- Call the statewide toll-free HICAP number: 1-800-434-0222
- Contact a local office using our list of counties
Medicare - Quick Facts for Consumers
Who is Eligible for Medicare?
- People age 65 and older.
- People under age 65 with certain disabilities.
Medicare Coverage Choices
- There are two main ways to get Medicare coverage – Original Medicare or a Medicare Advantage Plan.
- Original Medicare allows you to choose your doctors.
- Medicare Advantage (also called Medicare Part C) is managed care, which means you must see doctors within a certain group or network.
Medicare Part A
- Part A helps cover inpatient care at hospitals as well as hospice and home health care.
- It also covers care in a skilled nursing facility under certain circumstances.
- Most people do not pay a premium for Part A.
Medicare Part B
- Part B helps cover doctor and other health care providers' services, outpatient care, durable medical equipment, home health care, and some preventive services.
- You pay a Part B premium each month.
- A lifetime penalty may be added to your monthly Part B premium if you do not enroll when you are first eligible. Note: If you or your spouse continues working after age 65 and you receive health insurance from an employer, different rules may apply. Check with your Human Resources Department for more information.
Medicare Part C
- Medicare Part C is also called Medicare Advantage. It covers a variety of managed care options that private companies offer to Medicare beneficiaries.
- Medicare beneficiaries who choose to enroll in a Medicare Advantage plan still must pay any Part A or Part B premium they would pay if they remained in Original Medicare.
- In some cases, Medicare Advantage plans include prescription drug coverage.
- If you are enrolled in a Medicare Advantage plan, you do not need supplemental insurance (see below).
Medicare Part D
- Part D covers some prescription drug costs for people with Medicare Part A and/or B (or Medicare Part C in some cases).
- Beneficiaries pay premiums and other costs related to Part D plans.
- If you don’t join a Medicare drug plan when you’re first eligible, and you don’t have other creditable prescription drug coverage (for example, from an employer or union), you may pay a late enrollment penalty if you choose to join later.
Medicare Supplement Insurance (Medigap)
- A Medicare Supplement Insurance (Medigap) policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
Other Medicare Health Plans
- There are some plans that are not Medicare Advantage plans, but are still part of the Medicare system
- These include Medicare Cost Plans, Demonstration/Pilot Programs, and Programs of All-inclusive Care for the Elderly (PACE).
- Some of these plans provide Part A and Part B coverage; some also provide prescription drug coverage (Part D).
Medicare Does Not Cover Non-medical Care
- Medicare does not pay for non-medical care for people who have a chronic illness or disability. This includes non-skilled personal care assistance, like help with everyday activities, including dressing, bathing, and using the bathroom.
- Who is Eligible for Medicare?
- Official Guide to Medicare and Medicaid Services
California Medicare Beneficiary Education and Advocacy
California Health Advocates is a non-profit organization dedicated to Medicare advocacy and education for Californians.
Benefits Check-Up is an online program that helps people find out about a wide array of special state, federal and private programs and services available to help reduce costs of prescription drugs, medical care, transportation, food and utilities.
- Services By County
- Programs & Services
- Where To Call For Local Services
- Additional Resources
- California Health and Human Services Agency
- Contact CDA
- Contact HICAP at 1-800-434-0222 or use our list of counties
- Basic Medicare coverage
- Choosing a prescription drug plan
- How to become a HICAP counselor
- Finding a speaker to talk about Medicare
- Making an appointment to discuss long-term care insurance
- Reporting Medicare fraud and abuse
- Switching from a Medicare Advantage Plan to Original Medicare
- My Medicare Advantage plan
- Finding a doctor who is part of my CalMediConnect plan
- Programs offered by the Department of Aging
- Help for someone who doesn’t live in California
California HICAP is part of a national network of State Health Insurance Assistance Programs (SHIP). SHIP is a Federal Administration for Community Living (ACL) grant program that helps states enhance and support a network of local programs, staff, and volunteers. HICAP is supported by the California Department of Aging with financial assistance through a grant from the Administration for Community Living.