2023 FEHB Premiums

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Topic Author
tallguy3891
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2023 FEHB Premiums

Post by tallguy3891 »

Someone might have already mentioned this, but the 2023 FEHB premium charts are now available at OPM site.

Some plans had significant increases.

Any comments?
Haysnooze
Posts: 58
Joined: Wed Oct 02, 2019 5:24 pm

Re: 2023 FEHB Premiums

Post by Haysnooze »

Thanks for the heads up. Ours is only going up 7% so looking at some of the others, I guess we are lucky.
Tdubs
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Re: 2023 FEHB Premiums

Post by Tdubs »

GEHA HDHP up only about 5%
User avatar
HueyLD
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Re: 2023 FEHB Premiums

Post by HueyLD »

11% for BCBS. Yuck!
Haysnooze
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Re: 2023 FEHB Premiums

Post by Haysnooze »

Tdubs wrote: Fri Sep 30, 2022 6:21 pm GEHA HDHP up only about 5%
I'm calculating almost 10% for GEHA HDHP no matter self, self+1, or family. You might want to redo your math.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
RJC
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Re: 2023 FEHB Premiums

Post by RJC »

Inflation up, FEHB up, and I bet our annual pay raise will only be a small bump. Probably net less overall...
RJC
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Re: 2023 FEHB Premiums

Post by RJC »

Haysnooze wrote: Fri Sep 30, 2022 6:31 pm
Tdubs wrote: Fri Sep 30, 2022 6:21 pm GEHA HDHP up only about 5%
I'm calculating almost 10% for GEHA HDHP no matter self, self+1, or family. You might want to redo your math.
From 167 to 183 for family...
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

RJC wrote: Fri Sep 30, 2022 8:27 pm Inflation up, FEHB up, and I bet our annual pay raise will only be a small bump. Probably net less overall...
If one is a Social Security recipient or CSRS retiree, the cost of living adjustment will be determined when the final data is released next month. At this point it is at about 8.7% but may be lower, maybe in the 8.0-8.5% range (?), depending on the cpi-w for this month. That will be the largest increase in approx 40 years.

If one is a federal employee, the raise is apparently supposed to be 4.1% plus an average of 0.5% locality pay.

You are correct about that inflation and some of the FEHB plans and a possible net loss.
OpenMinded1
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Re: 2023 FEHB Premiums

Post by OpenMinded1 »

tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
tj
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Re: 2023 FEHB Premiums

Post by tj »

Haysnooze wrote: Fri Sep 30, 2022 6:31 pm
Tdubs wrote: Fri Sep 30, 2022 6:21 pm GEHA HDHP up only about 5%
I'm calculating almost 10% for GEHA HDHP no matter self, self+1, or family. You might want to redo your math.
I'm okay with it. The geha hdhp increase was almost nothing in 2020 and 2021.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
CORRECTED: We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request Medicare reimbursements. Very simple so far. The Rx copays are very good. At the end of the year the remaining fund is rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay multiple times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers their part for 60 days in coordination with Medicare, which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare. There is a form to request fund as Medicare reimbursement. See site for how.
Last edited by tallguy3891 on Sat Oct 01, 2022 6:14 pm, edited 2 times in total.
OpenMinded1
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Re: 2023 FEHB Premiums

Post by OpenMinded1 »

tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request reimbursements. Very simple so far. The Rx copays are very good. At the end of the year we can request to have the remainder issued to us (I think), or rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay 10-12 times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers 40 days after Medicare's 20 days which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare.
Thanks for the information. I'll definitely check into that. I will be going on medicare next year. My wife has a few years to go yet. I've been on BCBS Basic for awhile, but disappointed in the prescription coverage. It's mediocre.
mbres60
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Re: 2023 FEHB Premiums

Post by mbres60 »

Where on OPM is this info? I didn't see it. Thanks.
mbres60
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Re: 2023 FEHB Premiums

Post by mbres60 »

tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request reimbursements. Very simple so far. The Rx copays are very good. At the end of the year we can request to have the remainder issued to us (I think), or rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay 10-12 times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers 40 days after Medicare's 20 days which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare.
Just to make it clear, it sounds like you use your fund for copays. We have only a few Rx copays per year. We use the fund for Medicare Part B reimbursement.
eob616
Posts: 52
Joined: Sun Aug 26, 2018 10:01 am

Re: 2023 FEHB Premiums

Post by eob616 »

mbres60 wrote: Sat Oct 01, 2022 7:14 am Where on OPM is this info? I didn't see it. Thanks.
https://www.opm.gov/healthcare-insuranc ... /premiums/

Appreciate the heads up. Only up a bit over $1 biweekly for my Kaiser plan. I'll take it!
mbres60
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Re: 2023 FEHB Premiums

Post by mbres60 »

eob616 wrote: Sat Oct 01, 2022 7:28 am
mbres60 wrote: Sat Oct 01, 2022 7:14 am Where on OPM is this info? I didn't see it. Thanks.
https://www.opm.gov/healthcare-insuranc ... /premiums/

Appreciate the heads up. Only up a bit over $1 biweekly for my Kaiser plan. I'll take it!
Thanks!
BattyNatty
Posts: 49
Joined: Sat Feb 20, 2021 12:25 pm

Re: 2023 FEHB Premiums

Post by BattyNatty »

Employee share of my Kaiser family plan is going up a total of $4 per month. Will definitely take that!
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

mbres60 wrote: Sat Oct 01, 2022 7:17 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request reimbursements. Very simple so far. The Rx copays are very good. At the end of the year we can request to have the remainder issued to us (I think), or rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay 10-12 times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers 40 days after Medicare's 20 days which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare.
Just to make it clear, it sounds like you use your fund for copays. We have only a few Rx copays per year. We use the fund for Medicare Part B reimbursement.
When I go to pick up any Rx, the fund automatically covers the copay. The pharmacy has already received that info and my pickup cost is zero. My understanding is that the fund would also automatically cover any odds and ends covered cost from a provider, but so far our Medicare + Aetna Direct combo has covered 100% of the approved provider charges.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

OpenMinded1 wrote: Sat Oct 01, 2022 5:47 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request reimbursements. Very simple so far. The Rx copays are very good. At the end of the year we can request to have the remainder issued to us (I think), or rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay 10-12 times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers 40 days after Medicare's 20 days which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare.
Thanks for the information. I'll definitely check into that. I will be going on medicare next year. My wife has a few years to go yet. I've been on BCBS Basic for awhile, but disappointed in the prescription coverage. It's mediocre.
I personally would not use Aetna Direct unless I AND my spouse had Medicare parts A and B, but that is my choice for a variety of reasons. Apparently one can do so if one chooses. We find it works excellent with Medicare. Just my opinion.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

mbres60 wrote: Sat Oct 01, 2022 7:17 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request reimbursements. Very simple so far. The Rx copays are very good. At the end of the year we can request to have the remainder issued to us (I think), or rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay 10-12 times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers 40 days after Medicare's 20 days which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare.
Just to make it clear, it sounds like you use your fund for copays. We have only a few Rx copays per year. We use the fund for Medicare Part B reimbursement.
As far as I remember, as of this writing, I don't think one has a choice whether copays are automatically taken. Check the brochure/site for more specifics. I think right now one can get reimbursed for Medicare premiums, or let the fund roll over and be added to the next year, up to $10,000 for a self+one or family. UPDATE: I looked into this further: if I am reading it correctly, it states one cannot get the remainder in cash at end of the year (maybe referring to non-Medicare enrollees?), BUT there is a form to request the fund as Medicare reimbursement, so see the site for details of when/how.
Last edited by tallguy3891 on Sat Oct 01, 2022 6:10 pm, edited 2 times in total.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

Btw, the Aetna Direct plan is listed on OPM under HMO plans, not FFS plans, but, as of this date anyway, it is a PPO plan with an extensive provider network. Our cards specifically show "Open Choice PPO"
Topic Author
tallguy3891
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Joined: Sat Jul 03, 2021 10:47 am

Re: 2023 FEHB Premiums

Post by tallguy3891 »

Please see my "update" and "correction" of my prior posts and embedded uncorrectable quotes in others' posts regarding the Aetna Direct $1800 fund, as to how it can be used, rolled over, and claimed for Medicare reimbursement. See site for details about fund options and request form.
mbres60
Posts: 1303
Joined: Tue Jul 03, 2007 1:47 pm

Re: 2023 FEHB Premiums

Post by mbres60 »

tallguy3891 wrote: Sat Oct 01, 2022 11:35 am Btw, the Aetna Direct plan is listed on OPM under HMO plans, not FFS plans, but, as of this date anyway, it is a PPO plan with an extensive provider network. Our cards specifically show "Open Choice PPO"
I think it is listed this way (as an HMO) because there are a few parts of the country where it is not available. When you have Part B you can go to any doctor you want. They don't have to be "in network". If you use a lot of Rx drugs then, yes, your fund will get used up by that. We only have one Rx drug so we use most of the fund for Part B reimbursement. If you have any left over at the end of the year it does roll over. You will lose it, however, if you no longer will have Aetna Direct for the next year.

This plan was designed for people on Medicare Parts A & B. If someone does not have Part B or is not on Medicare, then it would be best to find another plan. We started using it when both of us were on Medicare.
OpenMinded1
Posts: 1576
Joined: Wed Feb 05, 2020 8:27 am

Re: 2023 FEHB Premiums

Post by OpenMinded1 »

tallguy3891 wrote: Sat Oct 01, 2022 11:24 am
OpenMinded1 wrote: Sat Oct 01, 2022 5:47 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request reimbursements. Very simple so far. The Rx copays are very good. At the end of the year we can request to have the remainder issued to us (I think), or rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay 10-12 times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers 40 days after Medicare's 20 days which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare.
Thanks for the information. I'll definitely check into that. I will be going on medicare next year. My wife has a few years to go yet. I've been on BCBS Basic for awhile, but disappointed in the prescription coverage. It's mediocre.
I personally would not use Aetna Direct unless I AND my spouse had Medicare parts A and B, but that is my choice for a variety of reasons. Apparently one can do so if one chooses. We find it works excellent with Medicare. Just my opinion.
Thanks again. As usual I'll analyze my options to death before making a decision. :D

I'm puzzled how you can have no out-of-pocket expenses for prescriptions. I understand you are using the $1800 to pay the copay on the prescriptions, but it doesn't seem like it would take many prescriptions to blow thru the $1800. Maybe your wife requires a lot of healthcare/Rx, but her prescription are the lower tier, less expensive ones? Am I right to assume you don't have Medicare prescription coverage (part D)?
cowbman
Posts: 638
Joined: Sat Jan 14, 2017 1:10 pm

Re: 2023 FEHB Premiums

Post by cowbman »

OpenMinded1 wrote: Sun Oct 02, 2022 8:00 am
tallguy3891 wrote: Sat Oct 01, 2022 11:24 am
OpenMinded1 wrote: Sat Oct 01, 2022 5:47 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm

You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request reimbursements. Very simple so far. The Rx copays are very good. At the end of the year we can request to have the remainder issued to us (I think), or rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay 10-12 times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers 40 days after Medicare's 20 days which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare.
Thanks for the information. I'll definitely check into that. I will be going on medicare next year. My wife has a few years to go yet. I've been on BCBS Basic for awhile, but disappointed in the prescription coverage. It's mediocre.
I personally would not use Aetna Direct unless I AND my spouse had Medicare parts A and B, but that is my choice for a variety of reasons. Apparently one can do so if one chooses. We find it works excellent with Medicare. Just my opinion.
Thanks again. As usual I'll analyze my options to death before making a decision. :D

I'm puzzled how you can have no out-of-pocket expenses for prescriptions. I understand you are using the $1800 to pay the copay on the prescriptions, but it doesn't seem like it would take many prescriptions to blow thru the $1800. Maybe your wife requires a lot of healthcare/Rx, but her prescription are the lower tier, less expensive ones? Am I right to assume you don't have Medicare prescription coverage (part D)?
Agree with above, this plan really only makes sense if you are on Medicare. GEHA in many states uses Aetna as the administrator/network, so if you aren't on Medicare yet, you get almost the same coverage for less.
Last edited by cowbman on Sun Oct 02, 2022 10:54 am, edited 1 time in total.
westie
Posts: 601
Joined: Thu Jan 19, 2012 7:00 am

Re: 2023 FEHB Premiums

Post by westie »

Retired fed here. Hopefully everyone with BC/BS takes advantage of premium rebates ( I call them that) through Wage Works. It's actually a HRA, Health Reimbursement Account. It may apply to other insurance programs too, I'm not sure. I've gotten over $800 back this year and past years. Wife also get a check for more than $800 too.

check it out...https://www.wageworks.com/
Topic Author
tallguy3891
Posts: 703
Joined: Sat Jul 03, 2021 10:47 am

Re: 2023 FEHB Premiums

Post by tallguy3891 »

westie wrote: Sun Oct 02, 2022 8:46 am Retired fed here. Hopefully everyone with BC/BS takes advantage of premium rebates ( I call them that) through Wage Works. It's actually a HRA, Health Reimbursement Account. It may apply to other insurance programs too, I'm not sure. I've gotten over $800 back this year and past years. Wife also get a check for more than $800 too.

check it out...https://www.wageworks.com/
We were very pleased with BCBS all the years we were on it, both before and after signing up for Medicare. The Basic plan gives the Medicare reimbursement, $800 individual and $1600 if both on Medicare. When we were on BCBS there were also incentives possible for a card with $ on it to be able to use for certain approved items.

I see that for 2023 the Aetna Direct premium is about $120 less per month for self+one than Basic, has more skilled nursing days coverage, and gives more of a medical fund than Basic, and for Basic one as of this date anyway, needs to be aware of it requiring in-network providers. Both have extensive provider networks. Basic premium is increasing about $47 per month in 2023, Direct about $7 for self+one.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

OpenMinded1 wrote: Sun Oct 02, 2022 8:00 am
tallguy3891 wrote: Sat Oct 01, 2022 11:24 am
OpenMinded1 wrote: Sat Oct 01, 2022 5:47 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm

You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request reimbursements. Very simple so far. The Rx copays are very good. At the end of the year we can request to have the remainder issued to us (I think), or rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay 10-12 times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers 40 days after Medicare's 20 days which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare.
Thanks for the information. I'll definitely check into that. I will be going on medicare next year. My wife has a few years to go yet. I've been on BCBS Basic for awhile, but disappointed in the prescription coverage. It's mediocre.
I personally would not use Aetna Direct unless I AND my spouse had Medicare parts A and B, but that is my choice for a variety of reasons. Apparently one can do so if one chooses. We find it works excellent with Medicare. Just my opinion.
Thanks again. As usual I'll analyze my options to death before making a decision. :D

I'm puzzled how you can have no out-of-pocket expenses for prescriptions. I understand you are using the $1800 to pay the copay on the prescriptions, but it doesn't seem like it would take many prescriptions to blow thru the $1800. Maybe your wife requires a lot of healthcare/Rx, but her prescription are the lower tier, less expensive ones? Am I right to assume you don't have Medicare prescription coverage (part D)?
We do not have Part D. She uses mostly the usual Rx, and her part is approx a few dollars to approx $20 for each, average per month, which comes out of the fund, and of course Direct covers the rest via their part. She did try a new med this year for which her part alone was over $400, which came automatically out of the fund. You are correct, though, if a person had certain prescriptions and specialty meds the fund could go pretty quickly but most plans don't even have a fund like this so $1800 is very helpful. It is late in the year and still over $400 in the fund, zero for Rx so far out of pocket, less hassle for us, and we will roll over any remaining to next year.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

While we're on the topic of FEHB premiums and so on, I've noticed there are quite a bit of differences in Specialty Rx coverage costs to consumer between plans.

BCBS Standard and Basic appear to be excellent, although personally from what I've seen as of the 2022 brochure, I would possibly go with NALC High option if we needed specialty meds. It has relatively good copays, but mainly it has very low catastrophic coverage compared to most other plans I've seen, which would be very nice in a costly specialty meds scenario. Although FEHB + Medicare recipients don't usually have to be too concerned about provider catastrophic coverage, it could benefit them for Rx coverage.

I was just wondering if anyone would be willing to share which plan they thought was best for a specialty med scenario, and why?
stan1
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Re: 2023 FEHB Premiums

Post by stan1 »

tallguy3891 wrote: Sun Oct 02, 2022 12:10 pm While we're on the topic of FEHB premiums and so on, I've noticed there are quite a bit of differences in Specialty Rx coverage costs to consumer between plans.

BCBS Standard and Basic appear to be excellent, although personally from what I've seen as of the 2022 brochure, I would possibly go with NALC High option if we needed specialty meds. It has relatively good copays, but mainly it has very low catastrophic coverage compared to most other plans I've seen, which would be very nice in a costly specialty meds scenario. Although FEHB + Medicare recipients don't usually have to be too concerned about provider catastrophic coverage, it could benefit them for Rx coverage.

I was just wondering if anyone would be willing to share which plan they thought was best for a specialty med scenario, and why?
Prescription coverage and co-pays is one of the major differentiators in plans including retail and mail order pharmacies. I review the formulary for each plan based on what prescriptions I need long term. It is not possible to predict what I might need in the future but open season allows for changing to a different plan if needed.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

There is also some additional information at OPM besides the 2023 premiums. The actual brochures have not come out yet that I see; there is something called Public Use Files (PUF) where one can see some basics about the plans for 2023, such as which zip codes are covered by which plans, and the basic costs, fund, catastrophic coverage, etc., of plans for 2023.

To see it, go to OPM--Insurance--Healthcare--Transparency in Healthcare--Public Use Files--2023 PUF tab.
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VictoriaF
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Re: 2023 FEHB Premiums

Post by VictoriaF »

I have been using Medicare Parts A and B in combination with GEHA-High and was pleased with the coverage. For 2023, my GEHA premium will increase from $227.20 to $229.10 and GEHA's Medicare Premium Reimbursement will increase from $800 to $1,000. See the brochure [PDF], https://www.geha.com/~/media93/Project/ ... -guide.pdf .

Victoria
Inventor of the Bogleheads Secret Handshake | Winner of the 2015 Boglehead Contest. | Every joke has a bit of a joke. ... The rest is the truth. (Marat F)
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

VictoriaF wrote: Mon Oct 03, 2022 1:08 pm I have been using Medicare Parts A and B in combination with GEHA-High and was pleased with the coverage. For 2023, my GEHA premium will increase from $227.20 to $229.10 and GEHA's Medicare Premium Reimbursement will increase from $800 to $1,000. See the brochure [PDF], https://www.geha.com/~/media93/Project/ ... -guide.pdf .

Victoria
The increase to $1000 per eligible person is great. They seem to be giving a good increase every few years. From your posts it seems you like GEHA High Option. Do you have any comments about Aetna Direct? As of 2022, Direct has a significantly lower premium for self+one, almost the same medical fund, many more skilled nursing care days, a very extensive provider network, and better Rx coverage for the prescriptions I looked at. I appreciate any comments. I always like to know if I am missing something.
tj
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Re: 2023 FEHB Premiums

Post by tj »

tallguy3891 wrote: Mon Oct 03, 2022 8:24 pm
VictoriaF wrote: Mon Oct 03, 2022 1:08 pm I have been using Medicare Parts A and B in combination with GEHA-High and was pleased with the coverage. For 2023, my GEHA premium will increase from $227.20 to $229.10 and GEHA's Medicare Premium Reimbursement will increase from $800 to $1,000. See the brochure [PDF], https://www.geha.com/~/media93/Project/ ... -guide.pdf .

Victoria
The increase to $1000 per eligible person is great. They seem to be giving a good increase every few years. From your posts it seems you like GEHA High Option. Do you have any comments about Aetna Direct? As of 2022, Direct has a significantly lower premium for self+one, almost the same medical fund, many more skilled nursing care days, a very extensive provider network, and better Rx coverage for the prescriptions I looked at. I appreciate any comments. I always like to know if I am missing something.
Are you sure about it having many more skilled nursing days?
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

tj wrote: Mon Oct 03, 2022 8:30 pm
tallguy3891 wrote: Mon Oct 03, 2022 8:24 pm
VictoriaF wrote: Mon Oct 03, 2022 1:08 pm I have been using Medicare Parts A and B in combination with GEHA-High and was pleased with the coverage. For 2023, my GEHA premium will increase from $227.20 to $229.10 and GEHA's Medicare Premium Reimbursement will increase from $800 to $1,000. See the brochure [PDF], https://www.geha.com/~/media93/Project/ ... -guide.pdf .

Victoria
The increase to $1000 per eligible person is great. They seem to be giving a good increase every few years. From your posts it seems you like GEHA High Option. Do you have any comments about Aetna Direct? As of 2022, Direct has a significantly lower premium for self+one, almost the same medical fund, many more skilled nursing care days, a very extensive provider network, and better Rx coverage for the prescriptions I looked at. I appreciate any comments. I always like to know if I am missing something.
Are you sure about it having many more skilled nursing days?
2022 brochures show 60 for Direct and 21 for GEHA High.
tj
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Re: 2023 FEHB Premiums

Post by tj »

tallguy3891 wrote: Mon Oct 03, 2022 9:26 pm
tj wrote: Mon Oct 03, 2022 8:30 pm
tallguy3891 wrote: Mon Oct 03, 2022 8:24 pm
VictoriaF wrote: Mon Oct 03, 2022 1:08 pm I have been using Medicare Parts A and B in combination with GEHA-High and was pleased with the coverage. For 2023, my GEHA premium will increase from $227.20 to $229.10 and GEHA's Medicare Premium Reimbursement will increase from $800 to $1,000. See the brochure [PDF], https://www.geha.com/~/media93/Project/ ... -guide.pdf .

Victoria
The increase to $1000 per eligible person is great. They seem to be giving a good increase every few years. From your posts it seems you like GEHA High Option. Do you have any comments about Aetna Direct? As of 2022, Direct has a significantly lower premium for self+one, almost the same medical fund, many more skilled nursing care days, a very extensive provider network, and better Rx coverage for the prescriptions I looked at. I appreciate any comments. I always like to know if I am missing something.
Are you sure about it having many more skilled nursing days?
2022 brochures show 60 for Direct and 21 for GEHA High.
Those include the Medicare days, not additional. So GEHA covers 1 additional.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

tj wrote: Mon Oct 03, 2022 10:46 pm
tallguy3891 wrote: Mon Oct 03, 2022 9:26 pm
tj wrote: Mon Oct 03, 2022 8:30 pm
tallguy3891 wrote: Mon Oct 03, 2022 8:24 pm
VictoriaF wrote: Mon Oct 03, 2022 1:08 pm I have been using Medicare Parts A and B in combination with GEHA-High and was pleased with the coverage. For 2023, my GEHA premium will increase from $227.20 to $229.10 and GEHA's Medicare Premium Reimbursement will increase from $800 to $1,000. See the brochure [PDF], https://www.geha.com/~/media93/Project/ ... -guide.pdf .

Victoria
The increase to $1000 per eligible person is great. They seem to be giving a good increase every few years. From your posts it seems you like GEHA High Option. Do you have any comments about Aetna Direct? As of 2022, Direct has a significantly lower premium for self+one, almost the same medical fund, many more skilled nursing care days, a very extensive provider network, and better Rx coverage for the prescriptions I looked at. I appreciate any comments. I always like to know if I am missing something.
Are you sure about it having many more skilled nursing days?
2022 brochures show 60 for Direct and 21 for GEHA High.
Those include the Medicare days, not additional. So GEHA covers 1 additional.
Yep, GEHA states it covers the one day after the Medicare 20 days. I am not sure if the Direct 60 days is 60 days after the Medicare 20 days, or 40 more after the Medicare 20 (maybe someone can clarify), but the brochures are clear, GEHA covers 21 days per year and Direct 60 days, so to me that is significantly more days of coverage.

UPDATE: Looks like GEHA now offering (in 2023) 50 days of Skilled Nursing Facility days. Not sure if it applies to all of their plans. See brochures for details.
Last edited by tallguy3891 on Sun Nov 13, 2022 11:48 am, edited 2 times in total.
KeepGrowing
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Re: 2023 FEHB Premiums

Post by KeepGrowing »

tallguy3891 wrote: Sun Oct 02, 2022 12:10 pm While we're on the topic of FEHB premiums and so on, I've noticed there are quite a bit of differences in Specialty Rx coverage costs to consumer between plans.

BCBS Standard and Basic appear to be excellent, although personally from what I've seen as of the 2022 brochure, I would possibly go with NALC High option if we needed specialty meds. It has relatively good copays, but mainly it has very low catastrophic coverage compared to most other plans I've seen, which would be very nice in a costly specialty meds scenario. Although FEHB + Medicare recipients don't usually have to be too concerned about provider catastrophic coverage, it could benefit them for Rx coverage.

I was just wondering if anyone would be willing to share which plan they thought was best for a specialty med scenario, and why?
From the 2023 NALC brochure:
"High Option: For those services subject to a deductible, coinsurance and copayment (including mental health and substance use disorder care), we pay 100% of the Plan allowance for the remainder of the calendar year after your cost-share totals:
• $3,500 per person and $5,000 per family for services of PPO providers/facilities.
• $7,000 per person or family for services of PPO and non-PPO providers/facilities, combined.
• Coinsurance amounts for prescription drugs dispensed by an NALC CareSelect Network pharmacy and mail order copayment amounts (see Section 5(f). Prescription Drug Benefits) count toward a $3,100 per person or $4,000 family annual prescription out-of-pocket maximum excluding the following amounts..."

So it looks like there are separate out-of-pocket maximums for providers/facilities and for prescriptions.
Topic Author
tallguy3891
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Re: 2023 FEHB Premiums

Post by tallguy3891 »

KeepGrowing wrote: Sun Nov 13, 2022 10:46 am
tallguy3891 wrote: Sun Oct 02, 2022 12:10 pm While we're on the topic of FEHB premiums and so on, I've noticed there are quite a bit of differences in Specialty Rx coverage costs to consumer between plans.

BCBS Standard and Basic appear to be excellent, although personally from what I've seen as of the 2022 brochure, I would possibly go with NALC High option if we needed specialty meds. It has relatively good copays, but mainly it has very low catastrophic coverage compared to most other plans I've seen, which would be very nice in a costly specialty meds scenario. Although FEHB + Medicare recipients don't usually have to be too concerned about provider catastrophic coverage, it could benefit them for Rx coverage.

I was just wondering if anyone would be willing to share which plan they thought was best for a specialty med scenario, and why?
From the 2023 NALC brochure:
"High Option: For those services subject to a deductible, coinsurance and copayment (including mental health and substance use disorder care), we pay 100% of the Plan allowance for the remainder of the calendar year after your cost-share totals:
• $3,500 per person and $5,000 per family for services of PPO providers/facilities.
• $7,000 per person or family for services of PPO and non-PPO providers/facilities, combined.
• Coinsurance amounts for prescription drugs dispensed by an NALC CareSelect Network pharmacy and mail order copayment amounts (see Section 5(f). Prescription Drug Benefits) count toward a $3,100 per person or $4,000 family annual prescription out-of-pocket maximum excluding the following amounts..."

So it looks like there are separate out-of-pocket maximums for providers/facilities and for prescriptions.
This is why NALC High is always in my top choices. Although from what I saw BCBS Basic and Std are both lower cost for 90 day supplies of Specialty Rx, the NALC High Catastrophic for Rx could tip the scales in some instances such as multiple Specialty meds required. A cap on costs is always appealing. Another thing I saw with NALC High which I haven't noticed with other plans is (if I understood it correctly), when on Medicare Parts A and B with NALC High, NALC states it pays 100% also in situations where the provider does not accept Medicare assignment--in other words, NALC pays up to the limiting charge extra 15% in those cases. Not sure how often this comes up but nice to have. If we were not on Aetna Direct, I'm almost certain we would choose NALC High. Not the cheapest premium, but appears to have outstanding all around coverage in my opinion.
tj
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Re: 2023 FEHB Premiums

Post by tj »

I saw it noted in an early-retirement.org thread that the 2023 brochures s state that FEHB GEHA High, Standard, HDHP, and Elevate Plus plans have increased to 50 days for Skilled Nursing Benefits if the criteria are met, but Elevate does not. This is huge and helps bridge the gap for one of the biggest weakness in choosing these plans over a Medigap plan.
OpenMinded1
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Re: 2023 FEHB Premiums

Post by OpenMinded1 »

tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
CORRECTED: We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request Medicare reimbursements. Very simple so far. The Rx copays are very good. At the end of the year the remaining fund is rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay multiple times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers their part for 60 days in coordination with Medicare, which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare. There is a form to request fund as Medicare reimbursement. See site for how.
I have been doing a comparison of what Aetna Direct would likely cost me versus BCBS Basic, when I'm on Medicare A and B. Considering the fact that I take three brand name medications - there is no generic equivalent available - it seems like Aetna Direct would cost me considerably more out of pocket than BCBS Basic. Using local pharmacies, I estimate about $3,200 more per year for pharmaceuticals alone. It might actually cost less than BCBS Basic using mail-order, but I haven't dug deep into that yet. (Mail-order coverage isn't available thru BCBS Basic.) This number ($3200) takes into account annual premiums, Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. It also takes into account that after I go on Medicare, Aetna Direct would no longer have a $3200 deductible that would have to be paid before it would start paying some of the cost of prescriptions.

Curious about how Aetna Direct is cheaper for you and your wife when she "requires heavy use of healthcare/Rx. Does your wife use generic meds only? Do you use mail-order for meds? Consumer Checkbook also indicates that Aetna Direct is cheaper in most healthcare-use scenarios than BCBS Basic, even without being on Medicare. Makes me wonder what I'm missing.

Seems like the main thing to look at when comparing the two for someone on Medicare A and B would be prescription benefits, premiums, and Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. Doesn't seems like the difference in coverage for hospital stays would matter very much if on Medicare A. Seems like almost everything but prescriptions would be paid by either of the two when on Medicare A and B.
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Re: 2023 FEHB Premiums

Post by OpenMinded1 »

Delete
Last edited by OpenMinded1 on Fri Dec 02, 2022 4:10 pm, edited 2 times in total.
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Re: 2023 FEHB Premiums

Post by OpenMinded1 »

delete
jerryk68
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Re: 2023 FEHB Premiums

Post by jerryk68 »

OpenMinded1 wrote: Fri Dec 02, 2022 10:52 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
CORRECTED: We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request Medicare reimbursements. Very simple so far. The Rx copays are very good. At the end of the year the remaining fund is rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay multiple times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers their part for 60 days in coordination with Medicare, which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare. There is a form to request fund as Medicare reimbursement. See site for how.
I have been doing a comparison of what Aetna Direct would likely cost me versus BCBS Basic, when I'm on Medicare A and B. Considering the fact that I take three brand name medications - there is no generic equivalent available - it seems like Aetna Direct would cost me considerably more out of pocket than BCBS Basic. Using local pharmacies, I estimate about $3,200 more per year for pharmaceuticals alone. It might actually cost less than BCBS Basic using mail-order, but I haven't dug deep into that yet. (Mail-order coverage isn't available thru BCBS Basic.) This number ($3200) takes into account annual premiums, Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. It also takes into account that after I go on Medicare, Aetna Direct would no longer have a $3200 deductible that would have to be paid before it would start paying some of the cost of prescriptions.

Curious about how Aetna Direct is cheaper for you and your wife when she "requires heavy use of healthcare/Rx. Does your wife use generic meds only? Do you use mail-order for meds? Consumer Checkbook also indicates that Aetna Direct is cheaper in most healthcare-use scenarios than BCBS Basic, even without being on Medicare. Makes me wonder what I'm missing.

Seems like the main thing to look at when comparing the two for someone on Medicare A and B would be prescription benefits, premiums, and Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. Doesn't seems like the difference in coverage for hospital stays would matter very much if on Medicare A. Seems like almost everything but prescriptions would be paid by either of the two when on Medicare A and B.
In your statement above you say that (Mail-order coverage isn't available thru BCBS Basic.) Please be advised that mail order coverage with BCBS Basic is available when you have Medicare A & B.
OpenMinded1
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Re: 2023 FEHB Premiums

Post by OpenMinded1 »

jerryk68 wrote: Fri Dec 02, 2022 4:56 pm
OpenMinded1 wrote: Fri Dec 02, 2022 10:52 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
CORRECTED: We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request Medicare reimbursements. Very simple so far. The Rx copays are very good. At the end of the year the remaining fund is rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay multiple times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers their part for 60 days in coordination with Medicare, which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare. There is a form to request fund as Medicare reimbursement. See site for how.
I have been doing a comparison of what Aetna Direct would likely cost me versus BCBS Basic, when I'm on Medicare A and B. Considering the fact that I take three brand name medications - there is no generic equivalent available - it seems like Aetna Direct would cost me considerably more out of pocket than BCBS Basic. Using local pharmacies, I estimate about $3,200 more per year for pharmaceuticals alone. It might actually cost less than BCBS Basic using mail-order, but I haven't dug deep into that yet. (Mail-order coverage isn't available thru BCBS Basic.) This number ($3200) takes into account annual premiums, Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. It also takes into account that after I go on Medicare, Aetna Direct would no longer have a $3200 deductible that would have to be paid before it would start paying some of the cost of prescriptions.

Curious about how Aetna Direct is cheaper for you and your wife when she "requires heavy use of healthcare/Rx. Does your wife use generic meds only? Do you use mail-order for meds? Consumer Checkbook also indicates that Aetna Direct is cheaper in most healthcare-use scenarios than BCBS Basic, even without being on Medicare. Makes me wonder what I'm missing.

Seems like the main thing to look at when comparing the two for someone on Medicare A and B would be prescription benefits, premiums, and Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. Doesn't seems like the difference in coverage for hospital stays would matter very much if on Medicare A. Seems like almost everything but prescriptions would be paid by either of the two when on Medicare A and B.
In your statement above you say that (Mail-order coverage isn't available thru BCBS Basic.) Please be advised that mail order coverage with BCBS Basic is available when you have Medicare A & B.
Yes, thanks for that. You're right. I just verified it on Consumers Checkbook. I wonder why they make it available with Medicare A and B, but not without. One more thing to add to the complexity.
OpenMinded1
Posts: 1576
Joined: Wed Feb 05, 2020 8:27 am

Re: 2023 FEHB Premiums

Post by OpenMinded1 »

OpenMinded1 wrote: Fri Dec 02, 2022 5:42 pm
jerryk68 wrote: Fri Dec 02, 2022 4:56 pm
OpenMinded1 wrote: Fri Dec 02, 2022 10:52 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm

You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
CORRECTED: We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request Medicare reimbursements. Very simple so far. The Rx copays are very good. At the end of the year the remaining fund is rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay multiple times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers their part for 60 days in coordination with Medicare, which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare. There is a form to request fund as Medicare reimbursement. See site for how.
I have been doing a comparison of what Aetna Direct would likely cost me versus BCBS Basic, when I'm on Medicare A and B. Considering the fact that I take three brand name medications - there is no generic equivalent available - it seems like Aetna Direct would cost me considerably more out of pocket than BCBS Basic. Using local pharmacies, I estimate about $3,200 more per year for pharmaceuticals alone. It might actually cost less than BCBS Basic using mail-order, but I haven't dug deep into that yet. (Mail-order coverage isn't available thru BCBS Basic.) This number ($3200) takes into account annual premiums, Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. It also takes into account that after I go on Medicare, Aetna Direct would no longer have a $3200 deductible that would have to be paid before it would start paying some of the cost of prescriptions.

Curious about how Aetna Direct is cheaper for you and your wife when she "requires heavy use of healthcare/Rx. Does your wife use generic meds only? Do you use mail-order for meds? Consumer Checkbook also indicates that Aetna Direct is cheaper in most healthcare-use scenarios than BCBS Basic, even without being on Medicare. Makes me wonder what I'm missing.

Seems like the main thing to look at when comparing the two for someone on Medicare A and B would be prescription benefits, premiums, and Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. Doesn't seems like the difference in coverage for hospital stays would matter very much if on Medicare A. Seems like almost everything but prescriptions would be paid by either of the two when on Medicare A and B.
In your statement above you say that (Mail-order coverage isn't available thru BCBS Basic.) Please be advised that mail order coverage with BCBS Basic is available when you have Medicare A & B.
Delete. Sorry. I must keep hitting the quote button instead of edit.
Topic Author
tallguy3891
Posts: 703
Joined: Sat Jul 03, 2021 10:47 am

Re: 2023 FEHB Premiums

Post by tallguy3891 »

OpenMinded1 wrote: Fri Dec 02, 2022 10:52 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
CORRECTED: We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request Medicare reimbursements. Very simple so far. The Rx copays are very good. At the end of the year the remaining fund is rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay multiple times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers their part for 60 days in coordination with Medicare, which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare. There is a form to request fund as Medicare reimbursement. See site for how.
I have been doing a comparison of what Aetna Direct would likely cost me versus BCBS Basic, when I'm on Medicare A and B. Considering the fact that I take three brand name medications - there is no generic equivalent available - it seems like Aetna Direct would cost me considerably more out of pocket than BCBS Basic. Using local pharmacies, I estimate about $3,200 more per year for pharmaceuticals alone. It might actually cost less than BCBS Basic using mail-order, but I haven't dug deep into that yet. (Mail-order coverage isn't available thru BCBS Basic.) This number ($3200) takes into account annual premiums, Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. It also takes into account that after I go on Medicare, Aetna Direct would no longer have a $3200 deductible that would have to be paid before it would start paying some of the cost of prescriptions.

Curious about how Aetna Direct is cheaper for you and your wife when she "requires heavy use of healthcare/Rx. Does your wife use generic meds only? Do you use mail-order for meds? Consumer Checkbook also indicates that Aetna Direct is cheaper in most healthcare-use scenarios than BCBS Basic, even without being on Medicare. Makes me wonder what I'm missing.

Seems like the main thing to look at when comparing the two for someone on Medicare A and B would be prescription benefits, premiums, and Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. Doesn't seems like the difference in coverage for hospital stays would matter very much if on Medicare A. Seems like almost everything but prescriptions would be paid by either of the two when on Medicare A and B.
She does use generic for all of her meds except two which only come in brand name. The former she gets through a common retail pharmacy and the latter through CVS mail order. She could get them through local CVS too at same price as mail order but we have mail order set up for those and it is easy to do them online.

Also, I have noticed that various plans state they will cover brand name Rx when generic is available but only at a much higher coinsurance than generic. The plans address this in their brochures in Rx section. Easy to miss.

Btw, I do like BCBS Basic very much and had it previously, but currently it does not offer any Skilled Nursing Facility days, and based on prior experience, that is not best for our situation. When on Medicare A&B the coverages are similar, but a few differences, especially for SNF, Rx, and network coverage, and premiums.

Also, I never rely on the overview info for Rx in brochures. I go to the actual site via OPM and plug in each Rx in the prescription cost calculator. Aetna Direct has a specific portal for those with Medicare A&B so be aware. FEHB plans vary in Rx prices, sometimes by a significant amount. I have found BCBS, NALC High, MHBP Standard, and Aetna Direct very good, but everyone's situation is different.
OpenMinded1
Posts: 1576
Joined: Wed Feb 05, 2020 8:27 am

Re: 2023 FEHB Premiums

Post by OpenMinded1 »

tallguy3891 wrote: Fri Dec 02, 2022 8:41 pm
OpenMinded1 wrote: Fri Dec 02, 2022 10:52 am
tallguy3891 wrote: Fri Sep 30, 2022 11:26 pm
OpenMinded1 wrote: Fri Sep 30, 2022 9:21 pm
tallguy3891 wrote: Fri Sep 30, 2022 8:05 pm After decades on BCBS Standard and then Basic we switched to Aetna Direct this year since we are both on Medicare A&B. Looks like only a $7.20 increase for 2023 for self+one. Great! This past year we paid zero out of pocket for anything, including zero for Rx due to $1800 fund.

Will see what changes there are when plan brochures come out...
You have piqued my interest. Which Etna Direct do you have? Seems like the are two with Direct in their name in my area. 1) Aetna HealthFund HDHP and Aetna Direct Plan - CDHP, and 2) Aetna HealthFund HDHP and Aetna Direct Plan - HDHP. Is the refund aimed at helping to offset the medicare premium, or is it some other kind of refund?
CORRECTED: We have Aetna Direct CDHP (plan N6). My spouse requires heavy use of healthcare/Rx and we have been very happy with it. Zero out of pocket to date. It works great for us with our Medicare parts A and B. Nice low premium. Also gives us a fund of $1800 per year ($900 each) which can be used by both or one or the other in full. We like it because when we go to pick up an Rx, the copay is deducted automatically from the fund. I like this better than having to request Medicare reimbursements. Very simple so far. The Rx copays are very good. At the end of the year the remaining fund is rolled over to add to the new year fund of $1800. At least so far that has been how it works. Waiting to see the new 2023 brochure. It is like receiving $1800 tax free income per year. Not having to pay a copay multiple times per month is great. This year the plan offered 60 days skilled nursing coverage per year which apparently covers their part for 60 days in coordination with Medicare, which from what I've seen is better than most FEHB plans. Section 9 of the brochure explains very nicely how it coordinates with Medicare. There is a form to request fund as Medicare reimbursement. See site for how.
I have been doing a comparison of what Aetna Direct would likely cost me versus BCBS Basic, when I'm on Medicare A and B. Considering the fact that I take three brand name medications - there is no generic equivalent available - it seems like Aetna Direct would cost me considerably more out of pocket than BCBS Basic. Using local pharmacies, I estimate about $3,200 more per year for pharmaceuticals alone. It might actually cost less than BCBS Basic using mail-order, but I haven't dug deep into that yet. (Mail-order coverage isn't available thru BCBS Basic.) This number ($3200) takes into account annual premiums, Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. It also takes into account that after I go on Medicare, Aetna Direct would no longer have a $3200 deductible that would have to be paid before it would start paying some of the cost of prescriptions.

Curious about how Aetna Direct is cheaper for you and your wife when she "requires heavy use of healthcare/Rx. Does your wife use generic meds only? Do you use mail-order for meds? Consumer Checkbook also indicates that Aetna Direct is cheaper in most healthcare-use scenarios than BCBS Basic, even without being on Medicare. Makes me wonder what I'm missing.

Seems like the main thing to look at when comparing the two for someone on Medicare A and B would be prescription benefits, premiums, and Aetna Direct putting $900 in an account for healthcare spending, and BCBS Basic offering an $800 Medicare reimbursement. Doesn't seems like the difference in coverage for hospital stays would matter very much if on Medicare A. Seems like almost everything but prescriptions would be paid by either of the two when on Medicare A and B.
She does use generic for all of her meds except two which only come in brand name. The former she gets through a common retail pharmacy and the latter through CVS mail order. She could get them through local CVS too at same price as mail order but we have mail order set up for those and it is easy to do them online.

Also, I have noticed that various plans state they will cover brand name Rx when generic is available but only at a much higher coinsurance than generic. The plans address this in their brochures in Rx section. Easy to miss.

Btw, I do like BCBS Basic very much and had it previously, but currently it does not offer any Skilled Nursing Facility days, and based on prior experience, that is not best for our situation. When on Medicare A&B the coverages are similar, but a few differences, especially for SNF, Rx, and network coverage, and premiums.

Also, I never rely on the overview info for Rx in brochures. I go to the actual site via OPM and plug in each Rx in the prescription cost calculator. Aetna Direct has a specific portal for those with Medicare A&B so be aware. FEHB plans vary in Rx prices, sometimes by a significant amount. I have found BCBS, NALC High, MHBP Standard, and Aetna Direct very good, but everyone's situation is different.
Okay. Thanks for the information. I guess with Aetna Direct you would probably pay a lot less out-of-pocket than with BCBS Basic if one of you needs to spend days at a skilled nursing facility. This would probably be true for just about anybody that needs to spend time in a skilled nursing facility regardless of what pharmaceuticals they need. A stay in a skilled nursing facility would require a lot out-of-pocket without insurance coverage. Once again, BCBS Basic will not cover skilled nursing facility days in 2023. I think BCBS would cost me considerable less if I don't need to spend time at a skilled nursing facility. That's true because I have to use three brand name drugs. There are no generic equivalents. I have checked what I would have to pay for these out-of-pocket Aetna Direct vs. BCBS Basic.

I guess neither Medicare A or B would pay for skilled nursing facility days?
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slowandsteadywins
Posts: 301
Joined: Tue Dec 20, 2016 2:13 pm

Re: 2023 FEHB Premiums

Post by slowandsteadywins »

I used to only have FEDVIP for Delta Dental PPO as I have VA as my primary medical benefits. Recently, I decided to go with GEHA HDHP for the HSA account. Now, FEHB requires the FEHB plan to be primary payer for dental. My current dentist's office says they are not in network, and even if I keep the FEDVIP Dental, they would need to claim with GEHA HDHP first. The HDHP with GEHA provides preventive dental (2x cleanings annually, routine diagnostics) free. I think I may remove the Delta Dental PPO (FEDVIP) and if my dentist is that petty, it's time to find a new office who is willing to accept an extra step to get paid.
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