Dual Special Needs Plans are for people who have both Medicare and Medicaid (called "dual eligible"). A Dual Special Needs Plan (D-SNP) is a unique Medicare Advantage plan that coordinates your Medicare Part A and Part B benefits, and your Medicare Part D prescription drug coverage. You'll get extra support to help coordinate the plan with your Medi-Cal plan. In addition, a dual health plan provides extra benefits not provided by either Medicare or Medi-Cal.
Enrollment Under One Plan
Medicare Plus is a Dual Special Needs Plan (D-SNP) HMO for people who have both Medicare and Medi-Cal (called "dual eligible"). D-SNP is a unique Medicare Advantage plan that coordinates your Medicare Part A and Part B benefits, and your Medicare Part D prescription drug coverage.
As an L.A. Care Medicare Plus member, you will be enrolled with L.A. Care for both your Medicare and Medi-Cal Programs. By combining your Medicare and Medi-Cal benefits into a single plan, we coordinate your care while giving you access to MORE benefits and a dedicated care team.
It is important to remember, that when you enroll with L.A. Care Medicare Plus, your current Medi-Cal plan will automatically be changed to L.A. Care replacing any previous Medi-Cal coverage. The same goes for those separately enrolled in Medicare.
New to Medicare?
Learn about the difference in the L.A. Care Medicare Plus (HMO D-SNP) vs Medicare Fee for Service, how much premiums and deductibles are, the costs associated with hospital stays or doctor visits and whether there is a limit on the out-of-pocket amount for the year.
What are Original Medicare costs?
Original Medicare (Part A and Part B), which is your hospital (Part A) and medical insurance (Part B), there is no limit to the amount you pay out-of-pocket. The only way around this is through separate and optional supplemental coverage which is designed to fill in the gaps.
Enrollment in L.A. Care's Exclusively Aligned D-SNP
You are eligible for membership in our plan as long as all of the following are true:
- You have both Medicare Part A (Hospital) and Medicare Part B (Medical)
- You live in Los Angeles County
- You are age 21 and older at the time of enrollment (You can be eligible for Medicare before 65 if you are living with a qualifying disability)
- You receive full Medicaid (Medi-Cal) benefits (Medicaid is a joint federal and state government program that helps with medical costs for certain people with limited incomes and resources).
- To be eligible for our plan you must be eligible for both Medicare and Medicaid (dual eligible).
As a L.A. Care Medicare Plus member, your cost for the following items is $0:
- Plan premium
- Plan deductible
- Plan benefits
- Prescription medications (RX)
- Transportation
- Dental
- Vision
Original Medicare (Part A and Part B) combined will cover medical supplies, professionals, and various healthcare settings.
L.A. Care Medicare Plus covers everything Original Medicare does plus the addition of added benefits like hearing, dental, vision and transportation through Medicaid (Medi-Cal).
No. You will need to enroll into a Prescription Drug Plan (Part D).
With Original Medicare, you have the ability to go to any doctor that accepts Medicare.
L.A. Care Medicare Plus does require that members choose a doctor within our network of providers. L.A. Care Medicare Plus is proud to offer a wide network of doctors, specialists and hospitals.