Limited Changes in Coverage Likely

Unlike in some past years, plans are not under orders from Congress to add certain new benefits, and OPM itself imposed few new requirements for the 2004 plan year in its instructions to carriers earlier this year. In its instructions to carriers earlier this year, OPM mainly reminded them that current trends in the health care industry are to cover certain services not universal in the FEHB, including routine osteoporosis screening for all women age 65 and older and at 60 and older for those at increased risk, and influenza vaccination for those age 50 and older. A similar observation last year about certain other procedures, including colonoscopies, changes in cholesterol screenings and autologous tandem transplants for germ cell tumors, resulted in many plans incorporating those coverages for 2003; OPM earlier this year encouraged those who had not done so for 2003 to add those coverages for 2004. OPM also repeated its long-standing policy that additional coverage that carriers wish to offer on their own initiative must be cost-neutral, which limits their possible initiatives.