Part A: Hospital Coverage, Cost, and Eligibility
Medicare Part A is hospital insurance. It covers inpatient hospital care and surgery as well as skilled nursing facility, hospice, and home healthcare.
Medicare Part A is free to any person age 65 or older who is either:
- Eligible to receive a monthly Social Security benefit, or
- Eligible based on wages in which sufficient Medicare payroll taxes were paid.
You automatically apply for Medicare Part A when you apply for Social Security benefits. Your spouse may also qualify for Part A coverage at age 65, based on your eligibility for Social Security. If you are not eligible for free Part A coverage, you may purchase it.
Medicare Part A is free to any person under age 65 who is disabled and has either:
- Received Social Security disability benefits for 24 months as a worker, surviving spouse, or adult child of a retired, disabled, or deceased worker; or
- Accumulated a sufficient number of Social Security credits to be insured for Medicare and meets the requirements of the Social Security disability program.
For questions about eligibility for enrollment in Medicare Part A, contact Social Security directly.
Part B: Healthcare Coverage and Premium Structure
Part B Supplemental Medicare Insurance covers physician, lab, testing, and other costs. When you enroll in Medicare Part A, you are automatically enrolled in Medicare Part B unless you decline it. This rule applies to people age 65 or older and to those who are disabled under age 65.
If you pay a premium for Plan A, you must enroll in Part B if you also desire that coverage. Part B coverage is ordinarily deducted from your Social Security benefit.
If you select a LACERA-administered Medicare plan, the County may reimburse you for the Part B premium amount. This reimbursement program is subject to annual review by the Board of Supervisors.
If your modified adjusted gross income (MAGI) as reported on your IRS tax return from the previous two years is above a certain amount, you'll pay the standard premium amount plus an income-related monthly adjustment amount (IRMAA), an extra charge added to your premium. See a chart with current income limits and premium amounts on the Medicare website to see if you are subject to an IRMAA, or contact Social Security for more information.
If you are currently enrolled in Medicare Part A and Part B and your dependent is not, or vice versa, you will need to enroll in corresponding LACERA-administered health plans. See more below.
|LACERA-Administered Medicare Plan||Corresponding Non-Medicare Plan|
|Cigna-HealthSpring Preferred with Rx
(available in Maricopa County and Apache Junction, Pinal County, Arizona only)
|Cigna Network Model Plan|
|Kaiser Senior Advantage||Kaiser|
|UnitedHealthcare Medicare Advantage||UnitedHealthcare|
|SCAN Health Plan||NONE|
Medicare Supplement Plan
Anthem Blue Cross Plan III
Anthem Blue Cross Plan I OR Anthem Blue Cross Plan II