Additional Coverage
NEW Critical Illness Insurance
When a heart attack, stroke, or other serious illness strikes, we’ve got you covered with our new critical illness insurance.
This new coverage for active members only from The Standard is part of our commitment to protect you, From Day One.
- No cost to active members
- Lump-sum payment if diagnosed with a covered illness after enrollment
- Funds can be used for medical bills, household expenses, travel, etc.
- Additional "buy-up" options available
- Option to cover spouse/domestic partner and children (member-paid)
Buy-up Rates
- Rates are age-based and increase as you move into a new age bracket.
Buy-up and Dependent Options
You can purchase additional coverage for yourself, your spouse or domestic partner, and your children.
- Active LAFRA Member: Buy-up amounts are in addition to the LAFRA provided $10,000 coverage being provided at no cost to you.
- Spouse: You may cover a spouse/domestic partner at 100% of your own buy-up benefit level.
- Children: Children are covered at 50% of the active member’s buy-up benefit amount.
Medical Equipment
Durable medical equipment (DME) is an essential component of health coverage, and LAFRA has many items available to members.
- Coverage: Applies to the purchase or rental of medical equipment, mechanical devices, or supplies
- Equipment access: Available for checkout on a first-come/first-served basis
- Available items: Canes, crutches, folding walkers, knee scooters, bedside commodes, rollators, shower chairs and wheelchairs
- Eligibility: Members, spouses/domestic partners, widows, dependent children, or household members
If LAFRA doesn’t have an item available, you must obtain the DME through your medical plan.
- PPO members: anthem.com/ca
- HMO members: (800) 464-4000
- Medicare members: medicare.gov
Questions?
(323) 259-5200 ext. 0
Medicare Integration
For Relief PPO Medical Plan Members
For members and eligible dependents covered under the Relief PPO Medical Plan, there are adjustments to your premiums once you reach age 65 and are no longer on active duty. At that point, it is mandatory to enroll in all eligible parts of Medicare A and B.
Important: You should begin the enrollment process with Medicare 90 days before your 65th birthday to allow sufficient time to process your application.
Step 1: Sign Up for Medicare
- Visit your local Social Security office
- Contact Social Security at (800) 772-1213
- Go to medicare.gov for information on Medicare eligibility, deductibles, and premiums
Step 2: Notify LAFRA of your Medicare status
- Fax a copy of your Medicare card to (323) 259-5222 or (323) 259-5223.
- Mail a copy to: Member Services, Los Angeles Firemen’s Relief Association, 7470 N. Figueroa Street, Los Angeles, CA 90041
How Medicare Works with the Relief PPO Medical Plan When Medicare is Primary
If you have Medicare Parts A and B:
- Covers your hospital deductible and coinsurance while you (or your eligible dependent) are in the hospital and using Medicare Part A
For Medicare Part B:
- Reimburses your deductible
- Pays 20% of Medicare-approved charges
- Pays 80% of any remaining balance
- Never pays more than what the plan would pay if you didn’t have other insurance
If you have Medicare Part B only:
- Covers your regular hospital benefits, except for lab and x-ray charges already covered by Medicare Part B
Also:
- Reimburses your Part B deductible
- Pays 20% of Medicare-approved charges
- Pays 80% of any remaining balance
- Never pays more than what the plan would pay on its own
Payment of Claims
Submit expenses to Medicare using the payment form from your handbook or local Social Security office. For Relief PPO reimbursement, send the “Explanation of Medicare Benefits” and an itemized bill to the plan.