In a time of COVID-19, health care access is especially critical and, sadly, may be especially at risk . Only persons who have an employer group health plan through active employment qualify for the special enrollment period. The Medi-Cal health plan will be responsible for authorizing the Medi-Cal benefits you need. When you have Medicare Parts A and B, Medicare is your primary insurance and pays for most of your medical care. A United States citizen or legal permanent resident; You have lived in the United States continuously for at least five years. (LA County residents), Medicare and Medi-Cal: Learn about your benefits. For more information on your options, see Medicare Financial Assistance Programs. You enroll into a Medicare Part D plan that only provides drug coverage you pay $1-3 for each prescription per month. What do I pay when my provider accepts assignment? There are two 12-month periods or two years  between the end of her IEP and the end of the enrollment period during which she finally enrolled in Part A. Amy is assessed two year 10% late enrollment penalty for twice the number of years she was late, or 48 months. 520 S La Fayette Park Place 520 S La Fayette Park Place (LA County residents), Option 1: Original Medicare  + Part D prescription drug plan (PDP) + Medi-Cal health plan, Option 2: Medicare Advantage Plan + Medi-Cal health plan, Option 3: Enroll into a Cal MediConnect Plan, Medicare and Medi-Cal: Learn about your benefits, Skilled care in a skilled Nursing facility, Provides benefits not covered by Medicare such as –. What do I pay if my provider does not accept assignment? Medicare covers home health visits if you meet all of the following conditions: .visualizer-1108headerRow {background-color: #bce6fc !important; color: #000000 !important;}.visualizer-1108oddTableRow {background-color: #ffffff !important; color: #000000 !important;}.visualizer-1108evenTableRow {background-color: #e5f6ff !important; color: #000000 !important;}. English | Español, “Medigaps” Medicare Supplement Insurance Policies Are age 65 or older and eligible for Social Security or Railroad Retirement Benefits. Suite 214 If you are not eligible for Social Security benefits, you must pay a premium for Medicare Part A. Persons with COBRA or retiree coverage do not qualify for this special enrollment period and should not delay enrollment in Medicare. You will receive your Medicare card in the mail before your 65th birthday. The Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives. Because two full 12-month periods passed between the end of his IEP and the end of the GEP during which he enrolled in Part B, Sam will have a lifetime Part B late enrollment penalty of 20%. Do all Medicare providers accept Medicare assignment? You may also apply for Medicare online at https://secure.ssa.gov/iClaim/rib. The 60 “lifetime reserve days” can be used only once. Local phone: (213) 383-4519. If your provider does not accept assignment, s/he may charge you an additional 15% above the Medicare approved amount. Toll-free: (800) 824-0780 (LA County residents) Sample Part A MSN: http://www.medicare.gov/pubs/pdf/SummaryNoticeA.pdf, Sample Part B MSN: http://www.medicare.gov/pubs/pdf/SummaryNoticeB.pdf, Sample DME MSN: http://www.medicare.gov/pubs/pdf/SummaryNoticeDME.pdf. If your health care provider accepts assignment, they can only charge you the Medicare deductibles and coinsurance for Medicare-covered services. Medicare assignment is an agreement between your health care provider and Medicare that limits your provider’s charge to the Medicare “approved” amount. Skilled Care in a Skilled Nursing Facility, .visualizer-1123headerRow {background-color: #bce6fc !important; color: #000000 !important;}.visualizer-1123oddTableRow {background-color: #ffffff !important; color: #000000 !important;}.visualizer-1123evenTableRow {background-color: #e5f6ff !important; color: #000000 !important;}. For more information, see Medi-Cal Benefits and Coverage and Medicare Financial Assistance Programs. Center for Health Care Rights This means you are responsible for your annual Part B deductible and the 20% Medicare Part B coinsurance when you receive Part B services. You select the hospice benefit which provides palliative care over receiving curative care through the standard Medicare benefit. Center for Health Care Rights 520 S La Fayette Park Place Suite 214 Los Angeles, CA 90057. Beneficiaries who will pay the standard premium include: If your annual income is higher than $87,000/year (individual), or $174,000/year (married couple), you will pay the base Part B premium of $144.60/month and an additional income-related amount that is based on your income.