California had 4,684,845 Medicare beneficiaries in 2010, according to the Kaiser Family Foundation.
Medicare is a national health care program designed mainly for senior citizens aged 65 years or older. Original Medicare, Parts A and B, are standardized, with the same benefits available to all users, all over the United States. The other two parts of Medicare, Part C, which is also called Medicare Advantage, and Part D, are sold by private insurance companies. The details regarding these parts of Medicare can change drastically depending on where you live and from which company you buy them. California Medicare plans are overseen by the Department of Health Care Services.
Original Medicare
Original Medicare benefits offer coverage for a number of different services. These include inpatient and outpatient hospitalizations, inpatient and outpatient mental health services, home health care, hospice, physical exams and health screenings. Part A is often premium-free but has deductibles and coinsurance charges, while Part B has a monthly premium and a 20 percent copay for most services. Most Part B preventive screenings are free, although you may owe a copay to the doctor or hospital for performing the test.
Medicare Advantage
Medicare Advantage is the third part of Medicare. Since it is sold by private companies, these companies set their own premiums, deductibles, copays and coinsurance charges, although they must stay within the federal Medicare guidelines. California Medicare Advantage plans must include all the benefits you can get from Original Part A and Part B, except hospice care, which is always covered by original Medicare. As of 2011, the majority of California's Medicare Advantage policies were sold as HMO plans, PPOs, or private fee-for-service plans. Most are sold by county, although the Freedom Blue Plan I sold by Anthem BlueCross of California is a regional PPO sold throughout the state.
Part D
Part D Medicare covers only prescription drugs. If you already get prescription drug benefits through your Medicare Advantage plan, you do not need to purchase a separate Part D plan. Part D monthly premiums, copays and coinsurance costs are set mainly by the companies that sell it, but they cannot apply a maximum annual deductible higher than the one decided by Medicare. In 2011, the highest allowable annual deductible for Part D was $310. Part D plans are also sold by service area and may differ in the kinds and brands of drugs they cover. Examples of Part D plans offered in California in 2011 are the CVS Caremark Value, the Health Net Orange, the BlueCross MedicareRx Gold and the AARP MedicareRx Enhanced.
Medicare Savings Programs
California has several programs that help low-income seniors afford original Medicare's monthly premiums. Eligibility is decided by your income, assets and whether you are single or married. Depending on your eligibility, you may receive with help with the Part B premium, the coinsurance for Parts A and B and the annual deductibles. If you are a disabled working person who receives Medicare, you may qualify for help with the Part A premium as well.
Tags: Medicare Advantage, California Medicare, Part Part, annual deductible, California Medicare Advantage, coinsurance charges
