CALIFORNIA MEDICARE ADVANTAGE PLANS

At Buffalo Health Advisors, our health insurance agents are licensed and qualified to help you find Medicare Advantage plans in California. Medicare Advantage plans, also known as MA plans or Medicare Part C, are private alternatives to Original Medicare which is funded by the federal government.

a senior woman trying to find a California MA health insurance plan

How Do I Join a Medicare Advantage Plan in California?

If you want to sign up for an MA plan, you can either try to find a plan by yourself or work with a health insurance agent to find a plan specific to your needs. If you try to find a plan on your own, you will have to sort through pages of paperwork, sign up for dozens of quotes, and have to filter out hundreds of calls.

When you work with one of our health insurance agents, we help you find what you want. We take the process of finding the right plan and make it simple.

As for qualifications, in order to enroll in an MA plan, you must be signed up for both Medicare Part A and Part B. You must also be paying the Part B premiums while you have your advantage plan.

California Medicare Advantage Plans

If you’ve started searching for an MA plan in California, then you know there are many different plans offered by multiple providers. It doesn’t help that many of these plans are quite similar to each other. However, we can’t summarize all of the information of one healthcare plan on one page, so please, call one of our health insurance agents to pick out a specific plan.

All that said, there are at least four general categories that MA plans fall into in the state of California. The types of MA plans include:

A senior couple searching for a California Medicare Advantage Plan online

PPO Plans

One of the most popular options when it comes to health insurance over 65, PPO plans offer coverage with a network of doctors and hospitals who agree to the doctor to take their cases. You will be required to choose a primary care physician when you join a PPO, but you will still have coverage if you have to visit a provider outside of your network. However, it will be cheaper for you to visit your PCP and receive in-network care.

HMO Plans

When compared to PPO plans, HMOs are cheaper but more restrictive. When you join a health maintenance organization, your benefits will focus on maintaining your good health. Your PCP will also be your main in-network provider for this plan.

HMOs require beneficiaries to choose a PCP at the beginning of their coverage term. Your PCP must also be within the coverage area for the HMO. If you need to see anyone outside of your HMO, you will not have coverage.

Should you develop symptoms or a condition that must be attended to by a specialist, you must first visit your PCP and get a referral. When possible, many HMO beneficiaries choose to keep their PCP from previous health due to their established relationship.

PFFS Plans

In California, PFFS plans work the same as Medicare Part C, except they are provided for by private companies. As a result, these private plans have specific determinations in order for you to obtain coverage, you must accept the terms and conditions set by the private organization.

The terms and benefits of a PFFS vary from plan to plan. Some plans may allow you to see physicians outside of the network and others will not.

With the sheer variety of options available, we recommend calling one of our certified health insurance agents. Together, we will help you sort through all available PFFS plans in California and find the plan perfect for you.

Special Needs Plans

For people who have disabilities, End-Stage Renal Disease, or low-incomes. A special needs plan is a unique Medicare Advantage option as it does not require that beneficiaries are age 65 or older. Instead, anyone who has a qualifying debilitating disease or disability and falls within certain income tiers can qualify for an SNP.

Furthermore, SNPs are made specifically to fit the needs of their beneficiaries. Additionally, all SNP must provide Medicare prescription drug coverage for subscribers. If you feel that an SNP is right for you, call one of our expert healthcare agents to discuss your options.

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Qualifications for California Medicare Advantage Plans

In general, all Medicare insurance plans require applicants and beneficiaries to meet the following requirements.

  • Age 65 or older
  • Eligible for social security benefits
  • Have a permanent disability
  • Enrolled in Original Medicare

Finally, additional requirements include evidence of living in the United States for at least five years. If you are receiving benefits from the Railroad Retirement Board.

Help Finding California Medicare Advantage Plans

Finding the right health insurance plan is a confusing process, especially when it comes to Medicare Advantage. At Buffalo Health Advisors, we make it simple. Call one of our health insurance agents today to get the perfect plan for you.

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