GEHA VS BC/BS

FOR MEMBERS ON MEDICARE WITH STANDARD OPTION SUPPLEMEMTAL PLANS

At our November 20, 2009 meeting we heard the Blue Cross/Blue Shield representative discuss changes in their plan for the coming year. One of the changes is their shameless annual increase in premiums. Federal retirees get no COLA next year but BC/BS raised their premium another 9%. This is nothing new. Somehow GEHA manages to have minimal or no increases (That’s right, there were two years that I know of that GEHA did not increase their premiums) while BC/BS raises their premiums 8 to 10 % every year. And why shouldn’t they? We have members who are willing to pay some $2000/year more to BC/BS than they would pay GEHA for exactly the same coverage! In fact, this year it will cost subscribers who are loyal to BC/BS $2624.16/ year more for family and $1138.32/year more for individuals. And what do they get for the higher premiums? NOTHING. With GEHA you keep the same doctors, and same hospitals. The only thing that changes is your premium.

In past years it was difficult to select a carrier. We had to compare deductibles and copays for each plan and examine the list of preferred providers and participating physicians. Life became much simpler after Medicare – one of the advantages of aging. Once we are on Medicare, deductibles, copays, participating physicians and preferred providers are no longer an issue. Medicare pays their portion and our FEHB plan pays the rest – all of it. No deductibles, no copay, nothing. We can go to any physician in the country without looking at a list. The same is true for hospitals. In fact, before making a trip to Italy a few years ago I checked with GEHA on insurance. Since Medicare pays nothing when you are out of the U.S., GEHA picks up the entire medical cost – just like BC/BS.

So why did I pay $2256 more for BC/BS this year after preaching the advantage of post Medicare GEHA? You can be sure it had nothing to do with loyalty. The deciding factor was the cost of prescriptions. GEHA pays 50% and BC/BS pays $65 or $10 for a 90-day supply of brand name or generic drugs, respectively. With a prescription bill of more than $21,000 (one Rx alone costs $2000 for a 90 day supply) simple arithmetic pointed the way to BC/BS. But if you do not have huge prescription costs, GEHA is the obvious choice for you.

There is a change this year. GEHA still pays 50% toward prescriptions but with a maximum of 500.00 so I have to do the arithmetic again. Maybe I can switch back to GEHA. We had them for four years and only switched to BC/BC because our prescription costs took a gigantic leap.

It’s simple arithmetic, folks. Save yourself money and force BC/BS to work harder at controlling costs. As long as you are willing to pay an extra $218.68/ month (Medicare couples) or an extra $94.86/month for individuals on Medicare, BC/BS will never have reason to keep their rates competitive.

One final note: Our speaker from BC/BS mentioned the Blue Cross name as a criterion in selecting a plan. Nonsense! No one cares who pays after Medicare. The provider only bills Medicare and Medicare automatically passes the information on to the secondary insurer. They don’t even have to know who your secondary insurer is.

Nicholas Calvano November 20, 2009