About 6.3 million people in California use Medicare as their primary health insurance provider. The majority of these individuals are enrolled in Original Medicare (Part A and Part B), but there are also about 1.7 million enrolled in Medicare Advantage plans. Additionally, over 2.3 million people in California are enrolled in Medicare Part D prescription drug coverage. Those who are dually eligible for Medi-Cal and Medicare may be able to receive free or low-cost prescription drug coverage through a Special Needs Plan.
Medi-Cal Eligibility
Medicare is available to legal U.S. residents who are at least 65 years old or have certain disabilities, including ALS and End-Stage Renal Disease (ESRD). Those under 65 may qualify for Medicare through the Disability Insurance Benefits Program or SSDI. In addition to a basic Medicare Advantage plan, California residents can choose from various Medicare Supplement insurance options, called Medigap policies, which are sold by private insurers.
How to Apply for Medi-Cal?
Depending on your income, you may be eligible to receive financial help from Medicare to pay for your health care costs. You can apply for Medi-Cal and Medicare by calling your county office or visiting a local Social Security field office. There are offices located all over California. The office that you call will ask a few simple questions to determine your eligibility. They will also tell you whether you are eligible for other programs to help you pay your health care costs.
You can sign up for Medicare during your initial enrollment period, which begins three months before your 65th birthday and ends three months after it. This period is referred to as the Medicare Advantage open enrollment period. It is important to enroll during this period because it will avoid penalties and delays in coverage.
If you’re still working and have group health insurance, you can still sign up for Part B during the general enrollment period, which runs from January 1 to March 31 each year. However, you’ll have to pay a late-enrollment penalty.
If you have any questions about the Medicare application process, contact one of California’s regional area agencies on aging. The agency can connect you with a HICAP counselor, who will provide individualized one-on-one assistance and education. The organization also offers a variety of other resources to help you navigate Medicare.
California Medicare Advantage Plans
Many California Medicare Advantage beneficiaries find it difficult to navigate the plan options. Fortunately, there are several ways to get help with your Medicare Advantage plan selection process. You can access information online, by phone, or in person at a local Social Security office. Alternatively, you can enroll through a private insurance broker or a Medicare Advantage provider. It’s important to note that Medicare and Social Security don’t cold-call beneficiaries to solicit information.
If you’re a Medicare Advantage plan member, you can change plans during the annual Medicare Advantage open enrollment period, which runs from October 15 to December 7 each year. This open enrollment period is also a good time to switch to Medicare Part D, which covers prescription drugs. If you’re looking for a new Medicare Advantage plan, consider choosing one company with high ratings. Alignment Health Plan, Aetna, and SCAN offer low rates and useful perks for their Medicare Advantage plans.
If you’re unsure about whether Medicare Advantage is right for you, contact your local Area Agency on Aging. They can connect you to a Medicare counselor who can help you navigate the process. The counselor can also provide assistance with filing appeals and challenging denials. You can also visit the Medicare Rights Center website for more information. The site provides a free service for seniors, and is available in most states.
California Medicare Savings Program
The state where you live can greatly impact how much your Medicare benefits cost. In California, many retirees can take advantage of state programs that help pay for the Medicare Part B premium, deductible, and copayments. These programs are known as Medicare Savings Programs, and they can save retirees a lot of money. The eligibility rules for these programs vary by state, but they usually depend on your income and assets. Some states have lower income limits than others, and some don’t count your savings in the equation.
In some cases, these programs can eliminate the Medicare Part B premium and other costs for low-income Medicare beneficiaries. In other cases, they can reduce these costs for all Medicare beneficiaries. These programs are available through a variety of sources, including the Medicare agency in your state and local community services agencies. They can be applied for at the same time as Medicare or during an open enrollment period, which runs from Oct. 15 to Dec. 7.
Some states also offer other types of help for Medicare beneficiaries, such as Extra Help, a program that lowers Medicare Part D prescription drug costs. To qualify for this program, you must have low incomes and assets. You must apply for these benefits through your state’s Medicaid agency, and you can do so online or by phone. In addition, you must report any changes in your income or financial circumstances to your state Medicaid agency, or else you may lose your benefits.