Department of
Insurance

Options for Disabled Under 65 on Medicare

1. Employer Plan

   If you are on Medicare by reason of disability, and either you or your spouse is covered by a large group health plan (sponsored by an employer/employee organization of over 100 workers), the employer plan will provide your primary coverage and Medicare will be secondary. If you are not covered by such a plan, Medicare will be primary.

2. Medicare Savings Programs

   There are government programs in addition to Medicaid that help people with limited income and resources pay their Medicare costs.
   • QMB (Qualified Medicare Beneficiary) pays your monthly Medicare Part B premium ($96.40 in 2008) and all of your deductibles and coinsurance.
   • SLMB (Specified Low-Income Medicare Beneficiary) pays your monthly Medicare Part B premium only.

   To be eligible for these programs, your resources must be less than $4,000 for an individual and $6,000 for a couple. (Resources do not include your home, your car, or your household belongings.)

   Contact your local Department of Health and Welfare to find out more.

3. Medicare Advantage Plans

   Plans available in Idaho
   
   Refer to Compare Health Plans and Medigap Policies in Your Area on the www.medicare.gov website.
   

4. Medigap Insurance Policies

   Companies are not required to offer policies, most do not and will not accept those with ESRD.

5. At Age 65

   Under federal law, you are guaranteed the Medigap plan of your choice.