March 8th 2024
By Ari Parker
Explore the best Medicare Advantage plans in California and what you should consider when picking the right plan for you.
By Ari Parker
California has the highest senior population in America, so it’s not too surprising that it’s the state with the largest number of Medicare beneficiaries. Knowing your Medicare Advantage options in California is an important part of making an informed decision about your health insurance.
Medicare Advantage plans are a popular option in California—nearly half of all Medicare beneficiaries are enrolled in a Medicare Advantage plan (vs. Original Medicare). Medicare Advantage plans are available in all counties in California except for Trinity County. That said, plan availability varies widely from county to county, so you should make sure to look at your county specifically when comparing plans.
Keeping these factors in mind, we’ll explore some options for Medicare Advantage plans in California, including top-rated plans.
While there are top-rated Medicare Advantage plans in California, policies that are available to you depends on which county you live in.
The best California Medicare Advantage plan for you takes into account your unique healthcare, financial, and lifestyle needs.
Talking to a licensed Advisor can make choosing the right plan easier.
The average monthly premium is $16.24 for a Medicare Advantage plan.
There are 465 Medicare Advantage plans in California—availability varies by county.
There are 21 insurance providers that offer Medicare Advantage plans in CA.
When you sign up for Medicare, you have the option to enroll in Medicare Advantage as an alternative to Original Medicare. Medicare Advantage plans are a bundled, private option for Medicare insurance. In addition to providing coverage for the same services as Original Medicare, Medicare Advantage plans can cover routine vision, dental, and hearing services.
Some Medicare Advantage plans may also provide benefits for:
Fitness and wellness services
Monthly flex credits for over-the-counter (OTC) items
Prescription drug coverage
If you’re eligible, you can also enroll in a Medicare Advantage Special Needs Plan. These plans offer additional benefits that meet the special needs of specific populations. Here are the three types of Special Needs Plans:
Dual Eligible Special Needs Plan (D-SNP): for people who are eligible for Medicare and Medicaid
Chronic Conditions Special Needs Plan (C-SNP): for people who have a chronic or disabling condition
Institutional Special Needs Plan (I-SNP): for people who need the level of care that a skilled nursing home or similar institution provides
While Medicare Advantage plans can be beneficial for some people, there are some limitations that could be frustrating. Knowing these limitations could prevent future headaches. We also recommend planning ahead and familiarizing yourself with your summary of benefits to understand your specific Medicare Advantage plan’s coverage and benefits.
Network restrictions: Medicare Advantage plans often restrict you to a network of providers. If you see a provider out of your plan’s network, you could have more out-of-pocket costs.
Referrals for specialists: Medicare Advantage plans require a referral to see specialists, which could delay your access to care.
Prior authorization: Medicare Advantage plans often require prior authorization for services and equipment. If your prior authorization request is denied, you’ll be responsible for the full cost of the services you need.
High out-of-pocket costs: While many Medicare Advantage plans have $0 premiums, keep in mind you still have to pay your Part B premium if you enroll in a Medicare Advantage plan. Furthermore, there’s more to healthcare costs than your monthly premium. Pay close attention to copays, coinsurance, and covered drugs and doctors to be sure that a low-cost plan won’t actually cost you more out of pocket!
If you want to stick with Original Medicare to avoid network restrictions, prior authorization requirements, and referrals, you can purchase a California Medicare Supplement plan to reduce your out-of-pocket costs.
Every year, the Centers for Medicare and Medicaid Services (CMS) rates Medicare Advantage plans on a scale of 1 to 5 stars, with 5 being the highest rating. Take a look at the insurance providers below that carry a top-rated Medicare Advantage in California for 2024.
Insurance providers offering plans with 4.5 stars:
Sharp Health Plan
Insurance providers offering plans with 4 stars:
Aetna Medicare
Alignment Health Plan
Humana
Kaiser Permanente
Keep in mind that high star ratings doesn’t necessarily make these plans the best Medicare Advantage plans in California for everybody! Some of these plans may not be available in your area and may not address your specific health and financial needs. The best Medicare Advantage plans take care of your healthcare needs at a price that works for you.
When choosing a Medicare Advantage plan, it’s a good idea to make a list of the things that are important to your health. Think about the following factors.
Consider your health—what services do you typically need covered in a year? Knowing what services you need covered, how much you’re willing to pay for premiums and out-of-pocket costs, and what healthcare providers you want to see can guide you towards the best plan for you.
You have two options for prescription drug coverage (Part D). You can either enroll in a standalone plan or choose a Medicare Advantage plan that includes prescription coverage. Either way, it’s important to understand what prescriptions you need covered by your plan.
If you travel often, consider a Medicare Advantage plan that includes additional benefits while you travel. Medicare Supplement plans are also a good option for people who have Original Medicare and travel a lot domestically.
Between learning about California Medicare options and accounting for your health care needs, it can be difficult to choose the best Medicare Advantage plan for you. Talking to a licensed Advisor at Chapter can help you pick a plan that gets you the best value. Get started with us by calling 855-900-2427 or scheduling a time to talk.
