A Medigap plan is designed to fill in benefit gaps in Medicare coverage. While every state has a standardized Medigap plan, each of them has a different set of benefits. Fortunately, each of these plans must cover certain basic benefits, such as Medicare coinsurance and copayments. However, they don’t cover such things as long-term care, vision and dental care, hearing aids, private-duty nursing or unlimited prescription drugs.
While the cost of Medigap plans varies by state and locality, the cost of a particular plan may be much lower if you are willing to use specific hospitals and, in some cases, doctors. Plans that offer more restricted access to medical care are called Medicare Select plans. While a Medicare Select plan will not pay for care that you receive from non-plan providers, Medicare will pay its share of any regularly covered expenses. You will be responsible for paying any deductibles or coinsurances.
Do you need to buy a Medigap policy? If you are a federal retiree who is covered by Medicare and enrolled in a Medicare managed care plan or a fee-for-service plan, such as Blue Cross-Blue Shield or GEHA, the answer is no. The Department of Health and Human Services long ago reached that conclusion when it determined that a Medigap policy won’t provide you with any coverage that you don’t already have.
The National Association of Active and Retired Federal Employees (NARFE) agreed with that conclusion and said, “Federal Employees Health Benefits Program plans are far superior to most Medigap policies, annuitants who have Medicare and FEHB coverage have little need for any type of extra health plan. In most cases, those who do purchase additional policies are wasting money on duplicate coverage.”