Medicare in California: 2026 Plans, Costs, and Enrollment Guide

California Medicare Snapshot

California is one of the most diverse Medicare markets in the country — 391 MA plans from 41 carriers covering 56 of 57 counties for 2026 (CMS CY2026 Landscape). The state's dominant HMO culture, driven in part by Kaiser Permanente and SCAN Health Plan, distinguishes California from many other large states where PPOs are more prevalent.

The average consolidated MA premium is $14.70/month, with a median of $0 — the majority of California MA plans carry no monthly plan premium beyond the standard Medicare Part B premium ($202.90/month standard in 2026 per CMS). California also has a unique Medigap protections: the Birthday Rule gives beneficiaries an annual window to switch Medigap plans without underwriting.

Plan Types Available in California

Medicare Advantage (Part C)

In California, 391 MA plans are available for 2026 from 41 carriers (CMS CY2026 Landscape). Plan type mix: 174 HMO, 70 HMO-POS, 48 HMO D-SNP (dual-eligible special needs), 40 HMO C-SNP (chronic condition special needs), and 27 PPO plans, among others.

California's MA market is heavily HMO-oriented — HMOs and HMO variants make up the vast majority of available plans. County availability ranges from 121 MA plans in Los Angeles County to just 1 plan in Lake County.

Medigap (Medicare Supplement)

California has 24 Medigap carriers offering 9 of the 12 standardized plan letters. Plan G is available from 22 carriers. Plan F is closed to new enrollees as of January 1, 2020 (MACRA) — it remains available only to those who were Medicare-eligible before that date.

California's Birthday Rule (effective March 2022) gives policyholders a 63-day annual window to switch Medigap plans from any carrier without medical underwriting — a stronger consumer protection than most states. See our MA vs Medigap comparison →

Standalone Part D (Prescription Drug Plans)

California is CMS PDP Region 32 — California alone. For 2026, there are 12 standalone PDP plans from 6 carriers. Average total premium is $108.18/month — one of the higher averages nationally (CMS CY2026 Landscape).

Costs in California

Medicare Advantage Premiums

The average consolidated MA premium in California is $14.70/month (CMS CY2026 Landscape). The median is $0. The standard Medicare Part B premium is $202.90/month in 2026.

The top three carriers by plan count are SCAN Health Plan (52 plans), Kaiser Permanente (48 plans), and UnitedHealthcare (43 plans) (CMS CY2026 Landscape). Average star rating is 3.68.

Medigap Premiums — Plan G and HDG

Unlike most states, California Medigap rates are community-rated by statute (CA Insurance Code §10192.14 et seq.) — all enrollees in a given Medigap plan pay the same premium regardless of age, gender, or (in most cases) tobacco use. As a result, premium ranges in California reflect carrier-to-carrier variation rather than the age-band spreads you’ll see in other states. California also offers a separate Birthday Rule(63 days post-birthday, any equivalent-or-lesser plan from any carrier, guaranteed-issue) — broader than the more restrictive Illinois rule. Per-carrier Medigap rate data for California is not currently published in the same CMS-derived rate file used for other state guides; consult medicare.gov/plan-compare or the CA Department of Insurance for current carrier-specific community rates.

HDG and HDF are not offered in California; CA Medigap carriers do not file high-deductible variants under the community-rated rules (0 carriers in the CMS CY2026 rate file). Plan F-like catastrophic options are unavailable to new enrollees regardless.

Part D Costs and the LIS Benchmark

For 2026, California Part D premiums average $108.18/month across 12 standalone PDP plans — one of the higher averages nationally. The CMS Low Income Subsidy (LIS / Extra Help) benchmark premium for PDP Region 32 (California) is $12.00/month (CMS CY2026 Regional Rates and Benchmarks).

California-Specific Medicare Rules

The California Birthday Rule

California has a Birthday Rule (Cal. Ins. Code §10192.12(i), enacted by SB 407, Stats. 2019, Ch. 348) that gives Medigap policyholders a 63-day window starting on their birthday each year to switch to a Medigap plan with equal or lesser benefits from any carrier — without medical underwriting. This rule is operative for policy anniversaries beginning March 2022 per California DOI guidance.

Key details: Unlike the Illinois Birthday Rule (which limits switches to the same carrier or affiliate), California's rule allows switching to any participating carrier. The new plan must have equal or lesser benefits than your current plan. This gives California beneficiaries meaningful annual leverage to shop for lower premiums without risking denial based on health status.

Medicare Savings Programs (MSPs)

California offers Medicare Savings Programs (MSPs) through the Medi-Cal program:

• QMB (Qualified Medicare Beneficiary): Covers Part A and Part B premiums, deductibles, and cost-sharing.
• SLMB (Specified Low-Income Medicare Beneficiary): Covers Part B premiums only.
• QI (Qualifying Individual): Also covers Part B premiums; subject to annual appropriations.

Apply through the California Department of Health Care Services (Medi-Cal) or contact California HICAP (1-800-434-0222) for free enrollment assistance. MSP enrollment also automatically qualifies you for Extra Help / LIS on Part D. Learn more about MSPs →

California HICAP

California HICAP (Health Insurance Counseling & Advocacy Program) provides free, unbiased counseling on all Medicare options statewide.

Phone: 1-800-434-0222
Website: California HICAP

Enrolling in Medicare in California

Standard Enrollment Periods

• Initial Enrollment Period (IEP): 7-month window centered on your 65th birthday month. Enroll at ssa.gov or call 1-800-772-1213.
• Annual Election Period (AEP): October 15 – December 7 each year.
• Medicare Advantage Open Enrollment Period (OEP): January 1 – March 31.
• Medigap Open Enrollment Period:6-month guaranteed-issue window starting when you are 65+ and enrolled in Part B. After this window, California's Birthday Rule gives you a 63-day annual window to switch from any carrier without underwriting.
• Special Enrollment Periods (SEPs): Learn more →

California HICAP Counseling

California HICAP counselors are available statewide. Contact HICAP at 1-800-434-0222.

Frequently Asked Questions