Insurance and Patient Information

///Insurance and Patient Information
Insurance and Patient Information 2018-02-20T07:40:34+00:00

Medicare ABCD Coverage

Part A (“Original Medicare”) is your Hospital Coverage.  It helps cover inpatient hospital care, skilled nursing facilities, and some hospice and home healthcare.  Part A Coverage is free for most people.
Part B (“Original Medicare”) is your Medical Services & Supplies Coverage.  It helps pay for services such as doctor’s visits, preventative care services, outpatient procedures, rehabilitation therapy, lab tests, X-rays, mental health services, and medical equipment such as diabetes testing supplies, nebulizers, and walkers.  Part B is optional and most participants pay a monthly premium and annual deductible.
Part C (“Medicare Advantage”) is your Private Insurance Coverage.  You must have both Part A and B to enroll in a Medicare Advantage plan.  Part C provides all Part A and Part B benefits, except hospice care.  In addition, it generally offers additional benefits, such as vision, hearing, dental or fitness, and sometimes even combines Part D coverage.  The monthly premium, copays, and deductibles vary by plan.
Part D is your Prescription Drug Coverage offered through private plans approved by Medicare to help lower out-of-pocket prescription costs.  You must have both Part A and B to enroll in Part D.   It can either be a stand-alone Prescription Drug Pan (PDP) or a Medicare Advantage Prescription Drug (MA-PD) Plan.  The monthly premium and sometimes a deductible, as well as copays vary by plan.

Medicare vs. Medi-Cal

Medicare Medi-Cal
Federally governed health insurance program California Medicaid program.  Medicaid is a joint Federal-State program
Designed to help with long-term care for the elderly Designed to cover healthcare costs for the poor
For: people age 65 and older, younger people with disabilities, people of all ages with End-Stage Renal Disease For low-income individuals including: families with children, seniors, persons with disabilities, foster care, pregnant women, low-income people with specific diseases
Four parts of Medicare cover specific services: Part A, B, C, D
Administered by the Centers for Medicare and Medicaid Services (CMS) Administered by the California Department of Health Care Services (CDHS)
If you have both Medicare and Medi-Cal, Medicare pays first. Medi-Cal pays second.

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