Colorado Medicare Supplement Plans (Medigap)
Colorado Medicare Supplement Plans are designed to work with Medicare to complement your Original Medicare coverage. These supplemental policies were created to provide coverage for what’s not covered by Original Medicare. These include out of pocket expenses like deductibles, copayments, and coinsurance.
Medigap plans are the same as Medicare Supplement plan options, both of which are offered by private insurance companies. Colorado Medicare coverage is categorized into parts and plans.
Colorado State Medicare Options Explained
- Original Medicare: Part A and Part B Part A covers hospital care, and Part B covers physician care.
- Medicare Advantage plans: offered by private insurance companies. The choices for Medicare Advantage vary depending on where you live. Part C has limitations in coverage compared to Parts A & B.
- Medicare Part D Prescription Drug Plans: (PDPs) provide separate prescription medicine coverage for beneficiaries who have Original Medicare, Part A and Part B. Medicare Part D is available through private insurance companies that have been approved by Medicare. Another option for Medicare Part D is coverage through a Medicare Advantage Prescription Drug plan.
- Colorado Medicare Supplement Plans: Residents of Colorado who enroll in Medicare Parts A and B can purchase Medicare Supplement insurance or Medigap to cover a variety of health care costs that Original Medicare does not cover. The outlays include deductibles, coinsurance, copayments to doctors and hospitals, and other out-of-pocket expenditures.
For the most cost-effective and wide-ranging coverage for your Medicare plan, choose Medicare Parts A and B, the Part D Prescription Drug Plan, and a supplemental Medigap policy which you can purchase from a private insurer.
The first thing to do is apply for Medicare benefits. The process of applying for Medicare in Colorado is the same process as any other state. To qualify, you must be either a United States citizen or a legal permanent resident of at least five continuous years. If you are disabled and under 65, you can apply for Medicare.
Colorado Medicare Benefits for Those Under 65
Those under 65 and disabled will automatically get Medicare Part A and Medicare Part B after receiving disability benefits from Social Security, or disability benefits from the Railroad Retirement Benefits, for 24 months. In Colorado, Medigap plans for disabled and under 65 Medicare recipients is required.
What are the Parts of Medicare and What Do They Cover?
Medicare Part A covers inpatient hospital care, skilled nursing facility stays (with time limits), a selection of home health care services and hospice care. If you’ve worked for at least ten years, during which time you paid Medicare taxes, you are eligible for premium-free Part A. In other situations there will be a premium for this coverage.
For 2018, the Medicare Part A deductible is $1,340 for each benefit period. There are time-specific coinsurance payments as well.
- For the first 60 days, there is $0 coinsurance payment per day.
- For days 61 through 90, there is $335 per day coinsurance.
- For day 91 and on, there is $670 per day coinsurance for each lifetime reserve day (you may get up to 60 lifetime reserve days in your lifetime).
- After lifetime reserve days are used up, your inpatient hospital stay is typically not covered by Medicare Part A.
The deductible for 2018 for Medicare Part B is $183. This deductible goes towards physician services, outpatient hospital treatments, select home health care and specified medical equipment covered by Medicare.
After meeting the deductible, your responsibility for Part B coinsurance is 20% of the Medicare-approved amount. There are some limits on physical therapy coverage, occupational therapy, and speech-language pathology services.
The annual deductible for the basic Medicare Part D Prescription Drug Plan is $405 in 2018. These copays, pay gaps and deductibles can quickly add up for Medicare recipients in Colorado. A Medigap plan can cover the difference.
Requirements for Colorado Medicare Supplement Plans
Medigap Plans are available to Colorado Medicare enrollees who are 65 years or older and enrolled in Medicare Part B. You must make sure to enroll in Medicare Part B the month of your 65th birthday when you become eligible for coverage. If you fail to do so, you will be assessed a penalty, and you may not have coverage when you need it.
There are ten different options for Colorado Medicare supplemental insurance. Medicare Supplement plans in Colorado are set up to limit the amounts you pay for any out-of-pocket costs. The level of coverage you purchase is up to you.
All 10 Medigap plans in Colorado are standardized. Each letter plan has the same benefits. It doesn’t matter if you buy Plan F in Denver or Colorado Springs – the benefits will be the same.
Applying for Medicare Supplement or Medigap Coverage in Colorado
The Open Enrollment Period (OEP) starts on the first day of the month you turn 65, and you are covered under Medicare Part B. For example, if your birthday was August 31st and your Medicare Part B effective date was October 5th, then your OEP begins November 1st.
Your Open Enrollment Period lasts for six months, during which you are granted Guaranteed Issue (GI) for Supplement or Medigap coverage. Guaranteed Issue means that no matter what pre-existing conditions you have, insurers are required cover you. If you wait to enroll in a supplemental plan until after you OEP, pre-existing conditions can make it very hard to find the coverage you need.
There are Special Enrollment Periods (SEP) for some circumstances, including if you relocate to another state or are a newly naturalized citizen.
Colorado’s Best Supplemental Medicare Coverage Plans
Medicare Supplement plans (Medigap plans) are the same from carrier to carrier.
- Plan F and Plan G are the same, except that Plan F covers the Federal Medicare program Part B deductible, and Plan G does not.
- Plan N is the best choice for Colorado residents who frequently travel out of the United States. It does not cover excess Part B costs.
- Plan HDF (High Deductible F) offers a more affordable way to supplement Medicare. This plan comes with a higher deductible.
Colorado Medicare Advantage Plans
Medicare Advantage Plans – Part C – are lower in cost, but also lower in coverage and caregiver options. Compared to Medicare Part A, Part B and Part D coverage used in conjunction with a Medigap plan, Medicare Advantage Plans come up short in some ways.
Medicare Part C only offers providers at PPOs and HMOs of Medicare’s choice, and doesn’t have the kind of prescription coverage that Parts A & B, along with Medicare Part D and a Medigap plan, offers.
Colorado Medicare Part D Prescription Drug Plans
The prescription drug plan, Medicare Part D, works with Parts A and B, which do not cover prescription drug expenses. It’s important to enroll in Medicare Part D as soon as you become eligible for Medicare coverage to avoid adding a long-term penalty to your premiums.
How to Apply for Medicare in Colorado
For help with applying for Medicare and Medicare Supplemental insurance, give us a call! Our agents are licensed in Colorado and work with the top carriers. Compare rates over the phone or complete our online rate form here to get quotes.
Resources for Medicare in Colorado
For those whose income falls below a certain amount, there are state savings programs that can help with the cost of Medicare Parts A & B. The Colorado (SHIP) Senior Health Insurance Assistance Program (DORA) offers guidance for those with questions about Medicare and its various requirements and options.
Can I get both Medicaid and Medicare in Colorado? Health First Colorado is the state Medicaid program. If you are over 65 or under with a disability, there will be questions to answer to see if you qualify for Medicaid, but it’s possible you can get coverage with Medicaid if you have Medicare as well, depending on your situation.
Did Colorado quit paying Medicare premiums for low-income people? Colorado offers payment for Medicare Part B for those whose income is below a certain level. For information about what the qualifications are for Colorado residents, please visit this website.