Helping California Residents Compare Medicare Coverage
Choosing among the many Medicare plans in California can be confusing. Medicare Supplement plans, Medicare Advantage plans and Part D prescription drug plans work differently, and the right choice depends on more than just the monthly premium.
At Benefit Packages Insurance Agency, we help California Medicare beneficiaries understand their options and compare coverage based on their doctors, prescriptions, preferred hospitals, budget and healthcare needs.
Whether you're turning 65, retiring and leaving employer coverage, or reviewing the Medicare coverage you already have, our goal is simple: make Medicare easier to understand.
Medicare Supplement Plans in California
Medicare Supplement plans in California, also known as Medigap plans, work with Original Medicare to help cover certain costs that Medicare doesn't pay.
One of the biggest advantages of a Medicare Supplement is flexibility. With Original Medicare and a Medicare Supplement, you can generally receive covered care from any doctor or hospital nationwide that accepts Medicare. You aren't restricted to an HMO or PPO provider network, and referrals aren't required to see specialists.
Medicare Supplement benefits are standardized by plan letter. For example, a Medicare Supplement Plan G in California provides the same standardized medical benefits regardless of the insurance company offering it. Premiums, however, can vary significantly between companies, making it important to compare more than just benefits.
Plan G and Plan N are two popular Medicare Supplement choices. We can help you compare both the differences in coverage and the premiums available from different insurance companies. A carrier that is very competitively priced for Plan G, for example, may not be competitively priced for Plan N.
Medicare Advantage Plans in California
Medicare Advantage plans (MA/MAPD) in California, also known as Medicare Part C, provide another way to receive your Medicare benefits. Medicare Advantage plans are required to cover all medically necessary services that Original Medicare covers.
These plans are offered by private insurance companies approved by Medicare. Los Angeles, Orange, Riverside, Imperial and Ventura Counties have many $0-premium Medicare Advantage plans, including plans with Part D prescription drug coverage, commonly called Medicare Advantage Prescription Drug (MAPD) plans. Some plans may also offer a Medicare Part B premium reduction, often called a Part B “giveback.” Many plans include additional benefits such as dental, vision, hearing and fitness benefits.
Medicare Advantage plans use provider networks. HMO plans will often require a referral from your Primary Care Physician (PCP) to see a specialist, and both HMO and PPO plans may require prior authorization for certain medical services.
That's why choosing among the best Medicare Advantage plans in California isn't simply about finding the plan with the most benefits or the lowest premium. Medicare coverage often involves trade-offs. PPO plans, for example, generally offer greater provider flexibility but may have higher maximum out-of-pocket limits. An HMO that includes premier medical groups or health systems such as UCLA Health or Cedars-Sinai may have a higher maximum out-of-pocket limit or a monthly plan premium than other HMO choices.
The best plan for you should be evaluated based on your doctors, medical groups, hospitals, prescriptions, potential out-of-pocket exposure and overall healthcare needs.
Medicare Advantage or Medicare Supplement?
This is one of the most common questions we receive.
Someone who values broad access to doctors and hospitals and more predictable medical expenses may prefer Original Medicare with a Medicare Supplement.
Someone who prefers a lower monthly premium, bundled prescription drug coverage and additional benefits may prefer a Medicare Advantage plan.
Neither approach is automatically right for everyone. We help you understand the advantages and trade-offs of each before you make your decision.
Medicare Advantage vs. Medicare Supplement Plans in California: Which Is Right for You? →
Medicare Supplement Plan G vs. Plan N in California
Plan G and Plan N are two popular Medicare Supplement options that both help cover many of the out-of-pocket costs left by Original Medicare, but there are important differences.
Plan G generally provides more comprehensive coverage of Medicare-approved out-of-pocket medical expenses. Plan N typically has a lower premium in exchange for some additional cost sharing. Plan N may require copayments for certain office and emergency room visits and does not cover Medicare Part B excess charges. Plan G does cover Part B excess charges.
Part B excess charges can occur when a provider accepts Medicare patients but does not accept Medicare assignment, meaning the provider may charge more than the Medicare-approved amount within Medicare's rules.
Which plan provides the better value depends on the premium difference, your preference for predictable out-of-pocket costs and whether the providers you use accept Medicare assignment.
We can check your providers and compare available premiums to help you decide whether Medicare Plan G or Plan N in California may be the better fit for you.
The California Medicare Supplement Birthday Rule
California provides an important opportunity for people who already have Medicare Supplement coverage.
Under the California Medicare Birthday Rule, eligible Medicare Supplement policyholders have an annual period around their birthday when they may be able to change to another Medicare Supplement policy with equal or lesser benefits without medical underwriting.
This can provide an opportunity to shop for a more competitive premium without giving up your existing level of coverage.
Medicare Part D Prescription Drug Plans
If you choose Original Medicare with a Medicare Supplement, you'll generally want to consider a separate Medicare Part D prescription drug plan.
The lowest-premium Part D plan isn't necessarily the least expensive plan for you. Formularies, deductibles, pharmacy networks and the cost of your particular medications can make a significant difference.
We can help you compare your prescription drugs against available Part D plans when you're evaluating your Medicare coverage.
Turning 65 in California?
If you're approaching your 65th birthday, it's a good idea to begin understanding your Medicare options before your coverage needs to begin.
Depending on your circumstances, you may need to enroll in Medicare Parts A and B through Social Security and then decide whether to stay with Original Medicare and add supplemental coverage or receive your Medicare benefits through a Medicare Advantage plan.
If you're continuing to work or have employer-sponsored coverage through your or your spouse's current employment, your situation may be different.
We can help you understand your Medicare options and the questions you should consider before making a coverage decision.
Local Medicare Help Throughout California
Benefit Packages Insurance Agency serves Medicare beneficiaries throughout California, with particular emphasis on Los Angeles County, Ventura County, Orange County, Riverside County, San Bernardino County and Santa Barbara County.
We also work extensively with clients in communities including Westlake Village, Thousand Oaks, Agoura Hills, Calabasas and the San Fernando Valley.
Local knowledge can be particularly important when comparing Medicare Advantage plans because medical groups, hospitals and provider networks vary throughout California.
Get Help Comparing Medicare Plans in California
With so many Medicare choices available, you don't have to sort through them alone.
At Benefit Packages Insurance Agency, we help you compare:
- Medicare Supplement (Medigap) plans
- Medicare Advantage plans
- Medicare Part D prescription drug plans
- Plan G and Plan N options
- Insurance companies and premiums
- Doctor, medical group and hospital participation
- Prescription drug coverage
Our job isn't to tell everyone to choose the same type of Medicare coverage. It's to help you understand your options so you can make an informed decision based on what's important to you.
Have Questions About Medicare Plans in California?
Contact Benefit Packages Insurance Agency and let us help make Medicare easier.