California adds its own rules on top of federal Medicare, including a yearly chance to switch Medigap plans. Here’s what’s different and what it means for you.
Quick answer: Medicare works the same nationwide, but California adds a few rules. The biggest is the birthday rule: each year, for 60 days starting on your birthday, you can switch to a Medigap plan with equal or lesser benefits without answering health questions. Medicare Advantage plans and networks also vary by county.
Each year, for 60 days starting on your birthday, you can move to a Medigap plan with equal or lesser benefits from any insurer, with no health questions.
Medicare Advantage plans are approved county by county, so the options in San Diego County differ from the options in Los Angeles County.
Medicare Advantage networks are built around local hospitals and medical groups, so checking your doctors comes first.
| Enrollment window | When | What you can do |
|---|---|---|
| Initial Enrollment | The 7 months around your 65th birthday month | Sign up for Parts A and B, then choose Medicare Advantage or a Supplement with a Part D plan. |
| Annual Enrollment | October 15 – December 7 | Switch Medicare Advantage or Part D plans. Changes start January 1. |
| Medicare Advantage Open Enrollment | January 1 – March 31 | If you're in a Medicare Advantage plan, make one switch to another Advantage plan or return to Original Medicare. |
| California birthday rule | 60 days starting on your birthday | Switch to a Medigap plan with equal or lesser benefits without health questions. |
Each city page covers local hospitals, networks, and the questions people there ask us most.
Don’t see your city? We help Medicare clients across California by phone and video.
Each year, for 60 days starting on your birthday, California lets you switch to a Medicare Supplement plan with equal or lesser benefits without answering health questions. You can move to a different insurer or a lower-benefit plan, and the new coverage can’t be denied based on your health.
Yes. If you have Medicare because of a disability, California lets you buy certain Medigap plans during the six months after you enroll in Part B. Plan choices and prices vary by insurer.
Medicare Advantage plans are approved for specific service areas, usually by county, and built around local hospital and doctor networks. That’s why we start with your ZIP code and your doctors.
Yes. People who qualify for both are often called “Medi-Medi.” Medi-Cal can help with premiums and cost-sharing, and some Medicare Advantage plans are designed specifically for people who have both.
California’s State Health Insurance Program is HICAP, the Health Insurance Counseling and Advocacy Program. You can reach HICAP at 1-800-434-0222 for unbiased, one-on-one counseling.
One of our licensed agents checks your doctors, prescriptions, and ZIP code, then lays out the plans that fit.
Product availability varies by state and carrier.
