In California, millions of residents have chosen private Medicare Advantage plans over their Original Medicare coverage options. Los Angeles alone reports over 793,000 Medicare Advantage beneficiaries, with at least seven other counties reporting numbers in the hundreds of thousands.
As with all medical decisions, it’s essential to understand what Medicare Advantage is, the types of plans available, and what this type of coverage may cost before making a commitment or changing plans.
If you or a loved one is considering switching from Original Medicare coverage, read below to learn how California Medicare Advantage Plans may help.
Best Medicare Advantage plans in California
California Medicare Advantage plans allow policyholders to bundle their medical benefits into one policy. This means patients can receive medical and drug coverage, hearing, dental, and other related coverage from one easy-to-manage policy.
Since private insurance companies offer these plans, around 39 Medicare Advantage plans are available throughout California. With so many providers available, not all Medicare Advantage Plans offer drug coverage, so it’s important to know what coverage a plan provides before committing.
While looking for Medicare Advantage plans in California, it’s critical to remember that the federal government doesn’t standardize these plans. As a result, plan information and availability may change depending on your California zip code.
Staying informed about your options can help you make the best choices for your health needs. Below, we talk about California Advantage plans with zero-dollar premiums, some with zero-dollar drug deductibles, and some with 5-star ratings and Part B reductions.
Medicare Advantage plans with a zero-dollar premium in California
While a zero-dollar premium seems attractive, it’s important to remember that high copays, deductibles, and out-of-pocket maximums typically offset these premium savings.
The spot for the Medicare Advantage plan with a zero-dollar premium and the highest out-of-pocket maximum is tied between Kaiser Permanente and Wellcare. Each has an out-of-pocket maximum of $2900.
offers a California Medicare Advantage plan with the lowest maximum out-of-pocket costs at $800.
Finally, an excellent Medicare Advantage plan with a mid-range out-of-pocket maximum comes from Aetna, with a $2000 limit on this type of expense.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| $0 | $800 | HMO-POS | 4 | |
| Aetna | $0 | $2,000 | HMO | 4 |
| Kaiser Permanente | $0 | $2,900 | HMO | 5 |
| Central Health | $0 | $990 | HMO | 3 |
| Wellcare | $0 | $2,900 | HMO | 5 |
Medicare Advantage plans with a zero-dollar drug deductible in California
offers a Medicare Advantage plan with a zero-dollar drug deductible and a low out-of-pocket maximum in California.
Another great option is the Aetna Medicare Advantage plan, which provides a zero-dollar drug deductible and a mid-range out-of-pocket maximum of 2,000.
For those looking for the top tier of Medicare Advantage plans, the Kaiser Permanente plan is an excellent choice with an out-of-pocket maximum of $2900 and a zero-dollar drug deductible.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| $0 | $800 | HMO-POS | 4 | |
| Aetna | $0 | $2,000 | HMO | 4 |
| Kaiser Permanente | $0 | $2,900 | HMO | 5 |
| Central Health | $0 | $990 | HMO | 3 |
| Wellcare | $0 | $2,900 | HMO | 5 |
Medicare Advantage plans with a 5-star rating in California
Five-star plans in your area may qualify for a Special Enrollment Period. Check with your local California Medicare Advantage providers to learn more.
Regarding 5-star Medicare Advantage plans, your choices may be limited. The first plan comes from Kaiser Permanente, while the second 5-star Medicare Advantage Plan is available through Wellcare. Both plans have an out-of-pocket maximum of $2900.
| PLAN | PREMIUM | MOOP | PLAN TYPE | STAR RATINGS |
| Kaiser Permanente | $0 | $2,900 | HMO | 5 |
| Wellcare | $0 | $2,900 | HMO | 5 |
Medicare Advantage plans with a Part B reduction in California
Since the availability of Medicare Advantage plans varies by ZIP code, not all locations will offer plans with a Part B give-back aspect. Check with your local plan providers to determine whether Part B reductions are available with your area’s Medicare Advantage plans.
The Medicare Advantage plans with the most significant Part B reductions in some areas are Wellcare, SCAN Health, and Brand New Day, each offering $125.
Wellcare has the highest rating of the big three, and Brand New Day has the lowest.
Great mid-range choices include Imperial Health, with a Part B reduction of $85, or Blue Shield of California, which offers $49.
| PLAN | PREMIUM | MOOP | PART B REDUCTION | STAR RATINGS |
| Wellcare | $0 | $2,900 | $125.00 | 5 |
| Blue Shield of California | $0 | $3,400 | $49.00 | 4 |
| Imperial Health | $0 | $7,550 | $85.00 | 2 |
| SCAN Health | $0 | $1,000 | $125.00 | 4 |
| Brand New Day | $0 | $2,900 | $125.00 | 3 |
Ancillary/DVH
While some Medicare Advantage plans may have limitations, these plans typically offer additional benefits that Original Medicare and Medigap do not. These benefits include dental, vision, hearing, and coverage of select prescription drugs.
Cities in California with estimated premiums for supplemental coverage
The below cities have charts with average premiums for each type of supplemental coverage:
FAQs
How do I apply for Medicare in California?
For most people, the signup process for Medicare is handled through the Social Security Administration. Medicare may already be a part of disability benefits for a select few.
Who qualifies for Medicare in California?
In general, California residents who qualify for Medicare are:
- 65 or older
- Under 65 and permanently disabled
- Recipients of benefits from the Railroad Retirement Board
- Suffering from chronic conditions such as renal disease or ALS
What is the best Medicare Advantage plan in California?
The best California Medicare Advantage plans meet patients’ medical and drug expense needs without surpassing their budgets. For this reason, a plan that’s right for someone else may not be right for you.
What is Medicare jurisdiction in California?
California is in Jurisdiction D DME MAC. Noridian administers this jurisdiction.
What does Medicare cover in California?
The type of coverage received depends on your current California Medicare plan. Speak to your Medicare provider for details about what your plan does and does not cover.
How to get help enrolling in a California Medicare Advantage plan
Navigating Medicare and Medicare Advantage in California doesn’t have to be challenging. We’re here to help you compare California Medicare Advantage plans and find the best plan for your needs.
Please complete our online form or call us today for a free rate quote.
