Don’t re-enroll in your Medicare Plan until you hear what HICAP has to say!

You have until December 7th to re-enroll. Hear HICAP’s plan comparison and other information to make the most INFORMED decision, It is your health and money at stake.

HICAP (the Health Insurance Counseling & Advocacy Program) provides free and objective information and counseling about Medicare. Volunteer counselors can help you understand your specific rights and health care options. HICAP also offers free educational presentations to groups of Medicare beneficiaries, their families and/or providers on a variety of Medicare and other health insurance related topics.

Medicare Basics

Medicare is a federally-sponsored health insurance program for people age 65 and older; people younger than 65 with a disability; people diagnosed with amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig’s disease; and those with end-stage renal disease (ESRD). Medicare provides coverage for hospital care (Part A), medical services (Part B) and prescription drugs (Part D).

Medicare Part C, also known as Medicare Advantage, offers beneficiaries the option of receiving their Medicare benefits through private health plans.

Medicare Advantage (MA) is also known as Medicare Part C. An MA plan is an alternative to Original fee-for-service Medicare. MA plans are sponsored by Medicare, which pays private insurance companies to provide health services to beneficiaries who enroll in these plans.

In order to join an MA plan, you must be enrolled in both Medicare Part A and Part B, and you must continue to pay the Part B premium. If you join an MA plan, you are still on Medicare and retain the full rights and protections entitled to all beneficiaries.

You receive all Medicare-covered benefits through the private MA plan you choose. Some MA plans offer Medicare prescription drug coverage (these are known as MA-PD plans), but other plans do not (these are known as MA-only plans). If you join an MA-only plan, you may or may not join a separate Medicare Part D plan depending on the type of MA plan you join.

Medigap Plans

Medigap policies are a form of private supplemental insurance that pay for part or all of Medicare’s coinsurance and deductibles. Certain policies also cover health care costs that Medicare doesn’t cover, such as emergency medical care in foreign countries, and excess charges from a provider who does not acceptassignment.

Unlike certain Medicare Advantage (MA) plans, Medigap policies do not restrict you to a network of providers and facilities. If you have a Medigap policy, you can see any doctor or use any hospital that accepts Medicare.

Note: You do not need Medigap coverage if you have an MA plan, or receive fullMedi-Cal benefits.

HICAP has  compiled information on the 5 types of Medicare Advantage plans:

  1. Health Maintenance Organizations (HMOs)
  2. Preferred Provider Organizations (PPOs)
  3. Private Fee-for-Service (PFFS) Plans
  4. Special Needs Plans (SNPs)
  5. Medical Savings Accounts (MSAs)

Prescription Drugs (Medicare Part D)

Medicare Part D is an optional prescription drug insurance program available to everyone who has Medicare, regardless of income or health status. Private companies provide the insurance coverage, you choose the drug plan and pay a monthly premium. HICAP has compiled information on this drug benefit, resources for choosing a plan and financial assistance to help cover drug costs for qualified beneficiaries.

Plan Comparison Charts
Part D Benchmark Plans
Part D Stand-Alone Prescription Drug Plans
Orange County HICAP, a program of Council on Aging Orange County developed this chart and gave CHA permission to post online.

DO NOT APPLY FOR MEDICARE D, if you want to be on a Medicare C (Medicare Advantage Plan). Prescription Drugs are included in Medicare Advantage Plans.  If you apply for Medicare D you will cancel your Medicare C coverage.