Medicare Guide

”Whether you are looking for a change or are new to Medicare, this guide gives you clear information and helpful checklists.
You deserve clarity and confidence when it comes to your healthcare choices. That’s why we are committed to making Medicare enrollment simple and stress-free for you.
Contact us with any questions, large or small!
Yours truly,
Your CCHP Medicare Specialists

Contact Information:

Phone: 1-888-788-2594 (Monday through Sunday, 8am – 8pm)
Email: [email protected]

Medicare Basics

Medicare FAQs

Let's Start with the Basics:

What is Medicare?

Medicare is a federal program that provides health insurance primarily for people 65 and older, and some people younger than 65 who may qualify due to certain disabilities.

It has four main parts: A, B, C and D.

Hospital Insurance

Provides inpatient coverage like hospitalization

Included in Original Medicare
Free for most people who qualify

Medical Insurance

Provides outpatient/medical coverage like doctor visits

Included in Original Medicare
You pay a monthly premium

Part A & B cover only 80% of medical costs and do not include Part D prescription drug coverage.

Medicare Advantage Plans

An “all in one” alternative to Original Medicare offered by private health plans like CCHP. They include:

Part A
Part B

Plans can include:

Part D
Extra Benefits

With CCHP Medicare Advantage Plans, you’ll get Part D prescription coverage, as well as extra perks including vision, hearing, and dental benefits, and even a monthly allowance to purchase groceries.

Prescription Drug Coverage

Not included in Original Medicare. Purchased through private insurance.

All CCHP Medicare plans offer prescription drug coverage

Medicare Supplement / Medigap

Optional policy to cover your portion of out-of-pocket expenses if choosing to stay in Original Medicare.

Offered by private insurance companies
Often at high monthly premiums

Original Medicare Vs. Medicare Advantage

Original Medicare doesn’t cover all the care you need, such as dental, vision, prescription medications, and more. In fact, Original Medicare only covers about 80% of your medical cost. We are here to help you get the coverage you need. Check out this comparison chart to understand what you get and don’t get with each option.

Monthly Premiums

Coverage

Supplement Benefits

Extra Perks

Maximum Out-Of-Pocket

Part A & B
Original Medicare

Prescription drug coverage is not included.

Monthly Premiums
You pay for the Part B premium.

Coverage
Includes hospital and medical coverage only, covering only 80% of medical costs and not including Part D prescription drug coverage.

Supplemental Benefits
Original Medicare does not cover any supplemental benefit. That’s why many people choose Part C Medicare Advantage.

Extra Perks
Original Medicare does not offer any extra perks.

Maximum Out-Of-Pocket
There’s no limit to how much you have to pay for your care.

Part C
CCHP Medicare Advantage

Covers Part A, B, C, D and more.

Monthly Premiums
CCHP plans start at $0 monthly premium. Members continue to pay for the same Medicare Part B premium.

Coverage
CCHP plans cover what Original Medicare covers, plus prescription drug coverage and other supplemental benefits.

Supplemental Benefits
At CCHP, we offer dental, vision, hearing coverage, acupuncture, and more.

Extra Perks
CCHP plans include transportation services to and from your medical appointments. Some CCHP plans also include allowances for groceries to buy healthy foods and Over-The-Counter (OTC) non-prescription health and medical supplies.

Maximum Out-Of-Pocket
All CCHP plans have a maximum limit to how much you have to pay yearly. You won’t have to pay for covered services once you reach your limit.

Shop CCHP Medicare Plans

Medicare Eligibility Checklist

Here is an outline of the basic eligibility requirements for enrolling in the Medicare program. If you think you qualify, you can follow the Enrollment Checklist to transition your care into Medicare.

It is important to note that this checklist provides a general overview of eligibility requirements for Medicare. There may be additional factors and specific circumstances that can affect eligibility, contact CCHP Medicare Specialists for more details.

You must be at least 65 years old. However, individuals under 65 with certain disabilities or specific medical conditions may also qualify.
You must be a U.S. citizen or a legal resident who has lived in the U.S. continuously for at least 5 years.
To qualify for premium-free Part A. You are eligible for premium-free Part A if you or your spouse have paid Medicare taxes for at least 10 years (40 quarters) while working.

Medicare Pre-Enrollment Checklist

Now that you know what Medicare is and the options available to you, it’s time to enroll! Don’t wait too long or you might get hit with pesky penalties. But no worries, we’ve got your back. Just follow this checklist and you’ll be cruising into Medicare without any stress.

7-9 months before you turn 65

Start exploring your Medicare coverage options.

6 months before you turn 65.

Continue to learn about your Medicare options. Determine whether Original Medicare or Medicare Advantage best fits your care needs. Contact CCHP Medicare Specialists to help you decide.

3 months after you turn 65.

This is your last chance to be enrolled in Original Medicare and a Medicare Advantage Plan of your choice by now.

3 months before you turn 65.

Enroll in Original Medicare through your local Social Security Office.

Your 65th Birthday month.

Once enrolled in Original Medicare, you can sign up for a CCHP Medicare Advantage Plan.

Important Rules

Effect on Current Coverage. If you are currently enrolled in a Medicare Advantage plan, your current Medicare Advantage healthcare coverage will end once your new Medicare Advantage coverage starts. If you have Tricare, your coverage may be affected once your new Medicare Advantage coverage starts. Please contact Tricare for more information. If you have a Medigap plan, once your Medicare Advantage coverage starts, you may want to drop your Medigap policy because you will be paying for coverage you cannot use.

Frequently Asked Questions

What is Medicare and who can get it?

Medicare is a health insurance program for people age 65 or older. Some younger people with certain disabilities and medical conditions like End-Stage Renal Disease (ESRD) are also eligible.

What are my Medicare coverage options?

When you first enroll in Medicare and during certain times of the year, you can choose how you get your Medicare coverage. There are two main ways to get Medicare:

Original Medicare (Part A & B):

Original Medicare includes Medicare Part A (Hospital Insurance) and Part B (Medical Insurance).
Original Medicare covers only about 80% of medical costs. You are responsible for the remaining 20%.
If you want drug coverage, you can join a separate Medicare drug plan (Part D).
For extra cost, you can also buy Supplemental or Medigap coverage to help pay for the 20% of medical costs that Medicare doesn’t cover.

Medicare Advantage (Part C):

Medicare Advantage is an all-in-one alternative to Original Medicare. These “bundled” plans include Part A, Part B, and usually Part D.
Plans generally have lower out-of-pocket costs than Original Medicare.
In many cases, you’ll need to use doctors who are in the plan’s network.
Most plans offer extra benefits that Original Medicare doesn’t cover like vision, hearing, dental, and more.
Most plans include Part D prescription drug coverage.

When do I enroll in Original Medicare?

When you turn 65, you are automatically enrolled in Original Medicare if you receive Social Security retirement or Railroad Retirement benefits. If you are not automatically enrolled, you can sign up during your Initial Enrollment Period (IEP). IEP begins three months before your 65th birthday, during your birthday month, and then continues for three months after your birthday. For example, if your birthday is in May, your IEP is from February to August.

How do I sign up for Medicare?

If you already get Social Security benefits, you will be automatically enrolled in Original Medicare (Part A and Part B) when you become eligible. If you don’t get Social Security benefits and are not ready to apply for them yet, you can visit Social Security’s website or call Social Security’s office at 1-800-772-1213 (TTY 1-800-325-0778) (Mon – Fri, 8 a.m. – 7 p.m.) to apply for Medicare when you become eligible.

Am I eligible to enroll in Medicare Advantage (Part C)?

You are eligible to enroll in a Medicare Advantage plan, such as the ones offered by CCHP, as long as you have Medicare Parts A & B, and live in the plan’s service area.

When do I enroll in Medicare Advantage (Part C)?

Initial Enrollment Period (IEP)
Begins three months before your 65th birthday, during your birthday month, and then continues for three months after your birthday.

Annual Enrollment Period (AEP)
From October 15th to December 7th every year. This is when you can change plans or enroll in a Medicare Advantage plan if you missed the chance to enroll during your IEP.

Special Enrollment Period (SEP)
If you experience a qualifying life event, you have a 60-day period (known as SEP) to sign up for a plan.

How do I join CCHP Medicare Advantage plans?

CCHP has great Medicare Advantage options for your health coverage needs. We are committed to serving our members with our expansive choice of providers and access to top local hospitals.

San Francisco & San Mateo County residents with Original Medicare (Part A & Part B) can join CCHP Medicare Advantage plans. Contact our Medicare Enrollment Specialists for enrollment assistance by calling 1-888-749-5029 or sending an email to [email protected].

What are late enrollment penalties?

Each part can have late enrollment penalties for premiums if you don’t sign up for Medicare during your Initial Enrollment Period (IEP).

Part A: The penalty is 10% if you are required to pay a Part A premium, to be paid twice the number of years you were eligible for Part A but did not enroll.

Part B: The penalty is a 10% increase on the Part B premium for each full 12-month period that did not enroll but was eligible. This is a lifelong penalty.

Part D: The penalty is 1% of the average monthly prescription drug premium times the number of months late, rounded to the nearest 10 cents. The penalty is generally put in place if you’re not enrolled within 3 months of Medicare Part A or Part B.

To understand the Medicare enrollment penalties, visit Medicare’s website.

What Medicare Advantage plans are offered at CCHP?

For generations, it has been CCHP’s mission to improve our community’s health by providing high-quality, affordable healthcare. Our members’ health, wellness, and safety are our priority. That’s why all CCHP plans, including Medicare Advantage, offer preventive care services and fitness classes at no extra cost. Most of our Medicare plans even provide incentives to help members purchase healthy foods. Members have access to care through our ever-expanding provider network and choices of top local hospitals.

What's the cost of CCHP’s Medicare plans?

Most of CCHP’s Medicare Advantage plans have a $0 monthly premium based on the level of Extra Help the member receives.

CCHP knows that preventive services to help maintain your health shouldn’t cost extra. That’s why we cover basic services like an annual screening, labs, x-rays, and vaccinations without a copay. In addition, all of our Medicare Advantage plans have a $0 deductible, which means the health services you receive are covered by us from the get-go.