The California Medicare Supplement Plan Landscape

Maybe you’re tired of the A, B, C soup that seems to be swirling around you when you glance at the newly received California Medicare supplement plan offerings and with good reason. There are so many A’s, B’s, and F’s, that you would think you’ve come full circle back to kindergarten. We hope to shed some light on the subject of California Medigap plans to make clear how the various plans differ and reduce the chance of brochure induced headache, a very serious condition NOT covered by Medicare. So let’s dive into the California Medigap plans with a quick scan of what Traditional Medicare does, and more importantly, does not cover.

California Medicare is best thought of as an 80/20 plan with deductibles, two of them to be exact. It generally breaks down the core benefit (which account for the majority of your health care cost outside of medication which we’ll save for another article on California Part D) into hospital (Part A) and physician (Part B) costs. That’s the first two letters you’ll see before even looking at California Medicare supplement plans. Remember the “Part” part of the name since that tells you we’re talking about traditional Medicare and not a California Medigap plan. Part. Part. Part. Medicare section. Part A is generally facility based (hospital, surgi-center, etc) while Part B is generally physician based. Now that we understand the bulk of what makes up your health care costs, let’s look at the California Medicare supplement plans.

The California medicare plans are A, B, C, D, F, F high deductible, G, K, L, M, and N. In general, they increase in benefits (and cost) from A through F. The remaining generally add in cost sharing to the Medicare supplement subscriber but offer lower prices. For all the California Medigap plans, the main categories of traditional Medicare that they fill the gaps in are the following: Part A deductible, Part A co-insurance, Part B deductible, Part B co-insurance, Part B excess, Hospice Care, Skilled Nursing Facility, Foreign Emergency Travel, 1st 3 pints of blood, and Preventative co-insurance. The lettered California Medicare plans differ in these categories listed above. The F plan covers all these categories and remains the most popular California Medigap plan on the market. All the plans cover the Part A co-insurance completely. A through F cover the Part B co-insurance while G through N have varying degrees of coverage. It’s probably best to look at a California Medicare supplement plan comparison chart to make it clear but we’ll discuss the primary issues to concentrate on when deciding on your Medigap plan.

We want to focus on the costs that can either be very large or uncapped. This would be the Part B Excess charge (doctors can charge up to 15% higher than standard Medicare rate), Skilled Nursing Facility, and Part A deductible. The other expenses are probably less exorbitant but still important. The key is this – we’re not talking 100’s of dollars of difference in monthly premium between each California medicare plan so why take on the risk when it’s probably $ 10-20 difference per month between given plans. That’s why the F plan is so popular. It covers all the main gaps in California Medicare at a relatively low price. Also keep in mind that you’re entering a period of time when medical care (very expensive medical care) becomes more common and frequent regardless of your health at the time of enrolling. It’s a bad bet to buy a less rich California Medigap plan and save a few bucks only to pay much more later on. Take a look at the comparison chart at californiamedigap.com to get a better understanding and we’re happy to walk through your plan options as licensed California Medicare agents but all roads lead to the F plan. We’re happy to be your road map.

Dennis Jarvis is a licensed insurance agent concentrating on California Medicare supplement insurance.  Find more articles and guidance about california medigap plans.

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