Medicare is a national health insurance program for:

• Most people 65 and older.
• Some younger people with disabilities.
• People with End-Stage Renal Disease (kidney failure requiring dialysis or a transplant).

Medicare Advantage is Medicare's managed care program. If you join Medicare Advantage, you get all your care through an HMO or PPO that has a contract with Medicare.

The Federal Center for Medicare Services (CMS), not the California Department of Managed Health Care (DMHC), regulates Medicare Advantage plans.

Get Help from HICAP

HICAP is the Health Insurance Counseling and Advocacy Program. Anyone who has Medicare can get free help with forms, problems, and questions. Call HICAP at 1-800-434-0222 or visit the HICAP web site.

Medicare Part D

Medicare Part D is the new prescription drug program for people with Medicare. You can read more about Medicare Part D.

If You Have a Complaint

You have the right to file a complaint and to appeal a decision your Medicare Advantage health plan makes about your care.

• For help filing a complaint or an appeal, call HICAP at 1-800-434-0222.
• For certain kinds of problems, call Lumetra toll-free at 1-800-841-1602. Lumetra can help protect your Medicare rights. Call Lumetra if:
• You have a complaint about the quality of your care.
• You are delayed in receiving care.
• You are being sent home from the hospital too soon,
• Your home health care, nursing home care, or physical therapy is ending too soon.
• For more information on your rights, read about Medicare Appeals and Grievances or call Medicare at 1-800-MEDICARE (1-800-633-4227).

Resources

California's HMO Guide for Seniors
Information on HMOs for Medicare members
1-866-466-8900 (Spanish, Chinese)
1-866-499-0858 (TTY)
www.opa.ca.gov

CalMedicare
Information on Medicare in California, Medicare Part D and other prescription drug programs, and financial aid for low-income seniors
1-888-430-2423 (Spanish) (publications only)
www.cahealthadvocates.org (Spanish, Chinese, Vietnamese)

HICAP (California Health Insurance Counseling, and Advocacy Program)
Free information, counseling, and advocacy for Medicare members
1-800-434-0222

Lumetra (California Medical Review)
Help for Medicare members who have a complaint about the quality of care, delays in receiving care, or being sent home from the hospital too soon
1-800-841-1602
1-800-881-5980 (TTY)
www.lumetra.com

Medicare
The official Medicare website and phone number.
1-800-MEDICARE (Spanish)
1-877-486-2048 (TTY)
www.medicare.gov (Spanish)