SENIOR INSURANCE COVERAGE

MEDICARE SUPPLEMENT COVERAGE

Medicare Supplement Plans (Medigap) in California

Medicare Supplement (or Medigap) plans in California are designed to help cover expenses incurred under Original Medicare, Part A and Part B, including copayments, coinsurance, deductibles, and other out-of-pocket expenses.

Depending on the Zip Code area you reside in California, your Medigap coverage plan options will vary. 

If you want to apply for Medicare Supplement Health Insurance Coverage, you can apply several ways:

• Online enrollment here, enrolling online is the easiest way to compare multiple Medicare insurance plans, thus saving you time and money.
• By phone: (800) 624-8976, and one of ECIA insurance specialist will service your immediate insurance needs.
• Or, complete the Contact Request form, and an ECIA insurance specialist will contact you the same day, or  worse case the following day.

Medigap plans in California

In California, you have access to the same 10 standardized Medigap plans available in 47 states – all but Massachusetts, Minnesota, and Wisconsin, which have different types of Medigap plans. Each Medigap plan is labeled with one of 10 letters (A, B, C, D, F, G, K, L, M, and N), and plans of the same letter offer the same benefits.

You are eligible for Medigap insurance if you are currently enrolled in Original Medicare, Part A and Part B.

• The best time to buy a Medicare Supplement plan is during your Medigap Open Enrollment Period. This six-month period starts the first day a beneficiary is age 65 or older and is also enrolled in Medicare Part B. During this time, Medicare beneficiaries in California can sign up for any Medicare Supplement plan available in their area, offered by any insurance company, without being subject to medical underwriting or denied coverage for pre-existing conditions.

• These special Medigap protections are known as “guaranteed-issue rights” because insurance companies must issue you any plan offered in your service area during this period. Please note, you cannot be rejected for medical coverage, but the insurance company can apply a six-month waiting period of coverage for pre-existing conditions – even if you apply during your Medigap Open Enrollment Period.
• Outside of your one-time Medigap Open Enrollment Period, it’s generally harder to switch plans unless you have guaranteed-issue rights, and if you are able to find an insurance company willing over you a policy.  Keep in mind, you may have to pay more for coverage if you have pre-existing health conditions.
• California is one of the few states that has state-specific Medicare Supplement guidelines, making it easier to change Medicare Supplement plans outside of your Medigap Open Enrollment Period.
• Under the California “birthday rule,” a Medicare member already enrolled in a Medicare Supplement plan can switch to a different Medicare Supplement plan 30 days following the members birthday each year. During the member’s 30 leniency period, the Medicare member can change their Medigap plans with guaranteed issue if their new plan provides equal or lesser coverage than the members current Medicare Supplement plan.
• Please note, California resident enrolled in Medicare Supplement Plan A, you will NOT be able to enroll in Medicare Supplement Plan F with guaranteed issue under this birthday rule, because Plan F provides more coverage that Plan A.
• In addition, as a California resident, you may technically change your Medicare Supplement plan at any time during the calendar year, but during the annual “birthday rule” period you will not be subject to medical underwriting. You’ll also have these protections if you’re eligible for guaranteed-issue rights in certain situations; for example, if you were enrolled in a Medicare Advantage plan and you move out of the plan’s service area, you can enroll in certain Medigap plans with guaranteed issue (if you decide to go back to Original Medicare).
• Medigap plans in California and the rest of the United States do not offer prescription drug benefits. If you need help to cover medication costs, you may want to enroll in a stand-alone Medicare Part D Prescription Drug Plan.

These plans are available through private insurance companies contracted with Medicare. Click here, to request information about Medicare Part D Prescription Drug Plan.

Medicare rulings as of January 1, 2020:

• New clients seeking to purchase Medicare coverage cannot purchase plans to cover their Medicare Part “B” deductible.
• Medicare Supplement Plans “C” and ‘F” will no longer be available to new Medicare enrollees.
• Existing Medicare clients covered by Plan or Plan F can keep their current plan coverage.
• A new Plan “G” / high-deductible plan will be offered starting January 1, 2020
• Plan “K” and Plan “L” will pay 100% of all covered services for the balance of the members calendar year, after the member reaches their max out of pocket, and met their Part “B” deductible.
• Medicare Plan “N” pays 100% of the Medicare Part “B” co-insurance, but the Medicare Plan “N’ will NOT pay for all $20 copay doctor visit, or $50 emergency visits, if the member was not admitted.

With so many Medicare Supplement plan options in California, it may be a good idea for you to understand the value of each Medicare plan to learn which plan satisfies your personal health needs within your budget by calling: 800-624-8976.

If you want to apply for Medicare Supplement Health Insurance Coverage, you can apply several ways:

• Online enrollment here, enrolling online is the easiest way to compare multiple Medicare insurance plans, thus saving you time and money.
• By phone: (800) 624-8976, and one of ECIA insurance specialist will service your immediate insurance needs.
• Or, complete the Contact Request form, and an ECIA insurance specialist will contact you the same day, or  worse case the following day.