Learn About Your Medicare Options for 2022:

Enrollment & Eligibility for Medicare in San Diego

It is important for you to understand exactly when you are eligible to enroll in Medicare and make a plan to sign up.

The following page will outline the initial enrollment period for Original Medicare and the process to enroll in Original Medicare.

We will then dive into additional benefits to your Original Medicare Parts A and B by enrolling in either Supplement Insurance or an Advantage plan. At the end we will walk through how to enroll in a plan that will cover the costs for your prescription drugs.

Are you ready to enroll in Medicare insurance? Start with a quote and our Medicare plan team will answer any questions you have to start your enrollment.

When am I eligible for San Diego Medicare?

You are eligible for Original Medicare Parts A + B if you are at least 65 years old.

… or if you are under 65 and specially qualify because of a disability.
… and you are a U.S. Citizen or legal resident.
… and you have been living in the United States for at least 5 years straight.

 

When you turn eligible for Medicare you are also eligible to enroll in Supplement Insurance plans, Advantage plans, and Part D Prescription Drug plans all through the Medicare system. Contact us for details on Medicare enrollment options.

When is Medicare Initial Enrollment Period?

Your Initial Enrollment Period or IEP is 7 months long. This period includes your birthday month, the 3 months prior to your birthday month, and the 3 months after. During this time you can enroll in Original Medicare’s Part A, Part B, or both.

During these 7 months you can also join a Medicare Advantage Plan (also called Part C) or a Prescription Drug Plan (Part D). Supplement Insurance is also available for you to choose from during this Initial Enrollment Period.​

*Note: The IEP begins and ends 1 month earlier if you are born on the 1st of the month.

Is there a Special Enrollment Period?

Depending on your circumstances, you may be able to enroll in a Medicare plan outside of these months listed above.

Here are ways you may qualify for a Special Enrollment Period:

– Retire and lose your employer coverage
– Move out of your plan’s service area
– Receive Assistance from the state
– Have been diagnosed with certain disabilities
– Have been diagnosed with a chronic health condition
– Qualify for Extra Help

The 2 Most Common Original Medicare Enrollment Mistakes

1. Not Enrolling On Time

Having 3 months prior to your birthday month to enroll in Original Medicare seems like plenty of time to get the job done. However, it is a best practice to jump on this process as soon as you can.

The Social Security Administration office can take up to 6 weeks to send you your new Medicare number in the mail.

You are unable to sign up for a Supplement or Advantage plan without this Medicare number. Be sure to get the most difficult part of the process out of the way early in your eligibility period.

2. Forgetting to Enroll in Both Parts A and B

If you plan on enrolling in an Advantage or Supplement plan, you’ll need to enroll in both Parts A and B. If you are currently enrolled in a health insurance plan through your employer, the Social Security Administration may suggest to you that you should only enroll in Part A but not Part B.

This is true ONLY IF you wish to continue your employer sponsored insurance even though you are Medicare eligible. If you plan to stop your employer sponsored insurance now that you have a Medicare plan, you will want to enroll in both Parts A and B so you can complete your Supplement or Advantage enrollment.

2 Main Steps of Medicare Enrollment

Step 1 is to enroll in Original Medicare Parts A and B through Medicare.gov.

This process is often as easy as answering a few questions and selecting your enrollment. However, many people are not able to enter the site for a few days if not weeks.

Furthermore, it takes the Medicare team at the Social Security Offices a few weeks to create and send you your Medicare number. Complete step 1 early in your 7 month initial enrollment period to ensure you do not run out of time.

HealthyMarks recommends that you sign up for Original Medicare with us. Our team can help you navigate through the complexity of getting your Medicare Number. It is often best to start the process with a professional instead of trying to do it on your own. Start your Medicare quote here.

Step 2 is to pair your Original Medicare with additional coverage in the form of Supplement Plans, Advantage Plans, and Part D Prescription Drug plans.

HealthyMarks is your best resource to evaluate these plans and enroll in them. We are ready to help!

Original Medicare with Supplement Insurance or an Advantage Plan

Understanding your services and what will be covered with your Medicare Plan is essential to understanding your benefits and making a smart decision about your new health insurance Medicare plan here in San Diego. For this reason let’s take a look at Original Medicare, how to enroll, and why pairing it with Supplement Insurance or an Advantage Plan will make sure your Medicare package is complete.

About Original Medicare – Part A & Part B

Part A is most commonly paired with Part B to complete Original Medicare. Part A covers hospital stays and inpatient care. Part B covers doctor visits and outpatient care.

Part A is considered “entitled” while the standard monthly premium for Medicare Part B will be $170.10 for 2022.

Supplement Insurance and Medicare Advantage Plans are built to cover the gaps in your Original Medicare. For example if you enroll in Part A and Part B of Original Medicare, you will have access to doctors and they will provide you with services but you will have a very large deductible.

The Part A deductible is $1,556 in 2022. If you go ahead and pair your Original Medicare with a Supplement Insurance plan or an Advantage Plan you will be able to reduce that deductible to only a couple hundred dollars.

Supplement Plans Overview

A Supplement Plan will provide you access to any doctor throughout the United States. You can think of a Supplement Plan as a really robust PPO plan with access to every doctor in America for an in-network cost.

Advantage Plans Overview

An Advantage Plan will make you sign up for a San Diego network of doctors. Although you have emergency care worldwide, you can think of an Advantage Plan as having an HMO network of doctors that you need to stay within to make sure your care is handled a proper out of pocket cost for you.

Should I pair Original Medicare with a Supplement Plan or Advantage Plan?

Yes! You should absolutely pair your Original Medicare Plan with additional coverage. Do not sign up for Original Medicare and think you have completed the process. You will be much better off if you pair it with one of the strategies above.

Do not go this decision alone. HealthyMarks Medicare is a team of professionals who excel at helping new Medicare members better understand their options. Our team wants to help you so you can select the best plan for you and your family.

We offer all the best plans from all the best San Diego carriers. Our team is excited to talk to you about your medical needs and do not hesitate to give us a call so we can provide you with any information you need to select the best Supplement Plan or Advantage Plan here in San Diego.

About Supplement Insurance

Supplement Insurance is the more expensive option because of that robust network of nationwide doctors. You’ll also need to purchase additional prescription drug coverage in the form of a Part D plan to complete your coverage.

Click to view all insurance carriers offering Supplement Insurance and Advantage Plans in San Diego.

Supplement Insurance is often the most popular because you’ll have access to all the major San Diego doctor networks like Scripps, Sharp, and UCSD. You’ll also have nationwide access to doctors at an in network cost.

After you pay your small deductible, your Supplement Insurance plan will cover almost all of your medical costs. You can be confident because you have the best health insurance available to you.

About Advantage Plans

Advantage Plans are usually a lot less expensive each month in premiums compared to Supplement Plans. Advantage Plans allow the carriers to get creative to offer unique solutions to their services so they can better serve you and save money. Those savings by the insurance carrier are passed along as monthly premium savings to you the insured.

Advantage Plans are also unique because they bundle dental and vision services as well as your prescription drug services into one plan offered by one insurance carrier. An Advantage Plan offers a one stop shop for all of your medical needs for only a few dollars a month.

Read FAQs About Medicare Enrollment in San Diego

FAQs About Medicare Enrollment & Eligibility

  • Medicare Enrollment
  • Eligibility
  • General Plan Info
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  • 1. How do I get my Medicare Number?
     

    After you enroll in Original Medicare, you'll receive your Medicare number in the mail.  This can take up to 3 weeks for the Social Security Office to process your application and send you your Medicare number.  Enroll in Original Medicare here: https://www.ssa.gov/benefits/medicare/

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  • 2. Should I enroll in Medicare by myself or with the help of a broker?
     

    You should enroll with a Medicare broker like HealthyMarks. There are no drawbacks to working with a broker. The services offered by our team are free to you because insurance companies have agreed that our services are worth it to them. Our goal is to ensure you enroll in the best plan for you.

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  • 3. Should I stick with my Large Group Employer health insurance policy or switch to Medicare?
     

    For companies larger than 100 employees, health insurance policies are no longer age based. The group takes the entire age of the company, averages it out, and provides the same rate for all employees no matter their age.

    Even though you at age 65 will get a better deal than someone at age 30, these group health insurance plans still do not match the price or quality of care you can receive from a 2020 Medicare Supplement plan.

    For example. I have a family member approaching her 65th birthday. She has awesome insurance through her employer Nordstrom. Her company pays half the monthly plan costs meaning she only pays $230 a month. This is extremely inexpensive considering a similar plan on the age based market would cost $800 or more.

    Here is the kicker. The plan is not as good as a Supplement Plan from Medicare. Currently, her deductible through work is $2500. A great Supplement plan like Plan N or Plan G has a deductible of $198. All in with Original Medicare and the Supplement Plan N here in San Diego, she's looking at $256.28 a month and a much better plan with almost no deductible. So for a few extra dollars a month, she can reduce her $2500 deductible to $198, have a more robust and encompassing plan, and visit any network of doctors and hospitals in San Diego.

    In short, Medicare will likely be the better option. You should evaluate both and select the better insurance plan.

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  • 4. What are the major parts of Medicare?
     

    Original Medicare Parts A + B are the basic start to Medicare. To cover more of your medical expenses, you’ll want to pair your Original Medicare with a Supplement Plan or an Advantage Plan. Medicare Part D is to cover prescription drugs.

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  • 5. Should I still switch if my awesome health insurance is better than what's available through Medicare?
     

    Every once in a while I will come across an employee who does have awesome health insurance coverage, even better than what's available through Medicare. This means they are paying less than $300 a month in premiums, they have a deductible less than $200, and they are able to see the doctors they want to see. This is rare but amazing.

    Our Medicare Office Team is the best at evaluating your current plan and whether or not it is better for you to switch or stay. If you are enrolled in a plan better than what is offered through Medicare, you will want to know if you are subject to any late enrollment penalties. If you do not enroll in Original Medicare at the age of 65, you may end up paying more for it in the future due to late enrollment fees. However, you can avoid all penalties if you are receiving your health insurance from your employer. Our team is great at helping you avoid those penalties so you can stay with your awesome insurance.

    In these cases I like to discuss the process of moving to Medicare WHEN the right time comes. Our team is able to make sure you do not incur any penalties by not enrolling in Medicare. We'd love to help you evaluate your plan options and navigate the enrollment process.

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  • 6. Are my prescription drugs covered under Medicare?
     

    Prescription drugs are not covered by Original Medicare. You'll want to cover your prescription drug costs with a Medicare Advantage Plan or a Part D Prescription Drug Plan.

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  • 7. Should I still switch to Medicare even if my family is covered by my insurance plan?
     

    Yes! The savings you receive by switching to medicare is significant. So significant that it is still worth the switch to Medicare even if your family is covered by your current plan. Pairing your entire family into a single health insurance plan offers a handful of benefits. You'll all share a "family deductible" which can help save some out of pocket costs during an unhealthy year. However, pairing your entire family into a single plan does not save you money on monthly premiums.

    The best thing to do is enroll yourself in a medicare plan and enroll your family members in their own plan. You'll save money each month with your new, less expensive, Medicare plan and your family will be able to continue coverage through their individual plan.

    One scenario that may be difficult to evaluate is when you are eligible for Medicare but your employer is covering the costs for both your family members premiums and your own premiums. Our HealthyMarks team is excellent at evaluating these two options and figuring out the best course of action for you. We can calculate how much money you would save by switching to Medicare and how much money are you sacrificing by giving up your employer's contribution towards your dependent's plans. If you employer contributes a lot, you'll likely want to stay with that employers plan cause they are spoiling you and your family. In a majority of cases, employers only offer a small amount of money to cover dependents plan costs. In fact most businesses do not cover dependents at all because they are not required to.

    It is a very easy process to enroll your family members on a great individual plan. Our health insurance team is able to help you move to Medicare and move your family to an individual plan.

    Give us a call today so we can share with you the best path forward so you can save hundreds of dollars each month by moving to a San Diego Medicare plan.

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  • 8. Do Advantage plans cover prescription drugs?
     

    Yes. If you enroll in an Advantage plan you are bundling all of your medical services including prescription drugs.

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  • 9. Should I stick with my group health insurance policy or should I switch to Medicare?
     

    Perhaps you are not enrolled in a plan through the individual exchange but instead you are enrolled with a plan through your company. Similar to individual plans, group health insurance policies for businesses with 100 employees or fewer are also age based. When you approach your 65th birthday your group health insurance policy plan will be very expensive.

    The major difference between an individual policy and one through your company is that your employer is required to contribute some money to cover your monthly costs. By law, your company is required to pay for 50% of your health insurance premiums each month. Even after calculating the costs, 50% of a plan through your employer is more expensive than 100% of a medicare plan.​

    It is also nice to keep in mind how much money you can help your company save when you switch to Medicare. Employers are excited to help employees move to Medicare because they appreciate not paying so much each month for your insurance.

    I personally sell group health insurance policies here in San Diego and I can confidently say that a plan through Medicare, with either a supplement plan or an advantage plan, is going to be better than what you are receiving from your business.​

    However, some companies are extremely generous with their health insurance offering and it can make it difficult to switch over to Medicare. For example, I work with a company in Carlsbad that pays 100% of the employees health insurance costs and 80% of the family's costs. This is an unbelievably generous offer. Even in this scenario, it was worth it to evaluate the newly 65 year old's Medicare options. Both the employer and employee agreed that moving to Medicare was best.

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  • 10. Do Supplement plans cover prescription drugs?
     

    No. You will want to pair your Supplement plan with a Part D prescription drug plan.

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  • 11. Should I stick with my current Individual Health Insurance policy or switch to Medicare?
     

    You can get individual health insurance plans from the California Health Exchange called Covered California. You can also get an individual plan if you contact the insurance carrier directly and sign up with them. However, these plans are very expensive and get more expensive as you get older. The plans monthly premiums are age based meaning the older you get the more expensive they are.

    For example, let's assume you want access to Scripps Doctors in North County. The best option on the individual market for a 64 year old is to select the Silver HMO Trio plan from Blue Shield. This plan premium is $931.84 per month! With this plan you have a $4000 deductible!

    Now let's compare that to Original Medicare with a Supplement plan N here in San Diego. For most people, Original Medicare Parts A + B PLUS a Supplement plan will be less than $300 a month in premium and you'll have a very low deductible. Clearly, you'll want to switch to medicare from your Individual plan.

    Although the individual health insurance market has some solid silver and gold plans that will help you in your time of need, there is no question in my mind that not a single plan on the individual health experience exchange through Covered California is close to the benefits that you will receive from a Medicare Plan.

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  • 12. What’s the difference between Medicare and Medicaid?
     

    Medicare is a federal government-sponsored healthcare program for those 65 and over, and for younger people who are disabled. Medicaid is a healthcare program for low-income individuals who could not otherwise afford health insurance.

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  • 13. Should I switch to Medicare or Should I stay with the insurance I currently have in San Diego?
     

    Medicare is an incredible health insurance offering that you should absolutely take advantage of.

    It is our recommendation that you switch to Medicare as soon as you turn 65 years old. As a United States citizen you have been contributing money towards your Medicare policy for your entire working life. Now is your chance to take advantage of this government-sponsored Medicare health insurance plan. The plan premiums, deductibles, and out of pocket costs are all going to be a much better deal for you the consumer when you switch to Medicare. There are almost no examples of a non-Medicare plan that is better than the San Diego Medicare offerings.

    Medicare is fantastic. It is much better than all of the other San Diego health insurance offering you have. So let's take a look at your current situation and why it is going to be better for you to switch to Medicare.

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  • 14. Should I switch to Medicare if I have insurance elsewhere?
     

    Yes. By switching to Medicare you will likely save a lot of money and receive a better plan.

    Whether you are getting health insurance from your employer or even if your spouse is covered too, HealthyMarks would be happy to help you evaluate your options.

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  • 15. What doctors will accept Medicare?
     

    With Original Medicare and a Supplement Plan, you'll have access to just about any doctor you want to visit.  With an Advantage Plan, you'll have a network of doctors that you are required to stay within.

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  • 16. When am I eligible for Medicare?
     

    You can begin the medicare process on the 1st day of the month 3 months prior to your 65th birthday. Your application will be effective the 1st day on the month of your 65th birthday. Your initial enrollment period is 7 months long. This period includes your birthday month, the 3 months prior to your birthday month, and the 3 months after.

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  • 17. What is IRMAA and why do some Medicare beneficiaries have to pay more?
     

    The Medicare Income-Related Monthly Adjustment Amount (IRMAA) is an amount you may pay in addition to your Part B or Part D premium if your income is above a certain level. If you are a higher earner, you will likely pay more for your Medicare plans.

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  • 18. Why Do I need a Supplement or Advantage Plan when I sign up for Original Medicare?
     

    Original Medicare is an awesome product however it does not cover all of the costs associated with your health care. As you get older it's important to make sure that you are going to be completely covered for any of your medical needs. A Supplement Plan or an Advantage Plan will make sure that the costs out of your own pocket stay small anytime you need to go to the doctor. The best thing about a Medicare Advantage or a Medicare Supplement Plan is how little you need to pay out of pocket for your services.

    Although you do not need to sign up for a Supplement or an Advantage Plan I highly recommend it. Especially here in San Diego Medicare Supplement and Medicare Advantage plans are going to be extremely beneficial help you see the doctors that you want to see at the coverage that you want and you will pay very little out of your own pocket.

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  • 19. How Do I Choose between a Supplement plan and an Advantage Plan?
     

    Both Supplement Plans and Advantage Plans will serve your needs. However we can identify which plan is better for you by laying out the specific needs you may have. The first thing is that a Supplement Plan will provide you access to any doctor throughout the United States whereas an Advantage Plan will make you sign up for a San Diego network of doctors. You can think of a Supplement Plan as a really robust PPO plan with access to every doctor in America for an in-network cost. You can think of an Advantage Plan as having an HMO network of doctors that you need to stay within to make sure your care is handled a proper out of pocket cost for you.

    Supplement Plans are a bit more expensive because of that robust network of doctors and because most of your out of pocket costs will be covered immediately after a small deductible. Advantage Plans are usually a lot less expensive each month in premiums compared to Supplement Plans. Advantage Plans allow the carriers to get creative to offer unique solutions to their services so they can better serve you and save money. Those savings by the insurance carrier are passed along as monthly premium savings to you the insured. Sometimes these plans can be as inexpensive as only a few dollars a month. Advantage Plans are also unique because they can bundle dental and vision services as well as your prescription drug services into one plan offered by one insurance carrier. An Advantage Plan offers a one stop shop for all of your medical needs for only a few dollars a month.

    If you want access to all the San Diego doctors and doctors throughout the United States, you want that strong PPO in network plan. You should select the Supplement Plan and be confident because all of your costs will be covered. You will have no problem finding doctors who will accept your plan and you can always feel confident that you will have the best health insurance available to you.

    If you are interested in bundling all your prescription drugs needs, your medical needs, as well as dental and vision insurance, Advantage Plans can do this for you. When you select your Advantage Plan, make sure you can visit the doctors that you want to see for in network costs.

    Note that Blue Shield has been offering Supplement Plans alongside Part D Prescription Drug Plans that can be paired with a Blue Shield Dental and Vision VSP Plan. So if you want the power of a Supplement Plan paired with all the added benefits, I suggest Blue Shield here in San Diego.

    As always it is best that you speak to us: San Diego Medicare Brokers. Our HealthyMarks Medicare team can evaluate your needs and make the best decision for your health insurance. Our services are free to you, HealthyMarks has partnered with the insurance carriers in San Diego and they are willing to pay for our services to help you enroll in their plans.

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  • 20. Should I pair my Original Medicare with a Supplement Plan or Advantage Plan?
     

    YES! You should absolutely pair your Original Medicare Plan with additional coverage. Do not sign up for Original Medicare and think you have completed the process. You will be much better off if you pair it with one of the strategies above.

    Do not go this decision alone. HealthyMarks Medicare is a team of professionals who excel at helping new Medicare members better understand their options. Our team wants to help you so you can select the best plan for you and your family. We offer all the best plans from all the best San Diego carriers. Our team is excited to talk to you about your medical needs and do not hesitate to give us a call so we can provide you with any information you need to select the best Supplement Plan or Advantage Plan here in San Diego.

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  • 21. What is the IRMAA Extra Premium Charge for Higher Earners?
     

    IRMAA stands for income-related monthly adjustment amount and is an additional amount that some people might have to pay along with their Medicare premium.

    The Medicare Income-Related Monthly Adjustment Amount (IRMAA) is an amount you may pay in addition to your Part B or Part D premium if your income is above a certain level. If you are a higher earner, you will likely pay more for your Medicare plans.

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Popular Medicare Plan Providers / Carriers in San Diego

Use these pages to explore your San Diego Supplement Insurance and Advantage Plans.

Blue Shield

Blue Shield offers Supplement Plans with “extra” benefits like SilverSneakers and hearing aids. You’ll also have the opportunity to pair it with Blue Shield dental and vision insurance.

Scan

SCAN Advantage plans offer access to Scripps doctors and hospitals at lower premiums and lower out of pocket costs compared to Supplement Insurance. These Advantage plans also bundle extra benefits.

Anthem

Anthem offers Supplement Insurance plans with add-ons like SilverSneakers, dental and vision insurance. For those who qualify, Anthem still offers the popular but retired Plan F.

Kaiser

Kaiser’s Medicare Advantage HMO offers access to Kaiser facilities, plus Part D prescription drug coverage, and additional benefits, such as vision, dental, and hearing.

UnitedHealthcare / Sharp

UnitedHealthcare™ has partnered to offer the largest number of Supplement Insurance and Advantage Plans with access to Sharp Hospitals and Scripps Hospitals.

Humana

Humana offers multiple Supplement Insurance and Part D plans. Most interesting, Humana offers an Advantage HMO partnered with UCSD’s medical team.

Insurance carriers pay brokers like us to help you enroll in your Medicare plans.

So you can enroll with a professional free of charge!