Introduction to Federal Benefits and This Guide
As a Federal retiree, the benefits available to you represent a significant piece of your compensation package. They may provide important insurance coverage to protect
you and your family, and/or, in some cases, offer tax advantages that reduce the burden in paying for some health products and services, or dependent or elder care services.
The purpose of this guide is to provide basic information about the benefits offered to you as a Federal retiree, and assist you in making informed choices about these benefits as
you move through your retirement years.
Benefits Programs Included in this Guide
In addition to your Civil Service or Federal Employees Retirement System benefits and the Thrift Savings Plan, the Federal Government offers other benefits programs to eligible
retirees. This Guide includes information on these additional programs:
- Federal Employees Health Benefits Program
- Federal Employees Dental and Vision Insurance Program
- Federal Employees' Group Life Insurance Program
- Federal Long Term Care Insurance Program
If you are a retiree, it will provide the most current information regarding the benefit programs, and will support you as you make decisions during the annual Open Season, or
experience life events that cause you to reconsider previous choices. It also contains some tips on what to consider as you make your decisions.
Additional Information
You will find references throughout the guide to websites or other locations to obtain more detailed information. We encourage you to access these sites to become a more
educated decision-maker and consumer of Federal benefit programs.
Federal Employees Health Benefits (FEHB) Program
Health Information Technology and Price/Cost Transparency Leaders
Over the past few years, OPM has encouraged FEHB health benefits plans to increase their use of health information technology (HIT) to create efficient care delivery and to develop
tools to help you determine the quality 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 from, for instance, misread handwritten prescriptions, and emergency care medical decisions made
without complete and accurate 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 are being established to keep your records safe from inappropriate
disclosure.
Health Information Technology
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.
Quality and Price/Cost Transparency Online Tools
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 website information available includes online decision tools with cost estimators and quality indicators for physician and
hospital services and prescription drugs used to treat common 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 the following page met OPM's HIT, quality and price/cost transparency standards at the time this Guide went to press. As other plans bring these tools on line, we will add them to the list on our website. So, please check the updated information at www.opm.gov/insure
before you make your healthcare decisions.
The following health plans have demonstrated their commitment to efficiency, safety and quality through computer system enhancements that offer PHRs and quality and price/cost
transparency decision support tools
Aetna
APWU Health Plan
AvMed Health Plans
Blue Cross & Blue Shield of RI
BlueCross BlueShield Government Wide Service Benefit Plan
CareFirst BlueChoice, Inc
ConnectiCare, Inc
Blue Choice
Geisinger Health Plan
Government Employees Health Association, Inc. (GEHA)
Group Health Incorporated
Health Net of Arizona, Inc.
Health Net of California
HealthPartners, Inc.
HealthPlus of Michigan |
HIP Health Plan of New York
HMO Health Ohio
Humana
Independent Health Association, Inc.
Kaiser Foundation Health Plan (except Hawaii)
M.D. IPA
Medica Health Plans
MVP Health Care, Inc.
NALC Health Benefit Plan
PacifiCare Health Plans
Panama Canal Area Benefit Plan
SAMBA
SuperMed HMO
UniCare
UnitedHealthcare (except the River Valley, Inc. in Iowa and Illinois)
UPMC Health Plan |