Understanding Medicare
Are you or a loved one approaching retirement age and considering your healthcare options? At Pacific Health Brokers, we understand the importance of making informed decisions when it comes to your health and well-being. That’s why we specialize in helping Californians like you explore and select the best Medicare plans tailored to your unique needs.
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By understanding its various components, enrollment options, and coverage choices, you can make informed decisions to ensure you receive the medical care you need as you age. Stay informed, review your options annually, and make the most of the Medicare benefits available to you.
Let us help make your Medicare transition easy. Medicare can be a complex topic, and for over 30 years, we have assisted individuals in understanding their Medicare options, enrolling in suitable plans, and navigating the various choices available to our clients. Medicare can be confusing and intimidating. Allow us be your advocate and help explain the options you have available to you. We can also help service the plans after we enroll you.
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If you are tuning 65 soon and or have become eligible for Medicare then you likely have been getting bombarded with calls and mail about what you should do. Call us and schedule an appointment to discuss your options CALL 800-585-0563.
Medicare is divided into several parts:
- Medicare Part A: This part covers hospital care, skilled nursing facility care, hospice care, and some home health care services. Part A deductible is $1,632. * (This is for 2024 and will vary annually)
- Medicare Part B: Part B covers medical services like doctor visits, outpatient care, preventive services, and durable medical equipment. The 2024 Part B annual deductible is $240. * (This is for 2024 and will vary annually)
- Medicare Part C: Medicare Advantage Part C (Medicare Advantage): These are private insurance plans that combine the coverage of Part A and Part B, often with additional benefits like prescription drug coverage, dental, and vision. Medicare Advantage plans often include coverage for hospital stays, doctor visits, prescription drugs, and sometimes additional benefits like dental, vision, and hearing services. These plans may have provider networks, such as Health Maintenance Organizations (HMOs) or Preferred Provider Organizations (PPOs). It’s essential for beneficiaries to understand how the network works.
- Medicare Part D: This part provides prescription drug coverage, which can be added to Original Medicare (Part A and Part B) or obtained through a Medicare Advantage plan.
- Medicare Supplements Plans: Medicare supplements, also known as Medigap plans, are insurance policies designed to fill the gaps in coverage left by Original Medicare (Part A and Part B). Medicare supplements are private insurance policies sold by insurance companies to complement your Original Medicare coverage. These plans are standardized by the government. Medicare supplements cover various out-of-pocket costs such as deductibles, copayments, and coinsurance that you would otherwise pay with Original Medicare alone. Predictable Costs. Freedom to choose providers and no networks restrictions. Medigap plans typically do not have provider networks, so you don’t have to worry about referrals or getting approval to see a specialist.
Medicare Eligibility
Medicare is a federal health insurance program in the United States primarily designed for individuals aged 65 and older. However, it’s not limited to this age group. Medicare eligibility is typically based on your age and work history. You generally become eligible for Medicare at age 65 if you or your spouse have worked and paid Medicare taxes for at least 10 years, which is equivalent to 40 quarters. These quarters do not have to be consecutive, and you earn them based on your work history and the amount of Medicare taxes you’ve paid over the years.
- Age-Based Eligibility: Most people become eligible for Medicare when they turn 65.
You can enroll in Medicare during your Initial Enrollment Period, which begins three months before your 65th birthday month, includes your birthday month, and extends for three months after your birthday month. - Disability-Based Eligibility: Individuals under the age of 65 can also qualify for Medicare if they have been receiving Social Security Disability Insurance (SSDI) or Railroad Retirement Board (RRB) disability benefits for at least 24 months.
Certain medical conditions, like End-Stage Renal Disease (ESRD) or Amyotrophic Lateral Sclerosis (ALS), may also make someone eligible for Medicare before age 65. - Citizenship and Residency: To be eligible for Medicare, you must be a U.S. citizen or a legal permanent resident (green card holder) who has lived in the United States for at least five continuous years.
- Medicare Part A: This part covers hospital care, skilled nursing facility care, hospice care, and some home health care services.
- Medicare Part B: Part B covers medical services like doctor visits, outpatient care, preventive services, and durable medical equipment.
- Medicare Part C (Medicare Advantage): These are private insurance plans that combine the coverage of Part A and Part B, often with additional benefits like prescription drug coverage, dental, and vision.
- Medicare Part D: This part provides prescription drug coverage, which can be added to Original Medicare (Part A and Part B) or obtained through a Medicare Advantage plan.
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Friendly, experienced, licensed professionals standing by to answer your Medicare questions and assist you with enrollment. All at NO COST and no obligation.
Disclaimer: “We may not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all your options.”