Page 61 - The Informed Fed--Hearn (edited 10.29.20)

3 times a year, and are on several on-going medications, then a traditional
plan may be for you. Although there are usually higher premiums
associated with traditional plans, you will also be likely to have more of
your health expenses covered during the year. As with all of the health
plans offered through FEHB, there are annual out-of-pocket maximums
that limit how much you would have to pay in any given year.
Consumer-Driven Health Plans: These are recommended for
those who have fewer health issues than those mentioned for traditional
coverage. You might have a minor ongoing condition such as allergies
or acid reflux for which you take one or two prescriptions occasionally.
If you see a specialist, it might only be once or twice per year. Consumer-
Driven Health Plans typically have a set amount of coverage that they
pay before you are required to pay anything; a reverse deductible if you
will. As an example, the insurer might pay the first $2,500 in expenses on
a family’s coverage. You would then be responsible for the next $1,500
and then the insurance company would pick up 90% of the charges and
you would be responsible for 10%, up to an out-of-pocket maximum of
$6,000. Any amounts you do not use out of the insurer’s first $2,500 can
be rolled over to the next year, provided you stay in the same health plan.
So, if you only needed $2,000 of coverage this year and stayed in the
same plan; next year, the insurer would pay the first $3,000 of your
expenses ($500 from this year plus $2,500 for next year).

These plans are for those who are generally healthy:

HDHP – High-Deductible Health Plans. High-Deductible
Health Plan is a fairly new offering for the federal government. Less than
2% of federal employees are enrolled in these plans. We believe this is
not because they are not viable options, but because employees simply
don’t understand the benefits. If you do not have any known medical
issues and only go to the doctor for routine physicals or the occasional
flu, and you don’t have any ongoing prescription needs, this might be a

60