<p>You all have been so helpful in answering questions I’ve had in the past, so here goes:</p>
<p>As a new federal employee I’m presented with a number of health insurance options. I’m a Type 1 diabetic with persistent Rx costs amounting to roughly $1250 out-of-pocket monthly. With that in mind, what kind of plan should I be looking at in order to minimize costs? What are the important things to consider? Can one get “quotes” from insurance companies for particular drugs? For example, I can plainly see in the plan brochures that Company A will pay x% of their allowance for a particular drug, depending upon its “tier.” But I can’t seem to find any sort of listing of what this allowance is, and what tier my drug is. Can I just call them?</p>
<p>If anyone has any suggestions or suggestions to point me in the right direction, it would be much appreciated.</p>
<p>If you will be in an area that is served by an HMO such as Kaiser, consider them for consistent costs. Unless of course you will be in an area where you already have established relationships with your doctors.</p>
<p>You should be able to call or email each company you are considering and they should be able to tell you the out of pocket costs for your prescriptions. If you always use the same pharmacy it would probably help to have them all printed out. I’m going through this for my mom with Medicare. The costs can be significantly different.</p>
<p>Have you ruled out a High Deductible Health Plan? (Sometimes called Consumer Directed Plan.) </p>
<p>If you really have OOP Rx costs of $1250 per month, conceptually, you could meet your plan’s (~$5,000 or less) deductible in 2, 3, or 4 months. Then have no OOP for the rest of the year. Attach an HSA to the medical plan and it becomes a little easier to manage the deductible.</p>
<p>I think every federal employee has access to the Blue Cross Plan, but you can check your list to be sure. If it is offered in your location, here is the link where you can find the formularies and the copays.</p>
<p>Their mail order pharmacy rates are excellent IMO. This is where my coverage comes from and I get a 3 month supply of my specialty med for $80. This is a drug that retails close to $5K a month.</p>
<p>Standard option, if you are single, is $86 every 2 weeks ($2233 annually). </p>
<p>I agree with calling the plans. also visit your pharmacy and ask them what they suggest. And as another person said, many plans allow you to buy persciptions from mail order companies which are usually 90 day supplies and heavily discounted.</p>