Medicare Help Center
Medicare Made Simple.
Whether you’re new to Medicare, reviewing your coverage, or simply have questions, we’re here to help make things easier. Our Medicare Help Center brings together important information for Edinger Medical Group patients—all in one place.
Explore the Medicare plans we accept, review important policies and updates, learn about upcoming Medicare events, and find helpful resources to better understand your options and make informed decisions about your healthcare.
Select a tab below to learn more.
Medicare Coverage at Edinger Medical Group
There are several ways to receive care at Edinger Medical Group depending on your Medicare coverage. Not sure which option applies to you? Our team can help you understand how your Medicare coverage works with Edinger Medical Group and explain your options for becoming a patient.
Medicare Advantage HMO
Edinger Medical Group participates with select Medicare Advantage HMO plans. Patients enrolled in one of these plans may choose an Edinger Medical Group physician as their primary care provider, subject to their health plan’s eligibility and network requirement.
Call 714-965-2557 to confirm eligibility, or simply text images of your insurance cards to 714-965-2500.
AARP UNITEDHEALTHCARE
(UHC) AARP Medicare Advantage from UHC CA-003P (HMO-POS), formerly Harmony LA
(UHC) AARP Medicare Advantage from UHC CA-004P (HMO-POS), formerly Focus LA
(UHC) AARP Medicare Advantage from UHC CA-005P (HMO-POS,) formerly Focus OC
(UHC) AARP Medicare Advantage from UHC CA-021P (HMO-POS), formerly Harmony Plan OC
(UHC) AARP Medicare Advantage Giveback from UHC CA-19 (HMO-POS)
(UHC) AARP Medicare Advantage Giveback from UHC CA-20 (HMO-POS)
AARP Medicare Advantage Patriot No RX CA-MA01 (HMO-POS)
UHC Complete Care CA-18P (HMO-POS CSNP)
UHC Complete Care CA-19P (HMO-POS CSNP)
UHC Complete Care CA-1AP (HMO-POS CSNP)
United Healthcare Group Medicare Advantage (HMO)
BLUE SHIELD
Blue Shield Inspire (HMO)
Blue Shield 65+ (HMO)
Blue Shield 65+ Plan 2 (HMO)
Blue Shield AdvantageOptimum (HMO)
Blue Shield TotalDual Plan (HMO-DSNP)
HUMANA
Humana Gold Plus 021 (HMO)
Humana Gold Plus Giveback 146 (HMO)
SCAN
SCAN Affirm (HMO)
SCAN Balance (HMO-CSNP)
SCAN Classic (HMO)
SCAN Connections (HMO-DSNP)
SCAN Inspired (HMO)
SCAN MyChoice (HMO)
SCAN Prime (HMO)
SCAN Strive (HMO)
Original Medicare & PPO
Patients with Original Medicare—with or without a Medicare Supplement (Medigap) plan—or a Medicare Advantage PPO plan must enroll in Elevate, our enhanced primary care membership program, in order to receive care.
With Elevate, your applicable Medicare insurance coverage is still applied to eligible medical services, while your membership provides access to additional services and support like earlier appointment availability, expedited callbacks and refills, and more.
Please note, not all plans are eligible and our membership fees are not covered by your insurance.
Why does Edinger Medical Group prefer Medicare Advantage HMO plans?
We believe your primary care physician should be at the center of your healthcare.
Medicare Advantage HMO plans are designed around coordinated care, with your primary care physician at the center of your healthcare. This model allows our team to help coordinate specialist care, follow up on your health needs, and maintain a more complete picture of your overall care. At Edinger Medical Group, this approach aligns with our focus on proactive, relationship-based primary care.
What is the difference between Original Medicare and Medicare Advantage?
Original Medicare is provided directly through the federal government and includes Part A (hospital) and Part B (medical) coverage. You can generally see any provider who participates in Medicare nationwide.
Medicare Advantage plans are offered by private insurance companies and provide your Medicare benefits through a specific health plan, often with a provider network and additional benefits.
What is a Medicare Supplement (Medigap) plan?
A Medicare Supplement (Medigap) plan is additional insurance from a private company that works alongside Original Medicare to help cover certain out-of-pocket costs, such as deductibles, copayments, and coinsurance.
What is the difference between a Medicare Advantage HMO and PPO?
A Medicare Advantage HMO generally requires you to receive care within a specific network and select a primary care physician who helps coordinate your care. A Medicare Advantage PPO typically offers more flexibility to see providers both in and out of network, often at different costs.
Can Edinger Medical Group help me choose a Medicare plan?
We have a trusted network of local insurance brokers who are knowledgeable in all Medicare plans and are willing to answer questions and assist our patients step-by-step with enrollment for free. Please see the Events & Other Resources tab for our Medicare insurance brokers’ contact information.
How can I make sure Edinger Medical Group is included in a plan before I enroll?
Before enrolling in any Medicare plan, we highly recommend that you reach out to our team for help with insurance verification and understanding your options with Edinger: 714-965-2557.
Medicare Open Enrollment Seminar [in-person] - 10/29 @ 2:00pm
With Rachel Gajardo Reeves of Presley General Insurance Agency
At Polly’s Pies in Huntington Beach (9791 Adams Ave, Huntington Beach, CA 92646)
Medicare Open Enrollment Seminar [in-person] - 11/5 @ 2:00pm
With Tom & Melissa Grajeda of Presley General Insurance Agency
At Polly’s Pies in Huntington Beach (9791 Adams Ave, Huntington Beach, CA 92646)
Medicare Open Enrollment Seminar [in-person] - 11/12 @ 2:00pm
With Rachel Gajardo Reeves of Presley General Insurance Agency
At Polly’s Pies in Huntington Beach (9791 Adams Ave, Huntington Beach, CA 92646)
Medicare Open Enrollment Seminar [in-person] - 11/19 @ 2:00pm
With Tom & Melissa Grajeda of Presley General Insurance Agency
At Polly’s Pies in Huntington Beach (9791 Adams Ave, Huntington Beach, CA 92646)
Medicare Open Enrollment Seminar [virtual]
With a Policy Engineer Insurance Agent
Join virtually from anywhere via Zoom with your phone, tablet or computer!
Tom Grajeda | PGIA
(562) 273-2553
tgrajeda@presleyga.com
tomgrajedainsurance.com
Melissa Grajeda | PGIA
(562) 248-6585
mgrajeda@presleyga.com
Rachel Gajardo Reeves | PGIA
(714) 615-4839
rgajardo@presleyga.com
Carla Torrero | PGIA
(714) 833-2284
ctorero@presleyga.com
Cynthia Priebe | Policy Engineers
(213) 528-3650 cynthiapriebe@policyengineer.com
