Medicare

Medicare is a health insurance program for people 65+, those under age 65 with qualifying disabilities or any individual with end-stage renal disease. You MUST apply for Medicare benefits the month before you turn 65.You can apply for Medicare 3 months before turning 65 years old.

For a complete list of Medicare benefits visit medicare.gov or call (800) 633-4227.

Medicare Part A (Hospital Insurance)

You usually don’t pay a monthly premium for Part A coverage if you or your spouse paid Medicare taxes while working. If you did not pay Medicare taxes, you can buy Part A coverage and pay a monthly premium. Part A benefits include: • Inpatient care in hospitals • Skilled nursing facility care (for rehab services) • Hospice care • Home health care

Medicare Part B (Medical Insurance)

Part B benefits include: Services from doctors and other Health care providers • Outpatient care • Home health care • Durable medical equipment • Some preventative services

Medicare Part C (Medicare Advantage)

Managed by Medicare-approved private insurance companies. Includes: • All benefits and services covered under Part A and Part B (some co-payments and deductible may vary, and you may be required to use in-network providers) • Usually includes Medicare prescription drug coverage (Part D) as part of the plan • May include extra benefits and services for an extra cost

Medicare Part D (Medicare prescription drug coverage)

Managed by Medicare-approved private insurance companies. Helps cover the cost of prescription drug. May help lower your prescription drug costs and help protect against higher costs in the future (if you do not enroll in a Part D plan when you become eligible for Medicare benefits and enroll at a later time, you will be subject to penalties and your premiums will be higher).

Low Income Subsidy (LIS) - Also known as Extra Help with Medicare Part D

For individuals who receive Part D prescription drug coverage and are low income, there is assistance available for the costs of deductibles and copays. This Extra Help is also known as the Low-Income Subsidy (LIS). 52 | 2022-2023 Answers on Aging Resource Guide

Medicare Savings Programs (MSP)

Four Kinds of Medicare Savings Programs: • Qualified Medicare Beneficiary (QMB) Program • Specified Low Income Medicare Beneficiary (SLMB) Program • Qualifying Individual (QI) Program • Qualified Disabled and Working Individuals (QDWI) Program

For more information or assistance on Medicare plans and benefits, please contact the local State Health Insurance Assistance Program (SHIP) listed below:

UCHealth Senior Services/Aspen Club (local SHIP)

(970) 495-8560 1025 Garfield Street, Suite A, Fort Collins, CO 80524

The following agencies can also assist you with questions regarding Medicare Part D, Medicare Savings Program, and Low Income Subsidy benefits and enrollment:

Larimer County Office on Aging / Aging and Disability Resources for Colorado (ADRC)

1501 Blue Spruce Drive, Fort Collins, CO 80524 Medicare Saving Program application assistance.

Larimer County Department of Human Services

(970) 498-6300 1501 Blue Spruce Drive, Fort Collins, CO 80524 200 Peridot Avenue, Loveland, CO 80537 For information on Medicare Savings Programs

Social Security Administration

(800) 772-1213 To apply for Medicare, contact Social Security three months before you turn 65 years old. You can also apply for Part A (premium-free) and Part B (for which you pay a monthly premium) at socialsecurity.gov/retirement. If you are under 65 and disabled, you’ll automatically get Part A and Part B after you receive disability benefits from Social Security for 24 months.

MEDICARE QUALITY IMPROVEMENT ORGANIZATIONS

KEPRO (844) 430-9504

The Quality Improvement Organization (QIO) Program is dedicated to improving the quality of care and health outcomes for beneficiaries of Medicare. As the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO), KEPRO provides information and assistance to providers, patients, and families regarding beneficiary complaints, quality of care reviews, discharge appeals, and advocacy.