Please give me the same Health Insurance Options as Congress….Wait, is there any difference?


Currently there is a big uproar about how Americans want to have access to the same health care plans that are provided to Congress.  I’ve done some research and discovered that whoever started this rumor that Congress’s health care options are somehow special likes to spread misinformation.  In reality, Congress’s health care options are no different than any other federal employee (with the exception of members of the US Postal Service).  So, if we’re going to complain, at least we should make sure we’re complaining about the right demographic.  In this case, that would be every single federal employee.  However; what I am going to demonstrate is that there is no need to be complaining or wishing we had what “they” have.

Since I live in Florida I’ve compiled the following list of cost per plan for the various health insurance options that are currently available to all federal employees who reside in Florida.  Before we get there, please remember that some plans include a separate insurance premium deduction for Dental and/or Vision (if the employee elects those coverage’s as well).  You can check my facts and compile your own list of costs by going to the following link.  http://www.opm.gov/insure/index.aspx

  1. Consumer Driven (HMO/PPO) – These are the plans that I’ve most often been a part of with and has been offered by every single employer I’ve ever had that provided health coverage to it’s employees.  Most states are covered by this plan, so although I’m attempting to show the costs for a member living in Florida, these costs apply to almost any federal employee that elects to take this coverage.
    1. Aetna Health Fund (CDHP) – This plan requires the use of in-network doctors. 
        Monthly Premium Deductible
      Self $87.71 $750
      Family $201.72 $1,500
    1. High Deductible/Catastrophic Plans – These plans are a cool idea for those of us never go to the doctor.  Although these plans aren’t typically available through your employer the cost savings associated with a plan like this can be so substantial that if you feel you are a strong candidate for this kind of plan you should go out and buy it on your own.  These are VERY affordable plans as you are really only paying the cost of that catastrophic incident that may occur during a plan year and you don’t mind paying for the occasional doctor visit in full.  Most states are covered by this plan, so although I’m attempting to show the costs for a member living in Florida, these costs apply to almost any federal employee that elects to take this coverage.
      1. Aetna Health Fund (HDHP)
          Monthly Premium Deductible (In network) Deductible (Out of network)
        Self $67.01 $1,500 $2,500
        Family $146.75 $3,000 $5,000
          1. FFS (Fee For Service) – This is typically the most expensive kind of insurance around.  The reason for this is that you, the patient, get to chose what doctor you go to, what hospital you go to, etc. and the insurance company pays a portion of the total cost according to a schedule laid out in the policy.  The biggest consideration that should be taken with this plan is that although the premiums may not be very high, what is covered under the plan often turns out to be very little.  So, in addition to paying the premium, you’ll likely be paying the bill as well.
            1. Blue Cross Blue Shield FFS
                Monthly Premium Deductible
              Self $152.06 $300
              Family $356.59 $600

             

          Conclusion – It is true that federal employees have several options from which to chose when selecting health care plans.  The reality however is that federal employees encompass a very broad range of geographic locations within the country.  The health options available to these employees are typically regional as well with some carriers crossing state borders (as I’ve tried to use in my examples).  The overall cost however is not a significant savings over what the kind of insurance that non-federal employees are used to have accessible.  My last health care plan (I’m not a federal employee) cost me just under $300/month.  It was very similar to the Aetna Health Fund (CDHP) shown in the tables above.  I did not however have a large deductible as shown above.  My total out of pocket cost was comparable at the end of the year as that plan.  So, no I’m not bent out of shape that federal employees happen to have the same options available to me as my employer may happen to offer to me. 

          Additionally, didn’t someone once say that free market competition is what drives this great country?  Aren’t we supposed to allow the cream to rise to the top?  If this is the case, why should we insist that the federal government not give its employees access to the same insurance options that are available to any private company who wishes to provide the same?  If the private companies end up losing good employees because they aren’t happy with the benefits packages then those same private companies will falter.  Hence, the cream will continue to rise to the top.  What we need to be doing is not focusing on our attention on what health care options are available to federal employees.  We need to be focusing this attention on our own employers and saying, “we’ve had enough”.  Either they need to step up their game and give us the options we’re happy with, or they can face the reality of going under when they have nobody willing to work for them.

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