Table of Contents

Medicare Plans by State

STATE -Select-
  • Alabama
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Page Reviewed / Updated – December 20, 2023

Older adults can access Medicare coverage in two ways: by enrolling in Original Medicare (Parts A and B) or purchasing a Medicare Advantage Plan (also known as Part C) from a Medicare-approved private insurance company. Medicare Advantage providers must match the coverage of Parts A and B. Most MA policies also include prescription drug coverage (Part D). Original Medicare enrollees must purchase a separate Part D plan if they want drug coverage. 

Medicare Advantage Plans offer additional benefits that vary among insurers, such as vision and dental coverage not included in Original Medicare. While some plans result in lower out-of-pocket costs than Original Medicare, it’s crucial to compare costs, as some may have higher enrollee contributions. Unlike Original Medicare, Medicare Advantage requires using in-network providers and obtaining referrals for specialists, with higher charges for out-of-network care. These plans also set annual out-of-pocket caps for Part A and Part B services, a contrast to Original Medicare’s unlimited costs unless supplemented by Medigap coverage.

In California, Medicare Advantage enrollment increased by 9.54% between 2022 and 2023, broadly in line with the national average of 9.75%. The number of Californians eligible for Medicare Advantage policies grew by 2.59%, compared to a growth of 2.66% across the United States. Of the people meeting the Medicare Advantage eligibility criteria, 6.78% more enrolled in a Medicare Advantage Plan in 2023 than in 2022.

This guide offers a look into Medicare Advantage Plans in California, shedding light on what’s covered, who’s eligible, and how to sign up. It’s your go-to resource for statewide information and assistance.

The Top 10 Medicare Advantage Plans in California

Seniors in California have multiple options for Medicare Advantage enrollment because many private insurers offer these policies. The following table lists the 24 most popular Medicare Advantage providers according to their California enrollment numbers. Most companies provide multiple Medicare Advantage Plans, so cost information is displayed as a range. The total enrollment numbers combine the number of enrollees for each insurance company to reflect the total number of Californian beneficiaries. All information is correct as of July 2023, and seniors can find the most up-to-date figures and learn more about Medicare Advantage options in California by visiting Medicare.gov.

Name

Enrollment

Medicare Star Rating

Monthly Cost Range

Plan Types

Kaiser Permanente

1,438,814

3

$0 – $70

HMO

UnitedHealthcare

379,872

4

$0 – $119

HMO

SCAN Health Plan

288,353

3

$0 – $74

HMO

Humana

184,095

3

$0 – $170

PPO, HMO

Anthem Blue Cross

120,653

3

$0 – $60

HMO

Blue Cross Blue Shield of Michigan

110,712

3

$0 – $163

HMO

Alignment Health Plan

104,298

3.5

$0 – $97

PPO, HMO

Blue Cross and Blue Shield of IL, NM

90,615

4

$0 – $53

HMO

Aetna Medicare

77,302

3

$0 – $97

PPO, HMO

Blue Cross Blue Shield of Minnesota

75,306

3

$0 – $55

HMO

How Medicare Advantage Plans Work in California

Before enrolling in Medicare Advantage, it’s important to understand how the program works in California. Insurers typically offer multiple plans, from health maintenance organizations (HMOs) to preferred provider organizations (PPOs). Each type of plan has different requirements regarding the need for referrals, in-network versus out-of-network coverage, prescription drug coverage and the need to choose a primary care provider. You’ll find a description of the four most common plans below.

How to Find & Choose a Medicare Advantage Plan in California

What Medicare Advantage Plans Cover in California

With the exception of hospice care, Medicare Advantage Plans must cover the same services available to Original Medicare beneficiaries. These services include preventive screenings, lab tests, X-rays and care provided during a hospital admission. Medicare Advantage providers are also allowed to offer extra benefits, such as dental care, vision care and hearing aids.



Coverage Available With Medicare Parts A & B?

Coverage Available With Medicare Advantage?

Preventive Screenings

Yes

Yes

Hospital Care

Yes

Yes

Durable Medical Equipment

Yes

Yes

Prescription Drugs

No

Yes**

Vision Care

No

Yes*

Dental Care

No

Yes*

Hearing Aids

No

Yes*

*Select plans offer this coverage

** Most plans offer this coverage

Eligibility for Medicare Advantage in California

To qualify for Medicare Advantage, an applicant must already have Medicare Part A and Medicare Part B, live in the plan’s service area and meet all other Medicare eligibility requirements. Medicare enrollment is limited to adults who are at least 65 years old or have some type of disability that would qualify them for Medicare at a younger age. Every Medicare enrollee must also be a U.S. citizen or lawful immigrant. Like other types of health insurance, Medicare has limited enrollment periods, so it’s important for seniors to understand when they can enroll in Medicare or change plans. See the list below for more information about enrollment timing.

  • Initial Coverage Election Period: This is the initial 7-month period, coinciding with one’s 65th birthday, during which everyone is eligible to enroll in a Medicare Advantage plan.
  • Annual Election Period (AEP): Also referred to as the Open Enrollment Period, this is the time of year when anyone over 65 can enroll in Medicare Advantage for the first time or change to a new plan.
  • Medicare Advantage Open Enrollment Period: During this period, those who are already enrolled in Medicare Advantage can switch to a different plan or switch back to Original Medicare.

Start Date

End Date

Initial Coverage Election
Period

3 Months Before One’s
65th Birth Month

3 Months After One’s
65th Birth Month

Annual Election Period
(AEP)

October 15th

December 7th

Medicare Advantage Open
Enrollment Period

January 1st

March 31st

Additionally, Medicare Advantage plan participants can change their plan outside of these enrollment periods under certain qualifying circumstances, such as moving to a new state.

How to Find & Choose a Medicare Advantage Plan in California

Navigating the many intricacies of Medicare Advantage plan types, insurers, and the specific plan options available by region can be a difficult and time-consuming task. Below are several resources we’ve created to help you through the process.

First is a downloadable PDF that you can use as a guide to help you compare plans as you research. Finally, we have listed a number of organizations that you can contact with experts that will help you determine whether Medicare Advantage is right for you and what plans you should consider.

How Medicare Advantage Plans Work in California

State-Wide Medicare Advantage Resources

Health Insurance Counseling and Advocacy Program

California’s Health Insurance Counseling and Advocacy Program (HICAP) is a Medicare and long-term care counseling service for seniors. HICAP can help California residents understand how to enroll in Medicare and the various aspects of the program, determine which Medicare plan type is best for them, and have any related questions about Medicare and long-term care answered. One-on-one counseling is available free of charge for eligible California residents. To be eligible, one must be at least 65 years of age and eligible for Medicare, or be younger than 65 but will be eligible for Medicare in the near future or have a disability. HICAP also holds educational events, which are open to people of all ages. 

Contact Info

To locate the HICAP office closest to you or speak to someone about the program, call 1-800-434-0222. You can also search for your nearest HICAP office on the Department of Aging website

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California Health Advocates

California Health Advocates is a non-profit focused on Medicare advocacy and education. The group provides accurate and timely information for Medicare beneficiaries and their families to help them better understand the program and make the most of their health care coverage. Subscribers can access the group’s comprehensive fact sheets that cover a range of Medicare-related topics specific to California, including Medicare Advantage. California Health Advocates also publishes a regularly-updated, Medicare-focused blog on its website with hundreds of helpful articles. 

Contact Info

California Health Advocate’s main office can be reached at 916-231-5110 or [email protected]. More information regarding other office locations and contact information for specific departments can be found on the California Health Advocates website.  

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California Department of Managed Health Care

The California Department of Managed Health Care (DMHC) helps protect consumer rights and assists members of managed care plans (such as HMOs) with any problems to ensure all patients “receive the medical care and services to which they are entitled.” It also conducts plan compliance checks and issues public reports of its findings. On its website, the DMHC has information on California Medicare, choosing the right type of health care plan, enrollees’ health care rights, and more.

Contact Info

The DMHC is located in Sacramento, CA and can be reached via phone at 1-888-466-2219. The department may also be reached by email via this contact form. For more information on how to reach specific offices within the department, visit the DMHC website

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Office of the Patient Advocate

California’s Office of the Patient Advocate evaluates California health care plans based on patient experience and quality of care and gives each plan a rating based on this data. The ratings are published on the group’s website so consumers can research health care plans prior to enrolling. The group also rates hospitals and health groups and provides educational information such as the differences between different Medicare plan types. It also publishes annual reports of health care complaints made by California consumers. 

Contact Info

The Office of the Patient Advocate can be reached by phone at 916-324-6407 or email at [email protected]

Email

Local Medicare Advantage Resources

Aging and Disability Resource Connection

California’s Aging and Disability Resource Connection provides several support services, including “options counseling.” This counseling service can help connect Californians to public and private support services, including health care programs like Medicare. The services are available to anyone regardless of age, income, or ability. 

Contact Info

Aging and Disability Resource Connection services are provided on a county level. To locate services in your county, visit the California Department of Aging website

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Multipurpose Senior Services Program (MSSP)

The MSSP provides services to seniors in order to help them remain in their own homes and communities. One of the many available services is a complete health assessment to help seniors determine their needs. The MSSP team then works with the individual to develop a care plan. This assessment and support can be beneficial to seniors considering Medicare Advantage but who are unsure if it is the right decision for their health and financial situation. MSSP services are available to low-income California residents who qualify for Medi-Cal and are 65 years of age or older. 

Contact Info

MSSP services are provided on a county level. To locate an MSSP provider in your county, visit the California Department of Aging website.

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