(Final) YTD FEHB Aetna HDHP/HSA Costs

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Can a Federal Employee save money by switching his family of four to a High Deductible Health Plan (HDHP) / Health Savings Account (HSA)? Here’s another follow-up.

(Note: This is my final post regarding Aetna Health Savings Account (HSA).  I’ve switched employers, so this is my last month on the FEHB Aetna Plan.)

The answer is still NO.   We’re about $800 behind where we were last year with the conventional Blue Cross/Blue Shield (BCBS) plan.

Doctor and pharmacist visits for the month of August bring the 2013 Aenta YTD total to $5545, versus $4761 with BCBS (basic) during the same time period in 2012.

I was hoping that reaching the deductible would help our ‘medical cash burn rate’, but such has not been the case.  Since hitting the family $3,000 deductible in June, our Burn Rate for the Aetna High Deductible plan is still almost 2x our monthly expenses (all-in) on BCBS Basic.

Overall, if I had to do it all over again, I would stick with Blue Cross/Blue Shield.   Blue Cross is the choice of over 40% of Feds for good reasons-

• It’s the only nationwide PPO offered by Federal Employee Health Benefit (FEHB).
• Blue Cross treats their customers right.  They have among the highest payout ratios of the health insurers.
• Just about every medical and pharmacy provider front office (clerk) knows how to work with BCBS.  This reduces billing inconsistencies- and fewer billing errors leads to fewer Customer Service headaches.

… so enjoy the FEHB Blue Cross/Blue Shield benefit while you can.  It might be classified as a ‘Cadillac’ Health Plan by ObamaCare in 2018.

As for the Aetna HDHP/HSA, nothing against Aetna, but spending an extra $800 (YTD) on health care is not worth any supposed tax break I might get from the HSA.   If  I was still a Fed with Open Season rapidly approaching I’d be counting the days until my LES says ‘FEHB Code 112 – Blue Shield’ once again.  There are two fatal flaws with High Deductible Health Plans, and both have to do with cost transparency:

• We’ve not once paid the same price for the same drug prescription.   The price of prescription drugs fluctuates just as the ‘street price’ of illegal drugs does.   You can’t fight it- all you can do is track it using an app like LowestMed.
• You have no idea what the price is going to be when you walk in to a health provider’s office.  In one instance we paid $200 for a visit to our General Practice Doctor (no lab fees, no test fees- just the visit charge).

In summary, I do not recommend a High Deductible Health Plan (HDHP)/ Health Savings Account (HSA) for any Fed who:

• Has dependents
• Has (ahem) female plumbing
• Is over the age of 25

Other FEHB Aetna HDHP/HSA Notes:

• We’ve hit our $3,000 Deductible and are being reimbursed for just about everything now (Co-Pays instead of 100% of costs).
• Premium pass-through (rebate) of $125 posted early-month (August 12th).
• 3 visits to the dentist this month – 100% covered.
• I was only employed by Uncle Sam through early August and will be kicked off of Aetna (and enroll in our new employers’ plan) in 31 days.

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