Medicare Plans

​With healthcare in California constantly changing, it is important to know which plan is right for your specific needs. To help understand Medicare coverage, we’ve created a quick overview below:

 

Medicare Part A

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Most individuals are automatically enrolled in Medicare Part A upon turning 65. This coverage includes:

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• Hospital Care

• Skilled Nursing Facility Care

• Hospice Services

• Limited Home Health Services

 

Individuals with 40+ quarters of Medicare-covered employment receive Part A with no premium cost. Those with fewer quarters may pay a prorated premium.

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Medicare Part B

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Enrollment in Medicare Part B is not automatic and requires action when turning 65 or losing employer-sponsored coverage. Part B covers:

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• Physician Services

• Outpatient Services

• Home Health Services

• Durable Medical Equipment

 

In 2023, the Part B premium starts at $164.90 per month, adjusted for income. The annual deductible is $226.00 and is often deducted from Social Security payments.

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Medicare Part C (Medicare Advantage)

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Medicare Part C, or Medicare Advantage, combines Parts A and B through private insurance plans. These plans often include additional benefits like:

 

• Prescription Drug Coverage

• Vision, Dental, and Hearing Services
   

Premiums for Part C typically range from $0 to $100 per month, with costs determined by the plan provider. Many Advantage plans in California operate as HMOs.

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Medicare Part D

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Medicare Part D is coverage for prescription drugs and is purchased separately. Prescription Drug plans are available for purchase from a variety of carriers, as well as directly from Medicare. There are many variations of Part D plans in the cost of deductibles, cost sharing, etc.

 

Medicare Supplement Plans (Medigap)

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Medicare Supplement plans are private plans that are also known as Medigap plans. There are a variety of Supplement plans available, which are standardized and identifiable by letters (A-N). Each Supplement plan offers varying levels of coverage, intended to fill any gaps that are experienced by those with Medicare coverage. Due to the standardization of Supplement plans, each plan of a certain letter must offer the same coverage. These plans charge a monthly premium and will cover additional costs once Medicare pays for their portion of the medical services.​​

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​The California “Birthday Rule”

 

California residents with existing Medicare Supplement plans have an annual open enrollment period around their birthday. During this 60-day period, you can switch to another Supplement plan of equal or lesser benefits without underwriting.
 

CA Insurance Code 10192.11 (h) (1) An individual shall be entitled to an annual open enrollment period lasting 30 days or more, commencing with the individual's birthday, during which time that person may purchase any Medicare supplement policy that offers benefits equal to or lesser than those provided by the previous coverage. During this open enrollment period, no issuer that falls under this provision shall deny or condition the issuance or effectiveness of Medicare supplement coverage, nor discriminate in the pricing of coverage, because of health status, claims experience, receipt of health care, or medical condition of the individual if, at the time of the open enrollment period, the individual is covered under another Medicare supplement policy or contract. An issuer shall notify a policyholder of his or her rights under this subdivision at least 30 and no more than 60 days before the beginning of the open enrollment period.

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Medicare Supplement Discounts​

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• Blue Shield of California: Offers a “New to Medicare” discount of $25/month on select Supplement Plans (A, C, D, F, F Extra, G) and an additional $3/month discount with Easy$Pay. Plans also include the SilverSneakers Fitness Program.

• Anthem Blue Cross: Provides a “New to Medicare” discount of $25/month on Plan G for the first 12 months, plus a $2/month discount with autopay enrollment. Anthem plans also include SilverSneakers benefits.​
   

Why Choose Medicare Supplement Plans?
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Medicare Supplements help protect you from unexpected medical costs, providing financial stability and peace of mind. With over 40 years of experience, Dayton Sayer Insurance is Northern California’s trusted partner in navigating Medicare options. Contact us today to explore your options and simplify your Medicare journey.