Medicare has become an essential means of protection for millions of Americans 65 and older. But even Medicare doesn't cover everything. The LRFA - Medicare Supplemental Plans are designed to supplement Medicare by paying many of the hospital, medical, prescription drug and surgical expenses only partially covered or not covered by Medicare.
We offer a variety of Medicare Supplemental Plans to members who have Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). See Plan Types below for further details.
Eligibility & Enrollment
Anyone who wishes to be accepted into one of the LRFA Medicare Supplemental Plans, must be either enrolled in Medicare or within one month of eligibility for Medicare. Current LRFA members must complete and return form F-65a, 
with all applicable fees.
Anyone who is not currently an LRFA member must also send in a completed LRFA membership application form F-48(a) along with the appropriate fees.
Participation in our Medicare Supplemental plans is limited to LRFA members only and is NOT open to individuals who participate in the Medicaid (government medical assistance) program.
Waiting Periods*
In order to qualify for benefits, the following waiting periods apply (from the date of acceptance into a plan):
- No waiting period
- ...for any individual applying to an LRFA plan within 60 days of enrolling in Medicare Part A.
- ...for current LRFA members already covered under our LRFA Medicare Supplemental Plan M-1 and M-3 and supplementing coverage with M-4.
- ...for current LRFA members already covered under our LRFA Medicare Supplemental Plan(s) and supplementing coverage with M-2.
- One (1) month waiting period
- ...if applying for LRFA Medicare Supplemental coverage at least 30 days prior to the expiration date of your current policy, i.e., employer or other insurance company. Limitations apply.
- Three (3) month waiting period
- ...if applying for LRFA Medicare Supplemental coverage more than 60 days after enrolling in Medicare Part A.
- ...for current LRFA members already covered under our LRFA Medicare Supplemental plan(s) but supplementing coverage with any additional plan(s). If supplementing your coverage with the M-3 drug plan, during the 3 month waiting period, members may apply all prescription drugs dispensed during this period towards the deductible.
*There is no waiting period in the event of an emergency or accident, regardless of when applying. Limitations apply.
LRFA Plan Types
- M-Basic (Comparable to Medigap Plan A)
- Basic Benefits:
- Hospitalization: Part A coinsurance amounts, plus coverage for Part A eligible hospital expenses for an additional 365 days (in a lifetime) after Medicare benefits are exhausted
- Medical Expenses: Part B coinsurance amounts (20% of Medicare-approved expenses)
- Does not pay Part A & B deductibles
- M-1 (Comparable to Medigap Plan C)
Includes all benefits provided in M-Basic (Medigap Plan A) plus:
- Pays Part A deductible
- Pays Part B deductible
- Pays Skilled nursing facility coinsurance amounts
- M-2
- Covers 100% of the difference between the provider charges and the amount approved by Medicare, up to the amount of charge limitations set by either Medicare or state law. This applies only if the provider does not accept assignment, (i.e.) if the provider does not accept the Medicare approved amount as payment in full. This benefit covers up to a maximum of $3,000 in a calendar year.
- M-3
- Covers 50% of $8,310.00 of out-patient prescription drug expenses up to a maximum of $4,000 in a calendar year, after a $310 deductible is met.
- M-3D
- Initial coverage: Covers 100% of the
co-insurance amounts for Medicare approved prescription drug costs up to the Medicare Part D “coverage gap” stage, after the $310 deductible has been
met.
- Coverage gap: Covers 50% of the out-of-pocket expenses for Medicare approved prescription drug costs up to the
Medicare Part D “catastrophic coverage” stage.
- Catastrophic coverage: Covers 100% of the co-insurance amounts for Medicare approved prescription drug costs up to
$5,000 in total prescription drug costs in a calendar year.
- M-4 (Comparable to Medigap Plan J)
Includes all benefits provided in plans M-Basic, M-1, M-2, and M-3, plus:
- Preventative Medical Care - covers up to $120 per year for preventative care not covered by Medicare.
- At-Home Recovery Services - covers up to $1,600 per year and/or $40 per day for short-term, at-home assistance recovering from illness, injury, or surgery, if already receiving Medicare-covered home health services.
- M-4D
- Provides same coverage as plan M-4 but with M-3D coverage for prescription drugs.
Not Covered
The LRFA Medicare Supplemental Plans DO NOT cover:
- Routine vision and dental care; hearing aids
- Over-the-counter purchased drugs or supplies
- Services or supplies not approved or not within Medicare guidelines
- Expenses covered under another insurance plan or government medical assistance program, that is primary to Medicare
- Expenses not in accordance with Medicare and LRFA regulations or existing laws.
Requests for Benefits
The LRFA Medicare Supplemental Plan claims are processed based upon Medicare's determination as indicated in the "Medicare Summary Notice" received from Medicare. All requests must include Form F-66 and the Medicare document(s). Claims must be received by the LRFA office within one year of receiving medical treatment.
These pages are designed to provide general descriptions of our benefit plans and further restrictions may apply or may have changed. For further information, please contact the LRFA office or refer to specific plan Regulations.
