California Medicare Insurance Plans
Medicare is a federally sponsored health insurance program available to those over the age of 65, as well as to individuals who have certain disabilities. At the state level, however, there exist specific organizations that help beneficiaries better understand the Medicare process, and Medicare recipients may even qualify to receive state subsidies, depending on their circumstances. Consider the following information if you are interested in obtaining Medicare coverage in the state of California.
Medicare Supplement Insurance (Medigap) Policies
While Medicare Supplement Insurance policies are available to help cover costs outside Medicare, California has no requirement for insurers to sell Medicare Supplement Insurance policies for those under the age of 65.
Mini-COBRA Policies (Small Group)
In California, there is a program known as Cal-COBRA that can cover those whose COBRA coverage is expiring. Only the individual listed is eligible and in some cases spouses cannot be covered unless they were eligible before 2005.
California Medicare Savings Program
California has four Medicare Savings Programs available depending on income level.
*The following data is from 2016 and is based on federal amounts. These amounts may increase in 2017. If your income and resources are slightly higher, you should still apply, you may qualify for benefits even if your income is higher than the limits listed.*
- *Qualified Medicare Beneficiaries (QMBs): California will pay all premiums for Medicare Part B and all copayments and deductibles for Medicare Parts A and B. This program is for individuals with a monthly income below $1,010 and couples with a monthly income below $1,355.
- *Specified Low-Income Medicare Beneficiaries (SLMBs): For individuals with a monthly income below $1,208 or couples with monthly income below $1,622 the state pays premiums for Medicare Part B under this plan.
- *Qualified Individuals (QIs): The state will pay Medicare Part B premiums for individuals with income under $1,357 per month or couples with a combined income under $1,823 a month.
- *Qualified Disabled and Working Individuals (QDWIs): For individuals with monthly income under $4,045 or couples below $5,425, the state pays premiums for Medicare Part A.
*Data from medicare.gov
According to ssa.gov, you should be aware that several States may even disregard all resources for individuals or couples in certain categories.
Health Insurance Counseling and Advocacy Program (HICAP)
Local California HICAP centers are there to help individuals and couples understand the variety of Medicare programs available. California HICAP provides one-on-one educational counseling, seminars, and even speaking engagements throughout the state in order to educate California residents of the wide variety of medical care and insurance options available, including:
- Medicare (Parts A and B)
- Medicare Advantage Plans (Part C)
- Medicare Prescription Drug Plans (Medicare Part D)
- Medicare Supplement Insurance (Medigap)
- Prescription assistance programs
- Long-term care and payment options
- Health care rights and protections
- Low-income assistance programs
California HICAP also helps Medicare patients and works on their behalf with claims and disputes through a network of hundreds of trained, certified HICAP volunteers throughout the state of California.
Low-Income Subsidy (Extra Help) for Prescription Drugs
In 2016, you may qualify if you have up to $17,820 in yearly income ($24,030 for a married couple) and up to $13,640 in resources ($27,250 for a married couple).
Residents in California who need help determining which plan is the right one for them should consult with a licensed sales agent at MedicareSolutions.com for personalized assistance on what’s locally available. The licensed sales agents at MedicareSolutions.com can help compare plans and find the right match for your needs.