Medicare Advantage Plans for Contra Costa County for 2021
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Medicare Advantage (MAPD) plans are private insurance plans approved and subsidized by Medicare. They offer equivalent benefits to Medicare and are an alternative way of receiving Medicare coverage. You must have both Parts A and B of Medicare to join a Medicare Advantage plan and pay the same premiums, and any applicable income related surcharges and late enrollment penalties as those on Original Medicare.
All the Medicare Advantage plans in Contra Costa County are HMO’s. That means you must use the plan’s network providers and get referrals from your primary care physician for specialists. Generally any specialists must be part of the same physician’s group (IPA) as your primary care physician. Joining a Medicare Advantage plan means you may not use your Medicare card outside the plan. All Contra Costa County HMO’s include Part D prescription drug coverage.
Eligibility for these plans is based on your residence. Some are offered for the entire county, and some are limited to certain zip codes. (See the chart for details). Anyone can join a Medicare Advantage Plan. Beginning in 2021, people with End-Stage Renal Disease (ESRD) can enroll in Medicare Advantage Plans.
Unless you are in your initial Medicare enrollment period or a special enrollment period, you can only join or leave a plan at certain times. Open enrollment occurs each year between October 15th and December 7th. An exception to this rule is offered for a 5-Star Plan.
Switching to a 5-Star Plan
At any time during the year you have the right to enroll in a 5-star plan (a plan with a 5 star rating). This applies whether you have Original Medicare, with or without a Prescription Drug Plan, a Medicare Advantage Plan, or Contra Costa Health Plan. Two 5-Star Medicare Advantage plans are available in Contra Costa County. Both are offered by Kaiser. Note that the 5-Star option can be used only one time each year.
2021 Medicare Advantage Plans
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