MR. KOJO NNAMDIFor a lot of us, the annual open season for choosing a health plan means checking a box, renewing whatever plan we had the year before. For federal employees and many others, the decision comes in the middle of the busy holiday season, making it even less likely to get the attention it deserves. But with health care reform ruling out many premium spiking and a federal pay freeze on its way, it's more important than ever to review your health care plan and decide if it's the best value for what you need. Here to help you do that is Walt Francis, editor of Washington Consumers' Checkbook 2011 Guide to Health Plans for Federal Employees. Walt, good to see you again.

MR. WALT FRANCISIt's nice to see you, Kojo.

NNAMDIYou can start calling right now, 800-433-8850, or go to our website, kojoshow.org, with your questions or comments. Walt, possibly the biggest change for federal employees this year is the pay freeze President Obama announced that it would appear indirectly affects health care choices.

FRANCISIt is indirect, but it's a great signaling opportunity. I should -- there's some bad news and some good news.

NNAMDIOkay.

FRANCISThe only good news part is at least it signals you to pay attention.

NNAMDIYeah.

FRANCISLet's say you're a federal employee who might have gotten a 2 or 3 percent pay raise, maybe two grand or so. Hey, you can save that much by making a prudent health plan selection. It's not the same as getting the pay raise, but at least it gets rid some of the stain.

NNAMDICertainly helps. Health care reform itself won't be fully in effect until the year 2014. Is there anything in it that will affect federal employees for this go around?

FRANCISYeah. There are three changes, two clearly positive. The whole issue of your sort of deadbeat kid are -- excuse me, your aspiring young artist child who can't get a job with health insurance, the extension of coverage for adult children up to age 26. And in the FEHBP, it actually operates up to age 29.

NNAMDIWhen I saw that, I was a bit surprised. I'm gonna be like, at some point will it go up to, like, age 40? Three grandchildren, who knows.

FRANCISI think age 49 is the top.

NNAMDII would hope so.

FRANCISBut that's -- you know, that's awfully important to a lot of families...

NNAMDIYes.

FRANCIS...particularly in the middle of this severe recession. The other change that's kind of nice is that the federal employee program had a lot of very good preventive coverage. OPM has worked hard over the years to make sure the plans really did well on that. But this year, they bit the bullet and they said we're not gonna wait 'til 2014. We're gonna make sure every plan has zero cost preventive care. Your annual or biannual physical, your adult vaccines, your antismoking program, your drugs to get you off tobacco, anything prevention related that's in the mainstream, you will have coverage, no co-pays, no deductibles, no co-insurance.

NNAMDIHow about the notion of dropping someone for a preexisting condition?

FRANCISThat's never been an issue in this program because it could never -- open season could never work. So it's always been the case that a federal employee or retiree could, come January 1st, be in a new plan even if on December 31st, they were -- they had cancer or they were in the hospital or something like that. So that's gonna be a big change in the private sector in the years to come, but for federal employees, no immediate effect.

NNAMDIOn what basis should one decide to add his or her 28-year-old child to the plan?

FRANCISWell, they got to be pre-26 when you add them.

NNAMDIOh. I see.

FRANCISIf they've already hit birthday 26, they're out. But -- well, in almost -- if you're in a family plan to begin with, say it's a married couple with a couple of kids and one of them is in grad school, it costs zero extra premium. I mean, it's a no-brainer. If you pick up the phone, you call the help line and say, by the way, there's a third child in the family. If you're, on the other hand, say a single mother with only this one child in a self-only enrolment, you're gonna have to switch to a family enrollment, which, in most cases, will more than double your premium.

MR. WALTER FRANCISSo maybe in that case, if your adult son or adult daughter does have employer-provided insurance, then maybe they should stick with that and you stick where you are. So there could be individual circumstances where it matters. But in general, sign them up.

NNAMDIWe're getting calls already so let's start with Monica in Washington. Monica, you're on the air. Go ahead, please.

MONICAGood afternoon. I am a widow with -- and I kept my husband's Foreign Service Protective Association so I'm paying just the single. But it is modestly high. Fortunately, I haven't been sick so I don't quite get any good out of it, but I will eventually be using it. The question is, is it good to hang on to this, which I understand is a very good insurance, or shall I go for one of those, you know, what do they call them when you just -- because I'm on Medicare A and B. I'm paying the full freight on it, Foreign Service Protective. Shall I get one of those plans that just bridges the difference or am I better to stick with what I've got?

FRANCISNo. You're in a great plan. Let me go back a couple of steps so we understand. There's about 24 health plans available in the D.C. area, about a third of them HMOs, about a third of them high-deductible and consumer-driven plans and about a third of them national preferred provider fee for service plans. We rate each group by how much you're likely to be out of pocket for premium and health care expenses the plan doesn't cover or doesn't pay all of. In the group -- the national plan group that you're in, Foreign Service ranks third on our list of about 18, I don't know, whatever it is, 16 or 18 plans. It's a very good buy. I don't think you can improve on your choice so stick with it and count your blessings.

MONICASo you're not getting your money's worth. (laugh)

FRANCISYou are getting your money's worth. Remember, you're buying insurance.

MONICANow, listen, any insurance -- I don't wanna die quickly so my kids could get some insurance either. So insurance is one thing you have to pay for and if you're lucky, you don't get it.

FRANCISYou have to pay the premium, regardless, okay? So you're sure stuck with that. You're in a plan with a fairly low premium as they go, believe it or not. I know that's hard to believe because even a low premium these days is pretty expensive. But the point is, suppose, you know, next week, you get hit by a truck or you have a heart attack or stroke, there are so many things that can happen to you, and all these insurance plans cover you well in that circumstance. The Foreign Service Plan covers you exceptionally well. So you're in a good plan.

NNAMDIThank you very much for your call, Monica. You, too, can call us at 800-433-8850. When your health plan open enrollment comes around, do you take the time to review your options or do you just renew the same plan? 800-433-8850. Walt Francis, there's a debate about whether it's related to health care reform, but a lot of people have seen their premiums spike this year.

FRANCISIt's unrelated to health reform. That's -- that probably added -- the average premium increase in this program this year was 7 percent. It probably would have been 6 percent without health reform, but people got these extra benefits I mentioned. Now, the problem is the average hides differences, vast plan-to-plan differences. A number of plans this year have zero percent premium increase. There's one plan that has a 33 percent premium increase.

FRANCISSo what people need to do is pay attention, both to the plan they're in and how it's changing, both benefits and premium and what their options are. Most people, the majority of federal employees, can save many hundreds or several thousand dollars by switching plans. And you may have a good reason not to switch plans, but that's -- you still at least should think about it.

NNAMDIFor federal employees, it's my understanding the increase really depends on the plan. Increases so far have averaged around 7 percent. But apparently, what that masks is that the actual increase to a particular plan might be anywhere between zero and 33 percent so it's essential to check your plan and compare.

FRANCISRight.

NNAMDIOne goal of health care reform is to help coverage with people with preexisting conditions. As we mentioned, that doesn't affect federal employees, but they may want to switch plans anyway.

FRANCISSure. And there are so many reasons why you might wanna switch plans. Maybe you're gonna have a baby next year and you're in a great plan for you this year, but it's not gonna cover your maternity cost 100 percent when some other plan will, or your gynecologist that you wanna use isn't in the plan you're in or, you know, you already had that new baby or you just got married or you're retiring or you're turning age 65 and have to decide on Medicare. So there's just any number of circumstances including no change in you but a change in your plan you didn't notice because you didn't pay attention that (unintelligible)

NNAMDIJust good advice for people to review their health plan every year, even though, apparently, most people don't.

FRANCISRight. Unfortunately.

NNAMDIHere's Bill in Arlington, Va. Bill, your turn.

BILLYes. Thank you for having me on. I just want to ask a question. I had a plan with the health savings account and I noticed that's gone away and most of the other health savings account plan have gone away and I'm just wondering why.

FRANCISNow, wait a minute. Only one of those -- well, actually, two, the United Company pulled out both its consumer-driven and high-deductible plan. They had a relatively low enrollment, and I guess they decided for business reasons that it wasn't profitable to keep going. But look, there are six consumer-driven and high-deductible plans left in the D.C. metro area. The Aetna One is still there. It has a CD, consumer-driven, and an HD plan, APW consumer-driven. GEHA and Mail Handlers both have excellent high-deductible plans. Now, you've got lots of good choices left and so I -- if you're a person who's already mastered the reasons why HD plans are such great buys, by all means, just flip over to one of the others.

BILLOh, thank you. I missed that and it looks like that most of them are disappearing.

FRANCISNo, they're still there.

NNAMDIBill, thank you very much for your call.

BILLThank you.

NNAMDIWhen should someone consider a plan with a higher deductible?

FRANCISWell, I think, everyone should consider it every year, because they offer so many advantages. Typically, they have relatively low premiums. They all have very good catastrophic coverage. They're just a little frisky because they have this deal that you get a savings account, but once you've spent the savings account, you pay the next, and savings account maybe 1,500, $2,000 plus or minus for a family. But once you've used it up, you spend, out of pocket, the next 1,500 and $2,000. And then regular insurance kicks in. They're not for everybody but for people who are not sort of in a situation where they have known every year of three or $4,000 spending on drugs or something. Old or young, good health or bad, they are great options. Some of them give you a savings account that's more than you pay in premium.

NNAMDIWe're talking with Walt Francis, editor of "Washington Consumers' Checkbook 2011 Guide to Health Plans for Federal Employees." It's open season for federal employees, but you might wanna take this opportunity just to check out what kinds of health plans are available as you consider your own health insurance. Here is Leon in Bowie, Md. Leon, you're on the air. Go ahead, please.

LEONYeah, I'm on Medicare. I've also got this Foreign Service plan and I'm just wondering, is it worth it to keep paying that premium for a very comprehensive plan when I've got Medicare covering 80 percent?

FRANCISThat is a great question. There is no simple answer, but the key thing, that wonderful Foreign Service plan you were in at age 64 didn't get worse the year you turn 65. It was -- it’s still a wonderful plan. So the question is, why do you need to pay that extra premium at least $1,200 a year for Medicare part B? And for some people, it's a lot more. It's not just one premium everybody pays the same anymore. So it could be depending on your situation, 1,400, 1,800, $2,000. What you get out of that is the ability to go out of network, at no cost, 100 percent wrap around, almost all the national plans offer that deal, including foreign service. So no doctor cost, no hospital cost, regardless of who you use.

FRANCISThe question really is, I think, for most people, is it worth that ability to go out of the network and have that 100 percent coverage to pay their extra premium? And I don't think there's a simple answer for some people. It's worth every penny for other -- other people say, why am I doing it? You have a plan with good preferred providers whether you go out of them, you know, staying in their work. So you don't really need that extra protection from part B. But again, I don't have any -- you know, I can't wave a magic wand and say one size fits all because it wouldn't be true.

LEONThanks a lot.

NNAMDILeon, thank you very much for your call. Pretty much all of the advice you're giving today, Walt Francis, applies to everyone, not just federal employees, correct?

FRANCISIt does except most people don’t have the same choices, unfortunately. They'll be common but they're not here now.

NNAMDIHere is Heidi in Silver Spring, Md. Heidi, you're on the air. Go ahead, please.

HEIDIHi. Thanks. I have -- I've been a federal employee for several years. And we do have a CDHP plan, and it served us well. My husband just got a job this year with the federal government, so at the moment, he doesn't have any insurance because he's covered by my family plan. But we're wondering if he's allowed to opt into the flexible spending account because we weren't allowed to do that for health -- other out of pocket health expenses. We were told we were not allowed to do that when we're in a CDHP plan.

FRANCISYou're still -- I hate to tell you this but if you're in the consumer-driven, high-deductible plan, you can't -- neither one of you can have an FSA account. But there's a special kind of flexible spending account you can have. And it's got some funny name like FSA LEX, I think, (laugh) limited extra spending or something like that.

HEIDIOkay.

FRANCISAnd that will cover dental and vision spending. So yeah, you could pick up those costs, but, otherwise -- remember you're getting -- for those, who don't understand, she is getting and her husband are getting a big savings account, and it's better than a regular-flexible-spending account because those accounts are sort of user -- there you are -- use or lose at the end of the year. The one she's in could carry over build up tax preferred...

HEIDIIt does.

NNAMDIThat's the CDHP plan.

HEIDIYeah.

FRANCISYeah.

HEIDIBut we actually -- we do both need vision care. We both wear glasses or contacts. And actually, my husband had a lot of dental. So we were paying extra for dental, which was not covered by the CDHP. And so, we're wondering if we again -- if we -- you know, we're trying to balance the pros and cons of that flexible spending account with those costs.

FRANCISWell, you could be in your high-deductible plan and buy dental insurance and vision insurance and have a flexible spending account for dental cost that those other insurances don't cover, so that you're allowed to do.

HEIDIOkay. And does that affect -- I mean, we also now -- we have children in pre-school and such. So does the health side doesn't affect at all opening and having a dependent care, flexible spending account, correct?

FRANCISI believe it does not. We're getting into the weeds here a little bit. But yes, I don't think you're the kind that will pay day care, for example, yes. You could still get that kind.

NNAMDIHeidi, thank you very much for your call. We move on to William in Beltsville, Md. Hi, William.

WILLIAMHello. Yeah, I was just calling to ask about where does a BlueCross BlueChoice rank as far as premium. And then also, I'm getting ready to turn 50. I got an HMO and I thought probably, as I get older or have been in this a couple years, change over to PPO because the chances of me getting sick are going start becoming greater. But those are my two questions.

FRANCISOkay. Let me say, I kind of disagree with the premise in the first question. You can't just look at premiums. You have to look at the out of pocket cost side, okay? And in Checkbook's guide, we rate the plans to take account of both. That said, CareFirst BlueChoice is not one of the least expensive HMOs. You didn't say if you were married or not. But either case, self-only or family, you could -- you can buy one that's a little lower cost to you. For example, Aetna Open Access basic or M.D. IPA are both similar in operation in the one you're in. And for some people, Kaiser Standard or even Kaiser High Option are both for anyone. They're very good buys. As to getting older and switching out the HMO into a PPO plan, well, I don't know. Being older doesn't really affect, you know?

FRANCISIf you're happy with the doctors of your HMO, it doesn't really matter whether you see them once a year or five times a year, because you're older or feebler or something, (laugh) you know? I think all the local HMOs have a pretty good access to a wide range of specialists. So if something totally out of the blue happens, and you need -- you know, I don't know what, a foot doctor (laugh) or any kind of specialists, you're gonna find a good one in your HMOs. So I don't think that's a reason to switch.

NNAMDIWilliam? William, are you there?

WILLIAMYes.

NNAMDIThat works for you?

WILLIAMYes.

NNAMDIOkay. Thank you very much for your call. You too can call us, 800-433-8850. It is open season for Federal Employees in terms of switching health care plans. Do you have any specific questions for Walt Francis about your coverage for the year 2011? 800-433-8850. Mary in Montgomery County, Md. Your turn, Mary.

MARYYes. I'm a former spouse, and I had the right to continue the GEHA Insurance. And now, I'm also over 65. So I have, you know, the Medicare.

FRANCISOkay. I know your situation exactly. For those who don't know, if you're in the former spouse category, you are -- and I'm sure you are, paying the full premium. The government...

MARYRight.

FRANCIS...picks up none of its share.

MARYTo give a full example, I'm now paying or will be paying the first this year, $346.62. And he, you know, is retired, and he will continue his. He will be paying $86.65. So the government, you know, still pays their share, which is 259.97 for him. What it amounts to, for the people that don't know, they only pay one-fourth of the premium.

FRANCISOkay. I'm gonna abstract from the numbers, because they depend on which plan you joined. First point I'd make is there are, I don't know which key health plan you're in. The key standard option is a road to the economical plan, but there are plans that cost less. But that said, you are the only group of people who I recommend leave the Federal Employees Health Benefits Program. Once you hit 65, if you are paying full premiums in this program, it just doesn't -- it's not worth it. Your Medicare coverage has gotten a lot better in the last four or five years. We now have the Part D drug benefit. I think any -- you could join the Medicare Advantage Plan that lets you -- you can be an HMO, a PPO, any kind of plan you want.

FRANCISI recommend you stick with Medicare Parts A, B and D, all three. There's no penalty for you for Part D. You can sign up for it tomorrow. And in fact, this is open season for Medicare right now, all right? And get yourself situated. Go to the website, www.medicare.gov, or look at the Medicare in your handbook that most -- that everyone's mail whose -- once, they're on Medicare -- read what it says about your options. Pick yourself either original Medicare or Medicare Advantage Plan. Go that direction and save yourself that. And I won't try to multiply, but it sounds like three, four or five, $6,000 a year in premiums, because the Medicare coverage is not quite as good as the FEHBP coverage, but it's still very good indeed.

MARYOkay. Now, you are recommending that I leave the federal program and then is -- there's something about -- you can or you cannot -- when the open season comes again, can you -- if a former spouse leaves the federal program, can they get back in?

FRANCISOkay. I should have said it, and -- for most people, if you leave the Federal Employee Program, you can leave two ways. You could quit it flat out and then you could never get back in or you could suspend it. I think you probably have rights to suspend, which means that if you change your mind a couple of years down the road, you could get back in and pay those monster premiums you're paying. So what you need to do is call the officer personnel management and talk to them about your situation, and say you would like to suspend your enrollment because you wanna be in a -- and now, you will have to join something called the Medicare Advantage Plan.

FRANCISThere's about 30 or so of them available locally. They're very good. It's almost the same of kind of choice as in the Federal Employee Program. So you would join Medicare Advantage and you would suspend FEHBP enrollment. Preserve all your options and save yourself thousands of dollars in premium.

MARYAnd do you have an estimate of what a Medicare Advantage Plan -- what their premiums are?

FRANCISA lot of them charge you no extra premium above your Part B premium.

MARYOh.

FRANCISYeah. Okay. We're talking about saving a lot of money here. Some of...

MARYRight. Right. Because I'm, you know, it's like 4 or 5,000 and...

FRANCISNo. You're gonna save all the -- most of that 4 or 5,000, maybe all of it. Join the Medicare Advantage Plan, you pay only Part B premium or maybe a couple of hundred bucks extra.

NNAMDIMary, thank you very much for your call. But it does raise this issue, Walt Francis, which we got an e-mail from Vee in D.C. about, "Why are people with good plans draining Medicare needed by others who have no option?"

FRANCISWell, I don't think they're draining Medicare. I mean, once you turn 65 and you sign up for Medicare, Medicare Parts A and B, assuming you're not working, become primary. And this is true for everyone in America. I mean, it's nothing unique about Federal Employees Program. What federal employees have the right to do -- and it's part of their fringe benefits as employees. I mean, it's nothing -- is to supplement their Medicare plan with their Federal Employee plan. But with minor exceptions, most -- everybody should be at least in Medicare Part A and most in Medicare Part B.

NNAMDIAnd we got this post on our website from Jeff, "Does the surviving spouse of a federal retiree need to do anything if he or she is happy with the present -- their current coverage?"

FRANCISWell, whether or not you're a surviving spouse, if you are enrolled in this program, make sure you really are happy with your present coverage. Actually, think about your health situation, look at the plan brochure, make sure nothing has changed, look at other options. Maybe you're happy as a clam because you didn't realize there was a plan just as good that will save you 1,000 bucks a year. So...

NNAMDIA couple more. This post on our website from Sue, "I'm a retiree with both Medicare Part A and B and the Blue Cross standard plan. Any good alternatives for a lower price plan fee for servicing only, please?"

FRANCISAbsolutely. Most annuitants who are -- the majority of them are in Blue Cross standard option with Medicare A and B, that's past age 65, that's the most common choice, all those people can get the same wrap-around 100 percent coverage in a lower price spread. GHI has standard options, stands out. It's the least costly. The benefits are the same for you hospital and doctor coverage. It's not -- does not have as good a prescription drug benefit. So that's one caution there. Blue Cross basic, which is -- that will give you 100 percent wrap-around as long as you stay with Blue Cross-preferred providers. And if you go out of plan, you can always use Medicare. APW high option. There's three or four options that are very good to consider.

NNAMDISo I guess that answers this e-mail question from Jay, "Can you please provide information on health plans to be added to Medicare A and B? Which should one know or consider?"

FRANCISWell, the -- it's gets awfully complicated. For example, some people who were in HMOs may wanna have part B so they can -- even though they normally don't go out of plan with an HMO, you -- it covers you, you pay it all if you don’t use a plan provider. But if you have part B, you can go out of plan to any provider in the country. To some people, that's very valuable as sort of an opt-out ability. To other people, it's meaningless. They're gonna stick with their HMO doctors. So I can't -- I don't have any simple answer to that question. There are lots of good buy plans with HMOs.

FRANCISEven the high deductible -- excuse me, with Medicare, even the consumer-directed plans -- okay, you can't get one kind of savings account. But the consumer-directed plans with another kind of savings account works very well for people with Medicare.

NNAMDILots more calls and e-mails for Walt Francis. He is the editor of "Washington Consumers' Checkbook 2011 Guide to Health Plans for Federal Employees." If you wanna get through, it might be best to go to our website, kojoshow.org, ask a question or make your comment there. Or send us an e-mail to kojo@wamu.org or a tweet at kojoshow. I'm Kojo Nnamdi.

NNAMDIWe're discussing federal health care plans. It's open season for federal employees. We're discussing health insurance plans that are now available to federal employees. And you might just be interested in hearing a little more about them. Our guest is Walt Francis, editor of "Washington Consumers' Checkbook 2011 Guide to Health Plans for Federal Employees." Here is Valerie in McLean, Va. Hi, Valerie.

VALERIEHi, Kojo. My question for your guest has to do with the advent of the electronic health record and whether -- I'd like to hear your guest's thought from whether the electronic health record gives some of the plans a competitive edge over the others in terms of coordinating benefits.

FRANCISThat's an interesting question. I hadn't thought of it that way. All the plans have the ability to use the records of the people enrolled in them and they do for research purposes. And, you know, there's some privacy protections that are very important there, but, you know, assuming the plans meet the legal obligations for that. And they often will make fine-tuning adjustments to their benefits to reflect ways to save the plan, and hence, enrollees, because the enrollees pay the premium money by -- for example, which drugs do they make preferred, okay?

FRANCISAnd that's partly a clinical judgment, but it’s also a question of, if they find that a lot of people are able to use generic version and it's not -- doesn't create any other problems, they can be more confident that they would make that adjustment in their benefits.

NNAMDIValerie, thank you very much for your call. There was an article in The Washington Post yesterday indicating that the Office of Personnel Management is organizing a research database of insurance claims filed by the 8 million workers and dependents enrolled in the Federal Employees Health Benefits Program, as well as participants in two other federally administered programs. Why does the government want to keep a database of insurance claims? And privacy advocates have an issue with the idea and probably some federal employees, too. What do you think about it?

FRANCISI think it's a great idea, and I think the privacy advocates ought to get a life here. Medicare has -- had such a database on every senior -- virtually every senior citizen in America health care usage for the better part of 50 years. OPM has used Blue Cross, which has roughly half the enrollees in this program, and has a great research program using Blue Cross' own claims records. They've been using, directly or via Blue Cross, those records for decades. When the Medicare prescription drug benefit was added, those same Blue Cross records on prescription drug usage were used in designing that program.

FRANCISThis is not a new phenomenon. OMB -- excuse me, the OPM wants to expand it to cover the FEHBP plans. I say more power to them. Now, yes, they need to protect that information, and they promised they will. You know, the U.S. government hasn't done so well in protecting information, we've noticed, in the last month or two, certain kinds of information. I think people should always be concerned about the security of that data. But it's really not new to be using it, and it's not a new issue.

NNAMDIAmong the critics -- including the American Civil Liberties Union, Consumers Union and the American Federation of Government Employees -- they argue that the government should avoid setting up a repository of sensitive information that could be vulnerable to privacy beaches -- breaches at minimum, they say. And obviously, Walt agrees with this. OPM should provide more information about how the database called the Health Claims Data Warehouse will work and who will have access to it.

FRANCISAnd it won't be many people if they're doing it right.

NNAMDIOn -- back to the telephones again. We go to John in Washington, D.C. John, you're on the air. Go ahead, please.

JOHNHi, Kojo. Thanks very much. Walt, I wanted to give you some report back on some excellent advices, too, that Connolly gave us at Fairfax County Government Center Saturday morning, regarding the multiple coverage issue and suspending federal FEHB to rely on Medicare and TRICARE -- particularly TRICARE -- for life. The first thing was that I found that there's no way of doing it online through my agency's website, and there's no readily available number for OMB to get what is needed, which is a paper form. I find...

NNAMDIJohn, allow me to interrupt so Walt can explain to our listeners exactly what John is talking about because I don't get it.

FRANCISIt turns out there are several circumstances under which you can, quote, "suspend FEHBP"...

NNAMDIOkay.

FRANCIS...and enroll only in another health program, in his case, TRICARE, which is the...

NNAMDIRight.

FRANCIS...program for military retirees. And to do that, you have to be in touch with OPM and you have to fill out a special form. And I may not -- I'm gonna look through. Ah, got the phone numbers here. Let me also give you -- your listeners a web page. The Checkbook webpage is www.guidetohealthplans.org.

NNAMDIAnd you can find a link to that at our website, kojoshow.org.

FRANCISOkay. On that webpage, you get the -- free, the entire text of the advice in the guide, okay, including the part at the beginning that gives the phone numbers I'm about to read out, okay, and all our advice about things like how do you suspend -- we've had questions about high-deductible health plans and so on. So all that advice is free. And for about half of all federal agencies, if you're an employee of those agencies, you get free access to the online guide. And right on the homepage, you could check to see if your agency has bought you a free subscription. So by all means, take a look at the website.

FRANCISBut the phone number that I would use -- wait a minute, that's the annuitant number. I would call D.C. area, 202-606-0500. And they should be able to help you with any complicated question. For example, we had a lady on earlier who's paying full premium and about to go on Medicare. And for you, sir, as well, with your TRICARE issue. Good luck.

NNAMDIWe -- thank you very much for your call, John. We got an e-mailer, who asked, "Do I have to buy the Consumers' Checkbook or is there free information available for federal employees?" There is free information available for federal employees. And again, you can find links at our website, kojoshow.org, to the Office of Personnel Management's website, to Washington Consumer Checkbook's guide and to Plan SmartChoice. You can find all of those links at our website at kojoshow.org. On now to Steve in Washington, D.C. Steve, you're on the air. Go ahead, please.

STEVEThank you for having me. My wife was with the federal government for a number of years and actually left her agency as a full-time employee and came back as a contractor so she could do overseas work, more interesting work, and advance her career. We've -- we're now on a COBRA through OMB, and the government is paying for our premium. And the -- and they will continue to pay for our premium up to about -- I think it's $20,000 a year. My question is, can we stay within the government's health care plan, or will we have to go out once our COBRA is done? Are you familiar with the...

FRANCISYeah. Let me say this situation you described, I'm not 100 percent sure what it is. And you could send an e-mail to the station, and I could get more information to you later if need be. But sounds to me like you are not currently enrolled in the Federal Employees Health Benefits Program. If you are not currently enrolled and retire or leave the government and lose your enrollment that way, you have lost your post-retirement eligibility forever. The only way you can be sure that you have coverage is to be continuously enrolled for the five years before you retire.

FRANCISAnd that is retire on a defined pension, okay? So I think you may wanna call the OPM number I gave a few minutes ago and talk to them about this. But it sounds to me like you are -- if you're truly in COBRA and not something else called Temporary Continuation of Coverage -- but even Temporary Continuation of Coverage is temporary -- then you probably need to change your employment arrangements to get coverage for the rest of your lives.

NNAMDISteve, thank you for your call. You can save a lot by choosing a more limited plan like Blue Cross basic, which is cheaper than the regular Blue Cross plan. But what's the difference, Walt?

FRANCISIn that -- every plan poses its own special advantages and disadvantages. The huge advantage of Blue Cross basic is you save close to a couple of thousand dollars in premium for family coverage. Its benefit structure is mostly as good or a little better than Blue Cross standard. There's no deductible, for example. Its prescription drug coverage is not quite as good. But the big difference is Blue Cross standard says you are covered very well in network and reasonably well out of network. Blue Cross basic says you're covered reasonably well in network and not at all out of network, so you cannot use a non-preferred Blue Cross provider and get any coverage. So that's the big issue with -- and the big trade off in deciding whether or not to go to Blue Cross basic.

NNAMDIHMO-type plans can be quite a bit cheaper than traditional insurance plans. It's my understanding that Kaiser scores highly because there's no cost sharing of any kind. What's the downside?

FRANCISWell, there's a little bit of cost sharing, you know, that sort of $20 visit kind. The downside on any HMO is that you're agreeing to accept the HMO's panel of providers, and if you don't use one of them they will not cover you at all, similar to Blue Cross basic thing I just described. Kaiser has -- is somewhat unique among HMO they have locally. They actually use providers -- the great journey whom are on their payroll, okay? And it's quite a limited panel. But what they do is try to get you into a network -- their network using their clinics. And I have any number of friends who swear by Kaiser. They've been in it all their lives, they'll never leave it. And I have other friends who say I wouldn't touch it with a 10-foot pole. It's very much your own preference towards how you like your medical care.

NNAMDIHere is Richard in Tacoma Park, Md. Richard, you're on the air. Go ahead, please.

RICHARDYes. Thank you for taking my call. I have a question. If you have a rare illness and you wanna be able to go anywhere in the country to any specialists -- I'm not talking about alternative medicine, but sort of a recognized specialist -- what federal plan would be best? I'm looking right now at Blue Cross standard and NALC. And I'm also wondering whether maybe Medicare might be a better choice for this circumstance. I'm also Medicare illegible.

FRANCISWell, if either you're in Medicare Parts A and B or you're not. Have you signed up for part B?

RICHARDI'm on the free part. I don't know -- I can -- I'm gonna retire soon so I can sign up for that or I can continue with my federal health care. Or both, I guess.

FRANCISOh, okay. Right. People who are still working can delay their enrollment Medicare Part B, past age 65, without penalty. Okay. Your best...

RICHARDWhat would you say about -- okay, I'm sorry.

FRANCISYou -- I'm just letting other listeners know what you already know is you don't have to sign up at age 65 because you're still working.

RICHARDOkay.

FRANCISWhat I recommend in your case, if that's very important to you, you're one of those people who should be in Medicare Part B. It's a no-brainer. That guarantees you access to any Medicare-participating provider in the country, which is virtually all hospitals -- well, part A covers the hospital side, part B cover -- about 95 percent of all physicians are with part B. Worst case, you'll pay 20 percent. So I think that's just almost automatic for you.

FRANCISGiven that you're gonna do that, I think Blue Cross standard option is a bit pricy. You could move down to GEHA standard option or Blue Cross basic or APWU, some of the plans I've mentioned. NALC is kind of an in-between choice. Very good plan, very good prescription drug benefits especially, it's less expensive than Blue Cross standard but more expensive than some of the other ones I just mentioned.

NNAMDIRichard, thank you very much for your call. More than half of federal workers have a plan through Blue Cross/Blue Shield, but there are lesser known plans, aren't they, Walt, that are also very good?

FRANCISOh, absolutely. I mean, we have all these plans that have these postal names in them, like Mail Handlers, American Postal Workers Union and so on, National Association of Letter Carriers, NALC, that I'd just mentioned.

NNAMDIMm-hmm.

FRANCISThese plans let you enroll regardless of whether or not you're postal -- do not have to be a mailman to join. All federal employees and retirees are eligible for these plans. There's a CIA plan. It's called Compass Rose this year and the Foreign Service plan, and they are very broadly open to anyone who works in the intelligence, foreign affairs or DOD civilian side, so a lot of options here. Somebody's plans have better premiums and better benefits than the Blue Cross plans, not much better benefit because it's hard to beat the Blue Cross plans. They're such great coverage. But yeah, no, there's a lot of -- there's about 24 possibilities.

NNAMDIWalt Francis is editor of "Washington Consumers' Checkbook 2011 Guide to Health Plans for Federal Employees." Walt, thank you so much for joining us.

FRANCISWell, thank you, Kojo.

NNAMDIAs we mentioned earlier, you can go to our website, kojoshow.org. You'll find links to a number of websites there that can help you with the sometimes complicated process of choosing a new health care plan. I'm Kojo Nnamdi.