Medicare Options

California Medicare Market

I Specialize in the California Market and we represent 13 out of 14 MAPD (HMO) for seniors. However I can compare all the plans in the California Market. I Can Help you with MAPD-Medicare Advantage Prescription Drugs or Medical Supplements and PPO plans. Most of the MAPD Plans in Southern California have 0 premium, and some have a give-back for part B. For the upcoming year all the Part B Give Back Plans are going down Except one! The one that has not changed, is giving back $174.70 Monthly toward part B Premium. That is a Savings of almost $2094 a year.

This will be an increase in your part Social Security Check per year every year. If you would like to find out more about this plan please fill out the request form Here We are in the Southern California Area and I am very knowledgeable about my market and what I do not know I will find out and give you an honest answer. I am a Brokers which means I work for You the client to find you the best plan that fits your needs and your budget For more information about this plan or other Plans Click the Button Bellow:

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Medicare Choices

Before choosing a plan we want to be sure you know the difference between your many options;

In particular how Medicare Supplement Insurance Plans and Medicare Advantage Plans differ.

What Original Medicare Part A Covers and what Part B Covers

What Part A & Part B do not cover

Medicare

Medicare Supplement

A Medicare Supplement Insurance Plan is used with original Medicare. Any Doctor that accepts Medicare will take a Medicare Supplement Insurance Plan because they only need to bill Medicare.
Medicare pays their part (generally 80% of Medicare covered benefits) and sends the remainder of the bill to the Supplement which pays their part (generally 20%). It is important to note that Medicare Supplement Insurance Plans do NOT include Prescription Drug Coverage (Part D, PDP) and for those that do not get a PDP when first eligible there will be a penalty when they do get a PDP. (there are exceptions to this)
A Medicare Supplement Insurance Plan does not change year to year (although the cost does generally go up the coverage does not change).

Medicare Advantage

Medicare Advantage Plans, sometimes called "Part C" or "MA Plans," are an “all in one” alternative to Original Medicare. They are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. These "bundled" plans include Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance), and usually Medicare drug coverage (Part D). These plans are offered by private insurance companies and in order to entice you to join their plans they offer some dental coverage, Over the Counter Allowance, Vision allowance for glasses, Gym Membership etc.

The benefits change on a yearly basses. They can go up or down but that is why you have the opportunity to review your plan every year from October 15 to December 7th and decide if you want to stay on your current plan or change to another plan, that fits your needs better.

Medicare Part D

Medicare Prescription Drug Plan (Part D). These plans (sometimes called "PDPs") add drug coverage to Original Medicare. Original Medicare does not cover prescription drugs. However, if you do not have credible drug coverage you would need to buy a credible drug coverage even if you do not take medications. If you do not their will be a part B late enrollment penalty, that is tagged on to your future drug plan for the rest of your life.

Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different copay.

A drug in a lower tier will generally cost you less than a drug in a higher tier.
In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your doctor can ask your plan for an exception to get a lower copayment.

Medicare Alphabet

Part A (Hospital Insurance):

Helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care. There is a deductible for this benefit and it increases yearly. In 2025 it is $1976
per benefit period. If there is 60 days between each time you were in the hospital or a skilled nursing facility then that would be a new benefit period. And the deductible applies again. Usually this is covered by your supplement depending on which letter you are on or it is covered by your part C : MAPD-Medicare Advantage Prescription drug plan.

Part B (Medical Insurance):

Helps cover: Services from doctors and other health care providers. Outpatient care. Home health care. Durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment). Many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits) Original Medicare Part B only covers 80% the other 20% would be covered by your Supplement or your Part C.

Part D (Drug coverage):

Helps cover the cost of prescription drugs. You join a Medicare drug plan in addition to Original Medicare, or you get it by joining a Medicare Advantage Plan with drug coverage. Plans that offer Medicare drug coverage are run by private insurance companies that follow rules set by Medicare.

Part C (HMO or MAPD)
Includes Parts A, B, & D and it also offers extra benefits that original Medicare does not cover. It is run by private insurance companies and to entice you to sign up with them they offer dental allowance, Vision Allowance, Over the Counter allowance, Hearing Aid allowance. All of these are normally not covered by original Medicare.

The law and plans change yearly, that is why it is important to have someone to guide you through this process. Doctor networks change. There are a lot of moving parts.

Medicare Choices

Medicare

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