California health insurance can be quite expensive, as the average premium for a health insurance plan here is around $525 per month. For those who meet the requirements, there’s Medicare.
California Medicare insurance is comprised of Part A and Part B. Medicare Part A offers coverage for hospital inpatient care and other hospital services. Many beneficiaries do not have to pay premiums for Part A. Medicare Part B covers medical services, treatments, and supplies, and they typically require premiums. Parts A and B may also involve deductibles and coinsurance.
Medicare (Part A and Part B combined) is also known as Original Medicare. This is to differentiate the combination with alternative Medicare plans.
As a resident of California, you may get your Medicare plan from private carriers which have been approved by Medicare. These plans may not be as expensive as typical private health insurance plans as Medicare can pay the carriers part of the cost of the coverage.
These plans include the Medicare Advantage plans, which offer a type of coverage that is at least equal to the coverage provided by both Medicare Part A and Part B. These plans, which are sometimes called Medicare Part C, may also include coverage for additional medical services that are not included in Original Medicare.
There is a Medicare Plan D as well. These are plans that you can obtain to supplement the coverage of Parts A and B. The Plan D covers the costs of prescription drugs, which can be exorbitant for senior citizens with suboptimal health conditions.
Other options include Medicare Supplemental Plans that can cover the cost of the deductibles and coinsurance involved in Original Medicare. It may also cover medical services that are not covered by Medicare Part A and Part B.
Even Medicare can be expensive for some people if they have to pay for premiums, deductibles, and copayments. However, California residents who qualify for Medicare may also be eligible for assistance programs that can cover the various costs of Medicare coverage. The levels of assistance you receive will depend on many factors, including your income.
Assistance is available for Qualified Medicare Beneficiaries (QMB) to help cover the costs of premiums for Medicare Part A and Part B. QMBs may also receive help in paying for the associated deductibles and copayments required by Medicare. An individual who qualifies for the QMB program must have a monthly income no greater than $1,025. A married couple may also be eligible if their monthly incomes combine for a total of not more than $1,374.
Medicare Part B premiums may be covered for Specified Low-Income Medicare Beneficiaries (SLMB). The eligible individual must earn no more than $1,226 a month while married couples have a combined monthly income limit of $1,644.
Other Qualified Individuals (QI) may also receive assistance to pay for their Part B premiums. To qualify, QIs must earn no more than $1,377 a month. Married couples can also be eligible if their combined income per month is less than $1,847.
Another program is for Qualified Disabled and Working Individuals (QDWI). The eligible QDWIs must have a maximum monthly income of $4,105. Married couples can also qualify if their combined income per month is no more than $5,499 a month.
It is also possible for you to qualify for the Low-Income Subsidy program. To be eligible, your income for the year must be no more than $18,090 while your resources (such as your savings and stocks) are not worth more than $13,820. The program also applies to married couples if their annual income is no more than $24,360. They also should have resources that are worth less than $27,600.
These income limits are for 2017, so if your income is somewhat higher, you may apply and still be eligible for assistance for this year.
California has a Health Insurance Counseling and Advocacy Program (HICAP) to help residents of the state understand their various health insurance options. The program offers one-on-one counseling as well as seminars to make sure that you have a fuller understanding of how you can obtain proper health insurance coverage in California.
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