San Diego County seniors can choose from a wide range of Medicare and other health insurance products to supplement their traditional Medicare coverage. Use the links below to narrow your options to a specific type of Medicare insurance. Click here to learn more about your Medicare options.
To speak with a Medicare adviser, call us toll-free at 877-549-1452 (TTY 411). Our telephone hours are 6AM to 5PM PST, Monday through Friday.
San Diego County Medicare Insurance Options
Medicare Part A (inpatient) and Medicare Part B (outpatient), commonly called Original Medicare, is the same for everyone with Medicare benefits, including San Diego County. This is not true of the other parts of Medicare, which are highly dependent on where you live.
As if all of the various health insurance options aren’t confusing enough, you also need to make sure your doctor accepts the insurance you want, or find a doctor that does. Some doctors only work through insurance networks, while others treat patients with Original Medicare (and Medicaid). Some doctors do both.
The purpose of the MedicareWire.com website is to help guide you through the process of choosing your health insurance. It's all about providing you with the information you need so you can get on the phone with a licensed adviser and finalize your Medicare elections for the year.
Medicare Advantage Insurance in San Diego County
Medicare Advantage is a private health insurance replacement for Original Medicare. If you enroll in a San Diego County Medicare Advantage plan you are opting to receive all of your healthcare benefits through the plan. There are strict rules governing going back to Original Medicare, so read and be informed. In most cases you must wait until the next Annual Election Period.
There are 1 Medicare Advantage plans with prescription coverage and 1 without prescription coverage (Medicare Part D) in San Diego County. Monthly premiums range from $0.00 to $106.00.
Plans are not all the same, and there are several common types, including Private Fee-for-Service (PFFS), Health Maintenance Organization (HMO), and Preferred Provider Organization (PPO). Some areas also offer one or more Medical Savings Account (MSA) plans, but they are rare. HMO and PPO plans are by far the most common.
If you're on a fixed budget and have good health, look for a plan with a $0 monthly premium. What this means to you is that all of the extra benefits have no additional monthly cost to you. What you pay is your monthly Medicare Part B premium and the co-payments outlined by the plan. Just realize these plans are, most often, the most basic available.
Are you aware that Medicare Advantage has an annual out-of-pocket spending limit? This feature, called the Maximum Out-of-Pocket (MOOP) expense, is what safeguards you from the threat of high medical bills. Each year the Centers for Medicare and Medicaid Services (CMS) sets the maximum and an alternative minimum MOOP that plans may offer, so be sure to look for it when comparing your health insurance options.
About one-third of all seniors on Medicare enroll in a Medicare Advantage plan. You can learn more about this private health insurance option on our Medicare Advantage Frequently Asked Questions page and our Medicare Advantage Coverage page.
Medicare Supplement Insurance in San Diego County
Original Medicare offers California seniors the most flexibility in their healthcare options, but it also comes with a significant risk: Original Medicare does not have an out-of-pocket limit. This serious risk is the reason the insurance industry offers Medicare Supplemental insurance, also known as Medigap.
A Medigap policy is indemnity insurance that pays the portion of your bill not paid by Medicare (up to the limits of the policy). There are ten lettered plans in California (A through N) that are all standardized. So, no matter what carrier you choose, the lettered plan will be the same, only the premium will be different.
Medicare Supplement insurance is not like Medicare Advantage; by law it is not allowed to offer additional benefits, including prescription drug coverage. Each Medigap plan pays specific portions of the coverage gaps in Original Medicare. So, if it's not covered by Medicare Part A or Part be, Medigap insurance can't cover it either.
Medicare Prescription Drug Plans in San Diego County
One of the most important healthcare benefits needed by most California seniors is prescription medication coverage, and it's not included in Original Medicare. If you want assistance paying for your prescriptions you must enroll in a Medicare Advantage plan that includes it, or join a Medicare Part D plan (PDP).
There are a total of 5 PDPs available to California seniors. Premiums range from $24.50 to $112.80 per month. Also, be aware that some plans have an annual deductible that you must pay at the pharmacy before assistance begins. Some plans have a $0 deductible, but premiums are generally higher.
How-To Find a Medicare Doctor in San Diego County, California
We've recently added all San Diego County Medicare doctors (primary care physicians for now) to MedicareWire.com. Doctors who treat Medicare patients are listed by city or town. We have school information, years of experience, hospital affiliations and insurances for doctors in Alpine, Bonita, Bonsall, Borrego Springs, Cardiff By The Sea, Carlsbad, Chula Vista, Coronado, Del Mar, El Cajon, Encinitas, Escondido, Fallbrook, Imperial Beach, Jamul, Julian, La Jolla, La Mesa, Lakeside, Lemon Grove, National City, Oceanside, Poway, Ramona, Rancho Santa Fe, San Diego, San Marcos, San Ysidro, Santee, Solana Beach, Spring Valley, Valley Center, Vista, and surrounding areas.
This page was last updated on: 11/12/2014.