Medicare is a federal healthcare program that is used primarily by people age 65 and older. People of any age with disabilities and those with end stage renal disease (ESRD) or amyotrophic lateral sclerosis (ALS) are also able to receive Medicare coverage.
If you are eligible for Medicare, you can enroll in original Medicare (parts A and B), Medicare Advantage (Part C), and Medicare Part D.
By learning more about the Medicare plans available in California, you can find the coverage that will work best for you in 2021.
The Centers for Medicare & Medicaid Services (CMS) reported the following information on Medicare trends in California for the 2021 plan year:
- A total of 6,419,004 residents of California are enrolled in Medicare.
- The average Medicare Advantage monthly premium decreased in California compared to last year — from $22.39 in 2020 to $19.94 in 2021.
- There are 424 Medicare Advantage plans available in California for 2021, compared to 372 plans in 2020.
- Around 98 percent of California residents with Medicare have access to buy a Medicare Advantage plan — 92 percent have access to $0 premium plan options.
- There are 12 different Medigap plans offered in California for 2021.
Medicare is health insurance coverage for people age 65 and over. You may also be eligible for Medicare if you’re under 65 years old and are living with certain disabilities or health conditions.
Medicare plans in California include the following options.
You have several options for Medicare in California. Depending on your needs, you may choose original Medicare, which is made up of Medicare parts A and B.
Part B covers care outside of a hospital for things such as:
- doctors’ visits
- lab tests
- durable medical equipment
Medicare Advantage in California
Medicare Advantage plans (Part C) are offered through private insurers who bundle all your coverage for parts A and B, and sometimes prescription drug coverage, into a single plan.
Medicare Advantage plans must cover the same things as Medicare parts A and B, but some have extra coverage (and an additional premium) for things like:
- dental or vision services
- home wheelchair ramps
- meal delivery after a hospital stay
- transportation to and from medical appointments
These are some of the companies that currently offer Medicare Advantage plans in California:
- Aetna Medicare
- Alignment Health Plan
- Anthem Blue Cross
- Central Health Medicare Plan
- Clever Care Health Plan
- Golden State
- Health Net of California
- Imperial Health Plan of California
- Kaiser Permanente
Not every carrier offers plans throughout the state, so the choices you have available will vary depending on your county or even ZIP code.
Medicare supplement plans in California
Original Medicare doesn’t pay for all of your healthcare costs. To cover these costs, you may decide to buy Medicare supplement insurance, also called Medigap. These policies can help you pay for deductibles, coinsurance, and copayments.
Many companies offer Medigap plans in California In 2021, some of the companies offering Medigap plans in the state include:
California residents are eligible for Medicare andMedicare Advantage plans if:
- you’re a citizen of the United States or legal resident for the past 5 or more years
- you are ages 65 or over, and you or a spouse meets the requirements for work in a Medicare-sponsored job
People under age 65 may be eligible if:
- you have a disability and receive Social Security Disability Insurance (SSDI) or Railroad Retirement Board disability payments
- you have amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD)
If you still have questions about whether you qualify,you can use Medicare’s online eligibility tool.
When can I enroll in Medicare in California?
The initial coverage enrollment period (EIP) is a 7-month period that starts three months before your 65th birthday and ends 3 months after you turn 65 years old. If you enroll, your coverage will begin the first of the month that you turn 65 years old.
You can also make changes during Medicare’s open enrollment period between October 15 and December 7 each year.
If you’re already on a Medicare Advantage plan and want to switch to another Medicare Advantage plan or go to original Medicare, you can do that between January 1 and March 31 each year.
The general enrollment is between January 1 and March 31 each year. If you have Medicare Part A and want to enroll in Part B, a Medicare Advantage plan, or Part D coverage you can do it during this time.
Special enrollment periods allow you to enroll outside the normal enrollment periods under special circumstances.
Tips for enrolling in Medicare in California
Medicare and Medicare Advantage plans in California can be confusing, so before you sign up it’s important to evaluate your choices and compare factors like:
- providers and facilities in the plan’s network
- CMS star ratings for Part C and Part D plans
If you need help determining which plans are best for your needs or you have questions about available options, there are plenty of resources to assist you.
Health Insurance Counseling & Advocacy Program (HICAP)
The California Department of Aging offers Medicare counseling through HICAP. They provide:
- information on Medicare enrollment
- explanations of Parts A, B, and C, and how to determine what coverage you need
- answers to questions about Part D prescription drug coverage, costs, and eligibility
HICAP is confidential and free for anyone eligible for Medicare or about to become eligible. You can search for local HICAP services by county or call 800-434-0222.
Contact Medicare directly for assistance with enrollment or plan questions by calling 800-MEDICARE (800-633-4227) or visit medicare.gov. You can also call the regional CMS office in San Francisco at 415-744-3501.
If you have concerns or need help with Medicare California coverage purchased through an employer, contact the California Department of Managed Health Care at 888-466-2219 or email firstname.lastname@example.org.
- More than 6 million California residents are enrolled in Medicare.
- There are several private insurance companies offering various types of Medicare Advantage and Medigap plans throughout the state.
- Overall, monthly premium costs have decreased for 2021 Medicare Advantage plans in California.
- There are also several Medigap plan options if you live in California and are looking for additional coverage.