San Francisco 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. If you're not ready to make a decision click here to discover your 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 Francisco County Medicare Insurance Options
Original Medicare (Part A and Part B) is the only Medicare insurance that's standard in California. All private Medicare insurance is regulated by the federal government, but plan and policy availability is regional (e.g., within all parts of San Francisco County or throughout the state).
In addition to regional Medicare insurance options, you must match your most important doctor (generally your primary care physician) with a plan. Tens of thousands of doctors don't treat Medicare patients, and those that do don't accept all types of Medicare payment. Some only work with Medicare directly, some only work with specific Medicare Advantage plans, and some do both.
Our goal is to help you find all of the information you need to narrow your plan options to a small number so you can get on the phone with licensed adviser and make your final election for the year. In our experience, people who take a little more time investigating their options generally have better results with their healthcare.
Medicare Advantage Insurance in San Francisco County
If you're concerned that Original Medicare might be too expensive (you pay 20% of all costs), then a San Francisco County Medicare Advantage plan is the first option you need to explore. It's the private health insurance alternative that replaces your Medicare Part A and Part B benefits with a managed care plan (HMO or PPO), or a private fee-for-service plan (available in limited areas).
There are 4 Medicare Advantage plans with prescription coverage and 0 without prescription coverage (Medicare Part D) in San Francisco County. Monthly premiums range from $0.00 to $100.00.
Several different kinds of plans are available, but insurers generally offer just the most competitive plans for the area. Most commonly you will find HMO and PPO style managed care plans, but some areas have Private Fee-for-Service (PFFS) plans that work a lot like Original Medicare. A smaller number of areas have Medical Savings Account (MSA) style HMO plans.
Zero dollar ($0) plans are available in most areas, but not all. Zero dollar does not mean free, it simply indicates that there's no additional monthly premium to enroll. However, you are still required to pay your monthly Part B premium. This is the case with all Medicare Advantage plans.
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 Francisco County
The only relief California seniors have from the high cost of medical bills is additional insurance. That's because Original Medicare does not set limits on your annual out-of-pocket expenses. It's a serious risk that you need to consider. If you plan to keep your Original Medicare, the solution is Medicare Supplement insurance (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 Francisco County
In addition to no out-of-pocket limits, Original Medicare does not cover your prescription medications. It covers medications you need while hospitalized as an inpatient, but for outpatient care you must pay all costs or enroll in a California Medicare Part D plan (PDP) to get cost assistance.
You have a variety of options available to you throughout California. This year there are a total of 5 prescription drug plans available, each with its own formulary. Monthly premiums start at just $24.50 and go up to $112.80 per month for the most inclusive extended plan. While shopping and comparing, don't forget to look at the annual deductible. This is what you will pay at the pharmacy before assistance begins.
Prescription drug insurance is important, so be sure to learn as much as you can about Medicare Part D before enrolling. You'll find plenty of information on our Medicare Part D Frequently Asked Questions and Medicare Part D Coverage pages.
How-To Find a Medicare Doctor in San Francisco County, California
We've recently added all San Francisco 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 San Francisco, and surrounding areas.
This page was last updated on: 11/12/2014.