INSURANCE - HEALTH;

You asked what happened to Med Span, a Connecticut HMO, whether there is anything available to supplement Medicare coverage, and how does the Medicaid spend-down requirement work.

Med Span, a Connecticut-based HMO, merged with Oxford, another Connecticut-based HMO last year. Enrollees of Med Span are now covered by Oxford. Oxford continues the Medicare HMO program that Med Span operated.

Senior citizens who qualify for Social Security also participate in the federal Medicare health insurance program at age 65. Medicare pays 80% of their approved hospital and medical bills after an annual deductible. Private insurance companies sell individual Medicare supplement policies (also called “Medigap” insurance), which generally pay the other 20% of Medicare-approved expenses. In 1990, the federal government established 10 standardized Medigap plans, labeled Plans A through J. Benefits vary according to the plan an individual chooses.

To qualify financially for Medicaid, an individual must pass both an income and asset test. Medicaid’s spend-down provision allows people who are otherwise eligible for medical assistance except for their excess income to spend that excess income on unpaid medical bills over a six-month period to bring their income down to a level that qualifies them for Medicaid coverage.

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