Find 2021 Medicare Plans in California - CA Medicare Insurance Overview

Medicare Insurance in California

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California Medicare Insurance

California Medical Insurance Stats

Medicare in California

Medicare offers healthcare coverage to California residents age 65 or older, or to those California residents that suffer from certain medical disabilities. In 2018, 6,256,554 people are enrolled in Medicare in California, accounting for 16% of the population in California. Approximately $9,442 was spent per Medicare enrollee in California in 2016, about 3% lower than the national average of $9,533. From 2015 to 2030 the number of seniors in California is projected to rise by an estimated 58.54% according to calculations based off of the 2000 Census and therefore the number of Medicare enrollees in California is also expected to rise.

Local Medicare Resources

Residents of California that qualify or are enrolled in Medicare can receive free personalized and unbiased Medicare counseling and education from the California Health Insurance Counseling and Advocacy Program (HICAP), a part of a national network of State Health Insurance and Assistance Programs (SHIP). Additionally California's Senior Medicare Patrol (SMP) helps Medicare beneficiaries detect, avoid, and report healthcare fraud and abuse.

Types of Medicare Coverage

When you are eligible for Medicare you may sign up for Original Medicare (Part A & Part B), which cover hospital services and medical services, respectively, or you may enroll in a Medicare Advantage Plan (Medicare Part C). Keep in mind that you must be eligible for Original Medicare in order to enroll in a Medicare Advantage plan. If you sign up for Original Medicare you also have the option to purchase a separate or stand alone prescription drug plan (Part D). Original Medicare offers its beneficiaries flexibility in choosing their providers and you are not limited to a network. However, there is no limit on out-of-pocket medical expenses and you must always pay 20% coinsurance for medical service costs. For most Medicare beneficiaries, Part A is already paid through paycheck deductions during their working years (or their spouse's) but most Medicare beneficiaries pay premiums for Part B unless they qualify for financial assistance. Medicare Advantage plans require you to stay in network but some plans will also cover out-of-network care at a higher cost. Many Medicare Advantage plans also include additional health benefits such as vision, dental, or hearing coverage and you have the option to purchase a Medicare Advantage plan with prescription drug coverage (MAPD) in almost all states.

California 2019 Medicare Advantage Plans at a glance

Using CMS data HealthPocket found that:

  • The average total monthly premium for a 2019 Medicare Advantage plan in California is $35.00, 25% more than the national average of $28.00. 43.18% of 2019 Medicare Part C insurance plans in California have a $0 monthly premium.
  • The maximum possible annual drug deductible in any 2019 Medicare Advantage plan with a drug component is $415, but in California the average annual drug deductible for Medicare Part C insurance plans with drug components is $36.43. 64.76% of 2019 Medicare Part C insurance plans with a drug component in California have a $0 annual drug deductible.
  • 69.21% of 2019 Medicare Part C insurance plans with a drug component in California have a $0 monthly premium.
  • The average medical out-of-pocket limit for 2019 Medicare Part C insurance plans in California is $4650. 66.67% of 2019 Medicare Advantage plans in California had a medical out-of-pocket limit of $3,400 or less.

To assist seniors in choosing Medicare plans, CMS assigns star ratings to Medicare Part C and Part D plans each year based on preventive care, chronic condition management, customer service, member satisfaction, and drug pricing. Ratings range from 1 star (a poor plan) to 5 stars (an excellent plan).

  • The average overall CMS star rating assigned to Medicare Part C insurance plans in California was 4 stars in 2019.
  • Among California's 2019 Medicare Advantage plans with CMS star ratings:
    • 100% earned a score of 4 stars

Sources:

Data on Medicare eligibility, enrollment, and spending by state from Kaiser Family Foundation

There are 40 Medicare insurance providers that offer affordable and comprehensive Medicare insurance in California. Of these, the companies that offer the largest variety of plans to choose from are Kaiser Permanente, Humana, and UnitedHealthcare. In California,Kaiser Permanente has the largest selection of Medicare Advantage plans while Kaiser Permanente offers the most Medicare Part D plans. The following are all medicare insurance providers in California:

Aspire Health Plus (HMO-POS)
TYPE:HMO-POSCOST:from $269CMS Rating:
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Aspire Health Advantage (HMO)
TYPE:HMOCOST:from $139CMS Rating:
Select
Aspire Health Value (HMO)
TYPE:HMOCOST:from $52CMS Rating:
Select
Golden State Senior Health Plan (HMO)
TYPE:HMOCOST:from $0CMS Rating:
Select
Connected Care (HMO)
TYPE:HMOCOST:from $0CMS Rating:
Select

The following are the most popular medicare doctors in California based on the provider utilization and payment data published by the U.S. Department of Health & Human Services.

NameSpecialtyLocation
Thoracic Surgery (Cardiothoracic Vascular Surgery)LOS ANGELES, CA
Anatomic Pathology & Clinical PathologyPALO ALTO, CA
Vascular & Interventional RadiologyBEVERLY HILLS, CA
Vascular SurgeryWALNUT CREEK, CA
Vascular & Interventional RadiologyBAKERSFIELD, CA
Clinical Cardiac ElectrophysiologyRESEDA, CA
Cardiovascular DiseaseRESEDA, CA
Interventional CardiologyEL CENTRO, CA
Interventional CardiologyMOUNTAIN VIEW, CA
VISALIA, CA

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