Medicare Supplement (Medigap) plans in California

Medicare Supplement insurance — usually called Medigap — is private coverage that pairs with Original Medicare (Parts A and B). Instead of replacing Medicare, it fills the gaps: the deductibles, copayments and coinsurance you’d otherwise pay yourself. You then add a standalone Part D plan for prescriptions.

How Medigap is different from Advantage

California’s birthday rule, plainly

Every year, starting on your birthday and running for 60 days, you have the right to move your Medigap policy to any insurer’s plan with the same or lesser benefits — no health questions, no waiting period. A Plan G with one carrier can become a Plan G with a cheaper carrier, or a Plan N. Most states make you pass medical underwriting to do that, which traps people in policies whose premiums have climbed for years. In California the trap does not close. We re-shop every client’s supplement in the weeks before their birthday, as a matter of routine, using the filed rate history to see which carriers have held their increases down.

When you can buy without health questions

• Your six-month open enrollment at 65 (or when you enroll in Part B at 65 or later): any plan, any carrier, no underwriting.
• Under 65 on Medicare because of disability: California requires insurers to offer Medigap, with a six-month window when your Part B begins. Premiums for under-65 policies run higher, and the requirement does not extend to people under 65 with ESRD. You get a fresh open enrollment for every plan at 65.
• Guaranteed-issue events: your Advantage plan is discontinued or leaves your county, your employer coverage ends, you move out of your plan’s area, or you used the 12-month Advantage trial right. These generally run 63 days and cover a set of plan letters.
• The birthday rule, every year, for switching between plans of equal or lesser benefit.

How California premiums are priced

Most California Medigap policies are attained-age rated: the premium rises with your age plus the carrier’s filed increases. A few carriers use issue-age or community rating, which can be cheaper over a long horizon. Rather than guess, we look at the rate filings carrier by carrier, and because the birthday rule lets you change carriers every year, the initial price matters less here than a carrier’s habit of raising it.

Who Medigap tends to fit

People who want maximum freedom to choose doctors and hospitals — Stanford, UCLA, Cedars-Sinai, City of Hope without a group question — who split the year with another state, or who prefer a predictable premium over copays. If you are healthy, in one medical group, and want a $0 premium with extras, Advantage may fit better.