Federal Employee Health Benefits

OK - here we are again. I took a couple of days off for the weekend and now am back and feeling refreshed. I wasn't sure which way to go next - so I needed to clear my head a bit.

I thought it was important to debunk one of the health care myths - that the Federal Government would be taking themselves out of the new proposed program for health care benefits. I guess some people think that if it isn't good enough for Congress, than why would we think it was good enough for us. Well the easy answer is they're NOT excluding themselves - they've been excluding us for all these years - and with the new plan, we won't be excluded from an affordable choice of insurance plans anymore.

For the past 10 years, I've considered myself lucky. I work for a company that pays 100% of my insurance premiums. Plus, I have low co-pays for my services and no deductible to meet. I'm very appreciative of this and wish everyone would have that choice. And now, they will.
I'm a true believer that all Americans, not just the rich or the lucky, like myself, are entitled to a an affordable health care choice in insurance plans. And if the company I work for can do it, there's no reason that all employers can't do it - even if they need a little help - which they'll get with the new plan in the form of generous tax credits.

So I did a little homework. I googled the Federal Employees Health Care Benefits web page. I can see why it's such a good plan. So basically, after reading a great deal of the House Health Care Bill (I still have a lot more to read.), I discovered that their plan is actually quite similar to the plan I have at work - actually mine is just minimally better.

For instance, if you go on to the site, you can choose the state you live in. Once inside, you can look at the Plans that are available and the costs of the premiums.

I clicked on CA, there are about 10 plans to choose from. I clicked on PA, and again there are about 12 different plans to choose from. Keep in mind you can choose an HMO, PPO, Fee for Service Plan, High Deductible, Standard Deductible, etc..... You can also use your HealthCare Flex Plan. There are a lot of plans and coverages to choose from.

I ended up just picking a plan to research - the one I'm most familiar with - not the most expensive plan, also not the cheapest plan and here is what I discovered.

This particular company had 2 plans to choose from: a standard option plan and a high option plan. Below are some of the plan benefits and the monthly premiums.

Benefit, Standard Co-Pay, High Co-Pay

Office Visit, 30.00, 15.00
Inpatient Admission, 500.00, 250.00
Preventative, 10.00, 0
Medications, 15.00, 10.00
Vision, NA, 25% Discount
Chiropractic, 15.00, 15.00
Tests - Lab, Xrays, 10.00, 0
CT/PET, 50.00, 0
WellBaby, Maternity, 5.00, 5.00
ER, 100.00, 50.00


Now, I don't know what kind of coverage you all have, but I believe this is an excellent plan - much better than most people have. I have been hearing a lot of nightmare stories of people paying 5000.00 - 10,000.00 a year in high deductibles before their benefits even kick in. This is outlandish. How can anyone afford this on a yearly basis?

OK - now let's take a look at the monthly premiums. Again, I don't know what everyone else is paying, but these seem pretty reasonable to me - and let's remember, these do not take into consideration any one's age or pre-existing conditions. There aren't any exclusions.

Family Size, Standard Option, High Option

Single, 280.15, 647.49
Family, 443.28, 1024.53

Also keep in mind, this employer picks up 75% of these premiums. So the following are out of pocket premiums you pay if your employer chooses this option. My employer pays 100% as yours may as well.

Single, 70.00, 162.00
Family, 111.00, 256.00

So tell me, isn't this a heck of a better plan than most Americans are getting?? I would think so. And again, I've been hearing a lot of nightmares out there from my patients, my family and my friends. Just because you may have a great health insurance plan, as I do, remember there are many Americans out there who are filing for bankruptcy, losing everything they have including their homes. And there are many Americans who die or who get a lot sicker than they need to, just because they don't have adequate health insurance at all. These may be the young adults who just think they won't get sick, and choose to buy a car instead of health insurance. These may also be people who just can't afford health insurance, who have lost their jobs because of the horrible economy now. These may be people who are just falling through the cracks. And most importantly, only because I think people are generally unaware of the under-insured population, these are people who actually have insurance, but don't know they aren't appropriately covered. I believe most people think they like their insurance - because they don't use it much - but when they actually have an illness that requires specialized care or hospital admission, they find it doesn't really pay for the bills they incur. I ask you again, shouldn't all Americans be entitled to some basic benefits - especially health care at an affordable rate with an choice that is right for them and their families?

If you don't think so, tell me why. Let's hear your side.

By the way, are you aware that of all bankruptcies filed, 60+ percent are due to a health care crisis, and of those families, 80% of them had health insurance. Interesting !

If yes, pass this blog around, educate people - spend a little time with your friends, families and co-workers so people really now what's going on.

Take a listen to one of the Reality Check videos on the whitehouse.gov website. I've attached the link below - just click on it. It's only 2 - 3 minutes long. It's a question from a regular person just like you or me.

Have a great day. Give back a little in some way today.