What is Medicare?
As you approach retirement, have you made plans to protect your health in this new chapter of life? The U.S. government provides a dedicated health insurance program — Medicare for people aged 65 and over, as well as for certain individuals with disabilities or serious illnesses. KCAL Insurance would like to remind you that each year, from October 15 to December 7, is the brief Medicare Annual Enrollment Period. During this time, seniors can add, cancel, or switch their current health insurance plans. Our experienced Medicare consultants at KCAL Insurance are here to provide you with the most professional advice, the best prices, and the most comprehensive coverage.
You may be eligible to apply for Medicare if you meet the following conditions:
- You are a U.S. citizen or a green card holder who has lived in the U.S. for at least five years.
- You are 65 years of age or older, or meet eligibility due to disability or certain serious illnesses.
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When you become eligible for Medicare, you are automatically entitled to Part A (hospitalization) and Part B (outpatient services) benefits upon enrollment. However, Medicare only covers 80% of medical expenses. The remaining 20% requires the help of a professional health insurance consultant, who can recommend additional benefit packages tailored to your financial situation and health needs — ensuring that high medical costs won’t become a burden in your retirement years.
Medicare Advantage Plan - HMO
Offered by private health insurance companies, this plan supplements the coverage not provided by original Medicare. It combines Part A hospital and Part B outpatient benefits, and offers extra benefits such as dental, vision, and hearing coverage, as well as prescription drug coverage. For HMO plans, members must choose a primary care physician and receive medical services within a designated provider network. The plan also includes prescription drug benefits. A referral from a primary care physician is required to see specialists.
Medicare Advantage Plan - PPO
Also offered by private health insurance companies, this plan supplements original Medicare coverage. It combines Part A hospital and Part B outpatient benefits, with additional benefits like dental, vision, hearing, and prescription drug coverage. PPO plan members are not required to choose a primary care physician or stay within a provider network. They can visit both in-network and out-of-network doctors and hospitals without a referral.
Medicare Supplement (Medigap) Plan
Private health insurance companies offer these plans to fill in the gaps left by original Medicare coverage. There are no network restrictions, and usage is not limited by county or state.
Prescription Drug Plan (Part D)
Private health insurance companies offer plans that help cover the cost of prescription drugs. Different plans provide various levels of drug coverage and co-payment rules, depending on the drug tier and plan design.
Call the Medicare Hotline: (626) 363-0999
When can I apply for Medicare?
Initial Enrollment Period: When you turn 65 or become eligible for Medicare due to other reasons, you can use your initial enrollment period. Your initial enrollment period starts three months before your 65th birthday month, includes your birthday month, and ends three months after your birthday month (a total of seven months).
Annual Enrollment Period: From October 15 to December 7 each year, you can add, cancel, or switch Medicare plans.
Special Enrollment Period: In certain special situations, you may qualify for a special enrollment period. For example, if you retire and lose employer coverage, are diagnosed with certain qualifying disabilities or chronic illnesses, receive assistance from the state government, or move out of your plan’s service area.
What Changes Are Coming to Medicare in 2026?
Starting in 2026, Medicare will undergo three major changes, affecting seniors’ premiums and benefits:
Change 1: Part B Premiums May Exceed $200
Change 2: Insurance Market Reshuffling and Benefit Reductions
Change 3: Medi-Cal Asset Review May Return
Currently, Medi-Cal program determines eligibility based on income alone, without considering assets. However, in 2026, the state may reinstate asset review. In other words, the “no asset check” period may come to an end. If Medi-Cal eligibility is affected, your current Medicare plan may also need to be reassessed.
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