Medicare in Colorado - Plan Options
Colorado residents at least 65 years old or with a qualifying disability can receive medical insurance from Original Medicare, a federal program. Over 900,000 people in Colorado are currently covered by Medicare.
Medicare Plans in Colorado
Various Medicare plans in Colorado offer different coverage levels based on your medical needs and way of life. If you suffer from multiple health conditions or a disability, Original Medicare may not cover all your expenses, resulting in higher out-of-pocket costs. For comprehensive care, Medicare Advantage could be a suitable alternative. But, if you’re looking for more extensive coverage, a Medigap plan can assist in covering Medicare’s remaining gaps.
Let’s start with the basics. Here are the five types of Medicare plans in Colorado:
Original Medicare (Parts A & B)
In Colorado, Original Medicare serves as the base of the Medicare program. It encompasses Part A (hospital insurance) and Part B (medical insurance). Part A is typically premium-free for those who’ve paid Medicare taxes for at least ten years. On the other hand, Part B requires a monthly premium based on income. Although Original Medicare covers a wide range of healthcare services, it doesn’t include coverage for certain aspects like prescription drugs.
Medicare Advantage (Part C)
Private insurers offer Medicare Advantage (MA) plans in Colorado that Medicare approves. These plans provide all the benefits of Original Medicare, along with additional coverage for prescription drugs, vision, dental, and hearing. Compared to Original Medicare, MA plans typically have lower out-of-pocket costs. With a wide range of Medicare Advantage plans available in Colorado, it’s wise to compare and find the one that best suits your needs.
Medicare Supplement Insurance (Medigap)
In Colorado, private insurers also provide Medigap plans that fill the gaps in coverage left by Original Medicare. These plans cover expenses such as deductibles, co-payments, and coinsurances. Ten standardized Medigap plans are available, labeled with letters A through N, with Plan G being the most popular choice. Regardless of the insurance company, the government standardizes the benefits of each plan. In addition to your Original Medicare premium, Medigap policies require a monthly premium.
Medicare Prescription Drug Plans (Part D)
Prescription drug coverage is not included in Original Medicare for Colorado residents. However, there is an option to obtain it through a standalone Medicare prescription drug plan offered by private insurers approved by Medicare. It is important to note that each plan has a formulary, a list of covered prescription drugs. Therefore, selecting a plan that includes the medications you require is crucial. Additionally, it is worth considering that formulary changes may occur annually.
Special Needs Plans (SNPs)
In Colorado, there are Medicare Advantage plans called SNPs, designed for individuals with certain chronic conditions or those needing specialized care, such as those with Medicare and Medicaid. SNPs come in three types: Chronic Condition SNPs, Dual Eligible SNPs, and Institutional SNPs. It’s important to note that not all SNPs are available in every area of Colorado, and not all individuals are eligible for SNP plans.
Medicare Eligibility in Colorado
Medicare benefits in Colorado are available for individuals aged 65 and older, those with disabilities who are younger, and people diagnosed with End-Stage Renal Disease (ESRD).
To be eligible for Medicare in Colorado, you must meet national standards established by the Social Security Administration (SSA). As a U.S. citizen or permanent resident, if you’ve worked in Medicare-taxable jobs for at least ten years, you’ll be eligible for Medicare at age 65. Nevertheless, before applying for Medicare benefits, you must have resided in the United States for at least five consecutive years.
Individuals younger than 65 may be eligible if they have received Social Security disability benefits for at least 24 months or have ESRD. Individuals with ESRD must also meet residency requirements to be eligible.
In addition to meeting specific eligibility requirements, applicants must apply for Medicare coverage before their 65th birthday or within three months after their disability begins to avoid late enrollment penalties. Applicants can use the Social Security website or visit a local office for assistance and advice.
How Do I Apply for Medicare in Colorado?
Applying for Medicare in Colorado is an easy process. You can apply online or by phone.
If you apply online, you must visit the Social Security Administration website and complete an application. The website includes a helpful tutorial that walks you through the process step-by-step. Once your application has been submitted, completing the process typically takes less than 10 minutes.
If you prefer to apply over the phone, call 1-800-772-1213 (TTY users should call 1-800-325-0778).
As you can see, each plan type has unique features and benefits. Choosing the right Medicare plan in Colorado can seem daunting initially, but don’t let that scare you off. Take some time to research, ask questions, and decide which plan best fits your specific healthcare needs and budget. Colorado is known for its beautiful mountains and excellent healthcare; why not enjoy both?
Colorado Medicare Resources
Colorado residents should take the time to learn about the Medicare options that are available to them. There are various resources available to seniors and caregivers in Colorado that can improve their well-being, such as Area Agencies on Aging (AAAs), nearby public health agencies, and nonprofit groups. These organizations can provide important information and programs for seniors.