MEDICARE ENROLLMENT SAN DIEGO CALIFORNIA

A Guide for Getting Started

Congratulations on becoming eligible for Medicare in San Diego! Navigating the world of Medicare can seem overwhelming at first, but with the right information and guidance, you can make informed decisions about your healthcare coverage. Here's a helpful guide to getting started with Medicare in San Diego:

1. Understanding Medicare Basics:

Medicare is a federal health insurance program primarily for individuals aged 65 and older, as well as certain younger individuals with disabilities or specific medical conditions. It consists of several parts:

• Medicare Part A: Hospital insurance that helps cover inpatient care in hospitals, skilled nursing facilities, hospice care, and some home health care.
• Medicare Part B: Medical insurance that helps cover medically necessary services, such as doctor's visits, outpatient care, preventive services, and some medical equipment.
• Medicare Part C (Medicare Advantage): Plans offered by private insurance companies approved by Medicare to provide Part A and Part B coverage, often with additional benefits like prescription drug coverage and dental or vision services.
• Medicare Part D: Prescription drug coverage offered by private insurance companies approved by Medicare to help cover the cost of prescription medications.

2. Enrolling in Medicare:

• Initial Enrollment Period (IEP): You typically have a seven-month Initial Enrollment Period to sign up for Medicare, starting three months before the month you turn 65, including your birthday month, and ending three months after.
• Special Enrollment Periods (SEPs): You may qualify for a Special Enrollment Period if you delay enrolling in Medicare due to coverage through an employer or other circumstances.
• Annual Enrollment Period (AEP): Occurs every year from October 15th to December 7th, during which you can make changes to your Medicare coverage for the following year.

3. Choosing Medicare Coverage:

• Original Medicare (Parts A and B): Provides coverage for hospital and medical services but may require additional coverage, such as a Part D plan for prescription drugs or a Medicare Supplement Insurance (Medigap) policy to help pay for out-of-pocket costs.
• Medicare Advantage Plans: Offered by private insurance companies, Medicare Advantage plans provide all-in-one coverage that often includes Parts A, B, and D, as well as additional benefits like dental, vision, and wellness programs.

4. Finding Healthcare Providers:

• Medicare.gov Physician Finder: Use the online tool on the official Medicare website to search for healthcare providers, hospitals, and other facilities that accept Medicare in your area.
• Medicare Advantage Plan Networks: If you enroll in a Medicare Advantage plan, check the plan's provider network to ensure your preferred doctors and hospitals are included.

5. Understanding Costs and Coverage:

• Premiums: Most people do not pay a premium for Medicare Part A, but Part B and Part D plans typically have monthly premiums.
• Deductibles and Copayments: Original Medicare and Medicare Advantage plans have deductibles, copayments, and coinsurance, so be sure to review plan documents to understand your potential out-of-pocket costs.

6. Getting Help and Resources:

• Local Resources: Take advantage of resources available in San Diego, such as the San Diego County Aging & Independence Services, which provides information and assistance related to Medicare and other senior services.
• Insurance Counselors: Certified Medicare counselors or insurance agents can provide personalized guidance and help you understand your Medicare options.

Navigating Medicare in San Diego can be easier with the right information and assistance. By understanding your options, enrolling in the appropriate coverage, and accessing local resources, you can make the most of your Medicare benefits and ensure you receive the healthcare coverage you need.