California Medicare Supplement Plans: What You Need to Know
California has the most Medicare beneficiaries of any state, and it also has some of the strongest consumer protections for Medigap enrollees in the nation. Unlike most states, California offers year-round enrollment opportunities and a "birthday rule" that makes it easier to switch plans. Understanding these unique protections is essential for California residents.
Like other states, Medigap plans in California are standardized by letter (A, B, C, D, F, G, K, L, M, N). A Plan G from one company covers exactly the same benefits as a Plan G from another company. The only differences are the premium and customer service.
California's Birthday Rule - A Huge Advantage
California is one of only a few states with a "birthday rule." Each year, during the 30-day period starting on your birthday, you can switch to any Medigap plan of equal or lesser coverage without medical underwriting. This means you can shop for lower premiums every year without worrying about health conditions affecting your eligibility.
California's Year-Round Medigap Open Enrollment
California offers continuous open enrollment for Medigap plans. While the standard 6-month federal open enrollment period (starting when you turn 65 and enroll in Part B) still applies, California law provides additional protections:
- You can enroll in a Medigap plan at any time during the year
- Insurance companies cannot deny you coverage during open enrollment
- They cannot charge you more due to pre-existing conditions during this window
- The birthday rule gives you an annual opportunity to switch plans
Most Popular Medigap Plans in California
While 10 standardized Medigap plans are available in California, the most popular choices are:
| Plan | Coverage Level | Best For | CA Monthly Premium* |
|---|---|---|---|
| Plan G | Comprehensive | Most new enrollees (best value) | $130 - $280 |
| Plan N | High with copays | Those wanting lower premiums | $100 - $200 |
| Plan F | Most comprehensive | Those eligible before 2020 | $160 - $320 |
*Premium ranges are estimates and vary by age, location within California, gender, and tobacco use. Los Angeles and San Francisco tend to have higher premiums than rural areas. Contact us for personalized quotes.
Plan G vs Plan N in California
For most California residents new to Medicare, the choice comes down to Plan G or Plan N:
- Plan G covers everything except the Part B deductible ($240 in 2024). No copays, no surprises. Ideal if you want predictable costs and visit doctors frequently.
- Plan N has lower premiums but requires up to $20 copays for office visits and up to $50 for ER visits (waived if admitted). Good choice if you're healthy and want to save on monthly costs.
California's birthday rule makes Plan N especially attractive because you can always switch to Plan G later if your health needs change, without medical underwriting.
California Medicare Supplement vs Medicare Advantage
California has an extensive Medicare Advantage market with many $0-premium options. But these are very different products. Here's how they compare:
| Feature | Medigap (Supplement) | Medicare Advantage |
|---|---|---|
| Monthly Premium | $100 - $320+ | $0 - $50 (some higher) |
| Out-of-Pocket Maximum | Very low (predictable) | Up to $8,850/year |
| Doctor Network | Any doctor accepting Medicare | Network restrictions |
| Referrals Needed | No | Often yes (HMO plans) |
| Prescription Drug Coverage | Separate Part D plan needed | Usually included |
| Extra Benefits | None | May include dental, vision, gym |
Read our complete Medigap vs Medicare Advantage guide to understand which option might be better for your situation.
California-Specific Medicare Considerations
Kaiser Permanente and HMO Culture
California has a strong HMO culture, and Kaiser Permanente is particularly popular. If you're already a Kaiser member and like their integrated care model, their Medicare Advantage plan may work well for you. However, if you value the flexibility to see any doctor anywhere, Medigap provides that freedom.
Snowbirds and Part-Time Residents
Many Californians split their time between California and other states (especially Arizona and Nevada). If you travel frequently or live part-time elsewhere, Medigap offers a significant advantage: nationwide coverage. Your plan works with any doctor or hospital that accepts Medicare, anywhere in the United States.
California HICAP Program
California offers free counseling through the HICAP (Health Insurance Counseling & Advocacy Program). HICAP counselors can provide general Medicare information and help you understand your options. However, they cannot recommend specific plans or companies. That's where a fee-only Medicare advisor adds value: we can make specific recommendations based on your individual situation.
High Cost of Living Considerations
California's higher cost of living extends to healthcare. Medigap premiums in California tend to be higher than the national average, particularly in major metro areas like Los Angeles, San Francisco, and San Diego. However, the birthday rule helps by allowing you to shop for better rates each year.
Frequently Asked Questions: California Medicare
California's birthday rule allows you to switch Medigap plans once per year during a 30-day window that begins on your birthday. You can switch to a plan with equal or lesser coverage from any insurance company without medical underwriting. This is a significant advantage not available in most states.
Yes, California offers year-round Medigap open enrollment. While you have guaranteed issue rights during your initial 6-month enrollment period (when you turn 65 and enroll in Part B), you can also enroll at other times. However, outside of open enrollment and the birthday rule period, you may face medical underwriting.
Medigap premiums in California typically range from $100-$320+ per month depending on the plan letter, your age, location (LA and SF are often more expensive than rural areas), gender, and tobacco use. California tends to have higher Medigap premiums than many other states, but the birthday rule helps you find competitive rates.
Plan F is only available to those who became eligible for Medicare before January 1, 2020. If you turned 65 before that date, you can still enroll in Plan F. However, Plan G offers nearly identical coverage (minus the Part B deductible) and often has lower premiums.
Yes. Medigap plans do not include prescription drug coverage. You'll need to enroll in a standalone Medicare Part D plan separately. California has many Part D options, and we can help you compare them based on your specific medications.