Medicare Supplemental Plans in California

What are Medicare supplement plans?

Many California seniors are relieved to have Medicare cover many healthcare costs once they reach age 65, but the federal program doesn’t cover all healthcare costs. For the costs that Medicare doesn’t cover, there are Medicare supplement plans.

Medicare supplement plans provide additional health insurance coverage that complements the federal Medicare program. These plans can greatly expand what healthcare costs are covered.

Who in California should have Medicare supplement insurance?

California seniors usually become eligible for federal Medicare at age 65. Most who are enrolled in the program might greatly benefit from having Medicare supplement insurance that expands coverage.

Seniors are eligible for Medicare enrollment starting 3 months before they turn 65. It’s generally recommended that seniors enroll in the program during this time, so they have coverage the first day that they turn 65. Seniors also ought to explore their medicare supplement insurance options at this time, so any supplemental plan can be in place too.

Anyone who’s enrolled in Medicare through one of the few exceptions (e.g. 2+ years of SSDI) might also qualify for a Medicare supplement plan. This is an uncommon situation that should be navigated with the guidance of a knowledgeable insurance agent. An agent who specializes in these plans will know whether an individual is eligible, and which supplement plan would be best if eligibility criteria are met.

Does everyone need a Medicare supplement policy?

Medicare supplement policies can provide important protection for seniors who have only Medicare coverage. When other coverage is available, however, a supplement plan might not be needed. 

Specifically, seniors who have coverage through a Medicare Advantage plan, Medicaid, the Qualified Medicare Beneficiary Program, or an employer group health plan might not need to purchase a supplemental policy. 

A knowledgeable insurance agent can help seniors review what other coverage is available, and determine whether a supplemental plan makes sense.

What is a Medicare Part D Prescription Drug Plan?

One of the most common Medicare supplement policies is the Medicare Part D Prescription Drug Plan. This generally adds coverage for prescription drugs, which the federal Medicare Part A and Part B plans usually don’t offer.

Can seniors enroll in Medicare supplement insurance if they don’t have Medicare?

Medicare supplement insurance normally is only available to seniors who are enrolled in Medicare Part A and Medicare Part B. Not only do seniors need to be eligible for Medicare, but they also must have it. Purchasing a supplemental plan on its own typically isn’t an option.

Does enrolling in a Medicare supplement policy require changing doctors?

Medicare supplement policies tend to be flexible and convenient. Most don’t require changing doctors, although coverage may be different depending on whether doctors participate in Medicare assignment.

What’s the difference between a Medicare supplement and a Medigap plan?

Medicare supplement and Medigap refer to the same supplemental health insurance plans. They supplement Medicare (hence Medicare supplement), filling in some coverage gaps that Medicare has (hence Medigap). The two terms can be used interchangeably.

Can seniors enroll in multiple Medicare supplement policies?

Federal law currently only allows seniors to enroll in one Medicare supplement policy. Seniors who want better coverage should choose a policy letter that offers more extensive protection, rather than purchasing two distinct policies.

How can seniors in California get help with Medicare supplement plans?

If you need assistance sorting through all of the various medicare supplement plans, contact the independent insurance agents at SEI Agency. Our California agents can help you (or a loved one) better understand Medicare’s protections — and which additional coverages you may want.