Does the FEHB Program Offer Medigap Policies?

Supplemental Insurance plans, often called Medigap policies, are plans that supplement Medicare by paying for deductibles, coinsurance and copayments and by providing benefits that Medicare does not cover. The Federal Employees Health Benefits program (FEHB program) provides a variety of health insurance plans that include Fee-for-service plans, HMO plans, High Deductible Health plans, Consumer-Driven Health plans and Health Reimbursement Arrangement plans. Federal employees enrolled in FEHB programs have several health care options upon retirement.

Medicare

Original Medicare is health insurance for people who are 65 years old or who have some qualifying disability. Medicare Part A is hospital insurance and for most people does not require a monthly premium. Medicare Part B covers doctor visits, outpatient care and preventative care. Medicare Part D is prescription coverage. Parts B and D require a monthly premium and often require deductibles and copayments. Expenses mount quickly and some sort of Medigap policy is a wise choice for most seniors.

Medicare Enrollment

Upon reaching age 65, seniors have six months of open enrollment where they can pick any Medicare plan and insurance companies cannot deny coverage due to pre-existing conditions or raise premiums due to health problems. Seniors should contact their Social Security office for more information.

FEHB Program

The FEHB program has a variety of options, benefits, and premiums but generally it is similar to Medicare. However, the FEHB program has wider coverage in several areas including routine physicals and other preventative care, dental and vision care, and emergency care outside of the United States.

Enrollment

Seniors may change existing FEHB programs beginning 30 days before eligibility for Medicare. This special enrollment is a one-time opportunity. The FEHB program also offers an annual open season where annuitants can change their plans. Many seniors find that a lower cost FEHB program is adequate for their needs once they enroll in Medicare.

Benefit Payment

While an active Federal employee, the FEHB program must pay benefits first and Medicare will pay afterwards. Once retired and an annuitant of the FEHB program, Medicare will pay first and the FEHB program will act like a Medigap policy and pay second.