So, although both groups in the same plans pay the same premium, older individuals typically have higher costs.

In his CHECKBOOK guide, Francis estimates that a single retiree with Medicare Parts A and B who has an “average” medical year in 2013 will spend a total of $3,980 in premiums and out-of-pocket costs in the Blue Cross basic plan. Someone 55 and under, in the same plan who has average expenses next year will pay out a total of only $1,800 in 2013, he says. Both active and retired people pay the same FEHBP premiums. The difference in out-of-pocket payments is that they use more medical services and need more prescription drugs.

One way retirees can give themselves excellent coverage, while reducing their premiums, is to consider the managed-care HMOs. Francis gives top marks to Kaiser, CareFirst Blue Choice standard and Aetna basic. If you prefer fee-for-service plans he says that GEHA standard option, Foreign Service, Blue Cross basic, the MHBP standard Medicare Pilot and APWU high options will cover you nicely, and at lower premiums than the Blue Cross standard provided to remain in their network of physicians.


By Jack Moore

An incandescent light bulb, hanging in a fire station in Livermore, Calif., has been burning (nearly) continuously since it was installed sometime between 1901 and 1905.

(Source: Life’s Little Mysteries)


Are you in CSRS and your spouse or significant other is in FERS? If so, Federal News Radio wants to talk to you! Email Executive Editor Jason Miller for more information.

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