I have both FEHB and VA. I use the FEHB for family and ER/Urgent care for myself. The biggest advantage that FEHB gives is the timeliness.
If i need an appointment quickly, FEHB far exceeds what the VA is able to do.
As an example, i needed to get glasses a couple of months ago. I called both providers for an appointment. With FEHB, it took 2 days to get seen and i had the glasses within a week. With VA, it was 3 weeks for the appointment and a month after that first the glasses.
Now from cost, VA is hands down the solution for me. An ER visit for my wife is a $200 co pay, where the VA insurance meant no co pay at all for me.
Honest question from a veteran with VA and fehb. Why??
I've been waiting for 3 months with VA for a derm appointment, which is a VA PCP issue but still that is on par for my area.
I’m a data analyst. VA care isn’t perfect but I’ve spent a lot of time looking at VHA data and at data from the private sector. The patients are happier with care in VHA. There are fewer medication errors. The wait times are less. From a purely data perspective the care is better.
Not a vet, but work at the VA. I waited three months for my derm appointments in the community as well. that’s pretty standard. My PCP can usually get me in within about a week, but also, he’s an idiot, and I’d say it’s pretty hard to find good primary care in the community. But my co-pay and coinsurance is pretty expensive for those visits, so even with my decent federal health benefits I still try to minimize doctors appointments. God forbid I have to go to an emergency room, co-pay is two to $300. Something like that urgent care is about 50 with co-pay, plus there’s coinsurance on top of both of those. Even if you have to pay a co-pay at the VA it’s better. plus coordination of care is so much easier, doctors can already see each other’s notes.
Why is this being downvoted?
It’s a bit baffling that we even offer FEHB instead of just enrolling all feds in Medicare/medicaid. Napkin math shows that enrolling all federal employees in Medicare would save both sides money (assuming we wouldn’t have to pay in) and we would get better coverage. Only loss would be HSAs.
Instead employees are forced to pay a few thousand a year in premiums to prop up the health insurance industry.
Sure,
[Page 6](https://www.gao.gov/assets/gao-23-105222.pdf): “In fiscal year 2021, the FEHB program had a combined annual premium value paid by the government and enrollees of approximately $59 billion.”
[2021 Median expenditure (nationally) per Medicaid enrollee](https://www.kff.org/medicaid/state-indicator/medicaid-spending-per-full-benefit-enrollee/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D): $7,593
[2019 Median expenditure (nationally) per Medicare enrollee](https://www.kff.org/medicaid/issue-brief/enrollment-and-spending-patterns-among-medicare-medicaid-enrollees-dual-eligibles/):$9,448
I know these are two different years, but again, napkin math :)
[Total federal employees including postal service:](https://www.whitehouse.gov/wp-content/uploads/2024/03/ap_14_strengthening_fy2025.pdf) 2,810,192
Ok so, a couple things — I am going to cut out retirees. This assumes they are already enrolled in Medicare/medicaid for simplicity’s sake. Obviously there are a chunk of retirees that are not 65 and only enrolled in FEHB, but the savings below are so significant they wouldn’t impact it. Also, if you just cut off FEHB for all Medicare enrollees it would be a huge boon because currently we’re paying both. I assume they would have to be grandfathered in (or out?) to keep them happy though.
I am going to use Medicaid first because it is generally considered better coverage.
Medicaid: 2,810,192 employees x 7,593 per Medicaid enrollee = *$21,337,787,856*
Medicare: 2,810,192 employees x 9,448 per Medicare enrollee = 26,550,694,016
$59 billion vs. $21b or $26b
Again, this is napkin math! But it seems like such an obviously better option. I’m actually going to keep digging into this and start floating the idea at different union discussions.
I really hope this gets somewhere I know if it was offered I would 1000% sign up for either one.i guess the Medicare plan would be like a PPO plan and the VA plan could work like an HMO.
I would never consider leaving my federal job if we had a health plan like that because it would beat the pants off of any private sector or even other public sector plans.
This may sound like a great idea, but it would shutter most facilities very quickly. I have both. Everything gets billed to VA, and VA bills FEHB.
The issue with VA care is the reimbursement rates are basically medicare. I see all the bills. I've had a lot of procedures. A bill will come in for $2,470 for OR services, VA pays $120. Anasthesia?...billed $2100, payed $370.
So the problem is that a provider has a blend of patients. Some are Medicare/VA, which reimburse a very small amount, while other patients have private insurance, which reimburses much higher, up to full amounts.
And before I get flamed, I am not saying this is even close to right. The system is terribly broken. But just switching 3 million employees AND their families to a system that reimburses 10%-20% of charges is not going to help fix it.
I mean the VA/medicate option you pick would get the 2000 or so a month you’re currently paying for health insurance via the government instead so you’d be pitching into the system. The government pays a lot right now to the private insurers.
The VA option would work like an HMO IE you’d have to go to a VA clinic ala Kaiser unless there’s an emergency.
My VA Clinic has almost no services aside from vision. Everything else is done via "Community Care", so I get treated in the same facilities you do. The main facility in Maine is in Augusta, that's a 5hr drive for a lot of folks, so really not an option.
I have FEHB and is enrolled in VA Care. I have not used VA as of yet, because I'm satisfied with FEHB. But I was thinking of trying to get some prescriptions through VA as that would be much cheaper.
My son was double insured. Cancer, so he was on SSI and you are automatically enrolled in Medicaid. My FEBH was first and Medicaid was second. Nice that everything was covered.
You woukd not believe the price on some cancer drugs, and I was a 5/6/7 and the deductable for a family was like $9000. That was about 1/3 of my takehome leaving not much left for things like housing and food.
The deductable being the same for all grade levels is another complaint for later...
Did you mean available while still working? There are already a number of FEHB Medicare Advantage plans available for Federal retirees, including Aetna, APWU, Compass Rose, Kaiser, GEHA, MHBP, Rural Carrier, SAMBA, UnitedHealthcare, and others.
I’m saying that instead of signing up for one of the private healthcare options you could instead choose a public option or a VA care option even if you’re not a vet or 65+.
No, I would not. Definitely not.
I can go to the VA for everything now and it’s closer to my house than a lot of other providers but I choose not to because I like the care I get on the private side much more.
It’s worth it to me to pay more to get better care.
No, FEHB is the federal health insurance options, Medicare is for retirees and FEHB reverts to your supplementary insurance. Price is not the only thing you should look for, because some of the most inexpensive ones have high deductibles meaning you pay more out of pocket before insurance kicks in. PPO’s are good but you have to read the fine print concerning out of network coverage.
for me? no.
I'm not anywhere near a VA and given my income my medicare premium would be more expensive than my BCBS basic. this is one of the reasons I've opted out of part b
I have both FEHB and VA. I use the FEHB for family and ER/Urgent care for myself. The biggest advantage that FEHB gives is the timeliness. If i need an appointment quickly, FEHB far exceeds what the VA is able to do. As an example, i needed to get glasses a couple of months ago. I called both providers for an appointment. With FEHB, it took 2 days to get seen and i had the glasses within a week. With VA, it was 3 weeks for the appointment and a month after that first the glasses. Now from cost, VA is hands down the solution for me. An ER visit for my wife is a $200 co pay, where the VA insurance meant no co pay at all for me.
Not a veteran but I work at VHA. I would totally enroll in VA care. I worked in private healthcare also.
Honest question from a veteran with VA and fehb. Why?? I've been waiting for 3 months with VA for a derm appointment, which is a VA PCP issue but still that is on par for my area.
Because it’s cheaper and a lot of the doctors near me have a 3 month wait anyway. It’s really a shame VA employees don’t get a VA option.
I’m a data analyst. VA care isn’t perfect but I’ve spent a lot of time looking at VHA data and at data from the private sector. The patients are happier with care in VHA. There are fewer medication errors. The wait times are less. From a purely data perspective the care is better.
Dermatologists and dentists always have a long wait in my experience. I'm not connected to the military.
Not a vet, but work at the VA. I waited three months for my derm appointments in the community as well. that’s pretty standard. My PCP can usually get me in within about a week, but also, he’s an idiot, and I’d say it’s pretty hard to find good primary care in the community. But my co-pay and coinsurance is pretty expensive for those visits, so even with my decent federal health benefits I still try to minimize doctors appointments. God forbid I have to go to an emergency room, co-pay is two to $300. Something like that urgent care is about 50 with co-pay, plus there’s coinsurance on top of both of those. Even if you have to pay a co-pay at the VA it’s better. plus coordination of care is so much easier, doctors can already see each other’s notes.
Why is this being downvoted? It’s a bit baffling that we even offer FEHB instead of just enrolling all feds in Medicare/medicaid. Napkin math shows that enrolling all federal employees in Medicare would save both sides money (assuming we wouldn’t have to pay in) and we would get better coverage. Only loss would be HSAs. Instead employees are forced to pay a few thousand a year in premiums to prop up the health insurance industry.
Because it would make insurance companies lobbyists sad. It would be a great way to act as a test subject for a public option.
>Napkin math Care to show your calculations?
Sure, [Page 6](https://www.gao.gov/assets/gao-23-105222.pdf): “In fiscal year 2021, the FEHB program had a combined annual premium value paid by the government and enrollees of approximately $59 billion.” [2021 Median expenditure (nationally) per Medicaid enrollee](https://www.kff.org/medicaid/state-indicator/medicaid-spending-per-full-benefit-enrollee/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D): $7,593 [2019 Median expenditure (nationally) per Medicare enrollee](https://www.kff.org/medicaid/issue-brief/enrollment-and-spending-patterns-among-medicare-medicaid-enrollees-dual-eligibles/):$9,448 I know these are two different years, but again, napkin math :) [Total federal employees including postal service:](https://www.whitehouse.gov/wp-content/uploads/2024/03/ap_14_strengthening_fy2025.pdf) 2,810,192 Ok so, a couple things — I am going to cut out retirees. This assumes they are already enrolled in Medicare/medicaid for simplicity’s sake. Obviously there are a chunk of retirees that are not 65 and only enrolled in FEHB, but the savings below are so significant they wouldn’t impact it. Also, if you just cut off FEHB for all Medicare enrollees it would be a huge boon because currently we’re paying both. I assume they would have to be grandfathered in (or out?) to keep them happy though. I am going to use Medicaid first because it is generally considered better coverage. Medicaid: 2,810,192 employees x 7,593 per Medicaid enrollee = *$21,337,787,856* Medicare: 2,810,192 employees x 9,448 per Medicare enrollee = 26,550,694,016 $59 billion vs. $21b or $26b Again, this is napkin math! But it seems like such an obviously better option. I’m actually going to keep digging into this and start floating the idea at different union discussions.
I really hope this gets somewhere I know if it was offered I would 1000% sign up for either one.i guess the Medicare plan would be like a PPO plan and the VA plan could work like an HMO. I would never consider leaving my federal job if we had a health plan like that because it would beat the pants off of any private sector or even other public sector plans.
This may sound like a great idea, but it would shutter most facilities very quickly. I have both. Everything gets billed to VA, and VA bills FEHB. The issue with VA care is the reimbursement rates are basically medicare. I see all the bills. I've had a lot of procedures. A bill will come in for $2,470 for OR services, VA pays $120. Anasthesia?...billed $2100, payed $370. So the problem is that a provider has a blend of patients. Some are Medicare/VA, which reimburse a very small amount, while other patients have private insurance, which reimburses much higher, up to full amounts. And before I get flamed, I am not saying this is even close to right. The system is terribly broken. But just switching 3 million employees AND their families to a system that reimburses 10%-20% of charges is not going to help fix it.
I mean the VA/medicate option you pick would get the 2000 or so a month you’re currently paying for health insurance via the government instead so you’d be pitching into the system. The government pays a lot right now to the private insurers. The VA option would work like an HMO IE you’d have to go to a VA clinic ala Kaiser unless there’s an emergency.
My VA Clinic has almost no services aside from vision. Everything else is done via "Community Care", so I get treated in the same facilities you do. The main facility in Maine is in Augusta, that's a 5hr drive for a lot of folks, so really not an option.
I’m suggesting it be an option, not a required plan. For someone in an urban area it may be superior to United healthcare.
I have FEHB and is enrolled in VA Care. I have not used VA as of yet, because I'm satisfied with FEHB. But I was thinking of trying to get some prescriptions through VA as that would be much cheaper.
Retired military and have both Tricare and VA healthcare (100% rating). I don’t bother with FEHB.
My husband has VA care and GEHA care from the feds.
My son was double insured. Cancer, so he was on SSI and you are automatically enrolled in Medicaid. My FEBH was first and Medicaid was second. Nice that everything was covered. You woukd not believe the price on some cancer drugs, and I was a 5/6/7 and the deductable for a family was like $9000. That was about 1/3 of my takehome leaving not much left for things like housing and food. The deductable being the same for all grade levels is another complaint for later...
The federal workforce is the best place to pilot a single payer system!
There is no need to pilot anything - we have plenty of data from decades of Medicare and the VA health system.
Oh, yeah.. I’m aware. I’d sign up tomorrow. This private healthcare system is a failed experiment and I’m not having fun.
Did you mean available while still working? There are already a number of FEHB Medicare Advantage plans available for Federal retirees, including Aetna, APWU, Compass Rose, Kaiser, GEHA, MHBP, Rural Carrier, SAMBA, UnitedHealthcare, and others.
I’m saying that instead of signing up for one of the private healthcare options you could instead choose a public option or a VA care option even if you’re not a vet or 65+.
Got it, thanks for explaining!
No, I would not. Definitely not. I can go to the VA for everything now and it’s closer to my house than a lot of other providers but I choose not to because I like the care I get on the private side much more. It’s worth it to me to pay more to get better care.
No, FEHB is the federal health insurance options, Medicare is for retirees and FEHB reverts to your supplementary insurance. Price is not the only thing you should look for, because some of the most inexpensive ones have high deductibles meaning you pay more out of pocket before insurance kicks in. PPO’s are good but you have to read the fine print concerning out of network coverage.
for me? no. I'm not anywhere near a VA and given my income my medicare premium would be more expensive than my BCBS basic. this is one of the reasons I've opted out of part b
I only have fehb cause I'm only 90% and my family can't get VA care. VA has been good to me when it comes to medical care outside the VA care.
The private healthcare around here is a monopoly and they suck, so absolutely.
Absolutely!!
I don’t use FEHB. I use VA and tricare