Choosing a Health Plan

You have many more choices now that NANA is part of the Federal Employees Health Benefits (FEHB) system. Every family’s needs are different. Here are some tips for choosing a health plan that is right for you and your family. If you need definitions of common health insurance terms, click on the definitions page of this website:

  1. Think about your medical needs. Choose a plan that matches the way you use medical services. For example, if you have a lot of doctor visits, you may want a plan with lower out of pocket expenses. If you have prescription drugs you take every day, choose a plan that covers those drugs at the lowest cost.
  2. Choose a plan type. There are several types of health plans. The chart below gives you a quick guide to the different plan types. All FEHB plans include preventive services required by the Affordable Care Act at no additional charge to you.
  3. Look at networks. Your costs are lower when you use providers who are part of the plan; these are “in network” providers. If you have doctors or other health care providers that you like, call their office to see if they are in network for the plans you are considering. This means that they have an agreement with that plan’s insurance company to provide service to you at a lower price. In general, plans with a bigger network of healthcare providers will give you more choices. If you choose a plan, then use out of network providers, you may pay much more for your health care.
  4. Think about your budget. With many health plan choices, you can find a premium cost that fits your budget. But your total cost of health care also includes out of pocket costs. These are the part of the costs you pay for your health care, for deductibles (the amount you pay each year before your insurance benefits start) and co-pays or coinsurance (the amount or percentage you pay for each service, after you have met your deductible. In general, plans with higher premiums have lower out of pocket costs.
Plan Type
Features
Things to Consider

High Deductible Health Plan (HDHP) with Health Savings Account (HSA)

  • Covers high cost medical events
  • Includes a health savings account (HSA) you can use to pay for regular health care
  • Premiums are usually lower
  • Your HSA is yours to keep even if you leave the company
  • Some plans return part of your premium into your HSA, so your actual premium costs are lower
  • You cannot have an HSA if you are covered by another health plan, including Medicare, but most plans instead provide a Health Reimbursement Account (HRA)

Consumer-Driven High Deductible (CDHD) Plan

  • Your health plan puts money in a medical fund for you. If you do not spend more than your medical fund, you will have no out of pocket expenses.
  • Premiums are usually the lowest.
  • Most CDHD plans include catastrophic coverage.
  • If your costs are higher than your medical fund, you will pay deductibles and co-pays
  • Your medical fund does not earn interest and you lose the fund if you leave the company
  • If you have an FSA through another plan, or have certain other health coverage, you are not eligible for these plans.

Fee for Service (FFS) with a Preferred Provider Option (PPO)

  • See any doctor without a referral
  • Network of preferred providers
  • Nationwide and sometimes worldwide coverage
  • You may pay more out of pocket than with other plan types
  • If you use a provider outside of the network, you could pay a lot more

Health Maintenance Organization (HMO)

  • Your care is managed by a primary care physician
  • Some HMO plans have no or very low deductibles
  • HMO plans may have less paperwork
  • Premium costs are usually lower than FFS plans.
  • You may need a referral to see a specialist
  • You may pay the full cost of any care outside of the HMO, including medical costs when you travel
  • HMO plans are not available in every state

See the Guide to Plan Types for more information.