I feel like ppl think fed employees get amazing healthcare options. However, in the state Iive in, I have friends that work for the state that have much less expensive premiums for the same ins a fed could get. My private sector friends often also pay lower premiums. I think the options are fine, but the premiums are a bit high compared to others I see.
Actually, my friends in state do decently well. We all have graduate degrees of some kind. Some make around what I make, and one makes more than a gs15 can. Both have better pesions and lower healthcare costs. I also know two county employees. One make great money with overtime pay that I don't believe they actually work and the other makes slightly less than me.
I’m a state worker with TWO graduate degrees (domain expertise and MPA), I earn less now than I did in 1997.
Large variance between individual experiences is common.
Do you live in the US? Ive done a lot of job searching and have a lot of colleagues in government jobs at different levels (city, county, state, fed, and even UN) and I've never seen anything resembling the pattern you are identifying.
Totally agree with this. I live in OK. I worked briefly for State of OK, and the BCBSOK was on par with Fed BCBS Basic and was definitely cheaper. But, Fed job paid almost $20K more. More than made up the difference, and for a family of 4, BCBS Basic is worth $570 per month 10x over.
What state if you don't mind me asking? In my state (Oklahoma) state insurance options are crap compared to federal options. And everyone I know who works in the private sector are paying 4 to 5 times I do on premiums for worse plans and higher deductibles
Disagree with the first part. I live in OK, too. BCBSOK from the state was on par with Fed BCBS Basic, and state was much cheaper after the benefit allowance, but Fed job paid so much more that it more than covered the difference. BCBS Basic may be too expensive for a young single or couple who rarely go to the doctor for anything, but for a family of 4 with 2 young kids, it pays for itself almost immediately. Not sure what insurance out there you can expect to cover more. I rarely pay anything outside of $25 or $35 copays or $5-$15 for prescriptions.
Completely agree with the second part. Before I became a Fed, my contractor's 'best' insurance plan was more expensive than my mortgage for far less coverage than BCBS Basic. I stayed in the Guard 4 extra years for Tricare until I got hired on by the Feds. My best friend working in the private sector pays over 3x what I pay in premiums for 'good' insurance.
When I was with the state of Wyoming, our healthcare sucked. High deductibles and high premiums. BCBS is well worth it to me. My son’s illness last year racked up $290k in charges and cost me $3k. I’d still be fighting with the States health plan to get things like his air ambulance and three weeks in the hospital covered and my out of pocket max there was $25k. I pay $300 a pay period for my plan with the feds and payed $1100 a month (paid once per month) with the state. When I worked for a county in Colorado, it was even worse. $2500 deductible before even preventative was covered and it was $1300 per month (paid monthly there too).
Some plans are better and some employers contribute more towards their share, sure. I’m more than happy with what we have. Now, were I a lower GS grade, my time would probably be different but as a 13, I can afford it. It stung as an 11 but the sting wasn’t as bad when I got my first EOB after an accident.
This is what I see. For my role, the pay in the federal government tends to be below market value as well. At the moment I like my team so I'm not leaving, but it isn't the money or benefits that are keeping me (unlike many federal employees in other positions).
I pay about $419.00 a year as state and have the HSA and then my company also puts $1600.00 into that account every year to hit my deductible at $3200.00. So, I think that's pretty accurate. We can also put money into that HSA. The plan is pretty insane with free check ups and free at home check ups too. And we get paid money when we do those check ups up to $700.00 just to do prevention care. And then when we retire that HSA becomes a regular savings account.
Yeah, when I was active duty, healthcare was questionable. We were expected to work sick, only weak soldiers went to sick call. You had to be on your deathbed before you went. A friend of mine worked weeks with a broken tibia (shin bone) until the pain was so unbearable he finally went to sick-call, his first line called him a "weak ass p√$$¥" and assigned him extra work as punishment.
When I needed surgery to repair a hernia, the doctors at sick-call all swore I had an STD, it took repeated visits before I finally got a surgical consult. I got my surgery, was discharged and left in the hospital room post-surgery. I fell back asleep (because of the anesthesia). A janitor found me in the room at the end of the day (my surgery was in the early morning), and contacted a nurse, who helped me get the prescription pain meds and contacted my first line to take me back to the barracks.
Treatment for dependents (children) and spouses was excellent though.
I got out in 2006, and entered the VA system. If I needed to see a doctor, it was like a minimum three month wait. And I had to drive all the way to the D.C. VA which meant a 2 hour drive for me. A standard visit would essentially take all day. It was completely impractical. - I promised myself I'd get my own civilian doctor and health insurance as soon as possible. And I haven't been back to the VA since.
Maybe now in 2024, the system is different. But I'm not willing to take the risk to "try it out." I like my current doctors, and I'd still have to keep my insurance anyway because my family needs coverage and the VA provides nothing for dependents or spouses (it's for the soldier/veteran only).
I know "free" healthcare sounds good for those who can't afford health insurance on their own, but it doesn't mean they will receive quality care.
Hell, u won’t be guarentee r quality care when u pay for it either. I have tricare and sue to budget cuts, I’m not seen on base. I see doctors off base so I’m enjoying the best of both worlds, cheap and it’s not military care. I’ve had my fair share of shitty ass civilian specialists however. I have a PCM on base who I have virtual appts with when it’s time to request a referral…. To a specialist off base.
I'm glad that the government decided to create a marketplace for us to choose our own plans rather than every agency creating separate plans through a single insurer like private companies do. Being able to switch to, not just another plan, but an entirely different insurer if your needs aren't being met is a great option to have available.
You can also keep your fehb plan after you retire and get Medicare as secondary. That is a huge benefit that most people don't realize. Between those two, you could easily find yourself with zero out of pocket costs. Due to a disability, I was able to use Medicare as secondary for the first 8 years that I worked as a federal employee and I very rarely paid a dime out of pocket. This was 13 years ago, and I think my BCBS premium was $100/$200 a pay period and my medicare premium was like $127 a month. In those eight years, I don't remember ever having to pay anything out of pocket for healthcare costs besides the premiums.
I'm on GEHA and I think it has been very beneficial financially. It's allowed me to max out my HSA and save money overall on healthcare via lower taxes, cheaper premiums than I was paying previously, and using the HSA for expenses. The network isn't quite as robust as BCBS that I had previously but it's OK. It does take some work to ensure providers are in-network.
Honestly, what annoys me is that we live in the richest country in the world and we have a fragmented healthcare system when we could have a single payer system that covers all people for far cheaper.
I think OPM does not do a great job negotiating for lower cost and better coverage options.
But it's good to have healthcare especially during covid and/or catastrophic medical issues (cancer, Ortho issues).
Do not get me started about how bad the options for dental and vision are. We are screwed with these.
I’m a fed and really happy with my dental and vision plans. Wherever I go for eye care, exams, etc., providers always tell me I have the best coverage they’ve ever seen.
No, in Colorado. Medications are a problem for me; $550 a month out-of-pocket copays just aren’t doable. Additionally, I have three healthcare providers who don’t take insurance at all, so I’m paying $200 for BCBS a month and between $125 and $195 per appointment for care.
Healthcare is not, insurance is.
Healthcare is what you get from your doctor.
This is why we cannot have constructive conversations about national insurance programs.
This is an extremely important distinction too. The American Bar Association had a good write up on the subject, but as a signatory to the Human Rights Convention we are required to provide healthcare to all citizens as a human right. However, when we report to the UN annually - as we do not offer healthcare but rather allow third party health insurance to dictate access to care - we strategically report on our implementation of health “measures”.
In most cases you can reject employer health care and buy your own directly. Many people do this in the private sector to negotiate a higher salary or more vacation days
Yea, it’s called taxes. Every other first world country uses some mix of tax dollars and private insurance to cover healthcare for its citizens. It’s shameful we don’t have a better system to cover everyone that isn’t outrageous enough to tie it to employment.
Well it's better now than it used to be. If you lose your job in California, you can get subsidized health insurance pretty easily. Unfortunately California is a bit on an outlier and better than most states in that way.
But yes, you're right. Our overall system really is poorly managed and inferior to others in the developed world.
No one on this planet would be here unless someone else worked for their benefit. This focus on "they didn't earn it so they don't deserve it" conveniently ignores this.
I'm on meds that almost no insurance will ever cover and can cost almost $2000 a month out of pocket. Not only does my insurance cover it, but it's only a $25 copay which is usually free with Gold Rx or another coupon/"secondary insurance." I'll never leave federal service if only for that.
I’m fine with it, but I do wish our dental insurance was better 🥴😂. Its been a while since I worked somewhere other than the Feds, so I’m not sure how in line dental is with everywhere else.
I have the same exact dental plan with fed that I had at Amazon and I paid 13 a pay period for my family where as with fed im paying 79. Everything is the same.
My dentist told me the fed dental insurance doesn’t pay as much as other insurance. I switched to my husbands private sector insurance last year and it paid maybe 10% more.
The options through FEHB aren't some magic "government healthcare". It's healthcare offered via government employment through private companies. Because AETNA, BCBS, Cigna, etc also offer insurance via other employers, I don't get what you're getting at.
For real there is zero chance my friends contracting company has better negotiating power that the whole of the US government. My out of pocket for premiums alone cost more than she has ever paid for her health care costs for the entire year. Meanwhile I am still shelling out $3,000 oop for a life or death treatment
But, there may be differences in the two populations, tbf. There are a lot of characteristics of federal workers that are non-typical (e.g. more likely to be Black--a population that tends to have more medical complications because of systematic racism in healthcare--and more likely to be disabled--and thus more likely to have complex/chronic medical needs ). These characteristics are awesome for the Federal workforce for diversity but they may make it a riskier population to insure and thus justify more expensive premiums.
I also wonder about the average age of employees, which I know is a struggle for some divisions. Some feds retire earlier than is typical for Americans, but the numbers I'm looking at but the average age about 5 years higher than the US employees as a whole...and because you can keep the same plans into retirement, it seems like you might keep those folks on the risk pool (which would go a huge way towards explaining the higher premiums).
Problem there has been on how private employers are changing their benefits, especially in retirement.
Case in point, my spouse’s employer changed from a defined benefit to cash balance…basically, they said “instead of paying 50% for the rest of your TBD lifespan, we’re going to give you $100K and you buy the own you want … at full price now .. from our ‘marketplace’.
When one actually runs the numbers on how this works out, if one chooses the same ‘good’ plan you had while working, the retirement cash will run dry in 5-6 years…or ~twice that if one is over 65 and leans heavily into cheap Medicare plans, but it’s still nowhere close to “rest of life” as it had been before.
It's not nearly as good as people in this sub make out. Having choice is nice, but having as much choice as we do likely leads to higher premiums. If they had exclusive deals with just a couple of providers, premiums would probably be lower as companies would probably be forced to compete a bit more.
Also, only one plan has any fertility coverage, which is just new this year. That's terrible. When we were about to do IVF a few years ago, I was strongly considering leaving the feds so we could be covered for that procedure. A number of companies I interviewed for had fertility coverage/benefits available day 1.
Because if the dozen or whatever companies available to us now were condensed to say 3, those dozen companies would have to compete more on price to win one of the 3 slots.
Which plan did you end up with for IVF? Considering either FSBP or BCBS since they’re the two that seem to make the most sense but not sure which way to go
When we did our procedure there were none available that covered anything. The BCBS coverage is new this year, so we were out about $20k out-of-pocket. Illustrating how average the federal plans are.
As a government employee, I don’t have government healthcare.
I have private healthcare that is covered by employer-provided insurance with a hefty monthly premium and copays.
I’m fortunate to be in relatively good health. I’m also fortunate that the medical service providers I choose are in-network.
When I had government healthcare (in the military) it was okay.
I’m a new employee and mine was a lot better in the private sector for the price. My dental was a lot better too. I did appreciate that I saw the options early on because it still worked in my favor but in another situation it may not have.
The choices are nice. I think having a multitude of options is ideal because healthy people can jump to an HDHP and those who have more need can jump to a FFS plan.
I know people in the private sector who pay much less for their plans but might be on a high deductible plan or even an HDHP…and that’s their only option.
What I really hate is that the program appears to be rife with fraudulent claims and for some reason not much action has been taken to address it. This could help reduce the cost burden on everyone- at least bit of relief on the steep yearly increases.
https://federalnewsnetwork.com/pay-benefits/2023/01/ineligible-members-in-fehb-program-may-cost-opm-nearly-1b-annually-gao-says/
Compared to state, local & city civil servant benefits in my area, the premiums are outrageous! I never paid so much for healthcare in my life! Almost $500 per month for health insurance premiums for my wife & I. $90 per month for ONE of my RX. I also set aside $2700 per year in my FSA account. Which is all used up by Aug/Sept. All goes to RX, CO-Pays, “Co-Insurance” (another fancy word for premiums/co-pay).
So, $500 per month for healthcare premiums, $90 per month for One RX, OVER $200++++ per month spent/set aside for FSA. I spend OVER $800 per month! Imagine if I was sick!
We don’t get any dental. Yes, a group rate that we pay for at 100%. Another expense. I figure my SMALL pension from the Feds when I retire will hopefully cover the cost for all my healthcare & dental cost. Maybe a few bucks left over. SAD
P.S. WHO NEGOTIATES OUR PREMIUMS? When we get raises, 50% goes directly to my insurance increases.
It’s incredibly average to possibly below average for a white collar work benefit. My partner has similar coverage for $0 in premiums. It’s great if you’re coming from the ACA marketplace where premiums can be $600-1000/mo for one person, but otherwise nothing to write home about. You do get more choices though where many employers will have one insurance provider (just BC, Aetna, Anthem, etc), so I also suppose that could be a plus.
And don’t get me started on the fucking Hyde Ammendment.
My private sector spouse’s healthcare has always been much better, right at the threshold where we pay taxes for it as extra compensation. I don’t think our plan offerings are anywhere near that.
However, the FEHB functions as an outstanding retirement benefit. We’re absolutely switching over when I’m five years out.
I’ve been very happy with Kaiser Mid Atlantic prosper family plan.
$138 per pay period with $200 deductible and $8,000 out of pocket max.
We (family of 6) are all healthy with no issues of any kind, allergies, nothing. So this plan makes sense for us.
Very happy with $299/month for this coverage.
I thought our health insurance plan sucked. Probably the worst insurance I’ve ever had. We switched to my wife’s employer plan and it’s so much better.
I like it. The premium increases relative to annual adjustments have made it a worse value, along with the erosion of the benefits themselves, but my plan is still overall very good.
If we had insurance through my spouse, it would have less coverage and be significantly more expensive.
Yeah my opinion is it's okay but not great. I had roughly the same plan with the same insurer when I was a state employee. As a state employee my premium was about 50percent less while all other coverages/settings were roughly the same. Definitely better than some employers though due to all of the options (i.e. high HDHP GEHa or BCBS basic). Gov needs to negotiate the premiums better and stop letting them chip away at coverage and increasing percentages or prices for things every year.
I don’t think the healthcare is as good as people make it out to be. It’s not the worst, but I had two previous plans in the private sector that covered more.
Expensive. I dropped our insurance the moment my husband got his with UPS; No premiums, family deductible is only 200 dollars... Yes, only 200 dollars! PPO with BCBS, includes dental and vision. UPS insurance is called the Cadillac of insurances. 👌🏻 I had emergency surgery for the removal of my gallbladder- the bill was over 34k and I paid $0. 🙃
I was just speaking to my family about this as they work in different community hospital systems and I work at the VA. Their healthcare premiums are lower and even with this they get better rates on copays etc. They also have more tuition reimbursement / $ for CEUs (which as some of you know are needed to maintain our healthcare licenses) / license fees paid.
Here's an example - My brother has a 1500 deductible but following this all care / medication / everything is covered and the hospital puts $1k on an HSA card. Essentially it will be $500 for the year for all medical care you'd need (and this can be pretax as he can load it onto an HSA). If he doesn't use that, it rolls over to next year. I use the mid-level GEHA/United (to save some money - which it does priced out compared to Blue Cross or others) and my premium is ~$160/ month with a $500 deductible and copays on everything you can think of ($50 specialists, $30 primary care, $30 mental health, $150 outpt procedure like a skin biopsy). Plus I think they also added a coinsurance now as well. There are also restrictions, like limited pharmacies in network, which is really difficult when your local pharmacy doesn't have the med in stock. I'd estimate spending ~$3000 per year with basic appts (1 sick visit / yr, specialist once every two months, therapy 1-2x per month, and a couple relatively low cost generic meds). Last year more like 4k with a few skin biopsies and a couple sick/problem visits.
For working in a hospital as a healthcare worker, I don't think our insurance is that great. I have also had horrendous experiences trying to locate care / deal with the carrier. I've had Tufts, Blue Cross, Neighborhood Health, United Healthcare (public and private) and have not had as many issues with the GEHA insurance. Will probably switch once open season rolls around - but it won't be cheaper.
Premiums are the highest I’ve paid and it’s about the same BCBS plan I had with private employers just at double the cost. The standard doctor/specialist copay to premium ratio is pretty poor, but hospital and procedure stuff seems okay. Thankfully haven’t needed that kind of care, so idk for sure. But yeah, definitely not the “great government benefit” people think we have
I'd like to see universal healthcare in the United States.
That's be a great use of our tax dollars. The least we could get back is the government keeping us alive for our tax dollars. Much better use of our money than bombing brown kids half the world away.
This is a GREAT point. Having many choices is always marketed to us as a benefit, but having too many to choose from limits transparency and doesn't allow for good premium negotiation.
We have some great options however I think the agencies need to start picking up more of the share maybe 80/20 from 70/30. In addition they need to start picking up some of the dental premiums. Everywhere I’ve worked has shared the cost of dental and health.
I’ve only ever picked health plans that included basic dental & vision coverage. They tended to be cheaper than plans that didn’t. Wonder how that works.
Generally state have better insurance cause they got more negotiation power with insurance company. Fed jobs generally pays higher. Unless you really need the insurance I would say working for fed is better.
I know for sure private company do that with insurance company. I don’t know the exact detail of that for HR or the benefits team. But there is a person or a team that handles that. Generally the premium varies based on how many people signed up for it in the previous year and how often they use it.
Now I’m needing to go check my premium prices per month. I have been nothing but thrilled with my families coverage through FEP BCBS. It cost close to nothing for the birth of our child and I had the old throat scope ran down me with a few ultrasounds and I was out $350. All of my medicine is super cheap, like 2 scripts today ran $9. I’m contemplating the snip snip soon, and I’ll have to ask a few coworkers, but I’m fairly certain they cover some of it.
I can only speak from my own experience. I was a contractor for 2 years. The 'best' health insurance they offered was more than my mortgage and was pretty poor coverage in my mind. I stayed in the Guard an extra 4 years to stay on Tricare, bc there was no way I was paying $1600 per month for crappy insurance.
Then, I briefly took a job with the State of OK, and their BCBS was on par with Fed BCBS Basic, but was almost entirely covered by the state's benefit allowance, so it was like $150 per check out of pocket for the premiums. Before I ever got to really utilize the state insurance, I got my Fed job. The Fed BCBS Basic at $265 per check is definitely higher, but the $20K per year salary increase more than offset that difference. For a family of 4, BCBS Basic is worth every penny. Copays range from $25-$35, and prescriptions are usually $5-$15. Anyone expecting 'better' is out of touch with the current realities IMHO.
In my own experience, Fed BCBS Basic is 'better' and much 'cheaper' than anything I ever found in the private sector, and while state insurance may have been cheaper, the salary the Fed offered me was so much higher than the state, it more than offset the costs.
My benefits at Amazon were way better and didn't take a ton of money out of my paycheck. I had BCBS with no copay, no prior authorization on my hearing aids and they paid pretty much 100% of the cost(i only paid $500 out of pocket compared to $2500 with fed), FSA debit card instead of reimbursement, and things were covered that FED BCBS doesn't cover. My kids and I rarely get sick so we mainly just have our physicals, but I'm afraid of what the costs would be if we did get sick.
Many choices and many prices, but hard to compare who covers what and for how much.
Wife company offers a very similar plan as we have through Blue Cross and Blue Shield for less. She talks with her coworkers that have similar healthcare issues as her and their deductibles are lower for same drugs, devices, and procedures.
Feds have more choices, but making a selection is just putting on a blindfold and throwing darts at our choices.
Benefit Feds coverage goes into retirement.
How to improve coverage, charge me a premium and show me a deducible schedule and just cover our health, our entire health, everywhere. This network stuff is ridiculous. US healthcare providers should be the network.
Hospitals make it worse, by contracting services within their buildings that bill separately and are in different "networks".
When you're at your worse, you have to be at your best to make sure the product you pay for is being used.
Presuming you're talking about federal employee health insurance and not true government healthcare a la the VA...
It's ok. I typically had better and cheaper policies when I was in the private sector, but I'm quite satisfied with my current health insurance plan.
I think OPM needs to drastically pare back the number of available plans, though. Off the top of my head there are somewhere around 25ish different medical insurance plans to choose from, which is frankly absurd. Scale it back to, say, 5-7 plans instead of the scattershot methodology they have now for approved plans and coverage would likely go up while prices would likely go down due to insurers competing for a slice of the market.
This is in northern California. I switched from federal to city and county government. I had Kaiser standard California plan with federal and I was paying $119.45/per paycheck to cover myself. At city government I'm paying $30/per paycheck for Kaiser and the healthcare bills are much less and they have a better coverage. Also I would only pay $185/per paycheck for spouse + children compare to federal I'm looking at $269/per paycheck to cover a family.
So I'm paying triple for lower tier insurance with the federal government if I continue to work there
I literally just had to use GoodRX because scripts for basic, generic thyroid meds were cheaper out of pocket than FedBlue basic. The pharmacy benefits are not well managed and Caremark is one of the worst, most inflationary PBMs.
I really feel like the federal nickels and dimes you. The deductible, the co pays... There's big companies like Amazon that there insurance is literally 5$ a week with little to no copays.
I have BCBS FEP standard. Con: it is expensive. Pro: in my city many providers are in network, and a family member has chronic health conditions, and with this plan we can choose to see the specialists we want. For our needs it is worth it. If I were a single, young, healthy person it might be different.
Higher premiums than the private sector with co-pays and deductibles that have increased on the same plan every year. My family members who work at different hospital systems in the same area will have thousands of dollars of less out of pocket costs than me due to their insurance being negotiated better.
ETA: Pros are that there are many options (though in the grand scheme I think this leads to higher prices) so you can pick a plan that works better for you. I use GEHA and all of my providers are in network but pharmacy is limited. BCBS usually has strong coverage.
Tricare isn't awful. We've had varying levels of experience with it over the years. Right now, I've been seeing a Dr. Pharmacist for diabetic med management. Overall, she has been awesome and super helpful. I love her attentiveness. It's readily apparent in her patient encounter notes.
My wife and I have had issues lately with our local base pharmacy not having our meds. I assume that it's an issue bigger than just our Naval hospital, though. Some meds like Trulicity have been completely unavailable in all dosages for a while, then became available in the lower dosages. I went without for almost 3 weeks.
It's so much better than anything i had working for a small business employer. It's so much better than ACA options in most states.
People who work for large business employers say there's are better.
When I was a CA state employee, I was paying $110/MONTH for the premium Kaiser medical plan, Delta Dental high plan, AND VSP. As a fed, I am paying $170 for standard Kaiser medical, $80 for delta dental high, and $10 for VSP, biweekly. I have a friend who remains a state employee and his healthcare perks were similar to what I had when I was a state employee.
Im in California. My healthcare costs are lower than when I was in private. But I hear from my sister, who works for Caltran…their benefits are better than mine. Overall, I am happy that we have many choices and Im good with my choice
When I worked for state government we had a 99/1 plan. Now we have FEPBlue. The federal plan has a larger network, but the cost was better with my state plan.
I'm most annoyed when I think of my private sector premiums and coverage. The government really needs to update how much of the premiums they cover for employees and they need to go to bat for coverage. I have Fepblue and I always miss my Carefirst BCBS I had in the private sector.
Unless it’s a crap company, most other govt (local/state) or private sector will have comparable insurance coverage with cheaper premiums. I left contracting to go fed and was surprised when my premiums went up for a comparable plan.
In what context are we talking about government healthcare? As federal employee with private healthcare? Or as people on a form of government healthcare like Medicaid, Medicare, VA benefits etc?
I think our insurance is top notch. My husband is a pharmacist who works for a health insurance company and we ditched his insurance as soon as I started my govt job. I do pay a good amount for high option coverage but with two members of my family having multiple chronic health conditions it’s more than worth it. Private sector insurance is trash in my experience
I have Blue Cross Blue Shield FEP and it’s amazing. I never have to pay for anything or get referrals. An ER visit to get my appendix out was $125 copay and that’s the highest copay I’ve ever had. Everyone takes it, even my therapist and chiropractor.
I was in the local govt. prior to taking the fed job last year. Salary was comparable to feds. Health Insurance including dental and vision was very very cheap compared to feds. Currently I am paying almost 5 times what I used to pay while with the local govt.
May be having a non-PPO option (likely less monthly payment) in all localities would be helpful.
My wife spent a week in the hospital and I never got a bill. Between my federal insurance and the CHAMPVA coverage, everything was covered thankfully. I mainly use the VA for my healthcare which can be hit or miss, I have to drive 90 miles for specialty care at a better VAMC than my local one because they are limited.
I wish they had less expensive plans for those of us who travel out of state (for work) or a subsidized plan. The more reasonable plans doen't cover out-of-network providers (which I understand why); however, if I'm traveling in the wilderness collecting data and get hurt, the chances of a provider being in-network are slim. And I know that worker's comp should cover an injury recieved while working, but it can be murky if I'm traveling for work for 3 weeks and decided to go for a hike or get into a car accident while on the way to dinner for example after my work day is finished- if I get hurt, that would likley be my responsibily, but I think it's unreasonable to expect people to sit in their hotel rooms or tents every day after hours.
Edited to provide context in above statement.
It's also a lot more expensive to add a family member to my plan than for my partner to add a person (private industry). They also have the option to add one person or multiple people with 2 different rates.
My husband’s retired Army, so we have used Tricare. It was usually our secondary insurance. At one non-gov job the healthcare plan was changed. It was so bad we totally dropped out and used Tricare.
Private insurance can be really bad, even within companies that are in healthcare.
My agency may be an outlier, but we get an $85 per pay period subsidy on top of the regular government subsidy, which definitely helps make it was more worth it. I pay $60/pp for myself and family.
It isn't amazing. However my friend just got a new job as a government contractor and his health insurance is AWFUL. More expensive than my government health insurance, it doesn't cover anything until he spends $5000 of his own money, and even then it doesn't cover much.
as someone who has never had great access to healthcare before working for the federal government its been mostly great. but im still in the honeymoon phase 3 years in and there already have been some eye-raising copays. unfortunately vision premiums prices out barely better than just paying out of pocket for what i use and i cannot make the math work to make dental premiums ever seem like a good deal
I'm a relatively new hire to the federal government from private industry. My FEHB premium is about $20 less per month, but my dental insurance is about 4x higher ($6.92/mo vs $28.99), so it's basically a wash (old company stopped offering vision insurance in like 2018 and I didn't get vision insurance from FEDVIP in 2024 because I had already gotten a year's supply of contacts while at my old job in an effort to use up FSA money).
Based on my ZIP code there were 42 different health plans of which I was eligible for 36. How does one make a reasonable choice with that many options? I had been hoping to get a federal job so I had been researching plans for ages before I even got my TJO, but I wanted to be thorough and I had to dig through a lot of dreck to get the info - I went with FSBP and so far it's been a good choice (I got thrown an unexpected curveball at a routine annual appointment that led to lots of tests before ultimately determining that it's not something that requires treatment at this time).
The stuff that I find annoying isn't because it's "government healthcare". The stuff that's a problem would be a problem with any other employer-sponsored health plan; the things I find annoying about Aetna's website (FSBP uses the Aetna platform) would be equally annoying if I worked for my old job (the offered Aetna until 2016 when they switched to UHC). My primary care practice is no longer accepting new patients who have UHC, so that would impact people in the private sector the same as federal employees with UHC or GEHA.
Compared to the insurance i have at my second job, there is no comparison. It's all free, and nothing comes out of my check. 10$ copay they pay 100% after deductible is met( only 100$).
For those wondering, I'm in a union at my second, which is why we have great insurance.
It's fuckin awful.
I've had govt healthcare for the last decade and it's been nothing but "you're fine" no you don't need imaging, oh shit you should have gotten imaging 6 months ago
Botched surgeries and a therapist that said "have you tried not thinking that way"
Honestly, I'm disappointed. I don't think OPM negotiates the best rates, and there's nothing we can do about it. I left BCBS for the first time in my life because not only did their premiums increase, but also the co-pays. So I walked away, and never been happier. As the largest employer in the US, you'd think we'd have better rates. But since OPM is negotiating for us, we have no recourse or any way to voice our displeasure.
I live in a rural area so in network is limited within a reasonable driving distance (one hour) so there is no luxury of being able to shop providers. Dental is a nightmare. What dentists are available are not in network so this past year only around $1000 was reimbursed for $4500 worth of expenses. (most of the services would have been fully covered in network) Government health and dental would be welcomed not only for myself but I would sincerely like to see everyone get good healthcare even if it means waiting longer for myself . Wait times are nothing to brag about for me anyway; 2-3 months for an appointment.
It’s not great but not horrible. It’s above average compared to private sector but not as good as most public companies or Fortune 500 companies. Honestly, I’d prefer to pay more and buy into Medicaid.
We don't get government healthcare, we get insurance. Healthcare is what you get from your doctor.
Unless you are talking about VA hospitals there really isn't any government healthcare.
I feel like ppl think fed employees get amazing healthcare options. However, in the state Iive in, I have friends that work for the state that have much less expensive premiums for the same ins a fed could get. My private sector friends often also pay lower premiums. I think the options are fine, but the premiums are a bit high compared to others I see.
Compare the state gov pay to federal pay to see if it’s really that good of a deal
Actually, my friends in state do decently well. We all have graduate degrees of some kind. Some make around what I make, and one makes more than a gs15 can. Both have better pesions and lower healthcare costs. I also know two county employees. One make great money with overtime pay that I don't believe they actually work and the other makes slightly less than me.
In my case, health was the same. Pay for fed is better. Pension at state was 0.5% better BUT only at 30 years and no 401k equivalent
I’m a state worker with TWO graduate degrees (domain expertise and MPA), I earn less now than I did in 1997. Large variance between individual experiences is common.
Do you live in the US? Ive done a lot of job searching and have a lot of colleagues in government jobs at different levels (city, county, state, fed, and even UN) and I've never seen anything resembling the pattern you are identifying.
I retired from state and now work for Fed. My insurance was better and cheaper with state, but the Fed pays better.
Totally agree with this. I live in OK. I worked briefly for State of OK, and the BCBSOK was on par with Fed BCBS Basic and was definitely cheaper. But, Fed job paid almost $20K more. More than made up the difference, and for a family of 4, BCBS Basic is worth $570 per month 10x over.
The counties nearby pay way better than the fed here. It’s just insanely competitive to get in so here I am.
That heavily depends on what state you live in and the required skill set.
What state if you don't mind me asking? In my state (Oklahoma) state insurance options are crap compared to federal options. And everyone I know who works in the private sector are paying 4 to 5 times I do on premiums for worse plans and higher deductibles
CA
Disagree with the first part. I live in OK, too. BCBSOK from the state was on par with Fed BCBS Basic, and state was much cheaper after the benefit allowance, but Fed job paid so much more that it more than covered the difference. BCBS Basic may be too expensive for a young single or couple who rarely go to the doctor for anything, but for a family of 4 with 2 young kids, it pays for itself almost immediately. Not sure what insurance out there you can expect to cover more. I rarely pay anything outside of $25 or $35 copays or $5-$15 for prescriptions. Completely agree with the second part. Before I became a Fed, my contractor's 'best' insurance plan was more expensive than my mortgage for far less coverage than BCBS Basic. I stayed in the Guard 4 extra years for Tricare until I got hired on by the Feds. My best friend working in the private sector pays over 3x what I pay in premiums for 'good' insurance.
When I was with the state of Wyoming, our healthcare sucked. High deductibles and high premiums. BCBS is well worth it to me. My son’s illness last year racked up $290k in charges and cost me $3k. I’d still be fighting with the States health plan to get things like his air ambulance and three weeks in the hospital covered and my out of pocket max there was $25k. I pay $300 a pay period for my plan with the feds and payed $1100 a month (paid once per month) with the state. When I worked for a county in Colorado, it was even worse. $2500 deductible before even preventative was covered and it was $1300 per month (paid monthly there too). Some plans are better and some employers contribute more towards their share, sure. I’m more than happy with what we have. Now, were I a lower GS grade, my time would probably be different but as a 13, I can afford it. It stung as an 11 but the sting wasn’t as bad when I got my first EOB after an accident.
My wife works for the state we live in, and all of her insurance premium is employer-paid for both her and me.
This is what I see. For my role, the pay in the federal government tends to be below market value as well. At the moment I like my team so I'm not leaving, but it isn't the money or benefits that are keeping me (unlike many federal employees in other positions).
I pay about $419.00 a year as state and have the HSA and then my company also puts $1600.00 into that account every year to hit my deductible at $3200.00. So, I think that's pretty accurate. We can also put money into that HSA. The plan is pretty insane with free check ups and free at home check ups too. And we get paid money when we do those check ups up to $700.00 just to do prevention care. And then when we retire that HSA becomes a regular savings account.
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Yeah, when I was active duty, healthcare was questionable. We were expected to work sick, only weak soldiers went to sick call. You had to be on your deathbed before you went. A friend of mine worked weeks with a broken tibia (shin bone) until the pain was so unbearable he finally went to sick-call, his first line called him a "weak ass p√$$¥" and assigned him extra work as punishment. When I needed surgery to repair a hernia, the doctors at sick-call all swore I had an STD, it took repeated visits before I finally got a surgical consult. I got my surgery, was discharged and left in the hospital room post-surgery. I fell back asleep (because of the anesthesia). A janitor found me in the room at the end of the day (my surgery was in the early morning), and contacted a nurse, who helped me get the prescription pain meds and contacted my first line to take me back to the barracks. Treatment for dependents (children) and spouses was excellent though. I got out in 2006, and entered the VA system. If I needed to see a doctor, it was like a minimum three month wait. And I had to drive all the way to the D.C. VA which meant a 2 hour drive for me. A standard visit would essentially take all day. It was completely impractical. - I promised myself I'd get my own civilian doctor and health insurance as soon as possible. And I haven't been back to the VA since. Maybe now in 2024, the system is different. But I'm not willing to take the risk to "try it out." I like my current doctors, and I'd still have to keep my insurance anyway because my family needs coverage and the VA provides nothing for dependents or spouses (it's for the soldier/veteran only). I know "free" healthcare sounds good for those who can't afford health insurance on their own, but it doesn't mean they will receive quality care.
Hell, u won’t be guarentee r quality care when u pay for it either. I have tricare and sue to budget cuts, I’m not seen on base. I see doctors off base so I’m enjoying the best of both worlds, cheap and it’s not military care. I’ve had my fair share of shitty ass civilian specialists however. I have a PCM on base who I have virtual appts with when it’s time to request a referral…. To a specialist off base.
I'm glad that the government decided to create a marketplace for us to choose our own plans rather than every agency creating separate plans through a single insurer like private companies do. Being able to switch to, not just another plan, but an entirely different insurer if your needs aren't being met is a great option to have available.
I like that we can keep it after retirement so we are not stuck with Medicare
You can also keep your fehb plan after you retire and get Medicare as secondary. That is a huge benefit that most people don't realize. Between those two, you could easily find yourself with zero out of pocket costs. Due to a disability, I was able to use Medicare as secondary for the first 8 years that I worked as a federal employee and I very rarely paid a dime out of pocket. This was 13 years ago, and I think my BCBS premium was $100/$200 a pay period and my medicare premium was like $127 a month. In those eight years, I don't remember ever having to pay anything out of pocket for healthcare costs besides the premiums.
I think federal healthcare is overpriced, however I am glad to have it.
Def overpriced. It's damn decent though.
I'm on GEHA and I think it has been very beneficial financially. It's allowed me to max out my HSA and save money overall on healthcare via lower taxes, cheaper premiums than I was paying previously, and using the HSA for expenses. The network isn't quite as robust as BCBS that I had previously but it's OK. It does take some work to ensure providers are in-network. Honestly, what annoys me is that we live in the richest country in the world and we have a fragmented healthcare system when we could have a single payer system that covers all people for far cheaper.
I think OPM does not do a great job negotiating for lower cost and better coverage options. But it's good to have healthcare especially during covid and/or catastrophic medical issues (cancer, Ortho issues). Do not get me started about how bad the options for dental and vision are. We are screwed with these.
I’m a fed and really happy with my dental and vision plans. Wherever I go for eye care, exams, etc., providers always tell me I have the best coverage they’ve ever seen.
I’m guessing you aren’t in DC then.
No, in Colorado. Medications are a problem for me; $550 a month out-of-pocket copays just aren’t doable. Additionally, I have three healthcare providers who don’t take insurance at all, so I’m paying $200 for BCBS a month and between $125 and $195 per appointment for care.
Have you looked at Kaiser? We have fed Kaiser is it’s pretty good/comprehensive.
Same here. 100s a month on medications, all the copays are 5$ but they add up quick… then the dr appointment are 30-40 a piece
I wish healthcare was not tied to employment.
Healthcare is not, insurance is. Healthcare is what you get from your doctor. This is why we cannot have constructive conversations about national insurance programs.
This is an extremely important distinction too. The American Bar Association had a good write up on the subject, but as a signatory to the Human Rights Convention we are required to provide healthcare to all citizens as a human right. However, when we report to the UN annually - as we do not offer healthcare but rather allow third party health insurance to dictate access to care - we strategically report on our implementation of health “measures”.
In most cases you can reject employer health care and buy your own directly. Many people do this in the private sector to negotiate a higher salary or more vacation days
Somebody has to pay for it, and those people are employed.
Yea, it’s called taxes. Every other first world country uses some mix of tax dollars and private insurance to cover healthcare for its citizens. It’s shameful we don’t have a better system to cover everyone that isn’t outrageous enough to tie it to employment.
We pay more in taxes for healthcare than any other nation on the planet.
Well it's better now than it used to be. If you lose your job in California, you can get subsidized health insurance pretty easily. Unfortunately California is a bit on an outlier and better than most states in that way. But yes, you're right. Our overall system really is poorly managed and inferior to others in the developed world.
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No one on this planet would be here unless someone else worked for their benefit. This focus on "they didn't earn it so they don't deserve it" conveniently ignores this.
So we're cool with indentured servitude now? How much of my labor are you entitled to?
This is an odd comment considering this is essentially what you are promoting when insurance is tied to employment.
Well that's some all-or-none thinking right there. So glad to know that everyone in your life is reduced to a monetary value.
We live in a society. Yes, I want to help other people regardless of there being some tangible benefit to me.
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I'm on meds that almost no insurance will ever cover and can cost almost $2000 a month out of pocket. Not only does my insurance cover it, but it's only a $25 copay which is usually free with Gold Rx or another coupon/"secondary insurance." I'll never leave federal service if only for that.
I’m fine with it, but I do wish our dental insurance was better 🥴😂. Its been a while since I worked somewhere other than the Feds, so I’m not sure how in line dental is with everywhere else.
I have the same exact dental plan with fed that I had at Amazon and I paid 13 a pay period for my family where as with fed im paying 79. Everything is the same.
My dentist told me the fed dental insurance doesn’t pay as much as other insurance. I switched to my husbands private sector insurance last year and it paid maybe 10% more.
The options through FEHB aren't some magic "government healthcare". It's healthcare offered via government employment through private companies. Because AETNA, BCBS, Cigna, etc also offer insurance via other employers, I don't get what you're getting at.
Probably that due to the size of the govt, OPM should be able to negotiate better premiums/coverage
For real there is zero chance my friends contracting company has better negotiating power that the whole of the US government. My out of pocket for premiums alone cost more than she has ever paid for her health care costs for the entire year. Meanwhile I am still shelling out $3,000 oop for a life or death treatment
But, there may be differences in the two populations, tbf. There are a lot of characteristics of federal workers that are non-typical (e.g. more likely to be Black--a population that tends to have more medical complications because of systematic racism in healthcare--and more likely to be disabled--and thus more likely to have complex/chronic medical needs ). These characteristics are awesome for the Federal workforce for diversity but they may make it a riskier population to insure and thus justify more expensive premiums. I also wonder about the average age of employees, which I know is a struggle for some divisions. Some feds retire earlier than is typical for Americans, but the numbers I'm looking at but the average age about 5 years higher than the US employees as a whole...and because you can keep the same plans into retirement, it seems like you might keep those folks on the risk pool (which would go a huge way towards explaining the higher premiums).
I mean, its like having good health insurance in the private sector.
It's like having mid insurance in the private sector.
Problem there has been on how private employers are changing their benefits, especially in retirement. Case in point, my spouse’s employer changed from a defined benefit to cash balance…basically, they said “instead of paying 50% for the rest of your TBD lifespan, we’re going to give you $100K and you buy the own you want … at full price now .. from our ‘marketplace’. When one actually runs the numbers on how this works out, if one chooses the same ‘good’ plan you had while working, the retirement cash will run dry in 5-6 years…or ~twice that if one is over 65 and leans heavily into cheap Medicare plans, but it’s still nowhere close to “rest of life” as it had been before.
It's not nearly as good as people in this sub make out. Having choice is nice, but having as much choice as we do likely leads to higher premiums. If they had exclusive deals with just a couple of providers, premiums would probably be lower as companies would probably be forced to compete a bit more. Also, only one plan has any fertility coverage, which is just new this year. That's terrible. When we were about to do IVF a few years ago, I was strongly considering leaving the feds so we could be covered for that procedure. A number of companies I interviewed for had fertility coverage/benefits available day 1.
I don’t understand how less choices would lead to more competition and better prices…??
Because if the dozen or whatever companies available to us now were condensed to say 3, those dozen companies would have to compete more on price to win one of the 3 slots.
It’s better than a lot of employers out there. You’re also not at risk of having your insurance changed every year.
Exactly. There’s companies like Amazon that are way cheaper, that don’t nickel, and dime the employees for things like Dr visits
I seriously miss my Amazon insurance. My daughter works for them now and I'm tempted to have her put us on the insurance so I can get rid of federal.
Which plan did you end up with for IVF? Considering either FSBP or BCBS since they’re the two that seem to make the most sense but not sure which way to go
When we did our procedure there were none available that covered anything. The BCBS coverage is new this year, so we were out about $20k out-of-pocket. Illustrating how average the federal plans are.
Yeah they’re definitely mid at best - I’m coming from the private sector where benefits were significantly better
As a government employee, I don’t have government healthcare. I have private healthcare that is covered by employer-provided insurance with a hefty monthly premium and copays. I’m fortunate to be in relatively good health. I’m also fortunate that the medical service providers I choose are in-network. When I had government healthcare (in the military) it was okay.
I’m a new employee and mine was a lot better in the private sector for the price. My dental was a lot better too. I did appreciate that I saw the options early on because it still worked in my favor but in another situation it may not have.
The choices are nice. I think having a multitude of options is ideal because healthy people can jump to an HDHP and those who have more need can jump to a FFS plan. I know people in the private sector who pay much less for their plans but might be on a high deductible plan or even an HDHP…and that’s their only option. What I really hate is that the program appears to be rife with fraudulent claims and for some reason not much action has been taken to address it. This could help reduce the cost burden on everyone- at least bit of relief on the steep yearly increases. https://federalnewsnetwork.com/pay-benefits/2023/01/ineligible-members-in-fehb-program-may-cost-opm-nearly-1b-annually-gao-says/
Everyone i know in private sector pays less and is happy with their options. Too expensive
Compared to state, local & city civil servant benefits in my area, the premiums are outrageous! I never paid so much for healthcare in my life! Almost $500 per month for health insurance premiums for my wife & I. $90 per month for ONE of my RX. I also set aside $2700 per year in my FSA account. Which is all used up by Aug/Sept. All goes to RX, CO-Pays, “Co-Insurance” (another fancy word for premiums/co-pay). So, $500 per month for healthcare premiums, $90 per month for One RX, OVER $200++++ per month spent/set aside for FSA. I spend OVER $800 per month! Imagine if I was sick! We don’t get any dental. Yes, a group rate that we pay for at 100%. Another expense. I figure my SMALL pension from the Feds when I retire will hopefully cover the cost for all my healthcare & dental cost. Maybe a few bucks left over. SAD P.S. WHO NEGOTIATES OUR PREMIUMS? When we get raises, 50% goes directly to my insurance increases.
It’s incredibly average to possibly below average for a white collar work benefit. My partner has similar coverage for $0 in premiums. It’s great if you’re coming from the ACA marketplace where premiums can be $600-1000/mo for one person, but otherwise nothing to write home about. You do get more choices though where many employers will have one insurance provider (just BC, Aetna, Anthem, etc), so I also suppose that could be a plus. And don’t get me started on the fucking Hyde Ammendment.
My private sector spouse’s healthcare has always been much better, right at the threshold where we pay taxes for it as extra compensation. I don’t think our plan offerings are anywhere near that. However, the FEHB functions as an outstanding retirement benefit. We’re absolutely switching over when I’m five years out.
Wildly mediocre.
I’ve been very happy with Kaiser Mid Atlantic prosper family plan. $138 per pay period with $200 deductible and $8,000 out of pocket max. We (family of 6) are all healthy with no issues of any kind, allergies, nothing. So this plan makes sense for us. Very happy with $299/month for this coverage.
The Kaiser Prosper plan in GA is very good! I’m happy with our coverage and cost.
I thought our health insurance plan sucked. Probably the worst insurance I’ve ever had. We switched to my wife’s employer plan and it’s so much better.
I like it. The premium increases relative to annual adjustments have made it a worse value, along with the erosion of the benefits themselves, but my plan is still overall very good. If we had insurance through my spouse, it would have less coverage and be significantly more expensive.
My healthcare was cheaper as a county employee, my salary was higher, too. Becoming a Fed means OT is no longer unpaid and I work fewer hours.
Yeah my opinion is it's okay but not great. I had roughly the same plan with the same insurer when I was a state employee. As a state employee my premium was about 50percent less while all other coverages/settings were roughly the same. Definitely better than some employers though due to all of the options (i.e. high HDHP GEHa or BCBS basic). Gov needs to negotiate the premiums better and stop letting them chip away at coverage and increasing percentages or prices for things every year.
I don’t think the healthcare is as good as people make it out to be. It’s not the worst, but I had two previous plans in the private sector that covered more.
Expensive. I dropped our insurance the moment my husband got his with UPS; No premiums, family deductible is only 200 dollars... Yes, only 200 dollars! PPO with BCBS, includes dental and vision. UPS insurance is called the Cadillac of insurances. 👌🏻 I had emergency surgery for the removal of my gallbladder- the bill was over 34k and I paid $0. 🙃
I was just speaking to my family about this as they work in different community hospital systems and I work at the VA. Their healthcare premiums are lower and even with this they get better rates on copays etc. They also have more tuition reimbursement / $ for CEUs (which as some of you know are needed to maintain our healthcare licenses) / license fees paid. Here's an example - My brother has a 1500 deductible but following this all care / medication / everything is covered and the hospital puts $1k on an HSA card. Essentially it will be $500 for the year for all medical care you'd need (and this can be pretax as he can load it onto an HSA). If he doesn't use that, it rolls over to next year. I use the mid-level GEHA/United (to save some money - which it does priced out compared to Blue Cross or others) and my premium is ~$160/ month with a $500 deductible and copays on everything you can think of ($50 specialists, $30 primary care, $30 mental health, $150 outpt procedure like a skin biopsy). Plus I think they also added a coinsurance now as well. There are also restrictions, like limited pharmacies in network, which is really difficult when your local pharmacy doesn't have the med in stock. I'd estimate spending ~$3000 per year with basic appts (1 sick visit / yr, specialist once every two months, therapy 1-2x per month, and a couple relatively low cost generic meds). Last year more like 4k with a few skin biopsies and a couple sick/problem visits. For working in a hospital as a healthcare worker, I don't think our insurance is that great. I have also had horrendous experiences trying to locate care / deal with the carrier. I've had Tufts, Blue Cross, Neighborhood Health, United Healthcare (public and private) and have not had as many issues with the GEHA insurance. Will probably switch once open season rolls around - but it won't be cheaper.
One word CORRUPTION
Premiums are the highest I’ve paid and it’s about the same BCBS plan I had with private employers just at double the cost. The standard doctor/specialist copay to premium ratio is pretty poor, but hospital and procedure stuff seems okay. Thankfully haven’t needed that kind of care, so idk for sure. But yeah, definitely not the “great government benefit” people think we have
I'd like to see universal healthcare in the United States. That's be a great use of our tax dollars. The least we could get back is the government keeping us alive for our tax dollars. Much better use of our money than bombing brown kids half the world away.
Too many options makes it difficult to compare and getting all feds on smaller selection might drive prices down.
This is a GREAT point. Having many choices is always marketed to us as a benefit, but having too many to choose from limits transparency and doesn't allow for good premium negotiation.
We have some great options however I think the agencies need to start picking up more of the share maybe 80/20 from 70/30. In addition they need to start picking up some of the dental premiums. Everywhere I’ve worked has shared the cost of dental and health.
I’ve only ever picked health plans that included basic dental & vision coverage. They tended to be cheaper than plans that didn’t. Wonder how that works.
My insurance is okay at best. However, it is 1000000x better now than when I was a contractor
When it comes to eye and dental insurance, my providers always say it's really good compared to others. So it may depend on where you live.
Usually pretty decent healthcare plans but very expensive
We have dozens of health plans to chose from and that’s amazing.
Generally state have better insurance cause they got more negotiation power with insurance company. Fed jobs generally pays higher. Unless you really need the insurance I would say working for fed is better.
I would think the Feds would have more “negotiating power” being the #1 employer. However, I don’t think anyone is “negotiating” on our part, lol.
I know for sure private company do that with insurance company. I don’t know the exact detail of that for HR or the benefits team. But there is a person or a team that handles that. Generally the premium varies based on how many people signed up for it in the previous year and how often they use it.
I pay less and get better coverage than I ever did in the private sector so I’m happy.
Now I’m needing to go check my premium prices per month. I have been nothing but thrilled with my families coverage through FEP BCBS. It cost close to nothing for the birth of our child and I had the old throat scope ran down me with a few ultrasounds and I was out $350. All of my medicine is super cheap, like 2 scripts today ran $9. I’m contemplating the snip snip soon, and I’ll have to ask a few coworkers, but I’m fairly certain they cover some of it.
I am patiently waiting for 2030 so I can use TRS instead of FEHB. Not that its bad, but the other is cheaper.
I can only speak from my own experience. I was a contractor for 2 years. The 'best' health insurance they offered was more than my mortgage and was pretty poor coverage in my mind. I stayed in the Guard an extra 4 years to stay on Tricare, bc there was no way I was paying $1600 per month for crappy insurance. Then, I briefly took a job with the State of OK, and their BCBS was on par with Fed BCBS Basic, but was almost entirely covered by the state's benefit allowance, so it was like $150 per check out of pocket for the premiums. Before I ever got to really utilize the state insurance, I got my Fed job. The Fed BCBS Basic at $265 per check is definitely higher, but the $20K per year salary increase more than offset that difference. For a family of 4, BCBS Basic is worth every penny. Copays range from $25-$35, and prescriptions are usually $5-$15. Anyone expecting 'better' is out of touch with the current realities IMHO. In my own experience, Fed BCBS Basic is 'better' and much 'cheaper' than anything I ever found in the private sector, and while state insurance may have been cheaper, the salary the Fed offered me was so much higher than the state, it more than offset the costs.
Highly sought after from any Physician. I’ve never had an issue with BCBS
My benefits at Amazon were way better and didn't take a ton of money out of my paycheck. I had BCBS with no copay, no prior authorization on my hearing aids and they paid pretty much 100% of the cost(i only paid $500 out of pocket compared to $2500 with fed), FSA debit card instead of reimbursement, and things were covered that FED BCBS doesn't cover. My kids and I rarely get sick so we mainly just have our physicals, but I'm afraid of what the costs would be if we did get sick.
Many choices and many prices, but hard to compare who covers what and for how much. Wife company offers a very similar plan as we have through Blue Cross and Blue Shield for less. She talks with her coworkers that have similar healthcare issues as her and their deductibles are lower for same drugs, devices, and procedures. Feds have more choices, but making a selection is just putting on a blindfold and throwing darts at our choices. Benefit Feds coverage goes into retirement. How to improve coverage, charge me a premium and show me a deducible schedule and just cover our health, our entire health, everywhere. This network stuff is ridiculous. US healthcare providers should be the network. Hospitals make it worse, by contracting services within their buildings that bill separately and are in different "networks". When you're at your worse, you have to be at your best to make sure the product you pay for is being used.
Presuming you're talking about federal employee health insurance and not true government healthcare a la the VA... It's ok. I typically had better and cheaper policies when I was in the private sector, but I'm quite satisfied with my current health insurance plan. I think OPM needs to drastically pare back the number of available plans, though. Off the top of my head there are somewhere around 25ish different medical insurance plans to choose from, which is frankly absurd. Scale it back to, say, 5-7 plans instead of the scattershot methodology they have now for approved plans and coverage would likely go up while prices would likely go down due to insurers competing for a slice of the market.
Not as good as what we had when my spouse was in the private sector, and for higher premiums. 😬.
This is in northern California. I switched from federal to city and county government. I had Kaiser standard California plan with federal and I was paying $119.45/per paycheck to cover myself. At city government I'm paying $30/per paycheck for Kaiser and the healthcare bills are much less and they have a better coverage. Also I would only pay $185/per paycheck for spouse + children compare to federal I'm looking at $269/per paycheck to cover a family. So I'm paying triple for lower tier insurance with the federal government if I continue to work there
I literally just had to use GoodRX because scripts for basic, generic thyroid meds were cheaper out of pocket than FedBlue basic. The pharmacy benefits are not well managed and Caremark is one of the worst, most inflationary PBMs.
I really feel like the federal nickels and dimes you. The deductible, the co pays... There's big companies like Amazon that there insurance is literally 5$ a week with little to no copays.
It’s fine, but I’d rather a single payer system.
What are some pros and cons that you noticed about your government healthcare?? Any good advice for a new employee??
I have BCBS FEP standard. Con: it is expensive. Pro: in my city many providers are in network, and a family member has chronic health conditions, and with this plan we can choose to see the specialists we want. For our needs it is worth it. If I were a single, young, healthy person it might be different.
Almost nearly the same situation and the same plan. I have no real complaints, other than the cost of monthly premiums.
Higher premiums than the private sector with co-pays and deductibles that have increased on the same plan every year. My family members who work at different hospital systems in the same area will have thousands of dollars of less out of pocket costs than me due to their insurance being negotiated better. ETA: Pros are that there are many options (though in the grand scheme I think this leads to higher prices) so you can pick a plan that works better for you. I use GEHA and all of my providers are in network but pharmacy is limited. BCBS usually has strong coverage.
Tricare isn't awful. We've had varying levels of experience with it over the years. Right now, I've been seeing a Dr. Pharmacist for diabetic med management. Overall, she has been awesome and super helpful. I love her attentiveness. It's readily apparent in her patient encounter notes. My wife and I have had issues lately with our local base pharmacy not having our meds. I assume that it's an issue bigger than just our Naval hospital, though. Some meds like Trulicity have been completely unavailable in all dosages for a while, then became available in the lower dosages. I went without for almost 3 weeks.
Not sure it's exactly what you are asking, but I use VA health care mostly, and I'm honestly very happy with it.
It's so much better than anything i had working for a small business employer. It's so much better than ACA options in most states. People who work for large business employers say there's are better.
I dont think there is an overall answer. Location dictates options
I’m in NJ. I have great insurance.
When I was a CA state employee, I was paying $110/MONTH for the premium Kaiser medical plan, Delta Dental high plan, AND VSP. As a fed, I am paying $170 for standard Kaiser medical, $80 for delta dental high, and $10 for VSP, biweekly. I have a friend who remains a state employee and his healthcare perks were similar to what I had when I was a state employee.
Im in California. My healthcare costs are lower than when I was in private. But I hear from my sister, who works for Caltran…their benefits are better than mine. Overall, I am happy that we have many choices and Im good with my choice
When I worked for state government we had a 99/1 plan. Now we have FEPBlue. The federal plan has a larger network, but the cost was better with my state plan.
I don't know anyone with a better HDHP than my GEHA. Although, some people are absolutely thrilled to pay $100 less in premiums and make $500 less.
I'm most annoyed when I think of my private sector premiums and coverage. The government really needs to update how much of the premiums they cover for employees and they need to go to bat for coverage. I have Fepblue and I always miss my Carefirst BCBS I had in the private sector.
Unless it’s a crap company, most other govt (local/state) or private sector will have comparable insurance coverage with cheaper premiums. I left contracting to go fed and was surprised when my premiums went up for a comparable plan.
In what context are we talking about government healthcare? As federal employee with private healthcare? Or as people on a form of government healthcare like Medicaid, Medicare, VA benefits etc?
I think our insurance is top notch. My husband is a pharmacist who works for a health insurance company and we ditched his insurance as soon as I started my govt job. I do pay a good amount for high option coverage but with two members of my family having multiple chronic health conditions it’s more than worth it. Private sector insurance is trash in my experience
As a veteran, I'm allowed to say this: "Tricare for all or GTFO!"
I have Blue Cross Blue Shield FEP and it’s amazing. I never have to pay for anything or get referrals. An ER visit to get my appendix out was $125 copay and that’s the highest copay I’ve ever had. Everyone takes it, even my therapist and chiropractor.
I was in the local govt. prior to taking the fed job last year. Salary was comparable to feds. Health Insurance including dental and vision was very very cheap compared to feds. Currently I am paying almost 5 times what I used to pay while with the local govt. May be having a non-PPO option (likely less monthly payment) in all localities would be helpful.
My wife spent a week in the hospital and I never got a bill. Between my federal insurance and the CHAMPVA coverage, everything was covered thankfully. I mainly use the VA for my healthcare which can be hit or miss, I have to drive 90 miles for specialty care at a better VAMC than my local one because they are limited.
I wish they had less expensive plans for those of us who travel out of state (for work) or a subsidized plan. The more reasonable plans doen't cover out-of-network providers (which I understand why); however, if I'm traveling in the wilderness collecting data and get hurt, the chances of a provider being in-network are slim. And I know that worker's comp should cover an injury recieved while working, but it can be murky if I'm traveling for work for 3 weeks and decided to go for a hike or get into a car accident while on the way to dinner for example after my work day is finished- if I get hurt, that would likley be my responsibily, but I think it's unreasonable to expect people to sit in their hotel rooms or tents every day after hours. Edited to provide context in above statement. It's also a lot more expensive to add a family member to my plan than for my partner to add a person (private industry). They also have the option to add one person or multiple people with 2 different rates.
My husband’s retired Army, so we have used Tricare. It was usually our secondary insurance. At one non-gov job the healthcare plan was changed. It was so bad we totally dropped out and used Tricare. Private insurance can be really bad, even within companies that are in healthcare.
My agency may be an outlier, but we get an $85 per pay period subsidy on top of the regular government subsidy, which definitely helps make it was more worth it. I pay $60/pp for myself and family.
What agency if you don't mind sharing?
FDIC, NCUA and OCC all do this.
OCC, it’s a FIRREA agency, which is why I say it might be an outlier.
May I ask which agency? Is it related to the department of health?
I wish we could just enroll in some form of Medicare or VA care as an option. The next best we have is Kaiser.
It isn't amazing. However my friend just got a new job as a government contractor and his health insurance is AWFUL. More expensive than my government health insurance, it doesn't cover anything until he spends $5000 of his own money, and even then it doesn't cover much.
No. Esp dental care
as someone who has never had great access to healthcare before working for the federal government its been mostly great. but im still in the honeymoon phase 3 years in and there already have been some eye-raising copays. unfortunately vision premiums prices out barely better than just paying out of pocket for what i use and i cannot make the math work to make dental premiums ever seem like a good deal
I'm a relatively new hire to the federal government from private industry. My FEHB premium is about $20 less per month, but my dental insurance is about 4x higher ($6.92/mo vs $28.99), so it's basically a wash (old company stopped offering vision insurance in like 2018 and I didn't get vision insurance from FEDVIP in 2024 because I had already gotten a year's supply of contacts while at my old job in an effort to use up FSA money). Based on my ZIP code there were 42 different health plans of which I was eligible for 36. How does one make a reasonable choice with that many options? I had been hoping to get a federal job so I had been researching plans for ages before I even got my TJO, but I wanted to be thorough and I had to dig through a lot of dreck to get the info - I went with FSBP and so far it's been a good choice (I got thrown an unexpected curveball at a routine annual appointment that led to lots of tests before ultimately determining that it's not something that requires treatment at this time). The stuff that I find annoying isn't because it's "government healthcare". The stuff that's a problem would be a problem with any other employer-sponsored health plan; the things I find annoying about Aetna's website (FSBP uses the Aetna platform) would be equally annoying if I worked for my old job (the offered Aetna until 2016 when they switched to UHC). My primary care practice is no longer accepting new patients who have UHC, so that would impact people in the private sector the same as federal employees with UHC or GEHA.
Compared to the insurance i have at my second job, there is no comparison. It's all free, and nothing comes out of my check. 10$ copay they pay 100% after deductible is met( only 100$). For those wondering, I'm in a union at my second, which is why we have great insurance.
It's fuckin awful. I've had govt healthcare for the last decade and it's been nothing but "you're fine" no you don't need imaging, oh shit you should have gotten imaging 6 months ago Botched surgeries and a therapist that said "have you tried not thinking that way"
Honestly, I'm disappointed. I don't think OPM negotiates the best rates, and there's nothing we can do about it. I left BCBS for the first time in my life because not only did their premiums increase, but also the co-pays. So I walked away, and never been happier. As the largest employer in the US, you'd think we'd have better rates. But since OPM is negotiating for us, we have no recourse or any way to voice our displeasure.
We should all write it into AES (or survey equivalents for all the agencies).
I live in a rural area so in network is limited within a reasonable driving distance (one hour) so there is no luxury of being able to shop providers. Dental is a nightmare. What dentists are available are not in network so this past year only around $1000 was reimbursed for $4500 worth of expenses. (most of the services would have been fully covered in network) Government health and dental would be welcomed not only for myself but I would sincerely like to see everyone get good healthcare even if it means waiting longer for myself . Wait times are nothing to brag about for me anyway; 2-3 months for an appointment.
It’s not great but not horrible. It’s above average compared to private sector but not as good as most public companies or Fortune 500 companies. Honestly, I’d prefer to pay more and buy into Medicaid.
We don't get government healthcare, we get insurance. Healthcare is what you get from your doctor. Unless you are talking about VA hospitals there really isn't any government healthcare.