FEHB BCBS Choices

[zl55lz]

Now that it is Open Season for Federal Employees Health Benefits, I am seeking comments on the Blue Cross Blue Shield options.

I was on Standard for decades while still working, then went to Basic the year I became eligible for Medicare A&B, and am now on Aetna Direct. I did not see any point to being on Standard with Part B--expensive, and Basic does not have additional Skilled Nursing Facility days, but the Focus option is such a low premium and apparently covers just about as well as the others when combined with A&B that I thought it worth looking into. I was very pleased when on BCBS previously. I do know that Basic gives the $1600 per year reimbursement but that still doesn't make up for the premium difference between Basic and Focus (Self+One). I do see that the Specialty Rx appears better with Basic. Focus has a higher Catastrophic but that might not be such a factor with Medicare involved. Same with the lack of out of network coverage. I have been very pleased with Aetna Direct and its flexible HRA, especially covering Rx coinsurance/copays but do wonder if anyone sees anything else about the three BCBS options and why or why not they chose them.

I really haven't heard much about anyone using Focus with Medicare. Any comments?

 

[zl55lz]

Not to bump my own thread, but upon further thinking about these three FEHB BCBS plans:

Although without Medicare the three plans vary widely in their coverages, WITH Medicare also it seems the plans mostly boil down to:

1. The plans have very different monthly premiums, from approximately $250 to almost $700 for self+one.

2. The three appear to cover, as a secondary insurance combined with Medicare A&B, the same things?

3. Basic gives a Medicare Reimbursement of $1600 per year as of 2023 for a self+one with both on Medicare A&B.

4. While all three appear to give nice Rx coverage, Basic appears to be better overall than Focus, and Standard better overall than the other two, with Basic and Standard appearing overall better for Specialty Rx.

5. Standard gives Skilled Nursing Facility days, the others do not as of this date.

6. The Catastrophic Max are different.

7. Standard has out of network coverage, while the other two do not (but there are exceptions).

8. Possibly #6 and #7 could be mitigated somewhat by having Medicare?

So, it seems well worthwhile to review the plans to see which fits one's situation best.

 

[W2R]

I've had BCBS Standard for decades. When I was working, people at work always told me to get BCBS Basic but I like Standard so I didn't. I still like Standard but people on the forum have told me to get Basic. Not gonna do it! It is more expensive but it covers more, too, and I like not having big surprise medical bills. It's so nice to check out of the hospital or outpatient facility and being told I owe $0.00.

 

[rodi]

I've had BCBS Standard for decades. When I was working, people at work always told me to get BCBS Basic but I like Standard so I didn't. I still like Standard but people on the forum have told me to get Basic. Not gonna do it! It is more expensive but it covers more, too, and I like not having big surprise medical bills. It's so nice to check out of the hospital or outpatient facility and being told I owe $0.00.

DH is MIL's conservator - (dementia)... He has kept her on standard, which is what she was on when he took over her finances. At age 96 she definitely gets medical treatment... and every bill is $0. Only thing with any out of pocket is medications. For her it has been great. (And great for DH to manage).

 

[W2R]

DH is MIL's conservator - (dementia)... He has kept her on standard, which is what she was on when he took over her finances. At age 96 she definitely gets medical treatment... and every bill is $0. Only thing with any out of pocket is medications. For her it has been great. (And great for DH to manage).

That's what I think, too! Peace of mind has a monetary value, to me. When I'm really, really sick (like with severe Covid in a hospital in northern Arkansas ) it's such a relief to feel confident that at least my bills will be taken care of and I can just focus on getting well.

 

[Dreamer]

I switched from BC/BS Standard to Basic I think 2 years ago. My DH and I both have Medicare Part A/Part B. I talked it over with other Federal retirees and a guy I called at BC/BS. It has been good for us so far.

My DH had MRIs and a Biopsy for his Prostrate Cancer. He has a colonoscopy every 3 years. He went to the ER for a heart attack and had emergency surgery for a stent and was in the hospital for 4 days. He is going to cardiac rehab 3 times a week. He went to an urgent care in a different state when he got something in his eyes when he was at the car races. So far, everything has been completely paid in full. He is on several medications and one of them is what I would consider expensive for us. He is allowed to use Mail Delivery through CVS and it was $125.00 for 3 months, which was much cheaper.

I also like that we can switch health care plans once per year, if needed.

 

[zl55lz]

I switched from BC/BS Standard to Basic I think 2 years ago. My DH and I both have Medicare Part A/Part B. I talked it over with other Federal retirees and a guy I called at BC/BS. It has been good for us so far.

My DH had MRIs and a Biopsy for his Prostrate Cancer. He has a colonoscopy every 3 years. He went to the ER for a heart attack and had emergency surgery for a stent and was in the hospital for 4 days. He is going to cardiac rehab 3 times a week. He went to an urgent care in a different state when he got something in his eyes when he was at the car races. So far, everything has been completely paid in full. He is on several medications and one of them is what I would consider expensive for us. He is allowed to use Mail Delivery through CVS and it was $125.00 for 3 months, which was much cheaper.

I also like that we can switch health care plans once per year, if needed.

I think BCBS Standard and Basic are among the best FEHB plans if one needs expensive or Specialty Rx.