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Health Coverage

There are many options available for health coverage as you approach Medicare eligibility. Retirement is coming sooner than you think so we encourage you to explore these now. These resources can help you find the best option for you.

Medicare

Medicare is the federal health insurance program for:

  • People who are 65 or older

  • Certain younger people with disabilities

  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

 

There are a few things you should know about Medicare:

  • Medicare isn’t a health care provider, it’s a payment program, like other health insurance. You get to choose who and how you receive your coverage from.
     

  • Medicare doesn’t offer family plans, it’s only for the enrollee.
     

  • There are strict sign-up deadlines. If you enroll late, you could face permanent penalties and higher costs. Learn more about avoiding late enrollment penalties.
     

  • You’ll need to sign up for Medicare through the Social Security Administration, not Medicare. Once you create a Social Security account you can sign up at ssa.gov/medicare or call or visit your local Social Security office. However, if you’re already collecting Social Security as you approach age 65, you’ll automatically be enrolled in Medicare.

The Parts of Medicare

The parts of Medicare can be a confusing jumble of different names and parts. Bear with us as we try and unscramble this confusion. You may often hear discussion of Medicare Parts  A, B, C, and D — each part covers specific services, from medical care to prescription drugs.

  • Original Medicare, which includes Parts A (Hospital Coverage) and B (Medical Coverage requiring an additional premium), is provided by the federal government. Original Medicare covers only about 80% of hospital and medical expenses and does not include prescription drug coverage.
     

  • Medicare Advantage (also known as Part C) is another way to get Part A and Part B coverage. You can get Medicare Advantage plans from private healthcare providers like Kaiser Permanente. These plans are much like managed healthcare plans that you may be familiar with and often include additional benefits like vision, dental and prescription coverage.
     

  • Part D is prescription drug coverage that can be added to Original Medicare and is available from private healthcare providers like Kaiser Permanente.

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Learn more about what each part covers.

Medicare Supplement Insurance (Medigap)

If you choose Original Medicare, you can purchase Medicare Supplement Insurance plans — also called Medigap plans — to help you pay for care not covered by Parts A and B.

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Unlike Medicare Advantage, these plans offer limited coverage and do not include prescription drug coverage. You’d pay the Part B premium (a monthly health plan premium) and any coinsurance and deductibles for out-of-network care. Plus, you will need to find a Part D prescription drug coverage plan, which may require an additional premium.

Kaiser Permanente Health Coverage

Shop KP

Whether you need to find a new plan or you’re looking to switch plans, Shop KP locations help make it simple and stress-free. Shop KP licensed representatives offer one-on-one advice and walk you through everything you need to know:

  • Learn about KP health plans

  • Get answers to your questions

  • Get help enrolling in a Kaiser Permanente plan

  • Get help getting started as a new member

Kaiser Permanente Medicare Plans (Medicare Advantage)

Options for People with Low or No Income or Uninsured

  • Covered California: 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.
     

  • Alameda County Health Care Services Agency: For uninsured people living in Alameda County
     

  • Medi-Cal: Healthcare for low or no-income families and individuals

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