Medicare Advantage Plans in California
Though California Medicare Supplement plans offer the most extensive coverage; beneficiaries can also go for Medicare Advantage plans in California. Medicare Advantage plans are offered by private organizations that contract with Medicare. The best copays are only available if you agree to use the plan’s network of physicians and hospitals.
California Medicare Advantage plans may be less expensive than Medicare Supplements when it comes to premiums. However, you will incur copays along the way. For example, an appointment with your primary care physician (PCP) can cost you $20, while a specialist might cost you $60 or more.
As with many other types of healthcare, you’ll have to foot the bill for certain services, including hospital stays, physical exams, lab work, supplies, etc. Before signing up for a health insurance plan, ensure that your provider is in the network.
Even though most counties in the US offer Medicare Advantage plans, 14 counties in northern and central California offer Original Medicare Plans only. 44 of California’s 58 counties offer Medicare Advantage plans as of 2022. Within the 44 counties, plan availability ranges from one in Humboldt County to 117 in some regions of Los Angeles County.
There are four types of Medicare Advantage plans in California:
Health Maintenance Organization (HMO)
Most HMOs mandate that you use only in-network providers for all healthcare services:
- You must have a PCP (primary care physician), specialist referrals, and prior approvals for certain procedures and prescriptions.
- Plans typically provide drug coverage. You can’t purchase separate drug coverage.
- Staying within your network keeps costs low.