We do not handle Medi-Cal enrollment; please use the official resource, and complete the form pre-check to confirm eligibility.
We do not handle Medi-Cal enrollment; please use the official resource, and complete the form pre-check to confirm eligibility.
Stop guessing and start comparing with a real licensed agent. Medical Insurance Today offers free plan comparisons across Covered California, Medicare, and private individual plans. We factor in your doctors, medications, budget, and family size to find the right fit. Get started at medicalinsurancetoday.com or call (800) 590-7279.
Get a free, no-obligation quote for individual health coverage at medicalinsurancetoday.com or call (800) 590-7279. Our licensed agents compare plans from all major California carriers to find you the most affordable coverage — with no fees and no pressure. Hablamos español.
Book your free consult with a licensed California health insurance specialist at Medical Insurance Today. Available by phone at (800) 590-7279, online at medicalinsurancetoday.com, or in person at our Costa Mesa office. We serve all of California including Orange County, Los Angeles County, Riverside, San Diego, and beyond.
Scheduling a free consult with Medical Insurance Today is easy. Call us at (800) 590-7279 Monday through Thursday, 9am–6pm, visit medicalinsurancetoday.com to request a quote online, or stop by our office at 1500 Adams Ave #201, Costa Mesa, CA 92626. We also speak Spanish — hablamos español.
Yes — Medical Insurance Today offers completely free consultations for all California residents. There is no fee, no obligation, and no pressure. Our licensed agents are compensated by the insurance carriers, so our guidance costs you nothing. Call (800) 590-7279, schedule online, or walk into our Costa Mesa office to get started.
Agents are compensated directly by the insurance companies whose plans they sell. Your premium is the same whether you enroll through an agent or on your own — but with an agent, you get a free consult, personalized plan matching, and an ongoing advocate at no additional cost. It is one of the best-kept secrets in healthcare.
Health insurance agents are paid a commission by the insurance carrier — not by you. This means working with a licensed agent like those at Medical Insurance Today is completely free to consumers. You get expert guidance, plan comparisons, and year-round support without paying a single dollar more than you would buying a plan on your own.
Before signing up, ask: Is this plan on the Covered California marketplace? Am I eligible for financial help? Are my doctors and hospital in-network? What is the deductible and maximum out-of-pocket? Can I get dental and vision bundled? Our agents walk you through every one of these questions during your free consultation at Medical Insurance Today.
Great questions to ask include: Which plan keeps my current doctors in-network? Does my medication formulary change? What are the real out-of-pocket costs beyond the premium? Do I qualify for subsidies or tax credits? What happens if I need specialist care? Our agents at Medical Insurance Today answer all of these in your free consult — and we make it easy to understand.
Yes — our licensed agents specialize in Medicare plans for California residents, including Medicare Advantage (HMO and PPO), Medigap/Supplement plans, and Part D prescription drug coverage. We help you keep your doctors, understand your costs, and navigate enrollment timelines. Book a free Medicare consult at medicalinsurancetoday.com or call (800) 590-7279. Please note: we do not process Medi-Cal applications.
Medical Insurance Today works with California small business owners to find the right group health coverage for their team. Whether you have 2 employees or 50, our licensed agents provide a free consult to compare business medical plans, understand your contribution options, and help you offer competitive benefits. Visit medicalinsurancetoday.com/insurance-policy/business-medical-insurance/ to learn more.
Yes — medicalinsurancetoday.com connects you directly with licensed, certified agents serving all California residents. Book a free consult online, call (800) 590-7279, or visit us in Costa Mesa. No waiting rooms, no call centers — just direct access to a real licensed professional who advocates for you.
Every agent at Medical Insurance Today holds an active California insurance license. You can verify any agent’s license at the California Department of Insurance website (insurance.ca.gov). Our lead agent Thomas Feeney holds CA License #0G18420 and #0K50571. We are a fully compliant Covered California Enrollment Center.
Medical Insurance Today serves all of California with licensed agents available by phone, online, or in person at our Costa Mesa office. Schedule your free consult today — our agents are ready to guide you to the most affordable health insurance policy for your situation, at no cost to you. Call (800) 590-7279 or visit medicalinsurancetoday.com.
At Medical Insurance Today, we specialize in the full spectrum of California health coverage: Covered California marketplace plans, Medicare plans (including Advantage and Medigap), individual and family private plans, dental, vision, life, and small business group coverage. One free consultation gives you access to our entire portfolio across all major carriers.
Our agents specialize in Covered California plans, Medicare and Medicare Advantage, Individual and Family plans, Dental and Vision insurance, Life and Legacy insurance, Supplemental and Deductible Protection plans, and Business Medical Coverage. If you are a California resident looking for affordable health insurance, we can help — book your free consult today.
Our licensed agents provide: free consultations for individuals, families, and small businesses; plan comparisons across Covered California, Medicare, Individual/Family, Dental, Vision, and Life Insurance; enrollment assistance; annual plan reviews; and year-round support. Every service is free to consumers — we are paid by the insurance carriers, not by you.
Absolutely. Comparing health insurance plans on your own can be overwhelming. Our agents at Medical Insurance Today do this every day — comparing premiums, deductibles, networks, and drug formularies across all major California carriers including Anthem, Blue Shield, Kaiser, Health Net, Molina, and more. Book a free consult and we will do the heavy lifting for you.
Buying directly online means navigating complex plan details alone, with no advocate if something goes wrong. Our licensed agents provide personalized guidance, ensure you do not miss subsidies or tax credits you qualify for, help keep your existing doctors in-network, and remain available year-round for questions and changes — all at zero cost to you.
Working with a licensed agent from Medical Insurance Today means you get a free consult, expert plan matching, subsidy calculations, and a dedicated advocate in your corner. We make enrollment simple — whether by phone, online, or in person at our Costa Mesa office. Our clients get better plans at lower prices than they typically find on their own.
A licensed health insurance agent helps you compare, select, and enroll in the health plan that fits your budget, doctors, and coverage needs. At Medical Insurance Today, our agents offer free consultations, explain your options in plain language, and act as your ongoing advocate — managing your plan year after year at no charge to you.
Covered California and Medi-Cal are programs that help people get healthcare. Both include essential health benefits like doctor visits, hospital stays, prescription drugs, and preventive care.Covered California is the state’s health insurance marketplace where individuals and families can get a health plan through well-known companies. Financial help may be available to help with health care costs.Medi-Cal is California’s Medicaid program, offering low-cost or free health coverage to those earning up to a certain amount.
(CCA abbreviation going forward) is the state’s health insurance marketplace where individuals and families can get a health plan through well-known companies. Financial help may be available to help with health care cost. Covered California is a free service that connects Californians with brand-name health insurance under the Patient Protection and Affordable Care Act. It’s the only place where you can get financial help when you buy health insurance from well-known companies. That means when you apply, you may qualify for a discount on a health plan through Covered California, or get health insurance through the state’s Medi-Cal program. Either way, you’ll have great health coverage. CoveredCA.com is sponsored by Covered California and the Department of Health Care Services.
Anthem, Blueshield, Healthnet, Kaiser, Molina, IEHP, LA Care, Balance/CCHP, Share San Diego, VHP, Western Health, Aetna CVS
Your eligibility Covered California with financial help is based on your household size and income, using the Federal Poverty Level (FPL). Your immigration status and eligibility for other programs or services can also affect if you qualify. You will find out which program(s) you qualify for after you apply. Note: You can get a health plan from Covered California without financial help. You will pay the entire cost of the health plan, but your household size and income will not affect your eligibility. However, we will still confirm your identity, including your immigration and incarceration statuses.
Your household size = you + spouse + tax dependents. Include everyone, even if they don’t need health coverage.
Your household income = the adjusted gross income of you + spouse + tax dependents. Based on the year you want coverage.
Names, Dates of birth, address, social security numbers, Federal tax information, employment information, immigration documents.
You can continue seeing your current doctor if they are part of your new plan’s network. To confirm your doctors acceptance of the plan, please contact your doctor directly to ask their office, or check the insurance company website, under provider directory. Generally it’s best to ask your doctor what plan or company they want you on.
Getting your income filed correctly is important however if you mis-state your income, the difference will be reconciled annually when you file taxes. For example, if you file your income too low, then you might have to pay back the subsidy you received, which is done on your annual tax filing. If you file your income too high and make less income, you will receive additional credits when you file your annual tax.
No, you are not required to take the financial help offered. You can adjust the amount of subsidy you receive in covered California by calling directly and having the subsidy adjusted to your preference with a customer service representative.
Your eligibility Covered California with financial help is based on your household size and income, using the Federal Poverty Level (FPL). Your immigration status and eligibility for other programs or services can also affect if you qualify. You will find out which program(s) you qualify for after you apply. Note: You can get a health plan from Covered California without financial help. You will pay the entire cost of the health plan, but your household size and income will not affect your eligibility. However, we will still confirm your identity, including your immigration and incarceration statuses.
Your household size = you + spouse + tax dependents. Include everyone, even if they don’t need health coverage.
Your household income = the adjusted gross income of you + spouse + tax dependents. Based on the year you want coverage.
You can continue seeing your current doctor if they are part of your new plan’s network. To confirm your doctors acceptance of the plan, please contact your doctor directly to ask their office, or check the insurance company website, under provider directory. Generally it’s best to ask your doctor what plan or company they want you on.
Covered California and Medi-Cal are programs that help people get healthcare. Both include essential health benefits like doctor visits, hospital stays, prescription drugs, and preventive care.Covered California is the state’s health insurance marketplace where individuals and families can get a health plan through well-known companies. Financial help may be available to help with health care costs.Medi-Cal is California’s Medicaid program, offering low-cost or free health coverage to those earning up to a certain amount.
(CCA abbreviation going forward) is the state’s health insurance marketplace where individuals and families can get a health plan through well-known companies. Financial help may be available to help with health care cost. Covered California is a free service that connects Californians with brand-name health insurance under the Patient Protection and Affordable Care Act. It’s the only place where you can get financial help when you buy health insurance from well-known companies. That means when you apply, you may qualify for a discount on a health plan through Covered California, or get health insurance through the state’s Medi-Cal program. Either way, you’ll have great health coverage. CoveredCA.com is sponsored by Covered California and the Department of Health Care Services.
Anthem, Blueshield, Healthnet, Kaiser, Molina, IEHP, LA Care, Balance/CCHP, Share San Diego, VHP, Western Health, Aetna CVS
Your eligibility Covered California with financial help is based on your household size and income, using the Federal Poverty Level (FPL). Your immigration status and eligibility for other programs or services can also affect if you qualify. You will find out which program(s) you qualify for after you apply. Note: You can get a health plan from Covered California without financial help. You will pay the entire cost of the health plan, but your household size and income will not affect your eligibility. However, we will still confirm your identity, including your immigration and incarceration statuses.
Your household size = you + spouse + tax dependents. Include everyone, even if they don’t need health coverage.
Your household income = the adjusted gross income of you + spouse + tax dependents. Based on the year you want coverage.
Names, Dates of birth, address, social security numbers, Federal tax information, employment information, immigration documents.
Metal tiers determine how much you pay, and plan types determine your doctors and hospitals.
These benefits fit into 10 categories:
Open enrollment generally occurs November 1st through January 31st. This is the time of year consumers can enroll in a health plan, or switch from their existing plan for the following year.
This enrollment period, separate from the open enrollment period, requires enrollees to have a reason to apply, like losing other health insurance, moving residence, having a baby, getting married, gaining citizenship, suffering a hardship financially, turning 26 years old and losing your parents coverage, being released from jail.This enrollment period, separate from the open enrollment period, requires enrollees to have a reason to apply, like losing other health insurance, moving residence, having a baby, getting married, gaining citizenship, suffering a hardship financially, turning 26 years old and losing your parents coverage, being released from jail.
No, under the affordable care act, no consumer can be denied coverage due to a pre-existing condition. No health questions are asked at enrollment.
No, under the affordable care act, no pre-existing health issues are considered to get insurance.
If a consumer has a legitimate qualified event to enroll, or is enrolling during the annual open enrollment period, enrollment is guaranteed after monthly payments are made to your insurance company.
Insurance is paid monthly in a range of ways with your insurance company. You can pay monthly by credit card or check. Most insurance companies prefer monthly auto-deduction from your bank account or credit card.
No, your enrollment is processed online with no signature necessary from the consumer.
No, your coverage is paid monthly. You pay a month of premium, and you will receive a month of coverage. To cancel, there are no fees or hidden charges. Cancel by the 20th of the month you are in, to have your coverage end the last day of that month.
When on a covered California account, known as a “case”, coverage is cancelled with Covered California, not at your insurance company. Covered California then send your cancellation request to your insurance company
Your new insurance will begin on the first day of the following month after you enroll for coverage and make your first monthly payment.
All Covered California health plans include coverage for prescription drugs. The cost varies based on your plan’s metal tier and the category of the medication: generic, preferred, non-preferred, and specialty. Each health plan has a list, called a formulary, showing which drugs are covered and how much you’ll pay for them.
You can continue seeing your current doctor if they are part of your new plan’s network. To confirm your doctors acceptance of the plan, please contact your doctor directly to ask their office, or check the insurance company website, under provider directory. Generally it’s best to ask your doctor what plan or company they want you on.
There are two categories of health insurance costs: what you pay each month (known as your premium) and what you pay for services. You will receive a bill for your premium every month. When you receive services, you will have out-of-pocket costs such as copayments, coinsurance, or a deductible that needs to be met. The monthly premium will vary based upon your age and taxable income.
Premium is the monthly payment you make for coverage, paid to your insurance company directly.
A copayment, or copay, is a set amount you pay for certain services. The amounts can differ depending on the type of service and your metal tier. For example, seeing a doctor costs $15, but going to the emergency room costs $100
Coinsurance is a percentage of your healthcare costs, which goes into effect after you reach your deductible. For example, if your coinsurance is 20% and an office visit costs $100, you will pay the full $100 before your deductible is met. After meeting the deductible, you’ll pay 20% of the visit cost, which is $20. Lower monthly premiums = higher copay/coinsurance. Higher premiums = lower copay/coinsurance
A deductible is the amount you pay for covered services before your insurance starts to help. The amount of your deductible depends on the type of plan you choose.
Out-of-pocket costs are healthcare costs that your insurance does not cover and you must pay for yourself. They can include deductibles, coinsurance, and copayments for covered services. Once you reach your out-of-pocket cost limit, your health insurance company will pay 100% of your covered services for the rest of the calendar year.
Covered California is the only place to get help paying for health care costs. There are two types of financial help: the Premium Tax Credit and Cost-sharing reductions (CSR).Your Premium Tax Credit amount is estimated when you apply. You can have all, some, or none of that amount paid in advance to your health insurance company to lower your monthly bill (your premium). This is called the Advanced Premium Tax Credit (APTC). For example, if your premium is $700, and you get $600 in premium tax credit each month, you will pay $100 ($700 – $600 = $100). Any amount of APTC you do not take can be claimed when you file your taxes.
You can still choose a plan through cca if you do not qualify for financial help. You will pay the gross cost of the insurance policy premium monthly.
Medi-Cal offers low-cost or free health coverage to individuals and families, children, and pregnant individuals. You may qualify for Medi-Cal coverage based on your income, programs you use, among other qualifications.
Each program’s eligibility is based on your household size and income, immigration status, and other programs you use or qualify for. It is also decided at an individual level. Because of this, some family members may qualify for Covered California, while others qualify for Medi-Cal
La cobertura dental para niños está incluida sin costo en todos los planes de California. La cobertura dental para adultos se puede comprar por separado directamente con el agente Tommy Quotes Insurance Services.
Vision coverage (corrective lenses at an optometrist) can be purchased separately wit your agent Tommy Quotes Insurance Services. Medically related vision coverage at an opthamologist (not corrective lenses) will be included with your major medical health plan.
Yes, all major medical plans will cover hospitalization. Depending on the level tier of coverage, that will determine what your deductible, co-pay and maximum out of pocket costs will be for those services.
Yes, all major medical plans will cover surgical services. Depending on the level tier of coverage you have, that will determine what your deductible, co-pay and maximum out of pocket costs will be for those services.
Yes, all major medical plans will covere doctor and specialist services, for a co-pay. Depending on the level tier of coverage you have, that will determine what your deductible, co-pay and maximum out of pocket costs will be for those services.
Depending on the level tier of coverage you have, that will determine what your deductible, co-pay and maximum out of pocket costs will be for those services.
Yes, Depending on the level tier of coverage you have will determine what your deductible, co-pay and maximum out of pocket costs will be for those services.
Yes, depending on the level of coverage you have will determine what your deductible, co-pay, and maximum out-of-pocket costs will be for those services.
Yes, Depending on the level tier of coverage you have will determine what your deductible, co-pay and maximum out of pocket costs will be for those services.
Yes, maternity coverage is included in all Affordable Care Act plans, including covered California. Depending on the level tier of coverage you have, that will determine what your deductible, co-pay and maximum out of pocket costs will be for those services.
You pay your monthly premium directly with your insurance company. You can pay online, by calling or check by mail.
Former president Obama was the president that signed into legislation the Patient Protection Affordable Care Act. Hence, many people call the Affordable Care Act, Obamacare.
CCA offers plans directly from the name brand insurance companies you already know, like Anthem Bluecross, Healthnet, Blueshield, Kaiser and many others. The difference is consumers can possibly qualify for subsidies or discounts off the cost of those insurance plans via covered california, based on household taxable income.
The coverage you will receive is identical coverage from the insurance company via covered California, you will pay the full monthly price of the plan.
Health Maintenance Organization plans are health plans that require a primary care doctor who manages your care and all referrals to specialists for the patient. The patient will receive care from only one specific medical group that the primary care provider works with. HMO plans are the least expensive options available to purchase.
Preferred Provider Organizations allow for more flexibility with doctors and between doctor networks. PPO’s do not require patients to have a primay care doctor, they do not need referrals to specialists and will have “out of network” benefits covered.
HMO means Health Maintenance Organization. Generally, the least expensive options to purchase require you to work with one primary care doctor who manages the care.
PPO means preferred provider organization. Generally, more expensive because you can visit most doctors without a referral or primary care doctors. More freedom of movement between doctors requires a PPO plan.
Exclusive Provider Organizations are a blend between HMO and PPO. EPO’s allow for freedom of movement between doctors and do not require a patient have one primary care doctor managing their care. It is required to stay in-network on an EPO plan.
All health plans will allow access to doctors and medical care but to determine what is “best” is based on the customers needs. If low cost is the most important consideration, HMO plans will be the most affordable option. If broad access to many doctors is top priority, then a PPO option will be best however PPO’s will be the most expensive option to buy.
HMO or Health Maintenance Organization type plans will be the lease expensive to purchase. HMO’s work great, consumers will want to pick their own doctor from the network to get the best results.
People with health issues can get great care from HMO and PPO plans and it is highly recommended consumers contact their doctor as to which plan might be best for them. HMO plans require one primary care provider to manage their care and to direct their referrals to specialists. For consumers that want freedom to move from doctor to doctor with out any restriction will likely want to be on a PPO type plan. HMO plans will be less expensive generally while PPO plans are more expensive.
A subsidy received by a consumer for a covered California plan is a federal discount off the monthly cost of health insurance, based upon the family’shousehold taxable income. The lower the income in the household the lower the monthly payment. The lower the income the higher amount of subsidy or discount the family will receive.
You may have to pay a penalty for not having coverage unless you qualify for an exemption. The penalty for not having coverage the entire year will be at least $900 per adult and $450 per dependent child under 18 in the household when you file your 2023 state income tax return in 2024..
The individual mandate requires American tax filers to pay a penalty for not having health insurance. The penalty is $900 per adult and $450 per dependent child under.
Lawfully present means any immigrant documentation demonstrating their ability to reside in the United States. All lawfully present immigrants can qualify for covered California.
Immigrants who are not lawfully present do not qualify for a health plan through Covered California; however, they may qualify for coverage through Medi-Cal if they are younger than age 26 or are 50 or older, or are pregnant or were recently pregnant. Immigrants who are not lawfully present can also buy private health insurance on their own outside of Covered California.
1. Lawful permanent residents (LPR/green card holder). For pending applicants for adjustment to LPR, go to #22 of this section.
2. Asylees. For pending applicants for Asylum, go to #23 of this section.
3. Refugees
4. Conditional entrant (CE) granted before 1980 (Note: this is the immigration status used for refugees prior to the Refugee Act of 1980; most have adjusted to LPRs though some retain CE status.)
5. Individuals granted withholding of deportation or withholding of removal (under the immigration laws or under the Convention Against Torture [CAT])For pending applicants for withholding of deportation/ removal, go to #23 of this section.
6. Individuals paroled into the U.S.
7. Cuban or Haitian Entrants
8. Qualified Domestic Violence Survivor (the parent and/or child of a spouse or child who has been battered or subjected to extreme cruelty in the U.S. by a spouse, parent, or relative of the same household) who has been approved (or has a pending petition) under Violence Against Women Act (VAWA) for (1) status as a spouse or a child of a U.S. citizen, (2) status as a spouse or a child of a U.S. lawful permanent resident, (3) suspension of deportation, or (4) cancellation of removal.
9. Victim of Trafficking and his/her Spouse, Child, Sibling or Parent (or individuals with a pending application for a victim of trafficking visa).
10. Member of a federally recognized Indian tribe or American Indian born in Canada
11. Other Non-Immigrant Status (letter visas) including worker visas and student visas:
12. Citizens of Micronesia, the Marshall Islands, and Palau
13. Residents of American Samoa
14. Lawful Temporary Residents
15. Individuals with Temporary Protected Status (TPS). For pending applicants for TPS, go to #23 of this section.
16. Individuals granted Deferred Enforced Departure (DED)
17. Individuals granted Deferred Action Status
Note: Deferred Action for Childhood Arrivals (DACA) is not an eligible immigration status for health insurance through Covered California. The Employment Authorization Document (I-766) annotated Category “C33” is specific to DACA and is not proof of eligibility for Covered California. Individuals with DACA status may be eligible for Medi-Cal.
18. Family Unity beneficiaries
19. Individuals with Order of Supervision with employment authorization
20. Registry applicants with employment authorization
21. Applicant for Special Immigrant Juvenile Status
22. Applicant for Adjustment to LPR Status
23. Applicants for any of the following statuses must also submit an Employment Authorization Document (Card) (I-766).
24. Amerasian immigrant
25. Pending application for Creation of Record of Lawful Admission for Permanent Residence, with Employment Authorization
Getting health insurance through Covered California or using Medi-Cal generally does not impact your immigration status or eligibility for permanent residency or citizenship. However, two situations may affect your status: (1) receiving long-term care in a government facility paid for by Medi-Cal, or (2) being dishonest during the application process
COPYEach program’s eligibility is based on your household size and income, immigration status, and other programs you use or qualify for. It is also decided at an individual level. Because of this, some family members may qualify for Covered California, while others qualify for Medi-Cal.
You can call your insurance company directly at the number on the back of your insurance ID card, or by logging in online at your insurance company’s website.
COPYBronze plans typically have the lowest monthly premiums but the highest costs when you get care.The first three non-preventive doctor visits are not subject to a deductible.Free preventive care, covering the annual physical and labs at $0 cost. Free children’s dental and vision.
COPYGo to the doctor or take medication regularly? A Silver plan could be your best option. You might even qualify for an Enhanced Silver plan with zero deductibles and lower costs when you see your doctor. Free preventive care, covering the annual physical and labs at $0 cost.
Gold has $0 deductible and covers 80% of medical bills. Free preventive care, covering the annual physical and labs at $0 cost. Free preventive children’s dental and vision.
Platinum coverage has $0 deductible and covers 90% of medical bills. Free preventive care, covering the annual physical and labs at $0 cost. Free preventive children’s dental and vision.
Yes, all pre-existing health conditions are covered on the new plan. You may have a co-pay or deductible for treatment however any condition will be covered by the plan you select.
Preventive care is the annual well check visit, including annual lab tests ordered by your doctor.
Yes, emergency care is covered internationally and globally. If you have an emergency away from home, you are still covered by walking into an emergency room, anywhere in the world.
Mental health counseling and treatment are covered on all plans. Depending on your tier or level of coverage will determine your co-pay, deductible and cost-share for services.
After enrolling, new members will receive a welcome letter and a brochure from Covered California. You will also get an enrollment package and membership ID card from your health insurance company.You can use services covered by your health insurance plan starting the next month after you make your first payment, even before your membership ID card has arrived.
Your health insurance company will match you with a primary care physician. You can change to another one at any time. Your primary care physician will help you navigate the health care system when you need assistance selecting the proper specialist, coordinating your care with other providers or when you need help understanding your treatment options.
When the information that you put on your application changes during the year, you must report it. Changes to things like your address, family size and income can affect whether you qualify for Medi-Cal or get help paying for your health insurance through Covered California. People with Medi-Cal must report changes to their local county office within 10 days of the change. If you have health insurance through Covered California, you must report changes within 30 days
Call Covered California directly to make any changes at 800-300-1506.
Yes, maternity is covered on all affordable care act plans, including covered California.
Covered California does not require you to report a pregnancy.
If no changes are being made to your coverage, your plan will automatically renew every January 1st. Each year plans, prices and your situation may change. Get ready to renew your coverage for 2024 by reviewing your household income information to make sure you get the correct amount of savings if you’re eligible. We will be here to guide you through the process, so you’ll be informed and ready to make the best decision for your coverage needs.
No, you need to update your income annually based on your projected income for the upcoming year. Any time there is a measurable change in your income you should report it to covered California or your agent. For instance, if someone in your household loses a job or if significant time off happens during the work year.
NO, covered California is the state insurance marketplace to shop and apply for healthcare and possibly receive financial assistance for that paln; or if your income is low you may qualify for medi-cal.
Covered California is a marketplace where you can purchase a health plan, with or without financial help. What you pay for insurance depends on your income. Some people don’t qualify for financial help, so for them, it might be more cost-effective to enroll in a plan directly through a health insurance company. If you need to go outside of Covered California, please contact the 800 phone number on the tommyquotes.com website.
Individual and family plans are for consumers who do not get insurance from their employer, who do not have other government provided healthcare like V.A., Medicare or retirement insurance benefits from a previous employer. Many self-employed people will need to buy in the individual and family market.
Self employed consumers will likely need to buy an individual and family plan from covered California.
Self-employed consumers use their adjusted gross income (AGI) from their last years 1040 tax filings to claim with covered California.
Yes, you must file taxes annually to receive the subsidy or discount on your health plan. To reduce the monthly cost, you must file annual taxes.
If you do not file taxes, you will not be eligible for any subsidy or discount off your monthly health plan premium.
The subsidy is a mixture of federal and state subsidies, however a majority of the financial help comes from the federal government.
For w2, wage based employees, the covered California system wants the full gross, taxable wage you earn to be reported. For self-employed consumers, use the adjusted gross income for your income declaration. Please consult your tax professional for further guidance.
When a dependent turns 26 years old they are no longer eligible to be on their parent’s plan. The dependent will need to apply for new coverage.
If you are insured at your place of work, you likely will need to keep those benefits offered. If you are paying too much for insurance at work you can apply for coverage through covered California to shop for a new plan.
Healthcare costs have continually risen over the last three decades. Along with inflation, the cost of care at the doctor’s office and especially in the hospital or surgery center has skyrocketed. Healthcare has become one of the most important topics for Americans. For lower income Californian’s, covered California will offer the most affordable options, and the most reliable care, that are available in the market.
On a Covered California plan, you can rest assured that the most you will pay in any calendar year is the maximum out-of-pocket on your plan. Depending on the level of coverage you have will determine what your deductible, co-pay, and maximum out-of-pocket costs will be for those services.
On a covered California plan you can rest assured that the most you will pay in any calendar year, is the maximum out of pocket on your plan. Depending on the level tier of coverage you have will determine what your deductible, co-pay and maximum out of pocket costs will be for those services.
On a covered California plan you can rest assured that the most you will pay in any calendar year, is the maximum out of pocket on your plan. Depending on the level tier of coverage you have will determine what your deductible, co-pay and maximum out of pocket costs will be for those services.
On a Covered California plan, you can rest assured that the most you will pay in any calendar year is the maximum out-of-pocket on your plan. Depending on the level of coverage you have will determine what your deductible, co-pay, and maximum out-of-pocket costs will be for those services.
Part A generally described as hospital coverage, covers Inpatient Hospital care, skilled nursing facility care, hospice care, and home health care. This covers generally larger type care like hospitalizations or post hospital stay care in a skilled nursing facility.
Your eligibility Covered California with financial help is based on your household size and income, using the Federal Poverty Level (FPL). Your immigration status and eligibility for other programs or services can also affect if you qualify. You will find out which program(s) you qualify for after you apply. Note: You can get a health plan from Covered California without financial help. You will pay the entire cost of the health plan, but your household size and income will not affect your eligibility. However, we will still confirm your identity, including your immigration and incarceration statuses.
Your household size = you + spouse + tax dependents. Include everyone, even if they don’t need health coverage.
Your household income = the adjusted gross income of you + spouse + tax dependents. Based on the year you want coverage.
Names, Dates of birth, address, social security numbers, Federal tax information, employment information, immigration documents.
Medicare is health insurance for people 65 or older and for people with certain disabilities under the age of 65. Originally passed as legislation in 1965 under President Lyndon Johnson. The foundations of Original Medicare are parts A and B administered through the social security administration and CMS Centers for Medicare and Medicaid Services (Some people get part A and part B Medicare benefits automatically; others must actively sign up for A and B.
Part B is commonly described as outpatient medical care. These services include doctors and specialists, preventive and diagnostic tests, emergency care, ambulance services, durable medical equipment, mental health careand many othermedical services.
Medicare is health insurance for people 65 or older. You may be eligible to get Medicare earlier if you have certain disabilities.Often referred to as senior plans, commonly thought to be for people over the age of 65, however people with disabilities under 65 can be eligible for Medicare also.
Preventive services will typically fall under the annual physical exam or “wellness checkup” and will cover a long list of diagnostic tests and screenings. These can include but are not limited to blood work tests, laboratory services, mammograms, shots administered in the doctor’s office, bone density exams, cardiovascular screenings, cervical and vaginal screenings, diabetes testing, glaucoma and a host of other exams that will help diagnosis potential health concerns. Annual physical and preventive services are administered at zero cost to the consumer.
Medicare doesn’t cover everything. If you need services Part A or Part B doesn’t cover, you’ll have to pay for them yourself
If you’re not lawfully present in the U.S., Medicare won’t pay for your Part A and Part B claims, and you can’t join a Medicare Advantage Plan or a Medicare drug plan.
La Parte C, también conocida como Medicare Advantage, es a menudo la opción menos costosa para la cobertura. Incluye todos los beneficios de las partes A y B de Medicare original, y a menudo incluirá los beneficios de medicamentos recetados de la parte D (no siempre). La Parte C suele ser una cobertura de tipo HMO con un requisito de médico de atención primaria y requiere una derivación de su médico de atención primaria para ver a un especialista. En los últimos años, los planes Advantage de la Parte C han incorporado opciones PPO también para un acceso más amplio a una red de médicos.
Most people do not get a bill for part B Medicare because they get the monthly premium deducted from their social security benefit automatically every month. If you do not receive social security benefits you will pay your part B premium quarterly (every 3 months). There are numerous ways to pay if you do not receive social security monthly income. You can pay online at your social security account (medicare.gov), you can have the payment deducted automatically from your checking or savings account, or mail a check for your quarterly payment.
Most people will add a Medicare Advantage plan or supplemental plan and/or a part D prescription plan to fill in the gaps that are left by the part A and part B benefits. Medicare advantage plans will often provide part D prescription coverage and close many of the financial gaps in Original Medicare.
Most people earn their part A for paying taxes and earning the 40 credits required to receive part B benefits at no cost. In layman’s terms by working for 10 years (40 quarters) you will have paid into the Medicare system enough to receive part A for no cost monthly. For people that have not paid the 40 quarters or credits, they could have to pay for part A benefits. For more information contact social security directly, 800-772-1213.
Part D is prescription drug coverage for Medicare. You can get part D coverage one of two ways.
1. Medicare drug plans. These plans add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. You must have Medicare Part A (Hospital Insurance) and/or Medicare part B coverage to join a separate Medicare drug plan.
2. Medicare Advantage Plan (Part C) or other Medicare health plan with drug coverage. You get all of your Part A, Part B, and drug coverage, through these plans. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.
All plans must cover a range of medications that people with Medicare take, including most drugs in certain protected classes,” like drugs to treat cancer. A plan’s list of covered drugs is called a “formulary,” or list of drugs covered by that insurance company. Each company will offer a different formulary. Medicare drug coverage places drugs into different levels, called “tiers,” on their formularies. Drugs in each tier have a different cost. For example, a drug in a lower tier will generally cost you less than a drug in a higher tier.
Most Medicare drug plans (Medicare drug plans and Medicare Advantage Plans with prescription drug coverage) have their own list of what drugs are covered, called a formulary. Plans include both brand-name prescription drugs and generic drug coverage. The formulary includes at least 2 drugs in the most prescribed categories and classes. This helps make sure that people with different medical conditions can get the prescription drugs they need. All Medicare drug plans generally must cover at least 2 drugs per drug category, but plans can choose which drugs covered by Part D they will offer.The formulary might not include your specific drug. However, in most cases, a similar drug should be available. If you or your prescriber (your doctor or other health care provider who’s legally allowed to write prescriptions) believes none of the drugs on your plan’s formulary will work for your condition, you can ask for an exception. A Medicare drug plan can make some changes to its drug list during the year if it follows guidelines set by Medicare. Your plan may change its drug list during the year because drug therapies change, new drugs are released, or new medical information becomes available.Plans offering Medicare drug coverage under Part D may immediately remove drugs from their formularies after the Food and Drug Administrati.on (FDA) considers them unsafe or if their manufacturer removes them from the market. Plans meeting certain requirements also can immediately remove brand name drugs from their formularies and replace them with new generic drugs, or they can change the cost or coverage rules for brand name drugs when adding new generic drugs. If you’re currently taking any of these drugs, you’ll get information about the specific changes made.
A formulary is a list of drugs covered under a part D prescription plan. Drugs are classified in “tiers” and based on the tier of the medication, that will determine what the cost of the medication is at the pharmacy.
Each insurance company and plan will have a list of preferred and non-preferred pharmacies. It is always advised to use a preferred pharmacy, when possible, to receive the lowest co-payment possible. Non-preferred pharmacies will have a higher co-payment for medications.
Some plans may offer a mail-order program that allows you to get up to a 3-month supply of your covered prescription drugs sent directly to your home. This may be a cost-effective and convenient way to fill prescriptions you take regular.
“Extra Help” is a Medicare program to help people with limited income pay Medicare drug coverage (Part D) premiums, deductibles, coinsurance, and other costs. Often referred to as Medi-caid (or Medi-cal in California)
Supplemental coverage includes what are often called the letter plans (parts A, B, C, D, F, G, K, L, M, N). With this traditional plan type, there are no doctor networks so you can go to any doctor who accepts Medicare, nationwide; so it works as most people recognize a PPO. Consumers can go to doctors without a referral from their primary care doctor. The Medi-gap supplement plans will have a monthly premium which will increase annually with age. They also do not include prescription coverage, so you will want to add a separate part D drug plan to pair with your supplement.
Medicare Advantage is also known as a part C plan. Historically Advantage plans work within the HMO model of care, which requires a primary care doctor who writes your specialist referral for you, within your medical group. The benefits of Advantage plans include part A and part B coverage and often will include prescription drug coverage. Competitive benefits offered by insurance companies offering Advantage plans will be dental, vision, hearing and things like a gym membership and transportation benefits to help get seniors to the doctor.
Medicare advantage is not offered everywhere. More commonly in populous metropolitan areas you will have more doctors and hence more HMO Advantage plans offered. In rural areas, choices will be fewer or not offered at all.
Determining what is good for a consumer is always relative. Advantage plans are often the least expensive and have smaller doctor networks for consumers to access compared to Medi-gap. If your doctor accepts Medicare advantage it is certainly a plan to consider based on the lower cost. Recently there are PPO advantage plans that have been offered in the marketplace. With a lower monthly premium but often a higher co-pay for care, while keeping wide ranging PPO doctor access.
If you are accustomed to having PPO coverage and have multiple doctors that do not accept Medicare Advantage, then a Medi-gap supplement is likely your best option.
Medicare Advantage is the least expensive premium for Medicare secondary coverage.
Medicare open enrollment happens annually, starting on October 15th and ending December 7th.
Medicare special election period (SEP) is the season outside of the open enrollment period from October 15th through December 7th. You can make changes to your healthplan if you have certain events happen in your life; like moving or losing other insurance coverage and these events trigger an opportunity for consumer to shop and change plans within a specific amount of time. Some examples of changes include, a change in residence, losing other coverage from an employer or spousal coverage, changes in Medicaid or financial assistance status or having a sever or disabling health condition.
Yes, you can, however there are many things to consider when cancelling your coverage. Just because you cancel does not mean you can certainly acquire other secondary insurance for your Medicare prior to the open enrollment. Please consult one of our Medicare professionals prior to cancelling for specific details.
Ancillary benefits, or extra benefits are offered by insurance companies, and these go beyond the scope of original A and B Medicare coverage. Often included automatically, they can include dental, vision, hearing, gym membership, chiropractic, acupuncture, over the counter help, travel assistance, fit bit step tracker, lifeline response system (I’ve fallen, and I can’t get up) and transportation to and from the doctors offices that you see.
a) Seniors 65 or over with ten plus years of work history in the U.S. or long-term lawful presence in the U.S. b) disabled for 24 months of social security disability c) end stage renal disease (ESRD), kidney dialysis, had a kidney transplant d) disabled unmarried child over age 20 and disabled children under age 20.
Legal residents who have not worked 10 years in the U.S. can purchase Medicare part A and part B for a premium. Typically, part A has no premium if you have 10 years of work history. If you do not qualify for premium free part A because you do not have 10 years of work history, you may be eligible for an “on-exchange” health plan; in California that would be Covered California.
You can begin the enrollment process for Medicare 3 months before the month you turn 65, this is called your initial enrollment period. You can enroll online at ssa.gov/Medicare, by calling 800-772-1213 or by visiting your local social security office. If you miss your Initial Enrollment Period, your next option is to sign up during the General Enrollment Period that happens every year between January 1 and March 31.
The scope of appointment form is a document signed by you, the consumer and shared with an agent helping you, to disclose specifically what plans you and the agent will discuss. Typically, the scope of appointment form will include the option to discuss original Medicare, Medicare supplements, Medicare advantage, part D prescription coverage, vision and dental coverage and hospital indemnity coverage. By signing the scope of appointment form does not obligate you to buy anything, the agent provides it as a protection to the consumer, ensuring that only Medicare products are discussed.
If you have paid Medicare taxes through an employer for 40 quarters (10 years) over your lifetime, you can enroll at age 65 and don’t have to pay a Medicare Part A premium. Some enrollees without the 10 years of credits will have a premium to pay for part A.
Part B Medicare cost is based upon your taxable income. The part B cost in 2024 is $174.70. If you are single and have over $103,000 of annual income, then the part B cost will increase. If you have over $500,000 of annual income, the cost is $594 in 2024.
You enroll into Medicare with the social security administration. You can enroll online (easiest) at ssa.gov/medicare, by telephone at 800-772-1213 or at your local social services office.
If you receive Social Security income benefits, your enrollment into Original Medicare is automatic when you turn 65. If you do not receive social security income you may have to enroll yourself; this is done either online ssa.gov, by telephone (800-772-1213) or at your social security office.
SSA.GOV/Medicare
800-772-1213
Yes, you are required to have both parts A and B to enroll into a Medicare advantage plan.
No, you must have part A and/or part B to enroll to a part D prescription drug plan
If you have secondary coverage beyond original A and B Medicare, you will use the insurance company card for services at the doctor, and not your red, white and blue Medicare ID card.
If you have coverage through work, whether to enroll into Medicare depends on the size of workforce of the company you work for, specifically whether there are 20 or more employees. Generally, if you have employment-based insurance you will be able to keep that employment coverage until you retire and then you would go to Medicare. If you work for a small company with under 20 employees, you likely will want to take your Medicare coverage.
If you do not have other qualified prescription coverage (work health plan, VA, state assistance) and try to enroll after your initial eligibility, a surcharge is calculated based upon the national average drug plan cost. This complicated surcharge is then added to your monthly premium. In summation, the later you wait to get part D coverage, the more expensive it is to purchase later. The penalty is permanent, so you are best advised to include prescription coverage in your Medicare plan.
Many Advantage plans will offer additional benefits not included under part A and B original Medicare benefits. These can includedental, vision, hearing, a gym membership, chiropractic care, acupuncture care, over the counter financial help, travel assistance, fit bit step tracker, lifeline response system, transportation to and from the doctor and physician on call support.
Yes, if you are on Medicare Advantage you can change primary care doctor monthly.
Medicare is federal health insurance for people over 65 years old and certain people under 65 with disabilities. Medicaid is a state and federal program that provides healthcare to people with limited income and resources.
Plan G is one of the most sought after Medi-gap supplement plans for new enrollees because it has the lowest deductible available (currently $240/annually in 2024). Plan G allows you to access any doctor nationwide that accepts Medicare. If you are in the market for supplemental coverage, plan G is a considerable option.
Yes, if you are Medicare eligible because you are over 65 or have a qualifying disability to get Medicare, and you have limited income to qualify for Medicaid, you can have both simultaneously. This is often referred to as dual eligibility or Medi-Medi coverage.
There are a few ways to have Medicare coverage, and each customer will have different needs. The two main ways to have Medicare coverage are through original Medicarewith a Medi-gap supplement plan, plus a separate part D prescription plan. Typically, this has the most expensive premium monthly. The alternative is through a Medicare advantage plan, also known as a part C plan. Medicare Advantage, while including part D coverage in one “bundle” has the least expensive monthly premium.
Best is a difficult phrase to define when it comes to healthcare. It is going to be subjective to every person. If you are looking for the least expensive monthly Medicare option, an Advantage plan will be the likely route. If you are looking for biggest doctor network (list of doctors in a plan) then a supplemental plan will be the likely choice. Please consult one of our licensed Medicare specialists to discuss what plan could fit you best.
The Affordable Care Act, also known as Obamacare, has done many things to affect Medicare. Although most consumers have seen an increase in cost, a majority of Medicare plans have lowered cost since the Affordable Care Act. Many cost containing measures were put in place to lower cost for Medicare Advantage and certain prescription drug benefits.
No, when you become eligible for Medicare, you are no longer eligible for an on-exchange, Covered California plan. Medicare includes more coverage than a Covered California plan, and often, Medicare is less expensive, in monthly premium and consumer cost sharing.
Medicare serves the senior market and people with certain disabilities. Covered California was created for people under 65 and that do not have coverage through their job and are not eligible for other coverage. Medicare includes coverage for specific care like skilled nursing care and hospice care specifically, that are not included in any plans for people under the age of 65. Typically, Medicare is less expensive in monthly premium and often has less out of pocket cost to the consumer. It is not a measurement of one being better than the other, Medicare and Covered California are designed for different segments of the population.
1. Does my doctor accept the plan I’m thinking about buying? 2. Is there prescription coverage in my plan and are my medications covered? 3. Can I afford the monthly premium to continue the coverage?
The open enrollment period from October 15th to December 7th every year is the window of time that consumer can elect to change Medicare plans. Medicare Advantage plans are guaranteed to be accepted. Medi-gap supplements are not always guaranteed during the open enrollment but are guaranteed acceptance during your birthday month.
Yes, Medi-gap plans will increase annually because as you age the plans get more expensive. Historically plans increase 3-4% annually however since 2018 rate increases for Medi-gap supplements have ranged from 6-12% with inflation.
Special election period is the time of year, outside the open enrollment when medicare recipients can change their insurance plan. Making a plan change requires a change in circumstance like, moving to a new geographic region, having a change in Medicaid status, losing coverage from an employer or your Medicare plan making change to the benefits you are offered. Please contact one of our agents to see if you qualify for a special election period to change plans.
On average part D plans do increase every year. Some years plans do see decreases in cost or plans can offer new options that can be less expensive than alternate plans they offered in the past. Part D is not guaranteed to increase in cost however most years you will see the cost go up.
For Medicare Advantage recipients this period of time from January 1st to March 31st allows for Advantage plan consumers to make one change to another Advantage plan, away from their existing plan.
Medi-gap supplements, regarded as more traditional plans, have a monthly premium to pay and the premium increases every year. Supplements are typically for people with financial resources that want to have unrestricted access to be treated by any doctor that accepts Medicare. With recent additions of PPO Medicare Advantage plans, traditional Medi-gap has become less popular because of cost.
All insurance companies that offer Medicare secondary plans must comply to the benefits included in original Medicare parts A and B. All the companies have become highly competitive in cost and regarding the “extra benefits” they offer beyond original Medicare. There really is not a best company because they all strive to offer competitive prices and benefits. Call one of our licensed agents to help you find what is right for you.
The Medicare star rating ranges from 1 star to 5 stars, with 5 stars representing the highest grade: the more stars the better the plan. It is difficult to achieve a 5-star rating.
Under Medicare there is a long and standardized list of preventive diagnostics for beneficiaries. All insurance plans will comply to the list of preventive tests and screenings to follow the rule of law regarding Medicare. No plan can remove specific diagnostics or screenings from their coverage if original Medicare says the service is to be covered.
Depending upon the plan you have will determine if you doctor accepts it. Before you get services, make sure to check with your doctor to see if they accept your plan. Most plans outside of Medi-gap will have a network to determine if you are ‘in-network”. Always check with your doctor and your health plan before receiving services, especially if it’s a new doctor or facility.
Medicare Advantage has grown in popularity because of it’s low monthly premium/cost. Advantage plans will often have a network of doctors and facilities that are “in-network” so these limitations lead some seniors to not want an Advantage plan for their coverage. Medicare Advantage is the lowest costing premium available in most cases so measuring the doctor network against the cost will help determine if Medicare Advantage is right for you.
In the traditional medi-gap supplement market, these plans do not cover prescription drugs. Part D prescription plans can be paired with a Medi-gap supplement to make your coverage complete. IN this case you would have two policies and two bills to pay: Medi-gap plus the part D plan. In most Medicare Advantage plans the part D prescriptions are included in the coverage with just one cost.
In most cases you will keep your employer benefits and when you retire you will have a special election period to move into Medicare and a short window of time to find your secondary Medicare coverage.
Yes, most employers will disenroll you via a waiver of coverage for you to take your Medicare benefits at age 65. This is very common for employers to waive your coverage and then have you go onto Medicare.
California and thirteen other states have their own, individual “state exchange” for consumers to buy coverage from. If a state does not have it’s own exchange, then consumers can purchase coverage from the federally managed exchange known as healthcare.gov. The systems work identically, certain states elect to manage their own marketplace for their residents. Via heathcare.gov or on a state-based exchange, consumers can qualify for subsidy discount off the cost of their medical insurance.
If a state does not have it’s own exchange for consumers to buy coverage from, they can purchase from healthcare.gov, which is the federally managed marketplace to buy insurance coverage. These exchanges will include all the same insurance companies offered to individuals and families in that specific state. Via heathcare.gov consumers can qualify for a subsidy discount off the cost of their medical insurance.
The difference between Medigap and Medicare Advantage is that with a Medigap plan, you have the freedom to see any doctor that accepts Medicare, whereas with Medicare Advantage, you must get care within the plan’s network of doctors and hospitals. While Medi-gap offers a broader network, Advantage plans are less expensive. The choice of plan is relative to the customer, their needs and their budget. Speak with an agent today to discuss the differences.
Depending on whether you are buying an under age 65 plan or if you are on Medicare coverage, the cheapest monthly cost will vary. Under age 65 plans you will want to buy a bronze plan with a high deductible. If you are on Medicare you will want an Advantage plan to get the lowest cost.
Along with recent inflation costs, the Affordable Care Act has driven up the cost of healthcare since its inception in 2014. This complicated law has increased the billing cost and operational cost for all insurance companies. These additional expenses and higher utilization of care has eventually been passed down to the consumer in the form of higher premiums, deductibles and copayments.
This is a relative question. Depending on whether you want an HMO or PPO type plan, Anthem Bluecross, Blueshield and Healthnet have been the most dominant companies in California over the last decade under the Affordable Care Act regulation. Kaiser, United Healthcare, Scan and Molina have been amongst the top rated also.
Licensed agents are a valuable resource for individuals struggling with the Covered California system. We work free of charge and offer honest feedback and support. The best part? Our services are completely free to consumers as we advocate for your healthcare and help manage your case year after year.
Medicare plans accommodate individuals with disabilities. Many people with permanent disabilities may qualify for state assistance alongside Medicare. While we are not allowed to use the terms “best” or “better,” options from Scan, Anthem, Aetna, Humana, and UnitedHealthcare are all highly rated and worth considering.
Yes, a spouse, family member, or friend can assist with enrollment. If the assisting person is completing the enrollment on behalf of the beneficiary without their input, they must be a legally authorized representative, such as someone with Power of Attorney.
Keeping your doctor is what we help you determine which plans are best. We call this the glue to figuring out the best plan for each consumer. First we begin with what plans your doctor accepts and look at those plans first.
Medicare Advantage is a type of secondary insurance to Parts A and B. Medigap is a more traditional form of secondary coverage and usually requires a monthly premium, while most Medicare Advantage plans in California do not. Advantage plans can be HMO or PPO networks. Medigap operates on a fee-for-service basis, allowing you to see any doctor that accepts Medicare. The better option depends on your current doctors, the plans they accept, and your monthly budget. This is where our team at MIT comes in.
All Medicare Advantage plans in California offer dental, vision, and hearing (DVH) coverage. Many also include additional benefits such as a free gym membership, chiropractic care, and monthly allowances for over-the-counter items.
For the average individual in 2025, Medicare Part B costs $185 per month. If a single woman earns less than $21,600 annually, she may qualify for Medi-Cal along with Medicare. You can have both Medicare and Medi-Cal at the same time. Most Medi-Cal beneficiaries pay $0 per month for Part B. For higher-income earners, the Part B cost varies based on taxable income. For example, if a single woman earns over $106,000 annually, her cost increases to $259. See income chart. https://www.cms.gov/newsroom/fact-sheets/2025-medicare-parts-b-premiums-and-deductibles
Yes, all those tests are covered by Medicare as preventive measures. Because they are preventive diagnostics, they are covered at zero cost. In addition, Medicare covers a long list of other preventive diagnostics and procedures.
This is often referred to as “aging in” to Medicare. Most people apply for Medicare Parts A and B three months before their 65th birthday month, so coverage begins on the first day of that month. You have a seven-month window to enroll: three months before, the month of, and three months after your 65th birthday. If you miss this initial window, things can get complicated, so it’s best to take care of it early.
Yes, you are eligible at age 65 and then have the choice of keeping your employer benefits or enrolling in Medicare. The majority of people elect to take Medicare because of its rich benefits and low monthly premiums. This is where an experienced and honest agent can help compare your options and guide you toward the best route for your specific situation.
Medical Insurance Today is a vibrant, customer focused team with answers for you and your families, on healthcare insurance. After decades of being in this sector, we have created a concierge level service that puts you and your families first with live human agents who are bilingual in English and Spanish. You can also come in and see us at our new location in Costa Mesa, California. Our aim is to make your life easier to access our services both in person or online.
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