Supplemental Policies (Medigap)

In consideration of the payment or premiums, a Medigap policy covers deductibles and coinsurance not covered by Medicare and provides coverage for additional medical services. You do not need a Medigap policy if you have a Medicare HMO managed care plan.

Enrollment. The first 6 months following your enrollment in Medicare Part B is considered a "guaranteed enrollment period." This means that during the guaranteed enrollment period, you can obtain a Medigap policy regardless of your health. After this period you could be turned down for health reasons.

Preexisting Condition Exclusion. Most policies contain a provision excluding coverage for a set period immediately after you buy a policy of any illness or medical condition for which you have received treatment within a given period before your coverage began.

Standard Medigap Plans. Federal law mandates that all Medigap polices cover certain basic benefits, including inpatient hospital costs and the 20% coinsurance amount that Medicare Part B does not pay. There are ten standardized Medigap plans from which to choose. Contact your state insurance department to determine what types of Medigap policies is offered in your state.

Medicaid Assistance for Medicare Beneficiaries

There are two programs designed to help you if you are cannot afford to pay your Medicare deductibles and coinsurance and do not otherwise qualify for Medicaid. To apply for these programs contact your Larimer County Department of Human Services at 970.498.6800. listed in your local telephone directory under Government Services. These programs are:

1. The Qualified Medicare Beneficiary Program. (QMB)
2. The Specified Low-Income Medicare Beneficiary Program. (SLMB)

The Qualified Medicare Beneficiary Program (QMB) . If you are entitled to Medicare Part A benefits and your income is below the federal poverty level, the QMB program will pay your Medicare premiums, deductibles and coinsurance.

The Specified Low-Income Medicare Beneficiary Program (SLMB). If you are entitled to Medicare Part A benefits and your income is below certain limits but above the federal poverty level, SLMB will pay your Part B premiums. You are still responsible for paying your other deductibles and coinsurance.

Information courtesy of Elizabeth A. Kelly, Attorney/Mediator and Bill Beyers, Attorney at Law, Elder Care Network Participants. The information contained on this website is NOT a substitute for legal advice and no representations are made as to the accuracy of this information.