Medicare benefits in San Diego vary from other counties that offer Medicare Advantage Plans, otherwise known as Medicare Part C. Throughout California, eligible Medicare recipients select Part C plans based on the county they reside in. Each plan may be administered by the same health care company but may be very different from one county to the next.
Types Of Medicare Options – There are essentially three types of Medicare “structures” you can select from:
- Original Medicare
- Original Medicare with a supplement plan
- Medicare Advantage Part C
The 4th option would only be for people that qualify for Medicaid, in California the Medicaid program is called Medi-Cal.
Original Medicare involves several parts, most importantly Part A (Hospital coverage) and Part B (outpatient services). Selecting “Original Medicare” is the default selection, if you don’t do anything else, you will have “original medicare”. All of your medical services will be covered by Medicare up to 80% of the costs. The other 20% of the costs are your responsibility, regardless of how large the bill is (the average hospital stay is over $30,000, so your share of this bill would be $6000).
Original Medicare with a supplement plan is exactly like original medicare, but with an added layer of protection from a private health insurance company. You can take out an insurance policy to cover the 20% “gap” that original medicare doesn’t cover. Typical Supplemental Medicare Gap plans start at $130 per month and can go as high as $700 per month depending on your age.
Medicare Advantage Part C plans are a relatively new concept (medicare started in 1965, part c plans started around 2000). Essentially, Medicare Advantage plans are designed by health care companies to completely replace original medicare, and gives you extra benefits. Some of these benefits may include a free gym membership, vision coverage, dental coverage, additional screenings, 24 hour nurse info lines, and generous prescription drug plans. All part C plans must cover the same basic services as offered by original medicare.
In my next post, I’ll discuss the different “windows of eligibility” available for those looking to use their Medicare Benefits.
For more information, I can be reached at email@example.com or at 888-939-7383.