CAUSEY: Take advantage of guidance for enrolling in a health plan

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Nearly 8 million current and former federal and postal workers are in the midst of deciding which health plan to pick for 2009. Also trying to pick the best health plan are tens of thousands of ex-spouses, surviving spouses and dependent children who also are covered by the giant federal health program, called the FEHBP.

The decision they make between now and Dec. 8 (the close of open enrollment) will determine what kind of coverage they have next year and how much they will pay in premiums and out-of-pocket for services not covered by their plan. All of the FEHBP plans are rated good to excellent. But some of the premiums are too high for most people, and some of the plans have a much better catastrophic benefit (which limits your out-of-pocket liability) if the worst happens to you or yours next year.

Unlike many employers, who toss out a limited number of insurance options and let employees sink or swim, the federal government spends a bundle on general information and Web sites offering guidance and comparing premiums and benefits. In the metropolitan Washington area, most people are eligible to pick from 28 plans or options within a plan.

In addition to an excellent federal Web site, offered by the Office of Personnel Management (OPM), federal departments and agencies employing about 50 percent of the work force have gone the extra mile. They have subscribed to the Washington Consumers CHECKBOOK Guide to Health Plans. For those lucky employees, the Internet service (which people can also purchase on their own) is free. Information and help in picking the right plan are a mouse-click away.

So who are these departments that have gone the extra informational mile? They include all or parts of Agriculture, Commerce, Defense, Education, Energy, Health and Human Services, Homeland Security, Housing and Urban Development, Interior, Labor, Justice, State, Transportation, Treasury, and Veterans Affairs. Employees in the following independent agencies also can get the free information online: the U.S. Agency for International Development, Environmental Protection Agency, General Services Administration, NASA, National Science Foundation, Nuclear Regulatory Commission, OPM, Small Business Administration, and Social Security.

So what are health-plan hunters looking for? A couple of things:

1) Search for a plan that protects them from the sometimes backbreaking costs associated with a major illness or accident, which can strike any person, or family, at any time. Many plans limit your liability to several thousand dollars, but some require you to pay more.

2) Be sure that your favorite doctor or doctors are in the network of the plan or plans you are considering. In the Washington area, many physicians and hospitals are part of most plans. But you need to check. The best way to do it is to ask someone in your doctor's or doctors' office whether they will be in the network of the plan or plans you are considering. If not, your choices are to get another plan or pay very high out-of-network fees.

3) Don't fixate on premiums either way. The most expensive plans are not necessarily best for you. Often you will be paying for protection and coverage you aren't likely to need. Some excellent plans, such as the popular Blue Cross standard option (which covers about four of every 10 FEHBP participants) are going up next year. A lot. Walton Francis, who edits the CHECKBOOK guide, says many standard-option policyholders can get similar coverage next year, at a lower premium, if they switch to the Blues' basic option.

4) Look at options such as health savings accounts (which allow you to keep the money you don't use) and flexible spending accounts. Both permit you to use pre-tax dollars to pay for uncovered services. But be advised that although an HSA is like a bank account you can keep, FSAs are a use-it-or-lose-it deal. Money left in your account each year is forfeited. HSAs are used in conjunction with plans that have the HD (for high deductible) designation or CD (for consumer-driven) plans.

Among local HMOs, that includes Aetna, United Health Care and the Coventry plans. Among nationwide fee-for-service, that includes American Postal Workers Union, Government Employees Health Association or GEHA, and the Mail Handlers plans.

5) Check out some plans that were formerly limited to FBI, CIA and Drug Enforcement Administration personnel or to Foreign Service staffers. Those plans, SAMBA, Foreign Service and the association plans are open to all feds, or to the huge number of civil servants who are involved in defense or national security or foreign affairs operations. This includes workers at Defense, Homeland Security, Transportation Security Administration, and even portions of Agriculture's departments.

6) If you are retired military now working as a civilian federal employee and have Medicare-coordinated health plans such as Tri-Care or ChampVa, you might want to consider suspending your FEHBP coverage to avoid paying premiums to both plans. Benefits expert Ed Zurndorfer, with the National Institute of Transition Planning, says "there is no need to pay two premiums" if you have coverage under a Medicare-coordinated plan. In those situations, he says, "you may want to consider suspending - not dropping - your FEHBP coverage." In those cases, people who suspend FEHBP can return to it later on. But if they drop (as opposed to suspend) FEHBP coverage, they can never return.

Picking the best plan could save you $1,000 or more in premiums, and a lot more than that if you are hit with a catastrophic event such as cancer, heart problems, a stroke or a serious accident.

The old line "you can pay me now or pay me later" wasn't written for FEHBP shoppers. But it certainly applies to them.

• Mike Causey, senior editor at Federal News Radio AM 1050, can be reached at 202/895-5132 or mcausey@federalnewsradio.com.