California Medicare Supplement Insurance (Medigap)

Making changes to your coverage: If you’re in a Medicare Advantage Plan, you can leave your plan between January 1–February 14, and switch to Original Medicare. If you switch to Original Medicare during this period, you will have until February 14 to also join a Medicare Prescription Drug Plan to add drug coverage. Your coverage will begin the first day of the month after the plan gets your enrollment form.

During this period, you can’t do the following:

  • Switch from Original Medicare to a Medicare Advantage Plan
  • Switch from one Medicare Advantage Plan to another
  • Switch from one Medicare Prescription Drug Plan to another
  • Join, switch, or drop a Medicare Medical Savings Account Plan

*Information from medicare.gov

During this time you can leave your Advantage Plan and enroll in a Supplement Plan.

Free instant quote for California Medicare Supplement Plans (Medigap)

Medicare Supplement Insurance

While Medicare pays for a lot of health care services, there are still many it does not cover. The traditional Medicare Plan does not provide 100% coverage for medical expenses such as deductibles, co-payments, and co-insurance. Therefore Medigap was designed to help pay the costs that Medicare does not cover. Medigap in California is also referred to as ‘California Medicare Supplement Plans’.

There are 10 Medicare Supplement Insurance Plans available. The benefits of each plan are different, with the exception that all plans are required to cover the ‘Basic Benefits’.

A B C D F F G K L M N
Medicare Part A Coinsurance and Hospital Benefits check check check check
Medicare Part A Deductible 50% 75% 50% check
Medicare Part B Coinsurance or Co-payment check check check check check check 50% 75% check Copay*
Medicare Part B Deductible check check
Medicare Part B Excess Charges check check -<
Blood (First Three Pints) check check check check check check 50% 75% check check
Foreign Travel Emergency (Up to Plan Limits)** check check
Hospice Care Coinsurance or Co-payment check check check check check check 50% 75% check check
Preventive Care Coinsurance check check check check
Skilled Nursing Coinsurance 50% 75%
Out-of-Pocket Limit (1) (2) (2)
* Plan N pays Part B coinsurance or co-payment except for an insured copay of up to $20 for each doctor’s office visit and up to $50 for each emergency room visit (emergency room copay waived if admitted as an inpatient).

** You must also pay a separate deductible for foreign travel emergency care ($250 per year). The plan pays 80% after the $250 deductible up to the plans lifetime limit of $ 50,000

(1) High Deductible Plan F pays NO Benefits until a $2180 deductible is met. Medicare Supplement Plan F also has a high deductible option. If you select the high deductible plan F you have to pay the first $2,180 (deductible in 2016) in MediGap-covered costs before the MediGap policy pays anything. In some areas some companies will offer a Select Plan C and Select Plan F. The plans are the same as Plan C and Plan F except they will have network hospitals to use. Select Plan C and Select Plan F will have lower premiums.

(2) On plans K & L Only. After you meet your out-of-pocket yearly limit of $4620 on plan K and $2310 on plan L and your $155 yearly Part B deductible, the plan pays 100% of covered services for the rest of the calendar year.

What is Medigap and how do California Medicare Supplement Insurance Plans work?

Medigap is additional health care insurance provided by private insurance companies to cover the gaps in the Medicare Plan. Medigap policies are regulated by Federal and State Laws in order to protect you as a beneficiary. Medigap policies have to be clearly labeled as “Medicare Supplement Insurance”, and the policies are standardized for each State.

Medigap Eligibility Requirements

Medigap coverage works only in conjunction with the Medicare Plan. Typically, you must have Medicare Part A and Part B in order to be eligible for Medigap. Acceptance of your application is guaranteed if you are 65 or older and apply within six (6) months of your initial enrollment in Plan B of Medicare. Under certain circumstances pre-existing conditions might be waived. Please ask us for specific details. As Medigap policies only cover one person per policy you and your spouse must each purchase separate policies.

Prescription Drug Coverage

Medigap policies no longer cover prescription drugs. If you have a Medicare Prescription Drug Plan and a Medigap policy that covers drugs, then you need to tell your Medigap insurance provider to remove the drug coverage from your policy. While Medicare prescription drug coverage is more beneficial than Medigap drug coverage, you can also decide to keep your Medigap policy with prescription drug coverage instead.

Does Medigap work with an Advantage Plan?

No. If you enroll in a California Medicare Advantage Plan, your Medigap coverage will not work. You may wish to (although legally you don’t have to) cancel your Medigap policy if you choose a plan aside from the Original Medicare Plan.
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For further information or questions, please contact us at 1-800-266-3618.

Disclosure: This is a solicitation of insurance. A sales agent may mail, call or e-mail as a result of contacting us to discuss Medicare Advantage, Prescription Drug Plans or Medicare Supplement Insurance.

 





Disclosure: This website is privately owned and not approved, endorsed, or authorized by Medicare or any other government agency. For the federal Medicare program please visit http://www.medicare.gov.

This is a solicitation of insurance. It is not a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. The information is not a complete description of benefits. Medicare has neither reviewed nor endorsed this information. A sales agent may mail, call or e-mail as a result of contacting us to discuss Medicare Advantage, Prescription Drug Plans or Medicare Supplement Insurance. Medicare beneficiaries may also enroll through the CMS Medicare Online Enrollment Center located at http://www.medicare.gov.