Navigating Open Season

Federal Open Season is fast approaching, but the process of picking healthcare options is more confusing than ever for government employees. How do you navigate the blizzard of acronyms, conditions and terms for the best plan for you and yours?

“This money comes out of your pocket,” Sekou Mitchell, Federal Account Manager at Aetna, said during a GovLoop online training Tuesday. “It’s a very important decision. This is not one size fits all.”

This year’s Open Season begins Nov. 12 and ends Dec. 10, with the benefits government employees select starting Jan. 6, 2019. Mitchell said that this timeframe makes the process more stressful as it unfolds during the holidays.

“What’s the backdrop of Open Season?” he asked. “Thanksgiving and Christmas. Traditionally you have a very short amount of time and lots of distractions while making your selections.”

Mitchell said that federal employees must devote time to understanding what they’re buying during Open Season.

“The first thing I look at is price,” he said. “When you look at cars or outfits, you spend hours on it. Can you replace a car or cute shoes? Absolutely. You can’t replace your health and you can’t replace time.”

Mitchell also recommended that government employees educate themselves on healthcare’s unique language.

Deductibles, for example, are the amount paid out of pocket before your health plan pays benefits. Copays denote the set dollar amount paid for a healthcare service, while coinsurance is the set percentage amount for a healthcare service.

Another bewildering topic is whether your doctors are in-network or out-of-network. Mitchell said that the difference can greatly impact your wallet.

“Going to an in-network doctor you have the greatest benefits,” he said. “When you’re stepping out of network, just realize your benefits are reduced.”

Mitchell said that doctors participate with healthcare carriers that can add or drop them from your network at any time for multiple reasons. This results in unexpected costs for consumers.

“If you found a doctor you like, and you want to stick with them, ask them who they participate with,” he said. “Once you jump over that hurdle, you that’s when you use the online apparatus to find your carrier.”

Federal employees should determine whether their preferred doctor is on their network. From there, they should examine the available plans and select the choice best for them.

Mitchell said that people should examine their personal and family needs alongside the added benefits a plan offers. Some options include perks like gym memberships, coverage for alternative medicine and wellness rewards programs. Another consideration is whether packages contain standalone or incorporated dental and vision benefits.

“Who’s going to give you more bang for your buck?” Mitchell asked. “Who’s going to have more things you like? You really have to make that self-assessment on how you use your benefits.”

Aetna is a managed healthcare company that provides consumer-directed healthcare insurance plans, including the federal variety. AetnaFeds.com is a resource for journeying through this year’s Open Season.

Mitchell said that federal employees should always focus on their finances rather than the number of options facing them.

“Know the world you live in,” he said. “Understand your networks and what hospitals you are around. You don’t want to get into a situation where you over-insure yourself. It’s a good thing you’re a fed as you have a lot of options. It’s a bad thing you’re a fed as you have lots of options.”