California health insurance  -   California Medicare Supplement Center

 

 

California Medicare Supplement Center

 

Welcome to the Center for California Seniors with Medicare. 

 

This is the place to start if you are soon to be shopping for Medicare supplements or Advantage plans. 

 

You will likely be inundated with countless brochures and mailings regarding supplemental insurance for your Medicare but it helps to first understand the landscape, options, and get unbiased guidance first.

 

Don't take our words for it...

 

medicare agents with google reviews

 

Why is this so important?

 

Medicare is a great program but it has certain gaps in coverage that must be addressed.

 

There are many private companies that offer plans to address these gaps but some have sneaky discounts the first year which disappear later on.

 

Others are newer and less experienced in the market. 

 

Then there's the big decision between a Medicare supplement and Advantage plans

 

compare advantage plans versus supplements in california

 

Huge differences there aside from the just the cost. 

 

 

So let's begin.

 

We'll offer you Quick Points on market options and then tips on how to make a good decision for your coverage.

 

You can always run your Medicare Supplement or Advantage quote here:

 

quote medicare advantage plans

 

 There's ZERO cost for our assistance.

 

Quick Points on the Medicare supplement Market

  • Medicare is generally composed of Part A and B which is government sponsored.  These options  work like 80/20 plans with the government picking up 80% after you meet two types of deductibles (one for hospital and one for physician). 

  • Medication coverage is not covered under Medicare.  This is provided by a private plan called Part D.

  • Most seniors are eligible for Medicare on the 1st of the month that they turn 65 on or when they leave group health insurance (any age 65 or later) but there are other situations so check with us!

  • There may be waiting periods to secure Medicare and or a supplement if you wait too long to enroll in Part B or a Supplement.

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The three cost you can expect are:

 

  • Part B premium paid monthly to Medicare depending on income 

  • Medicare Supplement or Advantage Coverage (some have no cost)

  • Part D Prescription Plan

 

With these three components, you should have much less out of pocket when sick or hurt.

 

The supplement looks to Medicare to determine benefit eligibility and doctor network Medicare Supplement works more like a PPO while Advantage plans work more like an HMO plan. 

 

The Advantage plans tends to be more restrictive in terms of network and access but also cheaper in premium.  Learn about the Trade-off here.

 

 

compare advantage and supplement doctors

 

Tips for Shopping the Medicare Supplement Market

The first decision is definitely Medicare Supplement versus Advantage plan. 

 

Here are the key differences:

 

  • Access.  Supplements allow more control on doctors, hospitals, and self-referring.  Advantage plans will result in more "managed" care similar to an HMO style of access.

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  • Cost.  Supplements will generally run around $100-150/month for a 65 year old across the State.  Advantage plans will generally be no or low cost up to $50/month on average.

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  • Supplements will allow you to use providers across the State and country.  Advantage plans are generally tied to a local geographic region. 

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People generally have a sense of their preference in terms of HMO or PPO but we're here to help. 

 

In the end, cost dictates which way to go.  If the cost of a supplement will push your budget, Advantage plans might be the default option.  Get quotes for both of them here.  We have a massive review on Comparing Advantage and Medigap

 

Choosing a Medicare Supplement Plan

If you want more access to providers and greater freedom in terms of care, how do we then choose a supplement or "medigap" policy as they are often called?

 

The Supplement plans are given letter names such as the "A plan".  They each have different benefits in terms of which "gaps" they cover and how much of those.  Some have cost sharing built into how they will pay. 

 

So how do we analyze these options?

 

what does traditional medicare cover

 

By far, the G Plan is the most popular plan (since F is discontinued for new enrollees) and generally the best value long term.

 

The G Plan covers all of the main gaps (except the doctor deductible around $150/annually) in Medicare including Excess. 

 

Excess is the amount that Medicare allows providers to charge over what Medicare allows. 

 

what are the gaps in medicare

 

 

If you choose a plan that does not cover Excess, you could be on the hook for up to 15% of very large bills. 

 

The trend has been towards more doctors charging Excess and this will likely continue.

 

It does not make sense to have insurance but take the full risk of Excess

 

G Plan is the best protection for this reason alone. 

 

It also takes cares of the 20% coinsurance that Medicare does not pay which is really the reason to get supplemental coverage at all!

 

You can run your Medicare Supplement or Advantage quote here:

 

advantage plan quotes

 

So now that we narrowed the plan down, which carrier?

Most of the major carriers offer supplements, Advantage plans, or both.   We have a big comparison of Medicare plan carriers in California.

 

There are even large, well-known marketing entities such as AARP that partner with an underlying Medicare supplement company to offer coverage.

 

Ultimately, you're insured by the underlying company.

 

quote california medicare carriers and plans online

 

So how do we evaluate and who's good now?

 

Key concern for selecting a Medicare supplement carrier in California

Stability.

 

Will the carrier be stable both in terms of cost and company strength.

 

This is important.

 

You are considering a purchase that you will need rely on for decades.

 

Yes, decades possibly with Medigap plans.

 

Has the carrier been in the Supplement business for a while?

 

A decade plus? Have their rates remained competitive?

 

Keep in mind that the plan benefits are standardized by Medicare so an G Plan is a G Plan regardless of the carrier. 

 

Who meets this criteria?

 

Anthem Blue Cross and Blue Shield of California are two of the strongest since they have been offering stable options and rates for the longest in California.

 

Aetna, United, and Humana would be next.

 

AARP currently works with United Health so it's really the carrier we want to look at.

 

We wrote an entire article on how to insure between retirement and Medicare here.  Let's look at an increasingly popular option.

 

Medi Medi Plans - Dual Eligible Advantage Plans

Some people are eligible for both Medicare and Medi-cal coordination plans.

 

This is usually called "medi medi" or "dual eligible".

 

We have a big review on Special Need Plans generally and Anthem's Medi medi plan (very popular in Los Angeles).

These people may have access to richer benefits if eligible.

 

There are also SNPs build for people with chronic diseases and you can quote both types here:

 

quote california advantage plans for medication

 

 

 

Enrolling in a Medicare Supplement

Once we have decided on which plan and carrier we want, what's the enrollment process and timeline?

 

Here's our recommendation: 

 

  • 60 days prior to turning 65 or leaving group health insurance, contact CMS through medicare.gov to make sure your Part A and Part B are effective.  You'll have to "opt in" for Part B since there's a premium associated with it.  Verify your effective dates for both A and B. 

  • 30 days prior to the 1st of the month in which you turn 65 (or otherwise become eligible) or as soon as you have your Part A and B effective dates, complete the Medicare plan application right through the quote (most carriers offer).  Reach out to us if the "Add to Cart" is not available by your plan.

  • You can apply for Part D or Advantage plans right through the same quote!  It will even take into account your medications, doctors, and pharmacies.

 

 

 

 

That's it  Of course we can help with any questions along the way such as dental and vision options.  Please email us at help@calhealth.net with questions or set up a call.  We're here to help and there's no cost to you for our services.