Original Medicare provides comprehensive coverage and enables you to see any doctor who accepts Medicare across the country, making it an indispensable program when it comes to keeping you healthy and financially stable. But nevertheless, you might still struggle to afford the 20% Medicare Part B coinsurance, as well as other out-of-pocket expenses, and will most likely need additional coverage through a California Medicare Supplement Plan.
You can purchase California Medicare Supplement Plans through private insurance companies to fill any gaps left by Medicare Parts A and B, including out-of-pocket expenses like your Part A deductible, and your Part B 20% coinsurance. There are 10 different plans to choose from, but the federal government standardizes Medicare Supplement plans, and requires all plans with the same letter name to provide the same coverage across the country, so you’ll always know what you’re getting.
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But even though the Centers for Medicare and Medicaid Services (CMS) regulates the plans, insurers choose which plans they actually offer, as well as the price of their premiums. This means premiums can vary based on the insurance company you choose, so it’s important to compare both different California Medicare Supplement Plans and different insurers to find the best plan for you. EZ can help you with comparing both; first, though, take a look at our guide to how Medicare Supplement Plans work in California.
California Medicare Supplement Plans
If you are looking to fill the gaps in Original Medicare, especially the 20% coinsurance that you’ll need to pay each time you access Medicare Part B outpatient services, a Medicare Supplement Plan is the way to go.
As pointed out above, there are 10 California Medicare Supplement Plans to compare, each named after a different letter of the alphabet (A, B, C, D, F, G, K, L, M, and N). Legally, every insurance carrier must offer at least Plan A to their customers, but they are not required to offer all 10 plans. Additionally, there are 2 plans that only those who became Medicare eligible prior to January 1, 2020, can purchase: Plans C and F.
When it comes to the cost of California Medicare Supplement Plans, premiums in California can cost between $92 and $300 per month, depending on your plan and location.
Because there are so many options available, it can be hard to know where to begin. So, to get you started, we’ve explained each plan and what it covers.
Plan A
Medicare Supplement Plan A is the most basic option when it comes to Medicare Supplement Plans. Basic as this plan is, though, it does cover what could possibly be the most important thing that a plan can cover: the 20% coinsurance required each time you access an outpatient service . If you choose this plan, your monthly premiums could start as low as $121 per month in California.
Plan B
Medicare Supplement Plan B covers all the basics that Plan A does, including:
- Medicare Part A coinsurance and hospital costs – Part A only fully covers your first 60 days of inpatient hospital stays in a benefit period, after that you are required to pay a portion of your bills for each day after your initial 60 days. Days 61-90 have a coinsurance of $400 a day. If your stay is between 91 and 150 days, and you use your Lifetime Reserve days, your coinsurance will be $800 a day. Plan B covers 100% of these costs.
- Medicare Part B coinsurance or copay – You’ll typically have to pay Medicare Part B coinsurance for doctor visits and other outpatient care. That means Medicare Part B pays 80% of the Medicare-approved amount for covered services, leaving you to pay the remaining 20%. Plan B covers 100% of this.
- First 3 pints of blood – Original Medicare only pays for the fourth and subsequent pints of blood if you need blood during treatment. Plan B will pay for the first three pints.
- Part A hospice care and coinsurance – Hospice care is for patients who are nearing the end of their lives. These services are covered by Medicare, but copayments are required. These copayments include $5 for each symptom and pain relief medication prescription, as well as 5% of the Medicare-approved amount for inpatient assisted living. Plan B covers all expenses related to hospice care.
In addition, what makes Plan B different from Plan A is that it covers the Medicare Part A deductible, which is $1,600 per benefit period. Note that this deductible is not charged annually, but rather on a 60-day benefit period basis. Meaning you might have to pay it more than once in a single year. That’s where Plan B comes in. If you choose this plan over Plan A, you won’t have to meet the deductible repeatedly throughout the year.
Plan B premiums in California start at $170.
Plan C
This is one of the market’s most comprehensive Medicare Supplement Plans. With the exception of Medicare Part B excess charges, Plan C covers everything. This means that Plan C covers both your Parts A and B deductibles, in addition to the 20% coinsurance required for all outpatient care.
Coverage includes the following:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B coinsurance and copayments
- Part B deductible
- Other Medicare-approved expenses associated with Part B coverage
Unfortunately, If you became eligible for Medicare after January 1, 2020, you are not eligible to purchase Plan C. However, If you had Plan C, or were eligible for it before that date, you can keep it or you may still be able to enroll.
In California, Plan C premiums can start at around $201 a month.
Plan D
Plan D covers the majority of out-of-pocket expenses associated with Original Medicare, including :
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Part B coinsurance
- First 3 pints of blood
- Skilled nursing facility (SNF) care coinsurance – After the 20th day of your stay as an inpatient in a skilled nursing facility, Medicare Part A requires you to pay coinsurance. Part A coinsurance for skilled nursing facility care is $200 per day in 2023.
- Part A deductible
- 80% of foreign travel emergency costs (up to plan limits)
The only major expenses that Plan D doesn’t cover are Medicare Part B deductibles and excess charges. If your doctor doesn’t accept Medicare assignment, they can charge you up to 15% more for healthcare services than the Medicare- approved amount. The difference between what your doctor charges and the Medicare-approved amount is known as an “excess charge,”.
Plan D premiums start at $210 a month in California.
Plan F
Medicare Supplement Plan F has long been the best-selling plan on the market. It covers all of your out-of-pocket expenses. Meaning you’ll only pay your monthly Plan F premium if you have this plan. The covered expenses include:
- Part A hospital deductible and coinsurance
- Hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Part A hospice care coinsurance or copayment
- Blood (the first 3 pints)
- Other Medicare-approved expenses associated with Part A hospitalization
- Medicare Part B 20% coinsurance and copayments
- Medicare-approved doctor’s office fees
- Part B deductible
- Medicare Part B excess charges
- Other Medicare-approved expenses associated with Part B coverage
The only limitation is that Plan F is not available for anyone who became/becomes Medicare eligible after 2020. If you were eligible for Medicare before 2020, you can buy one of these plans. Additionally, if you have already bought Plan F and are grandfathered in, you can keep it for as long as you want.
Premiums for Plan F start at $202 a month in California.
Plan G
If you like the sound of Plan F, but are not eligible to purchase one of these plans, look into Plan G. This plan covers almost everything that Plan F does, including:
- Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Part B coinsurance or copayment
- Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so)
- Blood transfusion (first 3 pints)
The Medicare Part B deductible is the only major out-of-pocket expense that Plan G does not cover. Plan G premiums are commonly very competitive, with premiums in California starting at $157 per month.
Plan K
Medicare Supplement Plan K reduces your Original Medicare out-of-pocket expenses, but it does not completely fill the gaps. Plan K only covers 50% of some expenses, including:
- Medicare Part B coinsurance – Plan K covers half of these costs, so you will be responsible for 50% of your 20% coinsurance. For example, if your doctor charges $100 for a service, Medicare will cover $80, Plan K will cover $10, and you will pay the remaining $10.
- First 3 pints of blood
- Part A hospice care coinsurance or copayment – Plan K will pay for half of these costs.
- Skilled nursing facility care coinsurance – Plan K pays half of the coinsurance for medical care in skilled nursing care facilities.
- Medicare Part A deductible – Medicare Supplement Plan K will pay half of these deductibles, or $800. Plan K requires you to pay the Medicare Part B deductible, which is $226 in 2023.
Plan K requires you to pay more out-of-pocket at the time of service. However, it does have something that other plans do not: an out-of-pocket maximum. This means the maximum amount you’ll have to pay out-of-pocket for Plan K in a year is $6,620 (as of 2023). When you meet this limit, Medicare Supplement Plan K will cover the rest of the year’s approved costs. Your maximum will be reset at the start of each calendar year.
Moreover, while Plan K only covers 50% of most expenses, it covers 100% of the Medicare Part A coinsurance. This is the only basic benefit covered in full by Medicare Supplement Plan K.
Because of its higher out-of-pocket costs, Plan K’s premiums are in the lower range, with premiums starting at just $63 a month in California.
Plan L
Medicare Supplement Plan L also covers the majority of Original Medicare’s costs, though not all of them. And, like Plan K, it also has an out-of-pocket maximum ($3,310 in 2023). After you reach the maximum your insurer will cover all of your expenses for the remainder of the year.
Medicare Supplement Plan L covers all of Medicare Part A coinsurance and hospital costs. It also covers a percentage of :
- Medicare Part B coinsurance – Plan L covers 75% of your Part B coinsurance.
- Blood – If you require blood while in the hospital, Plan L will cover 75% of the cost of the first three pints.
- Part A hospice care copayments – Plan L pays 75% of your Part A copays for hospice care.
- Skilled nursing facility care coinsurance – Plan L pays 75% of the $200 per day (after the 20th day of your stay) coinsurance for medical care in skilled nursing care facilities.
- Part A deductible – Medicare Supplement Plan L will cover 75% of your Part A deductibles for each 60-day benefit period.
Plan L premiums start at $113 a month in California.
Plan M
Like Plan K and Plan L, Medicare Supplement Plan M covers the majority of the costs associated with Original Medicare, but not all of them.
Medicare Supplement Plan M covers all of Medicare Part A coinsurance and hospital costs. It also covers:
- Medicare Part B coinsurance – Plan M pays your Part B coinsurance and/or copayments in full.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan M will cover the first three pints of blood in full.
- Part A hospice care coinsurance or copayment – Plan M will cover all of your hospice care coinsurance and copays in full.
- Skilled nursing facility care coinsurance – Plan M covers the entire cost of Part A skilled nursing facility coinsurance.
- Part A deductible – Medicare Supplement Plan M will cover half of your Medicare Part A deductible. If you have Plan M, you will have to pay half of the $1,600 (or $800) deductible rather than the full $1,600.
Plan M premiums start at $117 a month in California.
Plan N
The vast majority of Original Medicare’s coverage gaps are filled by Medicare Supplement Plan N. The Medicare Part B deductible ($226 in 2023) and any Medicare Part B excess charges. Which are portions of medical bills that go over the Medicare-approved amount, are the sole exclusions. Therefore, Medicare Supplement Plan N provides coverage for all of the following:
- Medicare Part B coinsurance – Plan N will cover your Part B coinsurance costs in full, with the exception of a copayment of up to $20 for some office visits. For emergency room visits that do not result in an inpatient admission, a second copayment of up to $50 may be required.
- Blood – If you require blood while in the hospital, Medicare Supplement Plan N will cover the first three pints.
- Part A hospice care coinsurance or copayment – Plan N pays your hospice care coinsurance and copayments in full.
- Skilled nursing facility care coinsurance – Your skilled nursing facility coinsurance will be fully covered by Medicare Supplement Plan N.
- Part A deductible – Medicare Supplement Plan N pays your $1,600 deductible in full for each 60-day benefit period.
- Foreign travel emergency care – Original Medicare typically does not cover medical care received outside of the United States. If you need emergency care while traveling outside of the United States, Medicare Supplement Plan N will cover 80% of the costs of qualified emergency medical care.
Plan N premiums start at $128 a month in California.
When to Enroll
While there are technically multiple times when you can choose to enroll in a Medicare Supplement Plan, there is one time that will be most beneficial to you. This is your Medicare Supplement Open Enrollment Period. Which is the 6-month window that opens up to you when you turn 65 and enroll in Original Medicare.
The reason that you should purchase during this time is that you will be given “guaranteed issue rights”. This means that insurers cannot use medical underwriting to determine eligibility or premiums. In other words, insurance companies will not be able to deny you coverage or charge you more because of health conditions. So it’s important to take advantage of your Medicare Supplement Open Enrollment Period.
It’s important to note that federal regulations do not guarantee access to a Medicare Supplement plan if you are under 65 and eligible for Medicare due to a disability.
How To Choose
When it comes to Medicare coverage, don’t be afraid to ask questions. Speak to an EZ agent who can explain everything to you and tell you what you need to do to sign up. EZ can assist you in enrolling in Medicare, comparing Medicare Supplement Plans, or simply weighing your options. Our agents work with the best insurance companies in the country. They can provide you with a free comparison of all available plans in your area. We will go over your medical and financial needs with you and help you find a plan that works for you. To get started, simply enter your zip code in the bar below or give one of our licensed agents a call at 877-670-3602.
