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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