‘Tis the season — and we’re not just talking about pumpkin pie and Santa Claus.
As you’re making lists for Thanksgiving groceries and holiday gifts, don’t forget the shopping spree that began Nov. 14.
Running for about a month until Dec. 12, federal employees, retirees and some military service members will be able to browse the online marketplace to buy health insurance for next year. This annual period of open enrollment for employer-sponsored health care coverage is a chance to review and change coverage for twelve months beginning Jan. 1, 2023.
All told, more than 8 million people obtain coverage through the plans each year.
Federal Times has been tracking major changes to benefits leading up to the start of open enrollment, from telehealth to infertility treatment to why your premium costs are rising.
This guide summarizes these resources and breaks down what’s new for this year along with tips from benefit experts and tools to comparison shop.
What retirees should know about Medicare Advantage and FEHB
For plan year 2023, there are a handful of FEHB plans that have special Medicare Advantage plans that Kevin Moss of Consumers’ Checkbook said “are absolutely without a doubt the best deals for annuitants.”
Generally, plans under the FEHB Program help pay for the same kind of expenses as Medicare. FEHB plans also provide coverage for emergency care outside of the United States, which Medicare doesn’t provide.
Most of the Medicare Advantage plan options also provide reimbursement, either partial or full, for the Medicare Part B premium.
More on that breakdown here from Consumers’ Checkbook.
How benefits changed for 2023 program-wide
The Federal Employees Health Benefits Program has 271 health plans choices available for 2023, many of which are offered only regionally.
Insurance carriers offering these plans were asked by the Office of Personnel Management to focus on benefits for COVID-19, telehealth, maternal health, gender-affirming care and services, obesity, preventive services, assisted reproductive technology, and medical foods.
Some plans are also leaving the FEHB program, affecting residents of Georgia, Virginia, New Jersey, New York, Colorado, Missouri and Illinois. Those carriers are HMO Missouri Inc., HMO Colorado Inc., Emblem Health, Healthkeepers, and Blue Cross Blue Shield of Georgia.
See a list of individual plan names and zip codes affected here.
Enrollees in these terminating plans must elect another FEHB plan during open enrollment or else they will be automatically enrolled in the GEHA Indemnity Benefit Plan, Elevate Option, which is the lowest-cost nationwide plan option for 2023 as determined by OPM.
Leaving the FEHB program is only one way enrollment can be affected.
Even if your plan will remain an FEHB partner for 2023, it might still change in less obvious ways. Plans may reduce their service areas, eliminate its enrollment code or drop options.
See more changes here.
Health care premium costs spike for 2023, OPM says
Federal employees will spend an average of 8.7% more on their health insurance premiums in 2023. Rates will go up only an average of 0.21% for dental. For vision, rates will decrease by an average of 0.41%. This article explains why rates for vision and dental are more stable.
For more information on how those costs will show up in your paycheck, check out the story here.
Gender-affirming care expands
For 2023 plans, all FEHB providers will again include some forms of gender-affirming care, defined by the Kaiser Family Foundation as “social, psychological, behavioral or medical (including hormonal treatment or surgery) interventions designed to support and affirm an individual’s gender identity.”
For a breakdown of specific treatment options and coverages, check out the story here.
Infertility and maternity health
Federal Times reported in this article that beneficiaries can chose from four plan options that will provide assisted reproductive technology for a total of 18 plan options in 2023. One new plan option will provide a non-FEHB benefit for discounted ART procedures.
Expanded services will also include childbirth education classes, group prenatal care, home visits during pregnancy and postpartum, and care management for high-risk pregnancies.
All carriers will also cover the full range of contraceptives and contraceptive care for adolescent and adult women as provided in the Women’s Preventive Services Guidelines without cost sharing.
Can I still take advantage of telehealth with COVID-19 concerns?
For the most part, beneficiaries under the FEHB program will not see a major drop-off of telehealth options for 2023, said OPM in this interview with Federal Times.
Carriers are meeting this need in different ways, OPM said, which you can read more about here.
Comparison shop FEHB plans to maximize savings
Consider: Of the 2022 plans that will be available again in 2023, 56 have premiums that decreased. Nine plans have premiums that stayed the same.
In terms of the widely reported average increase, 119 plans had increases that were below the average, while 78 had average increases at or above 8.7%.
On each end of the spectrum, one plan decreased by about 35% while another increased by almost 50%.
How did your plan costs change? Check out these tips by retirement experts on how to find the best deal.
Plus, there are a number of additional resources readily available to help whittle down your options.
- Compare health plans at: www.opm.gov/fehbcompare
- Health plan brochures can be viewed at: www.opm.gov/FEHBbrochures.
- For Tribal employees, brochures are found at: www.opm.gov/healthcareinsurance/tribal-employers/plan-information
- Consumers’ Checkbook also offers its own plan comparison tool, which some federal agencies may give complimentary access to. See if you qualify at: www.checkbook.org/newhig2/hig.cfm
What about FEDVIP?
BENEFEDS is the enrollment and premium processing system sponsored by OPM that you must use to enroll in the Federal Employees Dental and Vision Insurance Program.
For the 2023 plan year, FEDVIP carriers eliminated waiting periods for orthodontic services, provided services targeting pregnant enrollee wellness and education and offered teledentistry services.
Can I get a flexible spending account?
Yes. More than 420,000 Feds use pre-tax dollars to save an average of 30% on their family’s health care and dependent care expenses, according to OPM.
A health care flexible spending account is a savings account used to pay for certain out-of-pocket health care costs not covered by insurance. Contributions to an FSA are not subject to payroll taxes
In 2023, employees contribute as little as $100 a year or as much as $3,050 a year, a $200 increase from the 2022 maximum of $2,850 to their FSAFEDS account.
I’m ready to enroll. Where do I go?
OPM has instructions for how to choose your benefits at this link.
And if you’re confused by all the acronyms and insurance jargon, check out this glossary of terms from accreditation to withholdings.
Happy Open Season!
Military personnel, Tricare open enrollment
P.S. If you’re a military service member and have questions about your Tricare health benefits, check out MilitaryTimes.com coverage here.
Molly Weisner is a staff reporter for Federal Times where she covers labor, policy and contracting pertaining to the government workforce. She made previous stops at USA Today and McClatchy as a digital producer, and worked at The New York Times as a copy editor. Molly majored in journalism at the University of North Carolina at Chapel Hill.