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Medicare Supplement Plans In California

Medicare Supplement Insurance is a popular coverage that many people combine with their Original Medicare benefits. While there are many useful benefits that come with Medicare Supplement plans, it can be hard to know how they work and which ones are worth considering. To help you decide, we wrote this guide to Medicare Supplement plans in California.

What Are Medicare Supplement Plans?

Medicare Supplement Insurance is a secondary coverage that’s designed to work with your Original Medicare benefits. These plans supplement your Part A and Part B coverage by paying for amounts that Original Medicare doesn’t.  The amounts that Medicare doesn’t cover are often called gaps. The gaps in Medicare include:

  • Part A deductible
  • Part A daily co-insurance amounts
  • Part B deductible
  • Part B co-insurance
  • Part B excess charges

These charges don’t come with any kind of cap or limit under Original Medicare; you are not protected from runaway medical expenses in any way. Medicare Supplement plans solve that problem. They step in where Original Medicare leaves off. Because these plans fill in or close some of these gaps, they are very often called Medigap plans. When you see a provider, you’ll provide both your Medicare card, and your Medigap Plan card. Your provider will bill both:

  • They’ll bill Medicare first, in accordance with the terms of Part A and Part B
  • They will also bill your Medigap plan according to the terms of the specific plan you’re enrolled in

If there’s still an amount due, you’ll be responsible for it. In this way, Medicare Supplement Insurance can greatly reduce the amount of money you have to pay for medical care when you have Medicare.

How Do Medicare Supplement Plans Work?

Medicare Supplement plans are standardized throughout 47 of the United States. Massachusetts, Minnesota, and Wisconsin have their own Medigap plans and laws. In the rest of this article, we’ll be talking about the way Medigap plans work in the 47 standardized states. There are 11 standardized Medigap plans currently available. They are each known by letter: Plans A, B, C, D, F, G, K, L, M, N, High Deductible F, and High Deductible G. Plans F, High Deductible F, and C are not available to anyone who becomes eligible for Medicare after December 31, 2019. Each one of the 11 standardized plans covers a different mixture of the costs and gaps in Part A and Part B. Some are more comprehensive, and others less so. This allows you to determine a level of coverage you think you need based on your needs.

What Are The Most Popular Medicare Supplement Plans In California?

Historically, Plan F has been the most popular Medicare Supplement plan. Since that plan isn’t available to new Medicare Beneficiaries, we’ll review the three most popular plans available today.

Medigap Plan A

This is the most basic plan, with the lowest level of coverage. Because of this, it’s also generally the most affordable Medigap plan available. Plan A only covers these gaps in Original Medicare:

  • Part A daily hospital co-insurance
  • Part A hospice co-insurance
  • Your first three pints of blood
  • Part B co-insurance

With Medigap Plan A, you’re on the hook for all of the other costs of your coverage, including the Part A deductible. Plan A doesn’t give you coverage outside the U.S.

Medigap Plan G

Plan G is the “new” Plan F; it covers almost all of the gaps in Medicare. The only gap Plan G leaves open is the Part B deductible. You have to meet this deductible before the plan will help pay your Part B costs. Since the Part B deductible is only $233 for 2022, you’re limited to a very small out of pocket expense during the year. Plan G is the most comprehensive plan available to new Medicare Beneficiaries.

Medigap Plan N

Plan N has coverage similar to Plan G, but with a few twists that make it a more affordable option. First of all, you’ll pay a $20 co-payment for office visits, and a $50 co-payment for Emergency Room visits. If you end up being admitted to the hospital after visiting the ER, your co-payment is waived. Besides this cost, Plan N also leaves you exposed to Part B excess charges. Excess charges are extra amounts that certain medical providers can add on to the normal cost for services and procedures. Excess charges are fairly rare, so they tend to not add much in the way of out of pocket expenses. Aside from these differences, the coverage between Plan N and Plan G are almost identical, but the cost for Plan N is usually quite a bit lower than for Plan G, giving it an attractive value.

How Can I Choose A Medicare Supplement Plan In California?

Picking a Medigap plan comes down to deciding how much coverage you want, and then finding the best price available. You’ll want to consider your coverage needs:

  • Do you want every penny covered, or are you willing to pay a little bit here and there in exchange for lower premiums?
  • Do you need a plan that will cover you internationally?
  • Does your health put you at risk for frequent medical treatment that can add up quickly?

By going over these questions, you can find out which Medigap plan will fit your needs. Once you’ve done that, you can shop for the best deal available.

How Can I Sign Up For California Medicare Supplement Plans?

In order to enroll in Medicare Supplement plans in California, you have to first be enrolled in both Part A and Part B of Original Medicare. You also have to stay enrolled in Part B by paying your Part B premium on an ongoing basis. Once you’re enrolled in Parts A and B, and you’ve chosen your Medigap plan, you can enroll in it in a number of ways:

  • By paper application
  • Online
  • By phone

If you’re working with a licensed health insurance agent, you can get help choosing and enrolling in the plan of your choice.

FAQ About California Medicare Supplement Plans

Do you have to be 65 years old to get Medigap coverage?

No, not in California. You can get Medigap coverage at any age, as long as you have both Part A and Part B. You may find premiums for under-65 Medigap coverage significantly higher than the premiums for people age 65 and above.

Can you switch Medicare Supplement Plans?

You may be able to switch from one Medigap plan to another, or from one insurance company to another. However, in some cases your current health or health history may prevent you from being approved.

Do Medicare Supplement Plans Cover prescription drugs?

No. In almost all cases, Medicare Supplement plans won’t cover routine medications. To get help with these costs, you’ll need to pick a Part D drug plan.

Do Medicare Supplement Plans cover dental, vision, or hearing?

No. Since those benefits aren’t covered by Original Medicare, they also aren’t covered by Medicare Supplement plans. You’ll need to look into individual coverage options for those benefits.

When is the best time to enroll in a Medicare Supplement Plan?

The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period. This enrollment window lasts for six months and starts when you have turned 65 and are also active in Medicare Part B.

Selection Matters Most When You Choose a Medicare Supplement Plan

Every Medicare Supplement plan with the same plan letter (F, G, etc) offers precisely the same benefits to you, but prices vary widely from one insurer to another. It’s in your best interest to have access to as many plans by as many insurers as possible when you make your Medicare Supplement plan.

That’s where Medicare Consumer comes in. When you speak with our experts you get access to plans from dozens of different insurers. They’ll guide you to the right plan for you at the best possible rate.

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MedicareConsumer.com is a non-government agency and is on a mission to help current and future Medicare recipients find the best Medicare supplement plan for their unique needs. Medicare insurance logos as seen on MedicareConsumer.com belong to the respected trademark owners in our available network of Medicare insurance carriers. Any and all rate quotes for Medicare supplement plans are free to consumers and you are not obligated to purchase any plan from any carrier.

Participating sales agencies do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1–800–MEDICARE to get information on all of your options.

Participating sales agencies represent Medicare Advantage [HMO, PPO, PFFS, and PDP]organizations that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

Enrollment in the described plan type may be limited to certain times of the year unless you qualify for a special enrollment period.

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