Medicare Advantage in California
Medicare Advantage (also known as Medicare Part C) is an alternative way to receive your Medicare benefits. When you sign up for a Medicare Advantage plan, you’ll receive all your Medicare benefits from a single insurance company—much like employer-sponsored health insurance.
In California, 14 insurance companies offer Medicare Advantage plans.1 There are 220 such plans in all,2 but the number available to you depends on where in California you live. Four out of 10 Medicare beneficiaries in California are enrolled in private health plans like Medicare Advantage.3
Find out how to pick the best Medicare Advantage plan for you.
Medicare Advantage plan benefits
Medicare Advantage plans cover everything Original Medicare (Parts A and B) covers, but many Medicare Advantage plans in California pay for a lot more. These are a few of the most common extra benefits covered by Medicare Advantage plans:4
If you have a chronic illness in California, you may also be able to buy a Medicare Advantage plan that covers other services that could improve your well-being, such as meal delivery, non-medical transportation, home modifications, and air conditioners.5
Medicare Advantage plan costs in California
How much you’ll pay for a Medicare Advantage plan in California depends on the part of the state you live in and the plan you choose. But the average monthly premium for a Medicare Advantage plan in California is less than $30.
|Average annual cost||$5,234.43|
|Average monthly premium||$29.16|
|Average drug deductible||$140.46|
|Annual max out-of-pocket||$4,744|
Medicare Advantage insurers in California
Here are the 14 insurance providers that offer Medicare Advantage plans in California:
Top-rated Medicare Advantage providers
According to the Centers for Medicare and Medicaid Services (CMS), there are 20 top-rated, 5-star Medicare Advantage plans for 2020. Kaiser Permanente, which is a provider of several top-rated plans nationwide, offers a highly rated Medicare Advantage plan in 32 counties in California; as of October 2019, that plan had more than 1.2 million enrollees.6
The Medicare Star Rating is used by the CMS to help beneficiaries find the right plan for them.
Plans are rated on up to 45 quality and performance measurements, on a scale from 1 to 5, then averaged to form an overall star rating.7
Some California counties don’t have Medicare Star Rating data. In counties that do have the data, most Medicare Advantage beneficiaries are enrolled in plans that average 4–4.5 stars.8
Find the Medicare Advantage plan that fits you best
|Must stay in-network|
|Must choose a primary care physician|
|Referrals required to see a specialist|
|More expensive premiums|
|Can go out-of-network at a higher cost|
|May or may not choose a primary care physician|
|No referrals needed to see specialists|
Californians have access to 213 health maintenance organization (HMO) and seven local preferred provider organization (PPO) plans.9
Local resources in California
- California Health Advocates: A leading Medicare advocacy and education non-profit in the state of California, they provide timely Medicare information for beneficiaries in the state.
- Health Insurance Counseling and Advocacy Program (HICAP): Provided by the state of California, HICAP offers free counseling, education, and assistance to Medicare beneficiaries in California.
- Medi-Cal: As California’s Medicaid program Medi-Cal is specifically designed to assist lower-income individuals with their health care costs. Medi-Cal is separate from Medicare, but some people qualify for both programs.
1. Medicare, “Find a Medicare Plan”
2. Kaiser Family Foundation, “Medicare Advantage Plans, by Plan Type”
3. Kaiser Family Foundation, “A Dozen Facts about Medicare Advantage in 2020”
4. Kaiser Family Foundation, “A Dozen Facts about Medicare Advantage in 2020”
6. CMS.gov, “2019 Star Ratings Fact Sheet”
7. CMS.gov, “2019 Star Ratings Fact Sheet”
8. CMS.gov, “2019 Star Ratings Fact Sheet”
9. Kaiser Family Foundation, “Medicare Advantage Plans, by Plan Type”
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