Comparing Medigap Plans in California: A Comprehensive Guide

If you're enrolled in Original Medicare (Parts A and B), you've probably realized it doesn’t cover all of your healthcare costs. That’s where Medigap (Medicare Supplement Insurance) comes in. Designed to “fill the gaps” left by Original Medicare, Medigap plans can help cover expenses like deductibles, copays, and coinsurance. But with several plan options and a few California-specific rules, choosing the right Medigap policy requires a closer look.

In this comprehensive guide, we’ll walk you through how to compare Medigap plans in California so you can find the right balance of coverage and cost.

What Is a Medigap Plan?

Medigap plans are private insurance policies that work alongside Original Medicare. They are standardized by the federal government, meaning each plan (A, B, G, N, etc.) offers the same benefits no matter which insurance company sells it. The only differences are the premiums, customer service, and any added perks the insurer may offer.

To buy a Medigap plan, you must:

• Be enrolled in both Medicare Part A and Part B

• Live in the plan’s service area

• Apply during a time when you have guaranteed issue rights (like your Medigap Open Enrollment Period)

Medigap Plans Available in California

Here are the most common and popular plans available:

Plan G

• Covers: All Medicare-approved costs except the Part B deductible

• Why it’s popular: It offers the most comprehensive coverage available to new Medicare enrollees after 2020.

• Best for: Those who want peace of mind and minimal out-of-pocket costs

Plan F

• Covers: 100% of all gaps in Original Medicare, including the Part B deductible

• Important: Only available if you became eligible for Medicare before January 1, 2020

• Best for: Grandfathered enrollees who want complete coverage and no unexpected bills

Plan N

• Covers: Almost everything except small copays ($20 for office visits, $50 for ER visits) and Part B excess charges

• Why it’s a good option: Lower premiums than Plans G and F

• Best for: Healthier individuals looking for solid coverage with lower monthly costs

Key Factors to Compare

1. Monthly Premiums

Since the coverage is standardized, premiums vary by provider. Prices can differ by hundreds of dollars per year for the exact same plan.

Tip: Always compare at least three insurers when shopping for a plan.

2. Coverage Needs

• Do you travel often? Make sure your plan includes foreign emergency coverage (Plans G, F, and N do).

• See specialists frequently? Choose a plan with no referrals and strong excess charge protection (like Plan G).

3. Medical Needs and Budget

If you have a chronic condition or expect frequent doctor visits, a plan with higher coverage (like Plan G) might save you more in the long run, even with a higher premium.

If you’re generally healthy and want to save monthly, Plan N could be the smarter financial choice.

4. Provider Reputation

Look beyond price. Consider:

• Customer service ratings

• Claims processing speed

• Rate increase history

California’s Unique Birthday Rule

California has a Medigap Birthday Rule that allows you to switch Medigap plans once a year, without medical underwriting.

How it works:

• You have 60 days starting on your birthday to switch to another Medigap plan with equal or lesser benefits.

• You cannot be denied coverage based on pre-existing conditions during this window.

Why it matters:
You can shop for a lower premium every year without worrying about your health status. This flexibility is not available in most other states.

When to Enroll

The best time to enroll in a Medigap plan is during your Medigap Open Enrollment Period, which lasts for 6 months starting the month you turn 65 and enroll in Medicare Part B.

During this period:

• You can’t be denied coverage for health reasons

• Insurers must offer you the best available rate

Missed that window? You may still qualify for guaranteed issue rights during certain situations (like losing other coverage), or you can wait for your Birthday Rule window.

Conclusion

Comparing Medigap plans in California comes down to knowing what you need, what you’re willing to pay, and how to take advantage of the state’s unique protections. While Plan G is the top pick for comprehensive coverage, Plan N offers excellent value for healthier individuals, and Plan F is still unbeatable for those who qualify.

Use California’s Birthday Rule to your advantage and shop your plan annually—you could save hundreds without sacrificing coverage.