Medicare Supplement Plans in California


Beneficiaries enrolling in Medicare Supplement plans in California get special privileges not available in other states. Below, we discuss how California differs from other states regarding Medicare Supplement plans, as well as changes for 2022.

Medicare Supplement Availability in California

Like in the other 50 states, there are ten lettered Medicare Supplement (Medigap) plans and two High-Deductible Medicare Supplement plans available to Medicare beneficiaries. Of these, the most popular California Medicare Supplement plans are Medicare Supplement Plan F, Medicare Supplement Plan G, and Medicare Supplement Plan N.

Most major Medicare Supplement insurance carriers offer plans in California. The most prominent carriers in the state are Mutual of Omaha, UnitedHealthcare, Cigna, Blue Cross Blue Shield, and Aetna to name a few.

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How to Enroll in Medicare Supplement Plans in California

If you enroll in Medicare during your Initial Enrollment Period at age 65, the first time you can enroll in a Medicare Supplement plan is during your Medicare Supplement Open Enrollment Period. For many beneficiaries in California, this is the only opportunity you receive to initially enroll in a Medicare Supplement plan without underwriting health questions.

If you received Medicare due to a disability before age 65, you get two Medicare Supplement Open Enrollment Periods. The first comes when you initially enroll in Medicare, and the second happens when you turn 65. This ensures you get the opportunity to enroll in any Medicare Supplement plan available, as many plans are not available to those under age 65.

Suppose you delay enrolling in a Medicare Supplement plan due to creditable coverage. In this case, you’ll get a Special Enrollment Period that will allow you to enroll in a Medicare Supplement plan without underwriting health questions.

California Medigap Birthday Rule

California Medigap beneficiaries get a unique enrollment opportunity each year. The California birthday rule is excellent for residents because it grants an annual chance to enroll in a Medigap plan without the need to answer health questions.

This rule gives beneficiaries 91 days surrounding their birthday to enroll in a Medicare Supplement plan. The window beings 30 days before your birthday and ends 60 days after your birthday. During this time, carriers cannot deny you coverage based on pre-existing health conditions.

California Medigap Plan Birthday Rule
California Medicare Supplement plans are all subject to the state’s birthday rule.

California Birthday Rule Requirements

The California birthday rule only applies if you already have a Medicare Supplement plan in California. When using the rule, beneficiaries can change their Medigap plan to one of equal or lesser benefits.

However, you may not change to a plan with more benefits than your current plan. This means you can go from a Medigap Plan G to a Medigap Plan N, or from a Medigap Plan N with one carrier to a Medigap Plan N with another carrier at a lower rate, but cannot switch from a Medigap Plan G to a Medigap Plan F.

Keep in mind, this rule only applies to those already on a Medicare Supplement plan. It does not apply to beneficiaries with Medicare Advantage plan who wish to switch to a Medicare Supplement.

Also, outside any enrollment period, you can still apply for a Medicare Supplement plan at any time of the year. However, you’ll need to go through medical underwriting during the application process.

Best Medicare Supplement Plan in California

Determining the best Medicare Supplement plan in California is not easy. The best plan for one person may not be the best for another. Health and budget needs vary from one beneficiary to the next.

One of California’s most popular Medicare Supplement plans is Medicare Supplement Plan F.  Medigap Plan F includes coverage for the Medicare Part A and Part B deductibles, copayments, coinsurance, foreign travel emergency coverage, skilled nursing care, and any excess charges. A high deductible version of this plan allows you to keep the same benefits at a much lower cost.

Medigap Plan G is almost as well-liked as Medicare Supplement Plan F. On many occasions, though, we’ve found that Medigap Plan G can save beneficiaries more money annually than Medigap Plan F, even though with the latter, the beneficiary is responsible for the Medicare Part B deductible The reason is lower premium rates.

Make sure to compare the costs of these two plans before you enroll. There are also high deductible versions of both plans available for those looking for a lower monthly premium.

Medicare Supplement Plan N is another plan considered one of the best Supplement options. Medigap Plan N covers many of the same benefits as Plan G. However, when enrolled in Plan G, there is a small copay for some office visits and emergency room visits. You could be responsible for excess charges when seeing certain doctors who don’t accept Medicare assignment, as California allows excess charges.

Also, some carriers offer household and spousal discounts in California. You will find some carriers offer a spousal discount, and others provide a household discount, depending on your area. These discounts can range anywhere from 5%-20%. It’s best to work with an agent with knowledge of how to find the best plan for you.

Medigap in California Under Age 65

Not all states offer Medigap plans to those under 65. Fortunately, for those living in California, there are some plans available to you.

The downside to these plans when you are under 65 is the cost. Carriers tend to charge higher premiums to those who are disabled. If the premiums are too expensive, a Medicare Advantage plan could be an alternative.

Additional Medicare Coverage Options in California

Medicare Supplements are not the only coverage you will need when enrolled in Medicare in California. In addition to your Medicare Supplement Plan, it’s important to review prescription drug coverage and ancillary coverage to ensure all your needs are covered.

Medicare Part D plans help cover the cost of prescription drugs for beneficiaries. Alongside Medicare Part D, there are dental, vision, hearing, and critical illness plans available to round out your health care coverage in California.

FAQs

What does Medicare cover in California?
Part A covers your inpatient services, and Part B covers your outpatient services. There are out-of-pockets costs. However, a Medigap Plan will help cover most, if not all, of these out-of-pocket costs.
Is Covered California the same as Medicare?
No, Covered California and Medicare are not the same. You cannot have Medicare if you’re enrolled in Covered California.
Who is eligible for Medicare in California?
Anyone who is at least 65 years old or collecting Social Security Disability Benefits for 24 months is eligible for Medicare.
Can I enroll in A Medicare Supplement plan if I voluntarily terminate group coverage in California?
The California guidelines for voluntary group terminations state as long as your employer-sponsored plan is primary to Medicare, you have guaranteed issue rights when enrolling in a Medicare Supplement plan.

How to Apply for Medicare in California

When applying for a Medicare Supplement plan in California, it is essential to speak with a licensed insurance agent to make sure you have a good understanding of all your Medicare options.

To apply or inquire about all your Medicare options, fill out our compare rates form or call us at the number above. Our services are 100% free.

We work with all the top carriers and can provide you with a non biased opinion about your best options.

Plus, if you enroll in a plan through us, you'll have unlimited support from our Client Care Team. They will assist you with claims, as well as anything else you may need in the future regarding your plan.

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Jagger Esch

Jagger Esch is the Medicare expert for MedicareFAQ and the founder, president, and CEO of Elite Insurance Partners and MedicareFAQ.com. Since the inception of his first company in 2012, he has been dedicated to helping those eligible for Medicare by providing them with resources to educate themselves on all their Medicare options. He is featured in many publications as well as writes regularly for other expert columns regarding Medicare.

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