Original Medicare, which is Medicare Part A and Part B combined, helps to pay for many of your healthcare expenses.1 Original Medicare doesn’t cover all of your costs, though. A Medigap policy, also known as Medicare Supplement insurance, can help to cover the expenses that are left over from your Medicare policy. This can include copayments, coinsurance, and deductibles. Medigap can help to reduce or eliminate what you need to pay out of pocket for healthcare.
In California, you can choose from 10 Medigap policies. Two of those policies have high-deductible options available as well. Each policy offers slightly different coverage, and carries a different premium. You’ll want to choose the policy that’s best for the types of healthcare expenses that you most often face.
What You Need to Know
Medigap policies offer additional coverage to help pay for the expenses that Original Medicare doesn’t cover.
You must be enrolled in Medicare Part A and Part B to qualify for a Medigap policy.
In California, you can choose from 10 Medigap policies. Two of these policies are available in high-deductible versions.
When Can You Enroll in Medigap?
Medigap has an Open Enrollment Period that starts the month that you turn 65 and enroll in Medicare Part B (medical insurance).2 That Open Enrollment Period continues for six months. During this period, you can buy any Medigap policy that’s available in California, even if you have pre-existing health conditions. If you enroll in Medigap during this enrollment period, you may get a plan at a better price.
You can still potentially buy a policy once your Open Enrollment period has ended, but it may not be as easy. An insurance company can deny you for a pre-existing health condition, or they might decide not to cover that condition. A company could also require a six-month waiting period before your new Medigap policy goes into effect. This could leave you without coverage during that waiting period.
There are some special situations where you may get an exemption to these rules. If you qualify for guaranteed issue rights, then insurance providers must allow you to buy a policy even outside of the Open Enrollment Period.3 In this case, an insurance provider can’t increase your policy price and must cover any pre-existing conditions that you have. When you have other health coverage that changes in some way, you often have guaranteed issue rights.
Depending on your circumstances, you might also qualify for a Special Enrollment Period (SEP).4 If you qualify for a SEP, you’ll be able to change your coverage outside of the Open Enrollment Period. Common qualifying events for SEP include moving or losing your current coverage because of factors you can’t control. The changes that you’ll be able to make to your policy during SEP will depend on the type of event that you’ve experienced.
What Are the Most Popular Medicare Supplement Plans?
Plan Type | Quantity (Rounded) | Percent Total |
Plan F | 398,000 | 66% |
Plan G | 56,000 | 9% |
Plan N | 66,000 | 11% |
There are 10 Medigap policies available, and each policy offers slightly different coverage.5 Plans F, G, and N are some of the most popular options. Note: Plan F is not available if you are eligible for Medicare after January 1, 2020.
Plan F
Plan F is the most comprehensive option, covering all of the following:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Part B deductible
- Part B excess charges
- Foreign travel emergency – 80%
Plan G
Plan G includes everything covered under Plan F, except for the Part B deductible:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Part B excess charges
- Foreign travel emergency – 80%
Plan N
Plan N provides the same coverage as Plan F, minus the Part B deductible and Part B excess charges:
- Part A coinsurance and hospital costs
- Part B copays/coinsurance
- Blood (first 3 pints)
- Part A hospice
- Skilled nursing facility
- Part A deductible
- Foreign travel emergency – 80%
How to Choose a Medicare Supplement Plan
Each Medigap policy offers slightly different coverage. Policy premiums and deductibles also vary. To best understand the differences in plans, consider using a third-party comparison tool like HealthCare.com. To choose the right policy for your needs, think about the types of healthcare services that you need most often.
Ready to choose a policy? Compare Medigap policies with HealthCare.com
How Much Do Medigap Policies Cost?
The price of Medigap policies varies. To get a rough idea of price ranges, the following prices reflect a quote for a 65-year-old female and male in California who don’t use tobacco:6
65-Year-Old Woman, No Tobacco Use
Plan Type | Premium Range |
Plan F | $144-$279 |
Plan G | $118-$194 |
Plan N | $92-$180 |
65-Year-Old Man, No Tobacco Use
Plan Type | Premium Range |
Plan F | $144-279 |
Plan G | $118-$194 |
Plan N | $92-$180 |
What Companies Sell Medigap in California?
What If You Want to Change Your Medigap Policy?
You’ll only be able to change your Medigap policy at certain times, so it’s important to choose a policy that’s right for your needs when you initially select one.7 If you’re still within the Open Enrollment Period, you can change your policy. Some special circumstances, like moving to another state, will mean you can make changes, too.
What Are Alternatives to Medicare Supplement?
If a Medigap policy isn’t right for you, a Medicare Advantage Plan might be an option. Medicare Advantage Plans help to cover your Part A and Part B benefits. Some of these plans also offer prescription drug coverage.
What Are Medicare Resources in California?
- The California Health Insurance Counseling and Advocacy Program (HICAP) offers Medicare counseling and can help you through the process of choosing and enrolling in appropriate Medicare and long-term care insurance.
- The California Department of Insurance provides information on Medicare and related insurances available to California residents.
- The California Department of Health Care Services (DHCS) can help you apply for Medi-Cal, California’s Medicaid program. The DHCS also provides healthcare services and can help to answer questions about Medi-Cal.
You can also use MedicareGuide.com to view and compare available Medicare policies in California.
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Next Steps
Medicare can cover many healthcare expenses, but it doesn’t cover everything. If you anticipate needing healthcare services that aren’t covered by Medicare, a Medigap policy could be a smart investment. Coverage varies from plan to plan, so check out How to Choose a Medicare Supplement Plan for more information.