Medicare and Medi-Cal FAQs

What are the different parts of Medicare?

Medicare has 3 parts:
Part A:

• this covers hospitalizations, skilled nursing facilities, home health, and hospice

Part B:

• this covers doctor services (like the urologist) and other outpatient medical care

Part D:

• this covers prescription drugs

• You do not need Part D if you have drug coverage from the Veterans Administration or TRICARE for life. Other possible drug plans can be allowed if they are “creditable coverage”

How much does Medicare cost?

Part A:

• $0 in premiums if you have worked 40 quarters (10 years)

• Deductible of $1676 per year

Part B:

• $185/month premium

• 20% co-insurance (can be covered by Medi-gap or Medi-Cal)

Part D:

• $0 - $183.50/month in premiums depending on the plan

• There can be a deductible but the deductible cannot be more than $590

• After $2000 on covered drugs, you are guaranteed to pay $0.

How does Medi-Cal help?

Part A:

• Medi-Cal can pay the copayments and deductibles

Part B:

• Medi-Cal can pay the premium ($185/month) and the copayments and deductibles

Part D:

• You will be automatically enrolled in Extra Help which limits copayments to no more than $1.60 for generic drugs and $4.80 for brand name drugs

Additionally, Medi-Cal can pay for dental care, vision care, hearing aids, transportation to doctor/dentist/pharmacy, personal care services

Ultimately, if you have Medicare and Medi-Cal, you can have excellent care and most of your costs will be covered. Read more here if you have questions regarding Medicare Advantage (do not recommend). If you live in Los Angeles County, contact a consultant today.