California Medigap plans help to fill in the gaps between what Medicare pays and what you owe. Medicare supplement plans in California are standardized by the federal government. Each plan letter covers a different set of benefits.
California Medicare Initial Enrollment Period
California Medicare beneficiaries are eligible for Medicare at age 65, just like everywhere else. Your initial enrollment period begins 3 months before your birth month and lasts through 3 months after your birth month.
During this time, residents can apply for any California Medicare Supplement that they want. You cannot be turned down for health conditions since you don’t have to answer health questions on the application.
Many people consider this the best time to enroll in a California Medigap plan. If you miss this window, you’ll likely have to answer health questions to apply. You could be turned down by other California Medicare supplement plans. However, California has a unique feature that allows you to have a second shot at applying without health questions.
California Medigap Plans – Birthday Rule
Medicare beneficiaries in California are allowed to enroll in a Medigap plan during the days leading up to their birthday and the days directly after their birthday. The birthday rule takes effect 30 days before your birthday and ends 30 days after your birthday. This gives you a total of 61 days to change Medigap plans.
During this window, you cannot be denied for health conditions. There is one catch. You must already be enrolled in a California Medicare supplement in order to take advantage of the birthday rule. You can keep the same plan type or choose one of the California Medigap plans with lesser benefits.
For example, you can go from Plan G to Plan G, or from Plan G to Plan N, but you can’t go from Plan G to Plan F.
This rule gives California Medicare beneficiaries an annual chance to shop their rates regardless of health. They can simply wait until their next birthday and us the guaranteed issue birthday rule to gain less expensive coverage.
This rule does not apply to Medicare Advantage plans. If you choose a Medicare Advantage plan, you might not be eligible for the waived-underwriting on a new Medigap policy later on. So, you’ll want to consider that before enrolling into a California Medicare Advantage plan.
Outside of your annual birthday open enrollment, you can still apply for a California Medigap policy at any time, but you’ll have to go through the normal health underwriting process.
Popular California Medigap Plans
For nearly a decade, Medicare supplement Plan F has been a top seller. It covers all the gaps in Medicare, leaving you with little or nothing out of pocket. However, in 2020, Congress is phasing out Medigap Plan F. New Medicare enrollees at that time will not be able to purchase it.
You can read more about Plan F being discontinued here.
People already enrolled in Plan F will be grandfathered in and will get to keep their plan. However, some people consider enrolling in Medigap Plan G instead. Plan G is here to stay and covers everything Plan F does except the Part B annual deductible.
Sometimes we find that the rates for California Medigap Plan G can actually save you money annually over Plan F. Be sure to check the math before choosing your Medigap plan.
California Medicare Supplements for People Under Age 65
Some beneficiaries qualify for Medicare due to disability before they turn 65. These individuals have the right to purchase California Medigap plans during the first 6 months of their Part B coverage. There’s an exception to this rule. If they have been diagnosed with ESRD (End State Renal Disease, commonly known as kidney failure), then they can be denied coverage.
Although the insurance companies must sell a policy to the under-65 Medicare beneficiaries, they can charge whatever monthly premium they want to. So, you will see that rates for people under age 65 are often higher than for those age 65 and older.
We often find that California Medigap plans for people under 65 are extremely expensive. The insurance companies know that people under 65 have a health condition or injury that qualified them for Medicare early in the first place.
If the rates for California Medigap plans are too expensive, then you might consider a Medicare Advantage plan.
California Medicare Advantage Plans
While California Medicare supplements provide the most comprehensive coverage, another option beneficiaries can consider are California Medicare Advantage plans. Medicare Advantage plans are a type of private Medicare insurance. You agree to use the plan’s network of doctors and hospitals for your care in order to get the best copays.
California Medicare Advantage plans may often have lower premiums than Medicare Supplements. However, you will pay copays as you go along. For example, you might pay $10 for a visit to your primary care doctor, or perhaps $50 for a specialist.
There will also usually be copays for many other things like hospital stays, lab work, diagnostic imaging, ambulance rides, durable medical equipment, and surgeries. It’s important to determine if your doctor is in the network before you enroll.
Beneficiaries can only enroll in or disenroll from California Medicare Advantage plans at certain times of the year. Therefore, it’s important you choose the right plan, because you will be stuck in it for a year.
Common Questions About California Medicare:
These are some of the most common questions our team gets about Medicare supplements in California.
There are over 25 plans available to choose from, and this number changes from year to year as new plans are created or phased out.
No. Covered California doesn’t offer Medigap plans or drug plans. People on Medicare with low incomes, however, may be able to get financial assistance with Medicare premiums from Medi-Cal.
Medicare supplements Plan F and G have the most comprehensive coverage. It doesn’t matter which carrier you buy them from because the plans are standardized by the federal government. Our agency can quote you the plans with the lowest rates in California. We’ll also check each carrier’s rate increase history to help you make a wise decision.
Get expert assistance today with your California Medigap or California Medicare Advantage options. In California, we are known as Boomer Benefits Insurance Agency, and we can guide you from the beginning on how to enroll in Medicare supplements in California. We help you find the right plan for your needs and budget. Also, our services are free! Once enrolled, you’ll also have the added value of support from our team throughout the year when you have questions.
Request help from a California licensed insurance agent at Boomer Benefits Insurance Agency. We’ll reach out to you to provide free, easy quotes.