Your Medicare Questions Answered

Health plan specialist Sue Tarvin is a trusted source in the community for Medicare insurance coverage. The Costa Mesa-based independent licensed broker/agent sat down with us to answer some of your most pressing questions.

Q. What is Medicare?
A. Medicare, called “Original Medicare,” is health insurance for people age 65 and older, and people under 65 with certain disabilities.

Q. How do I get Medicare?
A. If you are already receiving Social Security or Railroad Retirement benefits, you will automatically get Medicare Parts A and B and receive your Medicare card in the mail three months before your 65 th birthday. People younger than 65 and people with disabilities get Medicare Parts A and B after receiving disability benefits from Social Security or Railroad Retirement for 24 months. Others must sign up through the Social Security office. Call 800-772-1213 or visit www.socialsecurity.gov/retirement.

Q. Medicare is confusing; what do Medicare Parts A, B, C & D mean?
A. Part A helps cover inpatient hospital charges.
Part B helps cover outpatient services and doctors.
Part C is Medicare Advantage (like HMO and PPO plans).
Part D helps covers prescription drug costs.
(Only Medicare Part A and Part B appear on your red, white and blue Medicare card.)

Q. Does Hoag take Medicare and my insurance?
A. Hoag Hospital Newport Beach and Hoag Hospital Irvine accepts most major insurance, certain Medicare Advantage plans, Original Medicare, Medicare Supplement Insurance (Medigap), and employer-sponsored group plans.

Q. What are my coverage options with Medicare Parts A and B?
A. There are two main options: You could opt for a Medicare Supplement Insurance (Medigap) policy or a Medicare Advantage Plan. For a monthly premium, the Medigap policy allows you to visit any Medicare doctor, hospital or specialist, nationwide. Medigap policies do not include prescription drug coverage, but Part D drug plans can be purchased for $12.60 a month and up. Generally, Medicare Advantage HMO plans in Orange County charge a $0 monthly plan premium and include Part D drug coverage. You must get your care and services from network providers and hospitals, except in cases of emergency and urgent care, and referrals are required for specialists. For a small monthly premium, you could also opt for a Medicare Advantage PPO, which can include drug coverage and does allow flexibility in choosing out-of-network Medicare physicians.