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The FEHB Program can help you and your family meet your health care needs. Federal employees, retirees and their survivors enjoy the widest selection of health plans in the country. You can choose from among Consumer-Driven and High Deductible plans that offer catastrophic risk protection with higher deductibles, health savings/reimbursable accounts and lower premiums, or Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Health Maintenance Organizations (HMO) if you live (or sometimes if you work) within the area serviced by the plan.
Use this site to compare the costs, benefits, and features of different plans. We chose the different benefit categories based on enrollee requests, differences among plans, and simplicity. However, we urge you to consider the total benefit package, in addition to service and cost, and provider availability when choosing a health plan.
The FEHB plan brochures show you what services and supplies are covered and the level of coverage. Review the brochures carefully. The brochures are formatted to ensure they are all organized alike. You can get brochures from the health plans or your human resource office. When it comes to your health care, the best surprise is no surprise.
OPM does not prohibit FEHB members from participating in pharmacy-sponsored incentive or pharmaceutical company co-pay reimbursement programs, and we are unaware of any Federal laws restricting participation. Enrollees in other Federal Programs such as Medicare and Medicaid are statutorily prohibited from participating in pharmacy incentive programs under section 1320a-7b of title 42, United States Code (“the Anti-Kickback Act). However, the FEHB Program is exempt from the application of this provision.
OPM does not have authority over promotional incentive programs retail pharmacies choose to offer customers, and OPM cannot direct retail pharmacies to provide the incentives to FEHB Program members. We are working with FEHB Program plans to remove any restrictions.
Over the past few years, OPM has encouraged FEHB health benefits plans to increase their use of health information technology (HIT). HIT can help your health plan and healthcare providers deliver safer more efficient care. Using HIT, your health plan can offer you tools to help you organize your health information, access information targeted to your health needs, and determine the quality and price/cost of the doctors, hospitals and other providers that you and your family use for day-to-day healthcare needs.
HIT based on broadly accepted standards, allows patients, healthcare providers and health plans to share information securely, driving down costs by avoiding duplicate procedures and manual transactions. More importantly, HIT reduces medical errors; for instance, from misread handwritten prescriptions, and emergency care medical decisions made without complete and accurate health information. HIT can also help you find appropriate health information to aid you and your doctor in making appropriate clinical decisions regarding your care. Since privacy and security considerations are vitally important, safeguards have been established to keep your records safe from inappropriate disclosure.
The health plans listed below have made a commitment to offer you and your family access to internet based personal health records (PHR). PHRs come in a variety of forms but what they all have in common is that they give you a convenient way to track, view, and manage your personal health information. PHRs also allow you to share your health information with your healthcare providers so they have a better picture of your health history. When providers know your health history they can make more accurate diagnoses and provide you with safer more efficient care.
The health plans listed here have also made a commitment to offer you and your family access to healthcare quality and price/cost information so you can make more informed choices on which providers to use to receive care. The web site information available includes online decision tools with cost estimators and quality indicators for physician and hospital services and prescription drugs used to treat common or chronic illnesses and conditions. These health plans describe the sources of this health information and any limitations so you can understand what the information means. Some examples of the types of surgical procedures for which you can obtain cost and quality information include: arthroscopy knee/shoulder, breast biopsy, cataract repair, cesarean delivery, colonoscopy, corneal surgery, gall bladder removal, heart catheterization, hysterectomy, inguinal hernia repair, knee replacement, and tonsillectomy. This information helps you understand the true price/cost and quality of your healthcare and enhances your ability to compare hospital, physician, prescription and other provider value as you make healthcare choices. FEHB health plans are working to expand the price/cost and quality information they provide to you.
The health plans listed on this page met OPM's HIT, quality and price/cost transparency standards at the time this report went to press. As other plans bring these tools on line, we will add them to the list on our web site. So, please check the updated information before you make your healthcare decisions.
The following 38 health plans have demonstrated their commitment to efficiency, safety and quality through computer system enhancements that offer PHRs, quality information, and price/cost transparency decision support tools:
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