California Medicare Supplements

New To Medicare

Congratulations on reaching an important milestone: Medicare eligibility! And congratulations on taking the first step in making sure you are taking care of your important healthcare needs. While there are a lot of details and plans that discuss Medicare available on this site and others, our job at California Insurance  is to make the transition and the job of navigating Medicare easy.

Traditional Medicare (Part A and B) provides excellent coverage.  However, traditional Medicare was never intended or designed to cover 100% of medical expenses.  By design, this can expose the Medicare recipient to potentially unlimited out of pocket expenses.  For this reason, we recommend everyone consider purchasing a California Medicare Supplemental Plan (aka Medigap Plans) that provides protection that exceeds original Medicare A & B.  There are plans that range from zero premium (Medicare Advantage Part C (HMO) to comprehensive PPO plans that cover the entire deductible of Part A and Part B.  These are the Medigap plans lettered A through J.

California Medicare Part A covers a large rage of inpatient hospitalization services.  If you have worked over 40 quarters you are eligible.  There is no charge for Medicare Part A

What are the other costs associated with Part A?

With original Medicare, you pay to use Part A services. If you go to a hospital, you will pay a deductible of $1,024 for up to 60 days. If you need to stay in the hospital for up to another 30 days, your cost is $256 for days 61-90. Part A also covers another 60 days over the course of one's lifetime, and the co-pay for those days is another $423 per day. These costs add up. Hospital charges alone (not including Medicare Part B doctors costs) can add up to over $33,000 if you stay in the hospital for 150 days. If you had to stay longer, original Medicare Part A would not cover those costs. Most supplemental health insurance policies cover a large portion of these incremental costs and protect you from large out of pocket exposure.  Thus, protecting your assets for retirement.

Is Medicare Part Enough Coverage?

Part A also covers skilled nursing and other inpatient services, which have additional costs associated with them. We recommend that no one go without either a Medicare Supplement (Medigap) or Medicare Advantage Plan to provide the peace of mind that they will be protected against unlimited financial exposure if they need to use Part A services. For help navigating Medicare and choosing a health insurance policy that meets your needs please give us a call at 877-840-0554.

Picture of Older Couple Looking for California Medicare Supplements

California Medicare Part B helps pay for doctor's office, outpatient services and many other services not covered with Medicare Part A.  Unlike Part A nearly everyone pays a premium for Part B.  In 2008 the premium is $96.40 per month.  This is typically deducted from a person's Social Security check.

What are the other costs of Medicare Part B?

Medicare Part B premiums are only one cost. Before you can use Part B, you must pay a $135 annual deductible. After you have met your annual deductible, you generally pay 20% of all additional costs for general office related services.

Is Medicare Part B Enough Insurance?

Many people can afford to pay the deductible and co-pays for routine Part B services without health insurance; however, Part B also covers many expensive outpatient services and drugs that quickly add up if you're paying 20% of those costs. For this reason, we recommend that no one go without either a Medicare Supplement (Medigap) or Medicare Advantage Plan to provide the peace of mind.  This policy will protect you against unlimited financial exposure and asset protection.

What are the income related premiums to Medicare Part B?

If you are single and make... Premium
Less than $82,000 a year $96.40
Between $82,000 and $102,000 a year $122.20
Between $102,000 and $153,000 a year $160.90
Between $153,000 and $205,000 a year $199.70
More than $205,000 a year $238.40
If you are married and make... Premium
Less than $164,000 a year $96.40
Between $164,000 and $204,000 a year $122.20
Between $204,000 and $306,000 a year $160.90
Between $306,000 and $410,000 a year $199.70
More than $410,000 a year $238.40


California Medicare Part C or Medicare Advantage is administrated through private insurance companies.  Traditionally, these HMO plans and Fee For Services (FFS) have comprehensive coverage that offers the subscriber the protection against high out of pocket exposure.

Medicare Part D is the prescription drug coverage for subscribers, which is only administered through private insurance companies - you cannot sign up for Part D through Social Security or Medicare.  We recommend everyone sign up for a Part D plan, even if they don't take prescription medications today for two reasons: 1) you never know if you'll need drugs in the future, 2) there is generally a penalty for not signing up for Part D when you're eligible.

What are the cost to enroll in Part D?

Medicare Part D, like all other parts of Medicare, is not free. Each month, you will pay a Part D premium as well a co-pay each time you purchase medications. The Part D premium will differ between insurance companies.  In addition to the premium, some companies have deductibles, "donut hole" coverage and co-pays, the amounts of which vary by plan. If it sounds a bit complicated, it is, but we are here to help. 

What is the coverage hole also known as the donut hole?

Probably the most talked about, confusing and dreaded feature of Medicare Part D is the coverage gap also known as the "donut hole".  After you have met your plan's calendar year deductible Part D typically pay for about 75% of your Rx cost.  But, only up to the cost of the donut hole.   For 2008, the donut hole begins at $2,510.   Which means that once your carrier has paid $2,510 you are now responsible for the cost of your prescriptions drugs.  Some Part D plans do offer coverage for generic drugs.  However, almost no plans offer coverage for the Brand Rx.  

Am I exposed to catastrophic prescription expenses, with the high cost of Brand Rx, after the carrier has paid $2,510?

There is hope-don't panic. In 2008 once a person has reached $4,050 Medicare will then cover about 95% of the remaining cost of your prescriptions.  Which means that if your prescriptions costs are $300 you will pay $15.

For free help navigating Medicare and to get a quote to help you select which California Medicare Supplemental plan is best for you [ click here ].


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