Choosing an FEHB plan
November 13th, 2009 | TriCare Help | Posted by Military Times
Q. My husband is retired from the U.S. Army and currently carries the FEHB Standard Blue Cross & Blue Shield and Tricare Standard. The cost of the FEHB BCBS Standard has risen considerably; do you know which fee-for-service FEHB plan works best with Tricare Standard as a secondary insurance? We were thinking about going with the BCBS Basic, which is almost half of what I am paying now for the BCBS Standard.
Regardless of what other health insurance (OHI) you have, Tricare is always second (last) payer, by law. When Tricare Standard coordinates its benefits with their OHI, some beneficiaries have told me that it usually pays most, or sometimes all, of the OHI’s deductibles and copayments. I have the impression, however, that much depends on the quality of the OHI.
Retirees I worked with at the CHAMPUS Headquarters (CHAMPUS was Tricare’s precursor until 1995) in the 1980s chose the cheapest FEHBP plan available because of the way Tricare coordinated benefits.
Folks working in the (now) Tricare Headquarters’ Coordination of Benefits (COB) section have told me that unless they have in hand a copy of the OHI claim, they can’t predict the amount Tricare will pay as second payer. Coordination of benefits has become that complicated.
I have been writing Tricare Help since 1992, and I have responded to thousands of beneficiary inquiries about many things. But, I have never heard of anybody collecting the data and doing the calculations necessary for a comparative analysis of the kind you suggest.
Not to be interpreted as advice — because I don’t know — but the BCBS Basic might be a nice conservative trial to see how well Tricare Standard serves as second payer to a less expensive plan than BCBS Standard. If you are willing to gamble, you can always change back during Open Season the next year if it doesn’t work out well.
If you do it, you’ll have a story to tell me about it in 2011. In turn, I will have something to report to the next person who asks the same question.
Tags: FEHBP, secondary insurance, Tricare Standard
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