Am I Eligible for a Medicare Advantage Plan in California?

Deciding eligibility for enrollment in a California Medicare Advantage plan is easier than you might think. It’s identical to an individual’s eligibility for Medicare Parts A and B, assuming you reside in an area where Medicare Advantage plans are sold. Plans can depend on county and zip code locations. Copayments, coinsurance and deductibles vary depending on the Medicare Advantage Plan you enroll in.

California residents cannot be enrolled in a Medicare Advantage Plan and a Medicare Supplement Insurance plan at the same time. A Medicare Supplement plan (Medigap) helps cover some of the gaps in coverage like copayments, coinsurance and deductibles that aren’t covered by Medicare Parts A and B.

When is the California Medicare Advantage Plan Enrollment Period?

Enrollment in a Medicare Advantage Plan occurs during specified enrollment periods. Medicare enrollment in California opens for residents prior to turning age 65 or earlier in special disability cases. The Initial Enrollment Period (IEP) runs for seven months.
IEP begins three months before turning age 65, including the birthday month, and ends three months after the birthday month. It is also the time allotted for enrollment in Medicare Parts A, B, C and D. For example, if you’re a Californian with a May birthday, your IEP runs from February through August.
You may also enroll in a Medicare Advantage plan during the Medicare Annual Enrollment Period, which occurs annually each fall. Medicare’s AEP runs from October 15 through December 7 each year. The key dates for AEP are as follows:

Oct. 15 – Annual Enrollment Period Begins

Dec. 7 – Annual Enrollment Period Ends

Jan. 1 – First Date Coverage can start

During the Annual Enrollment every year, California residents can:

• Switch from Medicare Parts A and B (Original Medicare) to a Medicare Advantage (Part C) plan

• Change from one Medicare Advantage Plan to another

• Switch from one Prescription Drug (Part D) plan to another

• Add a Prescription Drug (Part D) plan if you didn’t enroll when first eligible for Medicare

In addition to AEP, California residents who are enrolled in a Medicare Advantage plan can make a one-time plan change during the Open Enrollment (OEP) period, which occurs each year from January 1 through March 31. There are also Medicare Special Enrollment Periods (SEP) you may be able to enroll in Medicare or make changes to your existing Medicare Advantage coverage because of certain events and life changes, such as moving or losing employer coverage.