Medicare Advantage in California

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California state

Information about Medicare Advantage Plans in California

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There are 326 different California Medicare Advantage (Medicare Part C) plans offered in 2022.1 Plan selection can vary by location, however.

Call to speak with a licensed insurance agent who can help you compare the benefits and costs of Medicare Advantage plans that are available where you live in California.

Average costs of Medicare Advantage in California

The average premium for California Medicare Advantage plans in 2022 is $47.43 per month, though you may be able to find some plans where you live that offer $0 monthly premiums.

  • Average in-network out-of-pocket spending limit: $4,315.70
  • Average drug deductible for Medicare Advantage Prescription Drug plans (weighted): $3762

The premiums and other costs for Medicare Advantage plans may vary from one location to another.

A licensed insurance agent can help you compare Medicare Advantage plan costs in your area.

Compare California Medicare Advantage plan costs

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CA Medicare Eligibility & Enrollment

You may not sign up for a Medicare Advantage plan in California without first enrolling in Medicare Part A and Part B, otherwise known as Original Medicare.

In order to enroll in Original Medicare at age 65, you must be a U.S. citizen or permanent legal resident of at least five continuous years. You must also meet the following requirements: 

  • You or your spouse have worked long enough to be eligible for Social Security or Railroad Retirement benefits.

  • You or your spouse are government employees or retirees who have not paid into Social Security but have paid Medicare payroll taxes.

You may be eligible to sign up for Medicare before age 65 if:

  • You have been receiving Social Security disability benefits or certain Railroad Retirement Board disability benefits for at least 24 months.

  • You have ALS (amyotrophic lateral sclerosis, or Lou Gehrig's disease).

  • You have End-Stage Renal Disease (ESRD), and you or your spouse have paid Social Security taxes for a certain length of time.

If you have ESRD, you may be able to enroll in a Medicare Advantage plan or a California Medicare Special Needs Plan (SNP) that is designed to help meet your specific health care needs.

How to sign up for a Medicare Advantage Plan in California

There are a number of times that you may be able to enroll in a California Medicare Part C plan. The first is during your Medicare Initial Enrollment Period (IEP).

Medicare Initial Enrollment Period graphic

Your Medicare IEP begins three months before you turn 65 years old, includes the month of your birthday and then continues for another three months after your birthday.

Some other enrollment periods during which you may be able to sign up for Medicare Advantage include:

Medicare Advantage Open Enrollment Period graphic

Medicare Advantage Open Enrollment Period: January 1 – March 31

If you already have a Medicare Advantage plan, you may be able to switch Medicare Advantage plans or drop your Medicare Advantage plan and return to Original Medicare from Jan. 1 to March 31 each year.

You can also join a Medicare standalone prescription drug plan (Medicare Part D) during this period if you disenroll from Medicare Advantage and return to Original Medicare.

Medicare AEP graphic

Medicare Annual Enrollment Period (AEP): October 15 – December 7

During Medicare AEP, you may enroll in a Medicare Advantage plan or switch from one Medicare Advantage plan to another.

AEP (also called the Annual Election Period) lasts from Oct. 15 to Dec. 7 each year. During AEP, you may also be able to drop your existing Medicare Advantage plan and return to Original Medicare.

During AEP, you may also join, switch or drop a Medicare Part D plan. 

Medicare Special Enrollment Periods (SEP)

You may potentially be granted a Medicare Special Enrollment Period (SEP) at any time during the year, depending on your individual circumstances.

A licensed insurance agent can help you find out if you qualify for a Medicare Special Enrollment Period.

Find a $0 premium California Medicare Advantage plan today

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Or call TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

Top-rated Medicare Advantage Plans in California 2022

The Centers for Medicare & Medicaid Services (CMS) issues star ratings every year for all Medicare Advantage plans, using a system of one to five stars.3

In order for a Medicare Advantage plan to be considered a top-rated plan, it must have four or more stars out of five stars.

64.9% of Medicare Advantage plans in California are rated four stars or higher in 2022.

Medicare Star Ratings
Star Ratings

★★★★★

Excellent

★★★★

Above Average

★★★

Average

★★

Below Average

Poor

Medicare Advantage plan Star Ratings are based on information from Medicare's monitoring activities and from member surveys, and they rate plans based on the following five categories:

  • Preventive care and health maintenance (screenings, tests, vaccines, etc.)
  • Management of chronic conditions
  • Member experiences and ratings of the plan
  • Member complaints, problems receiving services and member retention
  • Customer service

List of Medicare Advantage Plans Available in California in 2022

To view a list of plans offered in your area within California, use our plan comparison tool.

Find a $0 premium California Medicare Advantage plan today

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Or call TTY Users: 711 to speak with a licensed insurance agent. We accept calls 24/7!

Private insurance companies offer Medicare Advantage plans in CA

Several insurance companies may offer Medicare Advantage plans in your area of California, though the selection of plans can vary. Depending on where you live, there may only be one insurance company that offers MA plans (if there are plans available in your county).

Private insurance companies offer Medicare Advantage plans that may be unique to the plan area they serve.

Call to speak with a licensed insurance agent who can help you compare Medicare Advantage plans that are sold by insurance companies in your area.

When you’re shopping for Medicare Advantage plans in California, you can compare plans from several different carriers. You can also use some of the following information to help you choose:

  • Medicare Star Ratings can give you an idea of a plan’s overall quality.

  • Agencies like A.M. Best, Moody’s and Standard & Poor’s can provide information about an insurance company’s credit rating and financial standing.

  • You can read through Medicare Advantage plan reviews and testimonials from customers.

California Medicare Advantage plans by county

Learn more about Medicare Advantage plans in some of California's most populous counties.

CA Medicare Advantage plans by plan type

The major types of Medicare Advantage plans include:

  • HMO
    Health Maintenance Organization (HMO) usually requires patients to use health care providers and pharmacies that are part of the plan’s network (except in the case of emergencies) while also typically requiring a referral from a primary care doctor in order to see a specialist.

  • PPO
    Medicare Advantage beneficiaries in a Preferred Provider Organization (PPO) are able to see providers outside of their plan’s network, often at a higher cost.

    Beneficiaries in this type of plan typically pay less out of pocket if they choose to receive medical services from providers within their plan’s network.

    PPO plans typically do not require patients to acquire a referral before visiting with a specialist.

  • SNP
    A Special Needs Plan (SNP) is a type of Medicare Advantage plan limited to people with certain chronic conditions and other specific characteristics.

Not all of these types of plans may be available in your area. A licensed insurance agent can help you compare the types of 2022 California Medicare Advantage plans that are available where you live.

Local health insurance resources in California

  • California’s Health Insurance Counseling and Advocacy Program (HICAP) provides free education, counseling and outreach for the state’s Medicare beneficiaries.

    You may contact California’s HICAP at 800-434-0222 with any questions about Medicare benefits, prescription drug coverage, Medicare Advantage plans, Medicare Supplement Insurance, long-term care insurance and more.

  • You can also explore more information about the insurance industry in California by visiting the state’s Department of Insurance website.

  • California Prescription Drug Assistance Programs
    The state of California has a number of programs designed to help with the cost of prescription drugs. There are programs for both Medicare beneficiaries and non-Medicare beneficiaries alike that can cover the cost of premiums and cost-sharing or even lower the cost of the drugs themselves.

 

1 Freed M. et al. (Nov. 2, 2021). Medicare Advantage 2022 Spotlight: First Look. Kaiser Family Foundation. Retrieved from www.kff.org/issue-brief/medicare-advantage-2022-spotlight-first-look.

2 MedicareAdvantage.com's The Best States for Medicare report.

3 Medicare evaluates plans based on a 5-star rating system.