If you're interested in Medicare, we provide no-cost, private seminars where you can learn about your new benefits. Medicare can help cover the cost of your healthcare if you're over 65, even if you haven't retired yet. During the seminar, you'll learn about:
- Medicare Part A, B and D (hospital, medical and prescription drug coverage, respectively)
- Medicare Part C (an option offered by private companies that includes Part A, B and D)
- How we can meet your healthcare needs with Medicare-covered services and providers
- If you qualify for a low-income subsidy to help cover costs of prescriptions and premiums
Why Choose Us for Medicare
Loma Linda University Health has a long history providing compassionate, quality care for our patients. Because many of our services and providers (including primary care) are covered under Medicare, you can continue to get the same level of care you've come to expect at our facilities. With the right plan, you can even save money and join our expanded network that includes a wide range of specialties, like world-class cancer and heart care.
Our commitment to patient care was recently recognized in 2020, when we received the Integrated Healthcare Association (IHA) Excellence in Healthcare award for the second consecutive year. IHA measures value in terms of care quality, patient experience and total cost of care. Of 175 participating providers, less than 25% achieved this recognition.
How do I enroll in Medicare?
If you currently collect Social Security benefits, you automatically enroll in Medicare Part A (Hospital Insurance) and Part B (Medical Insurance). You will receive your Medicare card by mail around three months before your 65th birthday.
You can apply for retirement benefits online at www.ssa.gov/benefits/medicare if you care not currently collecting Social Security benefits.
For those under the age of 65, disabled, and entitled to disability benefits under Social Security, you automatically enroll into Medicare Part A and Part B beginning the 25th month of your disability benefit entitlement. You will receive your Medicare card by mail around three months before your Medicare entitlement date.
How can I help control out-of-pocket costs?
Many private insurance carriers offer ‘Medigap’ coverage plans to help cover the cost incurred for Parts A and B deductibles and coinsurance. However, Medigap plans do not cover prescription drugs, which is available as a separate Medicare Part D coverage.
Some Medicare beneficiaries bundle their benefits together in a Medicare Advantage (Part C) plan, which groups parts A, B, and D together. There are several Medicare Advantage plans have no monthly premium and low co-pays for services. Many Medicare Advantage plans are network-based and provide care within one health system.
Admission to a Medicare Advantage (Part C) plan is not automatic. To select this plan type, you must work with a licensed health insurance broker to join a health network in your area that offers Medicare Advantage programs.
What are the differences between HMO, PPO, and FFS Health Insurance?
Health Maintenance Organization (HMO): The least expensive plan option, HMO plans decrease costs by providing care within a set network of care providers and services. HMO members will need to visit their Primary Care Physician to obtain any specialty referrals. All Medicare Advantage (Part C) plans are an HMO plan, and they can help to minimize any unexpected costs.
Preferred Provider Organization (PPO): Generally more expensive than HMOs, PPO options offer more flexibility regarding providers their members are allowed to visit. Many PPOs still operate within a set network, but members may elect to go out of their network for additional charges. In general, PPO members do not need a referral from a primary care physician to see a specialist.
Fee-For-Service (FFS): This plan type is the most expensive but affords members the most flexibility in where they elect to receive their care. There is no set network of care providers, and specialty referrals are not required.
Does VA health coverage allow me to access Medicare benefits?
You can have both Medicare and Veterans Affairs (VA) benefits, but Medicare and VA benefits do not work together. They provide two sets of healthcare providers from which to choose when you need care.
If you choose not to enroll in Medicare and to keep your VA coverage, you will not have health insurance for facilities outside the VA health system. Some choose to enroll in Medicare Part A (Hospital Insurance) because there is no premium required.
Does Medicare work with other insurance coverage?
If you have Medicare and other health insurance or coverage, each type of coverage is called a “plan”. When there is more than one plan, “coordination of benefits” rules decide which plan pays first. The primary plan pays what it owes on your bills first, and then sends the rest to the secondary or supplemental plan to pay.
Keep in mind that the primary plan pays up to the limits of its coverage. The second plan will only pay if there are costs the primary insurer didn’t cover. The secondary plan may not pay all the uncovered costs. If your employer insurance is the secondary payer, you may need to enroll in Medicare Part B (Medical Insurance) before your insurance will pay.
Medicare has neither reviewed nor endorsed the information on this page.