Path: bloom-picayune.mit.edu!enterpoop.mit.edu!snorkelwacker.mit.edu!americast.com!americast.com!americast-post Newsgroups: americast.wpost From: americast-post@AmeriCast.Com Organization: American Cybercasting Approved: americast-post@AmeriCast.com Subject: THE FEDERAL DIARY=Health Plan Options=By Mike Causey=Washington Post Staff Date: Wed, 25 Nov 92 04:45:04 EST Message-ID: <43.1992Nov25.044505@AmeriCast.com> Lines: 70 THE FEDERAL DIARY=Health Plan Options=By Mike Causey=Washington Post Staff Writer= The open season that ends Dec. 14 offers thousands of new federal workers their first opportunity to join a health plan. It also gives people looking for better benefits and lower premiums a chance to shop among the 26 plans open to area federal workers and retirees. Some of the best benefits (like preventive and dental care) and lowest premiums are offered by HMOs. But many policyholders prefer fee-for-service plans because they give them greater choices in doctors and hospitals and control over their treat- ment. Next question: What's an HMO? What's fee-for-service? The Office of Personnel Management explains it like this:Fee- for-service plans. These plans reimburse you or your health care provider for covered services. They allow you to pick your hospi- tal, doctor and other providers. Most fee-for-service plans also have preferred-provider arrangements. By using them you can reduce out-of-pocket expenses and, sometime, get enhanced bene- fits. Fee-for-service plans include the Letter Carriers, American Po- stal Workers Union, Blue Cross, GEHA, Mail Handlers, Alliance and Postmaster plans. Those limited to certain groups of workers in- clude BACE (congressional employees) Secret Service, NAPUS (post- masters), Rural Carriers, SAMBA (FBI) and a special plan offered by the CIA that we aren't even supposed to know about. HMOs. These are comprehensive medical plans/health maintenance organizations (CMP/HMOs) that provide or arrange for health care by designated physicians, hospitals and other providers in par- ticular locations. Most services under a CMP/HMO must be per- formed by the plan's participating providers. Some prepaid plans offer an "opt-out" benefit that allows you to obtain some bene- fits outside the plan's provider system on a fee-for-service basis. Check the individual plan's brochure to see if this bene- fit is offered. Each CMP/HMO is open to employees who live within the plan's enrollment area. Refer to the plan's brochures if you have any questions about the enrollment area. Locally they include Aetna, Kaiser, Prudential, George Washing- ton, Columbia, HealthPlus, CareFirst, Group Health, Physicians Care, Lincoln, Potomac, Free State and MD-IPA.Thinking Retire- ment? In most cases, workers must be enrolled in the federal health program (or its military counterpart, CHAMPUS) for five years im- mediately before retiring to continue their health benefits cov- erage after retirement. Many workers aren't covered by the federal program because their spouses' private plans are better or cheaper. The problem is that few, if any, private health plans offer benefits or premiums to retirees that match those available to federal retirees in the program. If you are close to retire- ment, sign up for one of the low-cost federal plans to maintain your eligibility for the federal program in retirement. Special Benefits A few plans will pay for acupuncture, chiropractic and Christian Science practitioners. For a rundown on the special benefits, check this space tomorrow.<02:32 11-25C9999----- Copyright 1992, The Washington Post. This story is from the Washington Post's Capitol Edition On-Line and is not to be ar- chived or redistributed. For more information, send-email to American Cybercasting Cor- poration (usa@AmeriCast.COM)