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Medicare in Colorado


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Colorado Medicare Plans

Whether you’re a Colorado resident who is new to Medicare or you’ve been enrolled for a while, you may be wondering how the program works in your state and what your options are. In general, Medicare in Colorado works in the same way as it does in the rest of the country.

Most people first become eligible for Medicare when they turn 65, unless they qualify for Medicare by disability or by having certain conditions, such as end-stage renal disease or amyotrophic lateral sclerosis (also known as Lou Gehrig’s disease). Original Medicare is the federally administered program, which comes in two parts: Medicare Part A (hospital insurance) and Part B (medical insurance). Original Medicare doesn’t cover most prescription drugs (Medicare Part D), so you can enroll in a stand-alone Medicare Prescription Drug Plan if you want this coverage. In addition, you may be able to buy a Medicare Supplement (Medigap) insurance plan that works alongside your Original Medicare coverage. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and in some states to those under age 65 eligible for Medicare due to disability or End Stage Renal disease.

Another option Colorado beneficiaries may have is Medicare Part C. This is an alternative to Original Medicare that is available through Medicare Advantage plans, which are offered through private insurance companies that contract with Medicare. Medicare Advantage plans must cover at least the same level of Medicare Part A and Part B benefits as Original Medicare. Medicare Advantage Plans may also include benefits that go beyond what Original Medicare covers, such as routine vision and dental, hearing, or prescription drugs. Unlike Original Medicare, if you decide you want prescription drug coverage, you can get these benefits through your Medicare Advantage plan, instead of enrolling in a stand-alone plan. These plans are known as Medicare Advantage Prescription Drug plans. You must continue to pay your Medicare Part B premium.

If you opt to get your coverage through a Medicare Advantage plan, you’re still enrolled in the Medicare program, but your benefits will be administered through the Medicare Advantage plan, not the federal program.

To help residents understand the different Medicare coverage options in Colorado, the state has established a number of agencies and organizations. These offices provide information, education, and guidance to Medicare beneficiaries, both those who are newly eligible and those who have been with the program for some time.

Medicare resources in Colorado

Colorado Commission on Aging – The Colorado Commission on Aging was established in 1964 and is currently a division of the Colorado Department of Human Services. Although this organization was primarily created to advocate for seniors, they do offer a limited amount of information about Colorado Medicare plans — specifically Medicare Prescription Drug Plans. The office also works to promote other programs and services that might complement Medicare coverage options. Existing programs are also reviewed regularly by the commission, with recommendations made to members of legislature to improve the quality of life for all seniors.

Colorado Division of Insurance – The Colorado Division of Insurance oversees the State Health Insurance Assistance Program (SHIP), which offers information on Medicare and health coverage, as well as free counseling services to Colorado Medicare beneficiaries. The program also provides information about preventing Medicare fraud and reporting Medicare claim errors.

Colorado Legal Services – Colorado Legal Services is an organization established to provide legal assistance to qualifying low-income residents. The office also offers information to all beneficiaries about the various Medicare options available to them in the state. The website provides links to a wealth of additional Medicare resources. Beneficiaries can learn more about enrolling in Medicare plans (including how to sign up for a Medicare Prescription Drug Plan) and Medicare eligibility requirements. For those who require personal assistance, legal help is available for low-income residents who qualify for services. The organization also provides public presentations from time to time on specific topics like Medicare.

Colorado Medicaid Department – Medicaid beneficiaries with limited income may be eligible for financial assistance with their health coverage. Medicare Savings Programs help with certain Medicare out-of-pocket costs, such as premiums, copayments, coinsurance, and deductibles. To qualify for financial help, you’ll need to meet income and asset thresholds. Find out if you’re eligible by contacting the Colorado Medicaid Department.

As you can see, Colorado residents have many options when it comes to their Medicare benefits. Keep in mind that Medicare plans vary when it comes to costs and benefits, so it’s important to research and compare plan options in your location. If you’d like help finding Medicare coverage options that may work for you, you can contact an eHealth licensed insurance agent to get personalized assistance with your needs.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

Facts about Medicare in Colorado in 2018

  • Colorado had 863,447 Medicare beneficiaries in 2018
  • 631,604 (or about 73% of all Medicare beneficiaries) were enrolled in one type of Medicare prescription drug coverage
  • 43 Medicare Advantage plans were available in Colorado and 24 Medicare prescription drug plans were available
  • 95% of people in Colorado with Medicare have access to a Medicare Advantage plan
  • $20.40 is the lowest monthly premium for a Medicare prescription drug plan

Information from Medicare Enrollment Dashboard and 2018 MA Part D Landscape State by State

The product and service descriptions, if any, provided on these eHealth Insurance Web pages are not intended to constitute offers to sell or solicitations in connection with any product or service. All products are not available in all areas and are subject to applicable laws, rules, and regulations.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply.
Benefits, premiums and/or copayments/co-insurance may change on January 1 of each year.

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