California Medicare Insurance - A Complete Guide

California Medicare insurance can be a rather confusing topic for people. There are now a host of different companies offering a number of plans all of which may vary in their coverage and prices. To enable you to make an informed decision on which particular plan is best for you it is important to understand the various aspects of Medicare. It is essential to be aware that the benefits and advantages as well as the pricings can change on an annual basis.

There are four separate parts within the Medicare program. Most people will know of Part A; this is the section that is also known as hospital insurance. It will cover the charges of many forms of in patient care including hospital stays, nursing facilities, home care, and hospices.

Medicare Part B relates to out-patient care. Included in this are certain laboratory tests, speech therapy, physical therapy, and doctor's fees. It may also cover the charges that are incurred in relation to ambulance transport, medical supplies, and medical equipment. Part B is not a compulsory aspect of Medicare. It may be the case that you are still in employment and that you already have a work-related health insurance plan that covers these needs; if this is the case then you should only consider signing up for Part B upon retirement.

The part of Medicare that is most confusing to people is Part C, otherwise known as Medicare Advantage. This is a form of private health care that is sponsored by the Medicare program. To be able to sign up for this aspect, you must have already joined both Part A and Part B of Medicare. It will still cover you for these as well as providing a greater array of benefits. There are 5 different schemes that fall under the domain of Medicare Advantage:

Medicare HMO: If you choose to join a Medicare HMO then you will only be entitled to use health facilities and doctors that are contracted to that particular health maintenance organization. In most cases you will need to register with a primary care doctor who will manage your health requirements. To be able to see a specialist you should normally get a referral from this specific doctor unless it is an emergency. It is important to understand that if you choose to visit a doctor without this referral then you will have to incur any medical expenses that are charged. Certain HMOs will include prescription drug coverage, whilst others may not.

Medicare PPO: This is similar to the HMO option in so much that there will be a network of health providers that the individual can visit. The difference is that you may visit a doctor outside of the network but the financial savings will not be so great. With a PPO plan the need for a referral before seeing a specialist is usually not required. As yet there are very few PPOs which offer a prescription drug service.

Medicare PFFS: This plan is more flexible. It allows you to visit any health centre or doctor and take treatment if they accept the payment terms of the plan. It is wise to check with your local doctor and health care specialists whether they are willing to treat you through this scheme. It is always important to find this out before you begin any treatment or use a particular health service, otherwise you may have to foot the bill. Some of the PFFS plans will cover the cost of prescription drugs.

Medicare SNP: These are specialist plans designed for people who require an exact form of medical attention. This can include those individuals in a nursing home or private home with medical care, and also people that have serious disabilities and chronic ailments. Every SNP plan will include coverage for the cost of prescription medications.

Medicare MSA: An MSA, or medical savings accounts, are a recent introduction in California. They have two main parts, first of all they include a high deductible plan which covers Parts A and B of the Medicare program when the deductible has been met, and also they involve the setting up of a bank account in which Medicare makes a deposit for the individual to use towards the cost of their health care. They do not include any form of prescription drug coverage, so the holder of the policy must sign up for Medicare Part D.

Part D of Medicare relates to the cost of prescription medications. If you sign up for this aspect of the program then you will receive the coverage no matter what your financial standing or health status. It involves paying a premium on a monthly basis.

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