Tuesday, November 13, 2001

You have 18 working days to make what could be the most important decision you’ve faced all year.
First, check your decision-making IQ: Did members of your car pool preapprove your choice of a spouse? If so, did they also handle your divorce? Did your-in-law, the worm rancher, set up your estate plan and design your living will?
The answer to all of the above I hope is “no.”
Picking your family’s health plan where life and limb are at stake is big league stuff. It requires the input of you and a pro not the advice of a well-meaning amateur.
So you need to do the homework, consult experts and ask your doctor or dentist about any health plan you are considering.
The federal health program covers half the people in the Washington area. Feds, retirees and family members have a dozen choices, and just until Dec. 10 to decide.
Premiums are going up, but they should not be the only consideration.
Look for coverage that will cover the catastrophic, limiting out-of-pocket expenses when medical bills run into the hundreds of thousands of dollars. It’s what you want, and hope you never need.
Should you go with a fee-for-service plan (where you pick the doctor, hospital and course of medical treatment) or save money and opt for a managed-care health maintenance organization that typically has better dental benefits?
HMOs stress preventive medicine, require minimal paperwork and deductibles and have lower premiums. But you don’t want an HMO if you travel a lot, or live half the year outside the HMO’s service area.
Asking a buddy at the office what he or she thinks isn’t much help unless that person is a mirror image of you: In health, age, marital status, family size, etc.
There is no one-size-fits-all health plan. The one with the lowest premiums may also have a very weak (or nonexistent) prescription drug benefit. That’s fine if you don’t need drugs. But it’s no bargain if you must pay full price for common prescription drugs.
Picking the best plan for you can save you lots of money in premiums and out-of-pocket costs. Picking the worst plan won’t kill you, but it could cost you.

During the open season I’ll devote part of each column to the best buys for singles, couples, big families, retirees with and without Medicare and people with special medical needs.
Get a head start by checking out information on premiums, benefits and actual ratings of service and satisfaction: “Checkbooks’s Guide of Health Plans.”
It’s available by mail for $10.45 per copy by calling 202/347-7283, or at area drugstores and newsstands for $8.95. It rates plans by benefits and your likely total average costs for next year.
“Checkbook” also has a Web site (//https://www.checkbook.org/newhig2/hig.cfm).
The Office of Personnel Management, which runs the federal health program, has an excellent free Web site with premium and benefit information (// https://www.opm.gov/-insure/02/index.htmlt).

Retiree premiums
Nonpostal federal workers and federal retirees in the same health plans pay the same premiums. But most feds wind up paying less because they can pay premiums with wages that are excluded from income tax and Social Security payroll tax.
President Clinton extended the so-called “premium conversion” benefit to feds, but he couldn’t help retirees. Federal law and the tax code do not allow retirees to pay premiums with pretax dollars.
The National Association of Retired Federal Employees is pushing a law change that would give retirees equal treatment. But that’s a very, very long shot. Reason: If the tax break was extended to federal retirees there would be demands to include all other (nonfederal) retirees in the break. That would cost the Internal Revenue Service millions of dollars in revenue each year.
Retirees can dream about getting the break which would save them a few hundred dollars each year but it’s unlikely it will ever happen.

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