Welcome website visitor
Are you New to Medicare?
Learn about how to enroll in Part A Hospital and Part B Doctor Visits and then follow the link to Medicare’s site where you can enroll. We are happy to help you enroll and there is no extra charge in plans to supplement Medicare, like Medi Gap, Part D Rx and Medicare Advantage.
We will try to give you everything you want to know in Plain English. Medicare might be very confusing. IMHO, if one just takes some patience and reviews the information and brochures, both from us and from Official Medicare Pamphlets, it should get clear. If not, email us, * set a meeting, * ask us a question right on our website, you don’t have to even leave your name.
See our NEW Virtual Introduction to Medicare Seminar. Just bring your own coffee & danish.
We highly recommend that you at least glance through Medicare & You Publication # 10050 which gives an EXCELLENT Overview and most of the Information you will ever want to know.
If you are viewing this webpage on a full screen monitor, we show many of the Medicare Brochures to the right, if you are viewing on a smartphone, just scroll down.
Medicare, Medicare Advantage nor Medi Gap pay for long term care either in a nursing home or at home care. Get more information on Long Term Care here. Even if you think you can’t afford any extra premiums,
Medicare Advantage Plans
aka Part C
These plans often include Dental & Part D – Rx Prescriptions and often have NO premiums! How is that possible? The Federal Government pays them around $700/month to handle your medical care. You must continue to pay your Medicare Part B premium of about $140/month. It’s best to apply when you turn 65 for the supplement plans or advantage plans, as that’s the main “Open Enrollment” period, guaranteed issue for any plan.
Medicare Advantage Plans also have an annual open enrollment now known as AEP Annual Election Period October 7 to December 15th.
Additional Coverage is important as Medical Bills are increasing Seniors Credit Card Debt or leading to possible bankruptcy?
You cannot buy additional coverage through #Covered California
if you have premium-free Medicare Part A Hospital
Medicare complies with Health Care Reform, so you do NOT need to get a an Individual policy or a subsidized one from Covered CA. It fact, it's illegal for anyone to sell you a policy! Kaiser Health News * Covered CA Medicare Fact Sheet * Medicare.Gov Medicare & Market Place #11694 * CMS.Gov FAQ Medicare & Marketplace * HealthCare.Gov when - how to change from Covered CA to Medicare * Social Security §1882 * Health Care.Gov
NOTE: This information also applies to people younger than 65 whose benefits begin the first month they receive disability benefits because they have Amyotrophic Lateral Sclerosis (ALS), better known as Lou Gehrig’s Disease, and to people younger than 65 who have Medicare because of a disability and are receiving SSDI Social Security Disability Insurance.
There are a lot of ands, if or buts in this complex issue. Please refer to the source material below. There are some exceptions, but they are very complex. Don't even think of getting a 1/2 correct answer over the phone. If you have to pay for Part A Hospital, then are options, like subsided Covered CA Plans. Email us [email protected] or ask a question below.
Video about Covered CA – if no Premium Free Part A – jump to 2:30 Medicare & the Marketplace (Covered CA
Links & Resources
(i) It is unlawful for a person to sell or issue to an individual entitled [no premium] to benefits under part A or enrolled under part B of this title (including an individual electing a Medicare+Choice plan [MAPD] under section 1851)—
(I) a health insurance policy with knowledge that the policy duplicates health benefits to which the individual is otherwise entitled under this title or title XIX,
(II) in the case of an individual not electing a Medicare+Choice plan, [aka MAPD Medicare Advantage] a medicare supplemental policy with knowledge that the individual is entitled to benefits under another medicare supplemental policy or in the case of an individual electing a Medicare+Choice plan, a medicare supplemental policy with knowledge that the policy duplicates health benefits to which the individual is otherwise entitled under the Medicare+Choice plan or under another medicare supplemental policy, or
(III) a health insurance policy (other than a medicare supplemental policy) with knowledge that the policy duplicates health benefits to which the individual is otherwise entitled, other than benefits to which the individual is entitled under a requirement of State or Federal law.
(ii) Whoever violates clause (i) shall be fined under title 18, United States Code, or imprisoned not more than 5 years, or both, and, in addition to or in lieu of such a criminal penalty, is subject to a civil money penalty of not to exceed $25,000 (or $15,000 in the case of a person other than the issuer of the policy) for each such prohibited act. Sec. 1882. [42 U.S.C. 1395ss]
Our webpages that touch on this Issue:
#Medicare10050 and You 2021
Everything you want to know - Read Along
- Enroll in Blue Cross
- Learn about UHC United Health Care
- Enroll in Blue Shield
- Don't like computers? Prefer a printed version be mailed to you? Audio MP 3
- Use our scheduler to Set a phone, Skype or Face to Face meeting
- #Intake Form - We can better prepare for the meeting
Medicare #Enrolling in Parts A & B # 11036
Our Webpage on Enrolling in Medicare A & B
- Part A Hospital rules for zero premium
- Part B – Doctors – How to sign up – Benefits
- How to apply for Part B during your special enrollment period # 10012
- Fact Sheet
Deciding Whether to Enroll in Medicare Part A and Part B When You Turn 65 15 pages
- Here's the CMS form to fill out L 564 E to get a special enrollment period, when you retire. VIDEO
- Here's the actual form to get Part B, if you already have Part A OMB No. 0938-1230 !
- If you need both, see our main webpage on Medicare Enrollment.
Care Compare Video
Care Compare on Medicare.gov is a streamlined redesign of the 8 Medicare.gov compare tools.
Medicare Video - Physician Compare
Our Webpage on What is it when your doctor Medicare agrees to Assignment?
Consumer Resources & Links
CBS News 10.2015 How will you get Health Insurance in Retirement?
Kaiser Foundation – Medicare Chart Book
Law Help.org Medicare
medicare.gov/cost/ deductibles, co pays, premium
Reforms to the Medicare payment system are meant to promote greater efficiency in the healthcare delivery system by restructuring Medicare reimbursements from fee-for-service to bundled payments. Under the new payment system, a single payment is paid to a hospital and a physician group for a defined episode of care (such as a hip replacement) rather than individual payments to individual service providers. In addition, it has been asserted that the Medicare Part D coverage gap (commonly called the “donut hole“) will shrink incrementally, closing completely by January 1, 2020. Wikipedia
The CBO averred that the bill would “substantially reduce the growth of Medicare’s payment rates for most services; impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the federal tax code, Medicare, Medicaid, and other programs”—ultimately extending the solvency of the Medicare trust fund by 8 years.
Child & Related Pages – Site Map
- Fraud, Scams, Waste & Abuse
- Medi Gap – Supplement Plans – non conical
- Medicare Advantage Plans – Part C
- Anthem MediBlue Plus
- Blue Shield 65 Plus – Inspire HMO 2021
- Enrollment Dates for MAPD – Medicare Advantage & Part D Rx
- Marketing Rules – Best Plan – SOC Scope of Appointment
- Togetherness – Loneliness Social Determinants of Health
- United Health Care
- Part D Rx Prescriptions
- Blue Cross Rx
- Blue Shield Rx
- Donut Hole – Coverage Gap
- Maximus Appeals LEP Late Enrollment Penalty
- Premiums for those with High Income Parts D Rx & B Doctor Visits
- Shop & Compare Tools Part D Rx
- UHC – Part D Rx
- Seminar – Medicare Information ONLINE
- Single Payer Cal Care AB 1400 – Medicare for All? – Funding
- What’s Covered in Part A Hospital & B Doctor Visits?
- Chiropractic – Medicare A & B – MAPD
- Durable Medical Equipment
- End Stage Renal – Kidney Failure
- Enroll ONLINE for Medicare Part A Hospital & B Doctor Visits
- Hearing Aids
- Physical therapy – occupational speech
- Skilled Nursing SNF & Home Health What Medicare Pays