Medicare

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Medicare Supplement Plans

CA Medicare Supplement plans pay many of the doctor and hospital bills that are not covered by Medicare. The graph below compares supplement plans currently offered.

Medigap policies are a form of private supplemental insurance that pay for part or all of Medicare’s coinsurance and deductibles. Certain policies also cover health care costs that Medicare doesn’t cover, such as emergency medical care in foreign countries, and excess charges from a provider who does not accept assignment. By law, companies can only offer 10 standardized Medigap policies, known as plans A-N. (These include plans A, B, C, D, F, G, K, L, M and N. Plans E, H, I and J were dropped due to changes in federal law effective June 2010.)
Unlike certain Medicare Advantage Plans in California, Medigap plans do not restrict you to a network of providers and facilities.
Medigap policies are sold through licensed insurance agents, sponsoring groups or through the mail by private insurance companies. You only need one policy, and it is illegal for an insurer to sell you more than one.

Preexisting Conditions

In California, certain Medigap companies impose a waiting period before paying benefits for a preexisting condition. By law the waiting period may last up to 6 months for conditions treated 6 months prior. During this time, the company is not required to cover costs associated with your pre-existing condition. Some companies use a shorter waiting period of 30 or 60 days.

You are eligible for Guarantee Issue if:

  • You had health coverage during the 6 months prior to purchasing a Medigap plan
  • You are in a guaranteed-issue period
  • You are buying a new Medigap policy to replace another one

Click for the Medicare and You Handbook
New to Medicare

You will receive your Medicare card in the mail in a plain white envelope typically 90 days before you turn age 65. You need to work roughly 10 years to qualify for Medicare. If you are retired and drawing Social Security, you should automatically receive Part B. It is always best to check with your local Social Security Office.

Enrolling online for Medicare

Medicare has a done a good job allowing you to enroll online instead of visiting a local Social Security office. You can enroll here.

Medigap & Medi-Cal

If you have full benefits from Medi-Cal (California’s Medicaid program), you do not need a Medigap policy.

If you have Medi-Cal with Share of cost (SOC), you can buy a Medigap policy to fill in the gaps.

Medicare and You Handbook
Click here for the latest handbook

Each year, Medicare will adjust the deductibles and co-payments when necessary as directed by CMS. It is important to note that Medicare Supplements
automatically adjust each year to any changes that Medicare makes. Please click here or the Medicare and You Handbook to view the latest benefits available.

 

 

 


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