Medicare is an essential means of protection for millions of Americans 65 and older. But Medicare doesn’t cover everything. A “Medigap” plan is health insurance sold by private insurance companies to fill gaps in Medicare coverage (coinsurance, copayments, or deductibles). The LRFA Medicare Supplemental plans are designed to help our members cover those expenses. Ir dažādi ALPF Medicare papildu plāni, kas izstrādāti, lai atbilstu jūsu vajadzībām, tostarp atsevišķs recepšu zāļu seguma plāns (M-3). Pievienojieties ALPF un ļaujiet mums jums palīdzēt.
Lieliska klientu apkalpošana!
“Man vienmēr šķita, ka cilvēki, ar kuriem runāju, zvanot, ir ārkārtīgi izpalīdzīgi un patīkami.“
“Jau daudzus gadus esmu ļoti apmierināta ar ALPF.“
The LRFA Medicare Supplemental Plan is unique.
LRFA strives to help make life a little easier for our members. We offer these benefits only to members with Medicare coverage. LRFA rates are the same for all 50 states. For insurance companies, your plan rates vary by state, gender, and other factors.
LRFA makes every effort to set our benefit plans at affordable rates for our members. Monthly payments are uniform, regardless of a participant’s state of residence or gender. Choice of health care providers is left entirely up to our member. When shopping a plan, service and reliability are also important factors to consider. LRFA takes pride in giving our members the best service possible. Our Medicare Supplemental department has been working to serve our members’ since 1966.
Features
- Vienkārši application with basic health questions; no physical exam required
- Reģistrēties plkst jebkurā laikā, nav jāgaida “reģistrācijas periods”
- Prēmijas neatšķiras atkarībā no dzīvesvietas valsts
- Segums ceļojuma laikā, bez iepriekšējas autorizācijas
- Mainiet vai palieliniet plānus jebkurā laikā, bez soda
- Pilna ārstu, slimnīcu un aptieku izvēle. Nav tīklu (no networks).
- Visas recepšu zāles (no augstām izmaksām, retām zālēm līdz lētākajām ģenēriskajām zālēm) ir iekļautas M3
- Lieliska klientu apkalpošana! – 97% aptaujāto dalībnieku mūsu klientu apkalpošanu novērtēja kā labu vai izcilu!
Eligibility & Enrollment
Lejupielādējiet Medicare papildu plāna reģistrācijas veidlapu
Current LRFA members must sign and complete the enrollment form, which includes basic health questions, and submit it by mail, along with all applicable fees. Upon receipt, LRFA will review your application and notify you of acceptance and start date. Anyone not currently an LRFA member may apply for membership at the same time as application. LRFA is not an insurance company and our plans are available only to LRFA members.*
Enrollment is open to all LRFA members, age 65 and older, who have Medicare coverage (Part A & B). You must provide a copy of your valid Medicare card. Individuals on Medicaid, Disability, or other government medical assistance programs are not eligible. Individuals with Medicare Advantage plans are not eligible.
Kas tiek segts?
The LRFA Medicare Supplemental Plans are designed with simplicity and cost-effectiveness. They help cover physician and hospital services, out-patient care, skilled nursing facility services, diagnostic tests, radiology and laboratory charges. We process your Medicare statements and follow Medicare guidelines for approved services, using the calculated amounts the patient is expected to pay. Invoices you receive from the provider should be submitted for all claims.
M-Basic vāki:
- Medicare Part A hospital co-insurance and Medicare Part B medical co-insurance
- Medicare A un B daļas asins pārliešana
- After a $8,000 benefit allowance is reached, expenses are covered at a 50% rate.
M-1 aptver:
- Medicare A daļas slimnīcas pašrisks UN kopapdrošināšana
- Medicare B daļas medicīniskais pašrisks UN kopapdrošināšana
- Medicare A un B daļas asins pārliešana
- Kvalificētu aprūpes iestāžu kopapdrošināšana
- After a $8,000 benefit allowance is reached, expenses are covered at a 50% rate.
M-2 sedz papildu maksas:
- 100% of the difference between Medicare’s approved amount for Part B services and the billed provider charges
- maksimālais ieguvums par vienu pakalpojumu sniedzēja sniegto pakalpojumu ir $500
- maximum benefit allowed in a calendar year is $4,000
M-3 is a Prescription drug coverage for LRFA members ages 65 and over. This plan covers 50% of all prescription drugs with no coverage gaps after a deductible has been met, up to the annual maximum. Drugs must be prescribed by a licensed physician but do not have to be Medicare approved. Participation in Medicare is not required.
M-4 aptver:
- Viss, kas iekļauts M-Basic, M-1, M-2 un M-3
- PLUSS: profilaktiskā aprūpe, tostarp pārbaudes, holesterīna skrīnings, cukura diabēta skrīnings, dzirdes testi un vairogdziedzera pārbaudes, ko nesedz Medicare
- Īstermiņa aprūpe, tostarp medicīniskā palīdzība mājās, atveseļojoties pēc slimības, traumas vai operācijas, ja jau saņem Medicare segtos mājas veselības aprūpes pakalpojumus
- After a $8,000 benefit allowance is reached, expenses are covered at a 50% rate.
M-6 aptver:
- tāds pats kā M-1, ar ātrumu 50%
- The maximum benefit allowed is $12,000 per calendar year
M-7 aptver:
- sedz to pašu, ko M-4, pēc tam, kad ir izpildīts pašrisks
- After a $8,000 benefit allowance is reached, expenses are covered at a 50% rate.
Gaidīšanas periodi
Pabalsta pieprasījumu gaidīšanas periods visiem jaunajiem dalībniekiem ir 3 mēneši (no dienas, kad tas ir iekļauts plānā).
Nav segts
ALPF Medicare papildu plāni NEATTIECAS:
- Regulāra redze un zobu kopšana
- Bezrecepšu zāles vai piederumi, tostarp dzirdes aparāti
- Pakalpojumi vai piegādes nav apstiprinātas vai neatbilst Medicare vadlīnijām
- Izdevumi, kas segti saskaņā ar citu apdrošināšanas plānu vai valdības medicīniskās palīdzības programmu, kas ir primārā Medicare
- Izdevumi neatbilst Medicare un LRFA noteikumiem vai esošajiem likumiem.
- Ierobežojumi var attiekties uz izdevumiem, kas pārsniedz parastās un parastās maksas.
Plan Fees for 2027
| M-Basic | VĀKI:
|
Age 65-70: $139 Age 71-80: $199 Age 81+: $208 mēnesī |
| M-1 | VĀKI:
|
Age 65-70: $210 Age 71-80: $318 Age 81+: $330 mēnesī |
| M-2 | VĀKI:
|
Age 65-70: $60 Age 71-80: $88 Age 81+: $115 mēnesī |
| M-3 | VĀKI:
|
Age 65-70: $100 Age 71-80: $139 Age 81+: $189 mēnesī |
| M-4 | Nodrošina tādu pašu pārklājumu kā plāni M-1, M-2 un M-3 kopā, kā arī:
|
Age 65-70: $370 Age 71-80: $545 Age 81+: $564 mēnesī |
| M-6 | ATTIECAS uz visām procedūrām, kas ietvertas M-1, ar ātrumu 50%
|
Age 65-70: $98 Age 71-80: $139 Age 81+: $166 mēnesī |
| M-7 | COVERS all procedures covered in M-4, after a deductible of $2,500 is met
|
Age 65-70: $220 Age 71-80: $242 Age 81+: $284 mēnesī |
Compare Medicare Supplemental Plans
Ātrās salīdzināšanas diagrammas Here is a quick look at how these plans compare in terms of coverage. Medicare alone does not offer complete protection from rising medical costs. For this reason most people seek additional coverage, which pays some of the amounts that Medicare does not pay for covered services and may pay for certain services not covered by Medicare. This type of private insurance is known as Medigap and is regulated by federal and state law, which mandates that all plans follow the same 10 standardized plans. This makes it easier for consumers to comparison shop.
Please read your plan regulations to determine how individual charges are calculated and any limits that may apply. LRFA is not an insurance company and provides benefits exclusively to our members.*
**Medigap plans C & F will no longer accept new enrollment as of Jan 1, 2020. If you live in Massachusetts, Minnesota, or Wisconsin, your state offers different standardized plans.
*Important Disclosures
The LRFA Medicare Supplemental Plan is a member benefit provided by LRFA, a nonprofit organization. It is not underwritten by an insurance company, and benefits are paid by LRFA, not by an insurer. The plan is not covered by the Pennsylvania Life and Health Insurance Guaranty Association. The plan is not major medical coverage and does not meet the requirements of the Affordable Care Act. It is available only to LRFA members and eligible dependents. Benefits are subject to exclusions, reductions, limitations, and waiting periods, and benefit amounts and fees depend on the plan selected. Please review the brochure and plan Regulations for complete details.