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Medicare Plans in California in 2022

In 2022, Medicare beneficiaries in California will have new plans that offer a range of benefits to provide more personalized health care coverage.

California residents who are nearing their Medicare enrollment should be aware of some state-specific Medigap rules. Additionally, where exactly you reside will have a significant impact on which Medicare Advantage plans (if any) you have available to you. 

That’s why it’s so important to have a good understanding of the nuances of Medicare in your state. Below we’ll be explaining your Medigap, Medicare Advantage, and Part D options in California.

How To Apply for Medicare in California

If you are a California resident who is only interested in enrolling in Original Medicare, you can do so through your local Social Security office. You can sign up in-person, online, or over the phone as early as three months before your 65th birthday.  

However, if you want to enroll in a Medicare Advantage plan, Medicare Supplement Insurance, or Part D drug coverage, we recommend you speak with a licensed insurance agent. They can walk you through the process and help you to find the right plan for you. 

Reach out to a team member here at Medicare Plans Direct today to have all of your Medicare-related questions answered.

Medicare Supplement Plans in California

There are some Medigap rules that are only applicable in California, which is why it is so important to stay informed on Medicare Supplement guidelines and regulations if you are a resident of the state. 

The Medigap plans that you have access to in California will depend on a number of factors, such as which insurance company you enroll with, when you enroll, where you reside, and more. 

In 2019, 599,507 Californians enrolled in Medicare Supplement Insurance. However, this figure represented less than 10% of the total of Medicare enrollees that year. As you can see, Medigap insurance is not the most common coverage option among California beneficiaries. 

Some of the most popular Medigap plans in California include Plans F, G, and N. These plans offer some of the most comprehensive coverage around.

However, beneficiaries who first became eligible for Medicare on or after January 1, 2020 will no longer be allowed to enroll in Plan F. Plans G and N are good alternatives.

Medigap Premiums in California

Most Medigap insurance companies in California use attained-age rating, which bases the premium on the age of the beneficiary. This means that Medigap premiums can increase over the years, which is an important detail to be aware of. 

Some insurers, however, use issue-age rating. In this case, the price of the monthly premium is determined by the age of the beneficiary when they enrolled in the plan.

These small details can have a significant impact on how much you end up paying for your Medigap coverage. That’s why we recommend consulting with a Medicare expert before making any Medicare decisions. 

Medigap Enrollment in California

If you want to sign up for Medicare Supplement Insurance in California, the best time to do so is during your Medigap Open Enrollment Period (OEP).

This occurs when you first become eligible for Medicare and enroll in Part B, and it lasts for 6 months. During this time, you can enroll in any Medigap plan offered in your area regardless of your health history

California beneficiaries under the age of 65 who qualify for Medicare because of a disability can also enroll in Medigap during their 6 month Medigap OEP. These individuals will have another OEP during the 6 months following their 65th birthday.

Medigap enrollees under the age of 65 in California have the right to enroll in Plans A, B, D, or G, a protection which is not ensured in many other states. Insurers must also offer Plan K or L, if offered by the company, or Plan M or N, if offered by the company. 

However, insurance companies are authorized to charge higher premiums for individuals under the age of 65 who enroll in one of their plans. You should also be aware that these protections don’t apply to beneficiaries under the age of 65 who qualify for Medicare because they suffer from End-Stage Renal Disease.

California Medigap Birthday Rule

California has a special Medicare Supplement enrollment period that applies to beneficiaries who are already enrolled in a Medigap plan. 

In most states, unless you qualify for a guaranteed issue right, you usually have to undergo medical underwriting if you want to modify your Medigap coverage after your OEP finalizes. In this case, insurance companies reserve the right to deny you coverage or charge you a higher premium. 

However, the state of California offers people an annual opportunity to modify their Medigap coverage. If a person already has Medicare Supplement Insurance, they can make changes to their plan once a year during the 60 days following their birthday

This California “Birthday Rule permits Medigap enrollees to switch to a plan with equal or lesser benefits outside of their OEP without having to undergo medical underwriting.

Medicare Advantage Plans in California

Another coverage option for people looking for more benefits than those offered by Original Medicare is Medicare Advantage. Also known as Part C, these plans provide the coverage that you get under Original Medicare. They often also include additional benefits, such as drug coverage, hearing coverage, vision coverage, dental coverage, and more

Medicare Advantage participation in California is quite popular, and 45.3% of Medicare beneficiaries were enrolled in a Medicare Advantage plan in 2021.

In 2022, there are 458 Medicare Advantage plans available in California. This is up from 424 plans in 2020, representing an 8% increase in plan availability. 

Which Medicare Advantage plans you can enroll in depends on where exactly you reside, as plan availability varies from county to county. In 2022, Medicare Advantage plans are only available in 45 of the 58 counties in California. However, the vast majority of Medicare beneficiaries in California (99%) have access to at least one Medicare Advantage plan. 

The three types of Medicare Advantage plans available to California beneficiaries in 2022 are HMO plans, PPO plans, and SNPs. 

You should also keep in mind that what you pay for your Medicare Advantage plan depends on where you live, the plan that you choose, and more. In 2022, the average Part C monthly premium for California enrollees is $18.12. Plus, 95% of Medicare beneficiaries in California have access to at least one plan with a $0 monthly premium. 

Deciding which is the right Medicare Advantage plan for you is best done with the help of an experienced insurance agent. Here at Medicare Plans Direct we help you make the best Medicare choices possible at no extra cost to you. Don’t hesitate to reach out to us today to receive free Medicare advice.

Medicare Part D in California

Another thing for California Medicare beneficiaries to keep in mind is their Medicare prescription drug coverage options. In 2022, there are 25 stand-alone Part D plans available to California Medicare enrollees

The cost of Part D plan premiums varies depending on where you live and which insurance company you purchase your plan through. The average Part D premium in California in 2022 is $55.82

You can also find drug plans with $0 deductibles, though these plans tend to have higher monthly premiums. In 2022, there are five plans with no deductible available to Californians, and the lowest cost stand-alone drug plan with a $0 deductible has a monthly premium of $68.90

It is important that you enroll in prescription drug coverage when you are first eligible if you foresee it being necessary in the future. If you don’t sign up for Medicare Part D when you are first eligible and don’t have some other form of creditable drug coverage, you could face late enrollment penalty fees in the future

You should be aware that certain types of Medicare Advantage plans include prescription drug coverage. However, if you are enrolled in Original Medicare and/or a Medigap plan, you will need a stand-alone drug plan to cover your prescription medication costs. 

As you can see, your Medicare coverage options depend on a number of factors, one of the most important ones being where you live. That’s where we come in. Our expertise can help you to make the best possible Medicare decisions, so reach out today for a free consultation.

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