General Medicare Information
Medicare is a federal health insurance program that covers millions of Americans. This basic health insurance provision is a part of Social Security. Medicare is regulated by the Centers for Medicare and Medicaid Services (CMS), and Medicare eligibility and enrollment is overseen by the Social Security Administration (SSA). Medicare is for individuals:
- Age 65 and older
- Under age 65 with certain disabilities
- With End-Stage Renal Disease (ESRD)
Knowing the different parts of Medicare and how they work together will help you make the best choice. The table below is a brief summary of the different parts of Medicare:
Details on each part click on the letter below:
Part A
Part B
Part C
Part D
The Anthem Medicare Advantage Plans and the Kaiser Senior Advantage are Medicare Advantage (Part C) plans, which requires enrollment in Medicare Part A and Part B. If you stop premium payments or cancel your Part A or B, you will automatically be dis-enrolled from the Plan. If you sign up for Part D prescription drug coverage outside of the Anthem Medicare Preferred PPO, Senior Secure HMO or Kaiser Senior Advantage Plan you will also be automatically dis-enrolled from the respective plan.
Description:
Inpatient Care
Outpatient Care
Medicare Advantage Plans (MA Plans)
Prescription Drug Coverage
Examples of coverage:
Inpatient hospital care, skilled nursing facility, hospice, lab tests, surgery and home health care.
Doctor and other health care providers’ services, outpatient care, durable medical equipment, home health care and some preventive services.
MA Plans, offered through private insurance companies, cover all services of Medicare Part A and B, and most offer extra coverage, like vision, hearing, dental, and/or health and wellness programs. Most are offered as PPO’s or HMO’s.
Most MA Plans include Part D coverage for your prescriptions with their own formulary, or list of covered drugs. If you decide to opt out of Part C and use traditional Medicare (Part A and B only), Part D plans can be purchased separately.
Premiums Varies by plan.
Do I have to sign up for the coverage?
Generally, enrollment is automatic, but if enrolling in Medicare and you want to keep Anthem Blue Cross as Part C and want your Part D reimbursed, you'll need to fill out the required forms from the OUHSD. Part D rein
For eligibility or premiums information: Please Contact Sarah Van Someren, Insurance Specialist
[email protected] or 805-385-2567
If you have questions about claims and coverage:
CSEBO Contact:
Trever Hansen, Health Benefits Manager (805)383-9388
[email protected]
Amanda Ragatz, Employee Benefits Specialist (805)383-9329
[email protected]
