How to Find the Best Medicare Supplement Plans in California: Why you need a California Medigap Plan
California is home to some of the most expensive health care options in the country. But, it also has a number of Medigap plans that can help you keep your costs down.
Medigap plans are supplemental insurance policies designed to fill gaps in Medicare core coverage and provide financial protection for medical expenses not covered by standard insurance.
If you want affordable healthcare or if you’re just trying to save money on healthcare costs, there are plenty of Medi-gap policies available from California Medigap plan providers.
To find the best Medicare Supplemental policy for you, keep reading
Table of Contents
What is a Medigap Plan?
A Medicare Supplement plan which is also knowns as a Medigap plan is a federal Medicare program established to supplement Original Medicare. The Medigap plan is a secondary insurance policy that can help pay some or all of the out-of-pocket costs that are not covered by Original Medicare, such as copayments, coinsurance, and deductibles.
Because a Medigap plan is a secondary policy it does not replace Original Medicare but rather fills in the gaps of coverage. As a result, Medicare Beneficiaries keep all of their earned health care benefits while increasing the available coverage.
There are 10 different types of Medigap plans that are standardized by the federal government, each with its own set of benefits.
Similar to the Affordable Care Act which is broken down by specific metal plans (Bronze, Silver, Gold, and Platnum) Medicare Supplemental plans are identified by a specific letter (Plan A, Plan B, Plan C, and so on).
The most popular type of plan was the Medigap Plan F prior to January 1, 2020, which covers the most out-of-pocket costs including your Medicare Part B deductible. After this date, Plan F was no longer available to new Medicare beneficiaries,s, and Medigap Plan G is now the most popular plan for those who live in California and beyond.
What are the Benefits of having a Medicare Supplement Plan In California?
There are many added Medicare benefits to having a Medigap plan, including:
- Helping to cover the costs of healthcare that are not covered by Original Medicare
- Giving you the freedom to see any doctor or specialist who accepts Medicare patients
- All medical facilities that accept Medicare are available to access including the major cancer research hospitals allowing you to receive the best cancer treatment
- Medical “service areas” do not exist with Medigap Plans
- Protecting you from high medical bills in the event of an unexpected illness or injury
- No requirement to obtain a referral or prior authorizations which can delay medical treatment from weeks to months
Medicare Supplement Insurance Plans in California: What's the Difference between each Medigap Plan?
The main difference between each letter plan is the level of additional coverage it provides. For instance, the least expensive of all the plans cover only the most basic of coverage which is Plan A. The majority of Medicare beneficiaries avoid these basic secondary insurance plans.
Where the Medicare Supplement Plan F covers 100% of all Medicare-approved medical costs.
Medicare beneficiaries in California who are new Medicare enrollees most often sign up for Medicare Supplement Plan G and Plan N.
There are pros and cons to the Medigap Plan N so make sure you talk with one of our Medicare insurance agents to discuss what costs you will be responsible for when you use this plan vs Plan G.
Medigap Plan N
Part B coinsurance is 100% covered under Plan N, with the exception of up to a $20 co-payment for office visits and a $50 co-payment for emergency room visits that do not result in an inpatient admission. Plan N also does not cover excess charges a doctor may charge of up to 15 percent above the usual and customary bill.
Medigap Plan G:
In contrast, Medicare Supplement Plan G covers all costs minus the Part B annual deductible.
How Much do Medigap Plans Cost in California?
There are several factors that affect Medigap rates, including:
- The type of Medigap policy you choose
- Your age
- Any tobacco use in the past 12 months
- Where you live
- Current health conditions if enrolling outside of your guaranteed issues rights
If you are enrolling in a Medigap plan at age 65 you can expect to pay around $150 for the base rates. Medicare insurance companies may offer a welcome discount for the first year which can reduce the monthly premium by $20 to $30.
After the first year, the discount is removed and you will be rated based on your current age.
How do I know if I am Eligible to Enroll in Medicare Supplement Plan G or N?
To be eligible to enroll in a Medicare Supplement plan you must be enrolled in both Part A and Part B of Medicare. You can enroll in a Medigap plan during your six-month Medigap Open Enrollment Period, which begins the first month you have both Medicare Part A and Part B coverage.
During the six-month Medigap open enrollment period, you have guaranteed issue rights meaning the insurance providers must accept you without considering any medical conditions.
If you have a pre-existing condition, you may be eligible for a Medigap plan outside of this enrollment period, however, the insurance company can charge a higher premium.
It is critical to apply for a Medigap plan during your guaranteed issue rights to avoid rating upcharges and denial of coverage.
The private insurance company must renew your policy no matter your future health conditions as long as you continue to pay your monthly insurance premiums.
How do I Compare Medigap Plans?
The best way to compare Medicare supplement plans is to talk with a Medicare insurance expert. They have the experience needed to help you compare each plan and the overall costs associated with the Medigap plan.
There are 10 standardized Medigap plans in 47 states (excluding MA, MN, and WI).
Each plan is identified by a letter of the alphabet (Plan A through Plan N), and each plan offers a different set of basic benefits.
When comparing each health insurance supplemental plan you will want to evaluate how much the plan covers versus how much you will need to cover related to the insurance premium and the costs to use your Medicare benefits.
Some states may utilize all ten standardized Medigap Plans or they may only allow for five or six Medigap plans.
No matter which Medigap Plan is available in your state the coverage is always the same in all 50 states.
Plan A will always be Plan A and cover only the core benefits. Plan G will always be Plan G and cover all core benefits except Part B deductible.
This means that you can use your Medigap plan in any state even if the plan is not specifically offered in that state. You don’t have to worry about different names or different plans when traveling out of your home state.
When you enroll in a California Medigap plan you can use it in New York without any issues.
How do I know if a Health Insurance Plan is right for me?
When reviewing your Medicare options, Medicare Beneficiaries are eligible for a California Medicare Supplement Insurance plan or a Medicare Advantage plan. Both of these plans require you to be enrolled in Medicare Parts A and B before you are able to apply for either option.
Medicare beneficiaries choose a Medicare Supplement plan for a number of reasons, including:
- They want the freedom to choose any doctor without restrictions
- They had a bad experience with a Medicare Advantage plan with a family member
- They don’t want an insurance company telling them they can or can not have a procedure
- Medicare beneficiaries want their doctors to have the ability to create a treatment plan and not the insurance company overruling the doctor’s recommendations
- No need for referrals and prior authorizations
- No max out-of-pocket costs with certain plans
- Health care costs are predictable
- Recommended by a friend or family member who was well educated on both Medicare plan options
- Need more than just emergency care when traveling
Medicare Beneficiaries apply to Medicare Advantage plans for the following reasons:
- They believe it is their best option
- Low or no additional monthly premium
- Out-of-pocket costs are capped
- Prefer the pay-as-you-use option
- The insurance agent did not tell the Medicare beneficiary that a Medigap plan was an option
- Does not qualify for a Medigap plan due to being outside of the guaranteed issue rights
- Seems simpler to join
- Was recommended by a healthy friend who was satisfied with their plan
What Insurance Providers Sell Health Care Coverage for Medigap in California?
here are a number of insurance companies that are approved by the Centers for Medicare and Medicaid CMS to offer Medicare Supplement plans. Integrity Now Insurance Brokers reviews these companies each year to ensure these companies are financially strong and have established customer service.
Each year new insurance companies attempt to provide plans but have not shown they are in it for the long haul. They may offer attractive rates for a couple of years and then raise prices that far exceed the amount other more established companies provide.
A few of the more well-established insurance companies in California that offer Medigap plans include:
- AARP Medicare Supplement Plans (United Healthcare)
- AETNA LIFE INSURANCE COMPANY
- Anthem Blue Cross
- Blue Shield of CA
- Mutual of Omaha
As an independent Medicare insurance agency our Agents review and provide our clients with access to all available Medigap plans in the state they live in. We are not restricted to only offering a single insurance company rather we can offer all insurance companies we want to represent.
Why Choose a California Medicare Supplement plan: Health Plan Benefits
A California Medicare Supplement plan can offer you a number of benefits, including:
- More comprehensive coverage than Original Medicare alone. A Supplement plan can help pay for some or all of the out-of-pocket costs that Medicare doesn’t cover, like deductibles, copayments, excess charges, and coinsurance.
- The freedom to see any doctor or specialist that accepts Medicare – you don’t need to get a referral from your primary care doctor.
- No network restrictions – you can use any hospital or facility that accepts Medicare patients.
Choosing the best Medigap plan in California for you depends on a number of factors, including your budget and the health care services needed. Be sure to compare plans carefully to find one that meets your needs and budget.
Buying Medigap plans help contain your medical costs so you do not have any surprising bills in the future.
How do Medicare Supplemental Insurance Plans work with Original Medicare in California?
Original Medicare is the government health insurance program for seniors and people with disabilities. Medicare Part A covers inpatient hospital coverage, while Medicare Part B covers outpatient medical care.
These two parts of Medicare do not cover all of your healthcare costs, however, That’s where Medicare Supplemental Insurance comes in.
For a small monthly premium, you can obtain a secondary insurance policy (Medigap Plan) to fill in the holes left behind by Original Medicare. You can choose from any of the 10 available plans based on how much additional coverage you need.
In California, all Medigap plans must follow federal rules regarding what benefits they must cover. However, insurers can set their own premiums for these plans. As such, it’s important to compare prices before enrolling in a plan.
Additionally, some insurers may offer additional benefits beyond what’s required by the law similar to Medicare Advantage plans.
It is vital to work with an insurance agent who specializes in Medicare allowing you to consider all your options before making a decision. They will also ensure you sign up for all needed coverages such as a Medicare Part D plan.
Which Medigap Plan do Medicare Beneficiaries Pick as the Best California Medicare Supplement Plans?
There is no one-size-fits-all answer to this question, as the best Medigap plan for you will depend on your individual needs and budget.
However, some of the most popular Medigap plans in California include Plan F, which offers comprehensive coverage with no deductibles or copayments; Plan G, which has slightly lower premiums than Plan F but requires beneficiaries to pay their own Part B deductible.
What is the California Medigap Birthday Rule?
The California Medigap Birthday Rule is a state law that allows Medicare beneficiaries to change their Medigap plan during their birthday month.
How does it work:
During your birthday month, you can change your Medigap plan available in your area, regardless of health conditions. You can also switch from one Medigap carrier to another.
What are the benefits:
The primary benefit of the California birthday rule is it provides a new Medicare Supplement open enrollment period for existing Medigap beneficiaries to switch to a new Medicare Supplement insurance carrier without the need for medical underwriting.
Can I be Disabled under 65 and sign up for a Medigap Plan G in California?
Beneficiaries who qualify for Medicare due to disability have the right to purchase California Medigap plans during their first 6 months of Part B coverage. The only exception is if they’ve been diagnosed with ESRD, in which case their application may be denied.
Insurance carriers are not allowed to discriminate against under-65 Medicare beneficiaries, which means they must sell a policy to them. However, the monthly premium rates for these people are often much higher than those over age 65.
These higher premiums can price you out of a Medicare Supplement plan.
Because people under the age of 65 have a health condition or injury that qualified them for Medicare early on, insurance companies know that they are likely to need medical care and will need to factor in higher pricing to cover their costs.
If you find that the rates for California Medigap plans are beyond your budget, you might want to explore a Medicare Advantage plan as an alternative.
Should you Choose a Medicare Advantage Plan in California vs Medigap Plan?
It really depends on your specific circumstances. If you are on a fixed income, then a Medigap plan may be the better option because it provides guaranteed coverage.
On the other hand, if you are relatively healthy and are looking for more comprehensive coverage, then a Medicare Advantage plan may be a better fit.
There is no “one size fits all” answer when it comes to choosing between a Medigap plan and a Medicare Advantage plan. The best way to make a decision is to sit down with a licensed insurance agent who can help you compare your options side-by-side.
Best Medicare Supplement Plans in California: Overall best Medicare Coverage
Medigap Plan F Coverage
Was the most popular plan in California prior to January 1, 2020, and for good reason. It offers excellent coverage with no out-of-pocket costs. If you are looking for comprehensive protection against high medical bills, Plan F is a great option.
Medicare Supplement Plan G
Plan G was a close second in popularity and now holds the top spot amounts Medicare Beneficiaries. It offers the same comprehensive coverage as Plan F but requires enrollees to pay their annual Part B deductible. If you are looking for comprehensive protection against high medical bills and are willing to pay a little more out of pocket for your care, Plan G is a great plan.
Medicare Supplement Plan N
Plan N is a Medigap plan that offers comprehensive protection against high medical bills, but with a few more out-of-pocket costs than Plan G and F.
These are the three most popular Medicare Supplement plans in California. All three offer excellent coverage, but each has its own unique benefits and drawbacks. You will need to compare the plans side-by-side to find the one that best meets your needs.
You can learn more about Medicare Supplement plans in California by visiting our website or calling one of our certified Medicare insurance agents.
California Medigap Plans Are Standardized?
Yes, all Medicare Supplement plans are standardized by the federal government. This means that each plan must offer the same basic benefits, regardless of which insurance company sells it.
There are a few different Plan types available, each offering different levels of coverage.
California residents have the same Medigap plan options as residents of other states. The only difference is that some plans may not be available in all areas of the state.
Contact us to compare Medigap plans in your area.
Best Dental, Vision, and Hearing Aid Plan In California
Integrity Now Insurance Brokers has access to a number of insurance companies that provide comprehensive dental, vision, and hearing aid coverage in California. We are here to provide assistance to Medicare beneficiaries who need help with all their Medicare needs.
California Medicare Supplement Plan Initial Enrollment Period: Why it matters
Your Medicare Supplement initial enrollment period is the time when you first become eligible for Medicare. If you enroll in a Medigap plan during this time, you are guaranteed to be accepted by the insurance company, regardless of your health status.
If you wait to enroll in a Medigap plan after your initial enrollment period, you may be denied coverage or charged higher premiums based on your health conditions.
It’s important to enroll in a Medigap plan during your initial enrollment period to ensure that you have the best chance of getting coverage at the lowest price.
Enrolling in Part D to Get Prescription Drug Coverage in California
Part D is a voluntary prescription drug benefit for Medicare beneficiaries. Part D plans are offered by private insurance companies and cover both brand-name and generic drugs.
If you are enrolled in Medicare Part A and/or Part B, you may also want to enroll in a Medicare Part D plan to get prescription drug coverage.
Medicare Beneficiaries enrolling in a Medicare Supplement plan will need to also enroll in a standalone Part D plan. Your Medicare insurance agent will need to know about the medications you are currently taking so they can find the best Part D plan for your specific needs.
US Veterans enrolled in the VA healthcare system do not need to sign up for a Part D plan as the VA provides creditable prescription drug coverage.
How do I Enroll in a Medigap Plan in California?
To be eligible for a Medigap Plan in California, you must be enrolled in Medicare Part A and Part B. The best time to enroll in a Medigap Plan is during your six-month Medigap Open Enrollment Period, which begins the first month you have both Medicare Part A and Part B coverage.
If you enroll outside of this period, you may be subject to medical underwriting.
Medicare Supplements Enrollment Process:
The enrollment process for a Medigap Plan in California is relatively simple. Reach out to one of our Medicare insurance agents and review all available Medigap plans. Once a plan is selected, they will obtain the needed information to complete the application.
Once your enrollment is confirmed, your coverage will begin on the first day of the following month.
If you need help with Medicare Supplement insurance quotes in California please reach out to one of our insurance representatives for a free quote. If you already have a Medicare Supplement and are interested in switching plans we can also help with finding a new plan with a different insurance company.