The Best Medicare Supplement (Medigap) Plans in California
- California Medicare Supplement (Medigap) plans help fill the gaps in Original Medicare, reducing your out-of-pocket costs. Read our review of California Medigap plans to find out more about this type of coverage.
Medicare Supplement Insurance is a supplemental insurance plan available to Original Medicare beneficiaries. Even though Original Medicare covers a wide range of preventive and diagnostic services, enrollees still have to pay copays, coinsurance and deductibles.
If you're living on a fixed income, these out-of-pocket costs can be difficult to afford. California Medicare Supplement Insurance, also known as Medigap, covers some of these costs, making health care more affordable.
Medigap is available to anyone who enrolls in Original Medicare, but only 1,035,631 California Medicare enrollees have signed up for the supplementary coverage. That's just 27.2% of all Original Medicare enrollees in the state. If you live in California, have Original Medicare coverage and don't have Medicare Supplement Insurance to reduce your out-of-pocket health costs, read on to learn about the Medigap plans available in your state.
You can find Medicare Supplement plans where you live by comparing plans from several different insurance companies online.
What Are the Best California Medicare Supplement Plans?
In California, you can pick from 10 Medicare Supplement Insurance plans. Some plans cover more of your out-of-pocket expenses than others, so it's important to review each one carefully. The chart below explains the benefits included with each plan.
|Medicare Supplement Benefits||A||B||C1||D||F1||G||K||L||M||N|
|Part A coinsurance and hospital costs||✓||✓||✓||✓||✓||✓||✓||✓||✓||✓|
|Part B coinsurance or copayment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|First 3 pints of blood||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Part A hospice care co-insurance or co-payment||✓||✓||✓||✓||✓||✓||50%||75%||✓||✓|
|Co-insurance for skilled nursing facility||✓||✓||✓||✓||50%||75%||✓||✓|
|Medicare Part A deductible||✓||✓||✓||✓||✓||50%||75%||50%||✓|
|Medicare Part B deductible||✓||✓|
|Medicare Part B excess charges||✓||✓|
|Foreign travel emergency||80%||80%||80%||80%||80%||80%|
|1. Plans C and F are not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
2. Plans F and G also offer a high deductible plan which has an annual deductible of $2,490 in 2022. Once the annual deductible is met, the plan pays 100% of covered services for the rest of the year. The high deductible Plan F is not available to new beneficiaries who became eligible for Medicare on or after January 1, 2020.
3. Plan K has an out-of-pocket yearly limit of $6,620 in 2022. Plan L has an out-of-pocket yearly limit of $3,310 in 2022.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission.
View an image version of this table.
Every California Medigap plan covers your Medicare Part A coinsurance payments and gives you up to 365 days of extra hospital coverage beyond what Medicare Part A normally covers. Each plan also covers Medicare Part B copays, but plans K and L provide less coverage than the other options.
Some of the more robust plans even cover your Medicare Part B deductible, but others don't. Additional limitations may apply; for example, plan K only covers up to 50% of the cost of a blood transfusion. Plans A, B, K and L also provide no coverage for expenses incurred while you're traveling in a foreign country.
Out of the 10 options available, plans F, G and N are the most popular. Many Original Medicare enrollees sign up for plans F and G because of their low premiums, and plan N is popular due to the high level of coverage it provides. In exchange for low premiums on plans F and G, you'll have to pay a high deductible before your Medigap plan kicks in. Plan N has higher premiums, but it also provides more coverage. For example, many of your copays may be covered completely.
How Do I Enroll in a California Medigap Plan?
California Medigap coverage is only available to Original Medicare enrollees. If you enroll in Medicare Advantage, you won't be able to get this type of coverage. After you sign up for Medicare Part A and Part B, you'll have six months to enroll in Medicare Supplement Insurance. The six-month Medigap open enrollment period begins the month you turn 65. It's important to remember when the Medigap open enrollment period starts because this is the only time you can sign up for Medigap without any restrictions. During the open enrollment period, Medigap is a "guaranteed issue" type of insurance. That means an insurance company can't deny you due to your age or health status.
If you don't enroll during the six-month Medigap open enrollment period, insurance companies can use a process called underwriting to determine if you qualify for coverage. You may not be able to get supplementary coverage if the insurance company determines that you present too great of a medical risk. Some exceptions apply:
- If you don't purchase Part B coverage when you turn 65 because you still have health coverage through an employer, your California Medigap open enrollment period won't start until the month in which you sign up for Part B. This assumes that your employer-sponsored coverage is ending in the same month.
- Even if you're not denied due to a pre-existing condition, your Medigap insurance provider may set a waiting period of six months before it will cover any expenses relating to that condition. For example, if you have heart disease, you may have to wait six months before you can use your Medigap plan to pay for expenses arising from certain tests ordered by your cardiologist.
- You may have guaranteed issue rights outside the Medigap open enrollment period. These rights usually apply to Medicare beneficiaries who lose their health coverage or whose coverage changes. If you have guaranteed issue rights, an insurance company must sell you a Medigap plan, must cover your pre-existing conditions and can't charge you a higher premium based on your health history and current health status.
If you've had health coverage for at least six months, and that plan covered your pre-existing conditions, you may be able to get immediate Medigap coverage.