CareFirst HDHP — what am I missing?

[Anonymous]

I’m a Fed with a family, and we used to be BCBS Standard (like most Feds I know), but got tired of paying so much out of pocket, always a surprise.

Switched to the CareFirst Standard, which is an HMO with the same provider network. Higher premiums, but we paid next to nothing out of pocket, no surprises.

Been researching the CareFirst HDHP. Comparing just the premiums for Self+family, HDHP is about $6,500 less annually. Even when I add in the cost of the $2,800 family deductible, HDHP is still about $3,700 less than Standard. And once the deductible is met, the coverage for HDHP is almost identical to the Standard coverage. And CareFirst contributes $1800 toward my deductible over the year.

So some wise DCUM person, please tell me what I’m missing! Why would I not switch to this particular plan before open season closes? (And to be clear, coming out of pocket for $2,800 in expenses before coverage kicks in will not be a hardship.)

[Anonymous]

You absolutely should. When I first did the math a decade or so ago, i was surprised as well. We always do the HDHP whenever we can. There is no scenario where the other plans come out ahead unless your employer eats most of the premium.

[Anonymous]

Anonymous wrote:You absolutely should. When I first did the math a decade or so ago, i was surprised as well. We always do the HDHP whenever we can. There is no scenario where the other plans come out ahead unless your employer eats most of the premium.

Thank you!

I've been conditioned to be skeptical of "too good to be true," and I think that's why I'm double checking here!

[Anonymous]

We just switched to this plan, too. Eager to see if anybody points out a downside we're missing.

[Anonymous]

I thought most feds have BCBS basic. Seems like that’s the smartest plan for young, relatively healthy families

[Anonymous]

Anonymous wrote:I thought most feds have BCBS basic. Seems like that’s the smartest plan for young, relatively healthy families

I think it works out well for most families.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I thought most feds have BCBS basic. Seems like that’s the smartest plan for young, relatively healthy families

I think it works out well for most families.

Perhaps, but that wasn’t the question being asked here. (And just because lots of people do something doesn’t mean it makes the most financial sense.)

[Anonymous]

We’re on Carefirst HDHP and it’s been great. It is a little bit of an adjustment when you first start getting bills for pediatrician visits and stuff (though preventative care is still totally free), but the math works out way in your favor. We’ve been on it for 3 years and have I think $21k or so in our HSA, and we’ve paid less in healthcare costs (premium+deductible) than we would have paid only for the premiums on the standard plan.

[Anonymous]

Following... had the same question as OP. The math seems to good to be true. We are currently on BCBS basic. Reviews on Consumer Checkbook and google say that customer service is atrocious. That gives me pause. Also, did you feel like you were paying huge medical bills at the beginning? I understand that preventative care is included, but it seems risky to me.

[Anonymous]

Compare the Carefirst HDHP to the GEHA HDHP. Essentially identical premiums. GEHA effective deductible is $200 more but your costs after the deductible will be lower (except in maybe very specific circumstances that aren't common). Also, GEHA FEHB includes dental coverage and glasses/contacts.

[Anonymous]

I've had it for the past 2 years and am switching to GEHA standard as I am hoping for a more straightforward plan.

I felt like I've had to pay a lot out of pocket even after the deductible. Some of it could be because I had imaging done and the radiologist ended up being out of network which is annoying. For example, I got an MRI at Sibley and the imaging was covered but not the radiologist's fees. A mammogram that was diagnostic not preventive was not covered.

[Anonymous]

Anonymous wrote:I've had it for the past 2 years and am switching to GEHA standard as I am hoping for a more straightforward plan.

I felt like I've had to pay a lot out of pocket even after the deductible. Some of it could be because I had imaging done and the radiologist ended up being out of network which is annoying. For example, I got an MRI at Sibley and the imaging was covered but not the radiologist's fees. A mammogram that was diagnostic not preventive was not covered.

I’m the OP of this thread, and this is very useful feedback. I’m pretty vigilant about making sure everything is in network (I hardly visit the doctor, so it’s usually not a big deal for me), but I’ll definitely emphasize for my husband the importance of using only in-network labs, etc. Thanks, PP.

[Anonymous]

You're not missing anything. For most people, this is the best, most cost-effective choice, but people are sheep so they just keep going with BCBS Standard or Basic.

[Anonymous]

Anonymous wrote:You're not missing anything. For most people, this is the best, most cost-effective choice, but people are sheep so they just keep going with BCBS Standard or Basic.

I should add, it is annoying to have to shell out $$$ for my son's Concerta every month, but the math still works out better in the end.

[Anonymous]

Anonymous wrote:I've had it for the past 2 years and am switching to GEHA standard as I am hoping for a more straightforward plan.

I felt like I've had to pay a lot out of pocket even after the deductible. Some of it could be because I had imaging done and the radiologist ended up being out of network which is annoying. For example, I got an MRI at Sibley and the imaging was covered but not the radiologist's fees. A mammogram that was diagnostic not preventive was not covered.

That's a function of the Insurance agreement and not the plan. For example, my company has BCBS PPO and HDHP offerings. The network and rules are exactly the same. However, the deductible and copay for covered services are different. If I was in the same boat as you, BCBS would not have covered the radiologist or the mammogram in both plans. Check the rules.