Medicare Blog

nalc health benefit plan as supplemental when doctor doesn't participate in medicare - how does it

by Letitia Spinka PhD Published 2 years ago Updated 2 years ago

Having the NALC Health Benefit Plan in addition to your Medicare Parts A and B cov- erage is a good way to assure that you won’t be surprised by unexpected costs. The Plan pays for all out- of-pocket medical costs that Medicare doesn’t—deduct- ibles, co-payments and co-insurance charges—for doctor visits, procedures and hospitalization.

Full Answer

How does the NALC health benefit plan work with Medicare?

When you are eligible and enroll in the federal Medicare Program, having the NALC Health Benefit Plan as a secondary insurance offering full benefits gives you an added layer of protection. In most cases, when you are enrolled in Medicare Parts A and B and the NALC Health Benefit Plan, you will have no out-of-pocket costs for medical services.

Should I ask NALC about Medicare Part B?

Still, if you know of a specific illness or condition where the benefit from Medicare may differ markedly, making you wonder if Part B would be advisable for you in that instance, you may want to ask NALC specifically for the best answer. Sorry to be thanking you so late. Thank you so much for your answer.

Where can I find the benefits for the 2022 NALC health benefit plan?

Detailed information on the benefits for the 2022 NALC Health Benefit Plan can be found in the official brochure (RI 71-009). All benefits are subject to the definitions, limitations, and exclusions set forth in the official brochure. NALC Health Benefit Plan High Option - 2022 Medicare Benefits At-A-Glance

What is the NALC personal health record?

Personal Health Record The NALC Health Benefit Plan understands the importance of having an organized accounting of your health-related information. Our online Personal Health Record at www.nalchbp.orgis a helpful tool our members can utilize to create and keep up-to-date records of:

Is NALC a good health insurance?

As a top-rated FEHB plan, members will find the NALC HBP eager to assist you and ready to provide prompt and safety-minded responses to questions related to your medical care.

Does NALC require prior authorization?

We require prior authorization (PA) for certain drugs to ensure safety, clinical appropriateness and cost effectiveness. PA criteria is designed to determine coverage and help to promote safe and appropriate use of medications.

Does NALC cover Medicare Part B deductible?

If you are covered by Medicare Part B and it is the primary payor, the NALC Health Benefit Plan pays the Medicare Part B deductible and the balance of covered Part B expenses not paid by Medicare.

Does the NALC High Option include dental?

The NALC Health Benefit Plan does not offer routine dental or vision coverage.

Is NALC part of Cigna?

The NALC has partnered with Cigna so members of the health pan have open access to a network of doctors of 2,943,436 PPO providers nation wide. You do not have Cigna insurance however this partnership with Cigna allows access to nearly 3 million providers.

What type of insurance is NALC?

Since 1950, the NALC Health Benefit Plan (HBP) has provided letter carriers and their families with first-rate health insurance. The NALC's health plan is a natural choice—as the only health plan owned and operated by letter carriers, it pays particular attention to their health needs.

What is NALC Cdhp?

Welcome to the NALC Consumer Driven Health Plan (CDHP). Choosing a health insurance plan is a big decision. The right plan has to be the ideal balance of cost and coverage. It has to provide coverage for the services most important to you and your family, and it has to be provided at an affordable cost.

Is NALC a federal plan?

you a little bit about our history. 1950—NALC starts its own independent health benefits plan with two employees. Mid-1950s—Membership grows to 30,000, and our staff grows to 26 employees. Early 1960s—We become part of the Federal Employees Health Benefits (FEHB) Program.

Does NALC cover shingles vaccine?

We now cover the Shingrix vaccine for the prevention of herpes zoster (shingles).


The NALC Health Benefit Plan offers our members a nationwide PPO provider network with greater discounts through our partnership with the Cigna HealthCare Shared Administration OAP Network.

Who is eligible for NALC?

The NALC Group Insurance Coverage has been provided since 1985. All active, retired and city carrier assistants of the NALC in good standing are eligible for the benefit. It also includes other non-supervisory postal career service employees. The basic benefit coverage is $5,000 and there is no cost to the members.

What is a high option plan?

High Option Plan– a nationwide Fee-for-Service plan with a preferred provider organization (PPO). Our PPO network is Cigna HealthCare Shared Administration OAP Network and our prescription drug retail network and mail order pharmacy are through CVS Caremark®.

Where is the NALC health plan located?

Though the director of the NALC Health Benefit Plan is a national officer of NALC elected by the same procedures and to the same terms as other officers, the health benefit plan is a separate entity with its own headquarters, located in Ashburn, VA , and a separate HBP website.

Is NALC HBP a non profit?

And because NALC HBP is a not-for-profit organization , its only focus is the health of its members. Though the director of the NALC Health Benefit Plan is a national officer ...

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