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How Medicare Works with ACERA’s Medicare Plans

Eligible members, non-member payees, and dependents who are enrolled in Medicare Parts A and B, can elect to participate in an ACERA-sponsored medical plan, also known as an ACERA Medicare Plan.  

Depending on the plan you elect, the ACERA Medicare Plan provides or supplements your Medicare Parts A and B coverage and Medicare Part D prescription drug coverage. Participation in an ACERA Medicare Plan generally enhances the coverage provided through Medicare. You pay a monthly premium to ACERA in addition to the Medicare Part B premium you pay to the federal government for this coverage.  

To maintain coverage under an ACERA Medicare Plan, you MUST maintain enrollment in Medicare Parts A and B.  

Current plan details are described in the ACERA Enrollment and Health Plan Brochure. The plans offered are subject to change from year-toyear. Currently, ACERA provides Medicare-eligible individuals the opportunity to elect two different types of plans:  

Medicare Advantage Plan

When you enroll in an ACERA-sponsored Medicare Advantage Plan, you agree to allow the plan’s carrier (a private insurance company) to provide your Medicare Parts A and B benefits and your prescription drug coverage. In doing so, you authorize Medicare to pay your benefits directly to the insurance company.  

These plans are similar to an HMO, where you choose from a list of plan physicians. These plans are typically only available in California service areas.  

Supplemental Medicare Insurance Plan  

As an alternative to electing a Medicare Advantage plan, many Medicare-eligible individuals opt to enroll in an ACERA-sponsored Supplemental Medicare Insurance plan. Also known as a “Medigap” plan, these plans are private health insurance designed to work alongside Medicare by paying some of the health care costs not covered through Medicare.  

These plans are similar to a PPO, where you may select any physician that accepts Medicare. These plans can be used all across the U.S. Doctors you visit under this plan may ask to see your Medicare card so they can submit claims.

 

When I go into a Medicare plan can I keep my doctor?  

Check with your doctor to see if she/he accepts the Medicare medical plan you wish to enroll in. Eligibility for enrollment in a medical plan is determined by zip code. The service area for a Medicare medical plan may have different zip codes than a pre-Medicare plan from the same provider. Contact ACERA or the medical provider for verification before you enroll in a plan.

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