PlanSmartChoice – A Flawed FEHB Open Season Analysis Tool

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Happy Open Season, Feds!

It’s that time of year again where 95 percent of you do nothing and keep your existing health plan (for good reasons, see below).

For the minority of you who are considering switching plans, FEHB offers you the 3rd party tool PlanSmartChoice.com, which allows you to plug-in some assumptions about your family size and frequency of medical claims.   If you’ve used PlanSmartChoice before, it retains the info you input from last year, which is nice.  Here’s what it looks like for me:

 

It puts GEHA HDHP and Aetna HDHP at the top (best) in terms of Total Cost.  I strongly disagree with this assessment.  Why?

As I’ve documented in excruciating detail here, here, here, here, here, here and here, perceived savings- the Siren’s Song of a High Deductible Health Plan- can be a false economy when your family frequently visits the doctor or takes prescription drugs on a regular basis.  In my family’s case, we have been much better served (in both total overall cost and available providers) by the Blue Cross / Blue Shield ‘Basic’ (FEHB Code 112) plan.

High Deductible Health Plans (combined with a Health Savings Account) are often aggressively marketed as a retirement account that is even more powerful than an IRA.  If you’re a young health male, it is feasible you could use the HSA as a third retirement vehicle (in-line behind your TSP/401k and your Roth IRAs).   However, if you have a family or you’re a female it’s highly unlikely your HSA will act like a Health Savings Account- It’s more like a ‘Health Spending Account’ that gets depleted at a high rate of speed.

Specifics:

1) You have no clue what the retail price of a medical procedure is.  In our  case, we paid $200 for my wife to visit our Family Practitioner for a routine exam.  In this instance, there was no discount from Aetna, even though the Family Practicioner was listed as a ‘Preferred Aetna Provider’.

2) You can just as easily determine the street price of Heroin as you can the retail price of your prescriptions.  In our case, the price of a particular 90-day supply of a prescription drug changed each and every time we purchased it (as issued from the same doctor, filled at the same pharmacy, discounted or re-imbursed from the same insurance provider).  Don’t believe me?   Check the ‘street’ price of your favorite Rx Drug using the LowestMed app once every week and get back to me with your findings.

This is the fatal flaw with the PlanSmartChoice tool – It assumes you know the retail price of a Doctor’s Visit or the retail price of your Prescription Drugs.  You Don’t.

When sorting by ‘Total Cost’, BCBS Basic doesn’t even make the cut:

 

BCBS Standard (the more expensive of the Blue Shield choices) shows up as #28, though, behind MHBP (Mail Handlers Benefit Plan) Value Option and NALC Value Option – Two plans you could not encourage me to sign up for as a Fed if they were the only plans offered and I had Hepatitis C.   As a Fed eligible for FEHB, I would lie to the IRS and sign up for an Obamacare plan if NALC or MHBP were my only FEHB choices.

Not knowing any better, my family spent my first year of Federal Employment on NALC’s health plan- and I’m still hearing about it ten years later.

In our case, we chose NALC sight-unseen during FEHB Open Season based on their high marks in the FEHB brochures.  I’m convinced that the positive NALC ratings were skewed by union thugs or by NALC enrollees who received kickbacks from chums working for NALC.

In summary, there’s darn good reasons that  60+ percent of Feds choose one of the ‘Blues’ for FEHB.  Feds like myself have tried other health plans on occasion, but have simply found them inferior to BCBS.

If you’re considering an FEHB switch this Open Season, my best advice is to talk to a trusted friend or co-worker and ask them if they are satisfied with their current FEHB Plan.  Take the survey results in the glossy brochures and the 3rd party analysis tools with a wheelbarrow full of salt.

Happy Hunting during FEHB Open Season!

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