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Medicare can be a confusing program, and newly Medicare-eligible Californians likely have many questions. HealthMarkets can help you better understand Medicare eligibility in California, decide on Medicare supplemental policies, and select a Medicare plan. You can also start comparing Medicare plans right now.

Who Is Eligible for Medicare in California?

You can qualify for Original Medicare if you are a U.S. citizen or permanent legal resident who has lived in the U.S. for more than five years and one or more of the following describes your personal situation:2

  • You’re 65 or older. 
  • You’re under 65, permanently disabled, and receive disability benefits from Social Security or the Railroad Retirement Board.
  • You have end-stage renal disease (ESRD).
  • You have ALS (Amyotrophic Lateral Sclerosis), also known as Lou Gehrig’s disease.

In 2020, there were 3,612,462 eligible California residents receiving Original Medicare.Original Medicare includes Part A, insurance that covers inpatient stays in a hospital, and Part B, medical insurance that covers doctor visits and outpatient services.2

When Am I Eligible for Medicare Part C, Part D, and Medicare Supplement Plans? 

After you sign up for Original Medicare, you are eligible to enroll in a prescription drug plan (Part D), a Medicare Supplement plan, or a Medicare Advantage (Part C). Medicare Advantage includes Parts A and B, and often contains coverage for prescription drugs.3

There are a number of reasons why Medicare Advantage may be preferred to Original Medicare, including:

  • Copayments instead of coinsurance . Those enrolled in Medicare Advantage plans are more likely to pay a fixed amount per doctor’s visit, instead of paying a percentage of the cost. 
  • Dental, vision, and hearing coverage . Original Medicare does not cover these services, but many Medicare Advantage plans include them.
  • Caps on out-of-pocket costs. Medicare Advantage plans have a cap on how much you pay in out-of-pocket expenses per year. Original Medicare does not have a cap.3

How Do I Apply for Medicare in California?

You can apply for Medicare coverage in California by reaching out to your local Social Security office, either by phone or online.

Your Initial Medicare Enrollment Period is the first opportunity you have to sign up for Medicare in California. It begins three months before you turn 65, includes the month you turn 65, and ends three months afterward. If you miss out on this seven-month window, you can enroll during the General Enrollment Period from January 1 – March 31.4

Find out how to maximize your Medicare benefits by getting your free FitScore® with HealthMarkets. After answering a few quick questions, our FitScore can score and rank Medicare plans based on your needs, helping you compare your options. Afterward, it can continuously compare plans for you and notify you if a better fit becomes available.

Get started comparing today!


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References:
1.Total Number of Medicare Beneficiaries, KFF. 2020. Retrieved from https://www.kff.org/medicare/state-indicator/total-medicare-beneficiaries/ | 2. Original Medicare (Part A and B) Eligibility and Enrollment, CMS. 2020. Retrieved from https://www.cms.gov/Medicare/Eligibility-and-Enrollment/OrigMedicarePartABEligEnrol | 3. Understanding Medicare Advantage Plans, Medicare. 2020. Retrieved from https://www.medicare.gov/Pubs/pdf/12026-Understanding-Medicare-Advantage-Plans.pdf | 4. Medicare enrollment periods: when to sign up, Medicare. 2020. Retrieved from https://www.medicare.gov/blog/medicare-enrollment-period-2020#:~:text=General%20Medicare%20Enrollment%20Period%3A%20If,coverage%20will%20start%20July%201. 

HealthMarkets’ FitScore Forever Promise is to use technology to help identify and continuously search plans that fit your needs. Not available for all insurance types. Plan enrollment is customer’s responsibility. You should carefully review official plan materials.

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