You have many more choices now that BBNC is part of the Federal Employees Health Benefits (FEHB) system. Every family’s needs are different. Here are some tips for choosing a health plan that is right for you and your family.
Decide who to cover
The FEHB plans are available for:
⦁ Employee only
⦁ Employee + 1 (a spouse or a child)
⦁ Employee + family
Please note:
⦁ Domestic partners are not eligible for coverage in FEHB.
Think about your medical needs
Choose a plan that matches the way you use medical services. For example, if you have a lot of doctor visits, you may want a plan with lower out-of-pocket costs and office visit co-payments. If you have prescription drugs you take every day, consider a plan that covers those drugs at the lowest cost.
Look at networks
Your costs are lower when you use providers who are part of the plan; these are “in-network” providers. Each plan has a “Provider Directory.” You can check this directory to see if your health care providers are in-network for the plans you are considering. This means that they have an agreement with that plan’s insurance company to provide service to you at a lower price. Your doctor may accept that insurance, but if they are not a network provider, it is likely that you will pay more.
In general, plans with a bigger network of healthcare providers will give you more choices. If you use providers that are not in your plan’s network, you may pay much more.
Think about your budget
With many health plan choices, you can find a premium cost that fits your budget. However, your total cost of health care also includes out-of-pocket costs, so you need to compare those as well as the premium cost.
Some FEHB plans put part of your premium in a medical reimbursement account (HRA or HSA) for your use – consider this when comparing plan premium costs.
Health Plan definitions:
Premium: The amount paid for your health insurance every month.
Deductible: The amount you pay for health care services before your insurance plan starts to pay.
Co-Payment: A fixed payment for a service, paid at the time of service, not usually subject to a deductible.
Coinsurance: The percentage of the cost you pay for health services after you have paid your deductible.
Out-of-Pocket Costs: Costs for medical care that are not paid by insurance. This includes deductibles, co-payments and coinsurance for covered services. It also includes all costs for services that are not covered. Once you reach your out-of-pocket maximum, the insurance plan will pay 100% of eligible costs for the rest of the calendar year.
Covered Services: Services covered by your health insurance plan, listed in the plan’s Summary of Benefits.
Plan Types:
- Fee for Service – Visit the doctor of your choice. Fees generally higher if provider not in network.
- Health Maintenance Organization (HMO) – Care provided through a network of providers in a particular geographic area.
- Consumer Driven Health Plan (CDHP) – Plans that give you incentive to help control costs.
- High Deductible Health Plan (HDHP) – Plans with higher deductibles that may allow an individual to participate in a Health Savings Account.
For more information:
Guide to Plan Types
Features & Tradeoffs