Operated by HealthBenefitsCompass LLC, a subsidiary of HealthcareGPS Inc.Medicare education · Not a government websiteReviewed by Lauri Middleton, RN, MSN (licensed Medicare agent) and Karen OrillaHow we prepare our guidance →Meet our reviewers →

Reviewed for accuracy by Lauri Middleton, RN, MSN, licensed Medicare agentReviewed for clarity by Karen OrillaReviewed September 10, 2026Meet our reviewers →

MEDICARE GUIDANCE FOR CALIFORNIANS

Make sense of Medicare.Find your next step.

Turning 65, reviewing your coverage, or helping someone you love? Start with your situation. Leave with a clearer next step.

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What brings you here today?

I’m getting started with MedicareTurning 65, retiring, or still working.I already have MedicareCheck what changed and what needs attention.I’m helping someone elsePrepare a checklist to review together.I need help with costs or a coverage problemFind public programs and official help.

More situations

California · A useful next step

Find your next step in California.

Starting Medicare, helping family, or sorting out a notice? Pair clear preparation with free HICAP counseling.

Start Medicare with a clear sequence

A first-enrollment checklist you can take to Social Security.

Prepare my next step 02

Review before changing coverage

A clear list to verify before any switch.

Prepare my next step 03

Help someone with their Medicare

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Prepare my next step

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Open Enrollment is open: October 15 to December 7. Changes take effect January 1. I already have Medicare →

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Medicare choices

Two ways to get your Medicare coverage.

Tap any piece to see what it covers, what you pay, and what to watch. Or pick a situation below.

A + B

Original Medicare

You assemble it from separate pieces

Any doctor in the U.S. who accepts Medicare
No yearly medical limit; supplemental coverage may help

Think of it this way

Original Medicare is the foundation. You may add separate drug and supplemental insurance; each has its own terms.

Medicare Advantage

One bundled plan from a private insurer

The plan’s network of doctors and hospitals
A yearly cap on what you pay for medical care
Medigap cannot be combined with Medicare Advantage

Think of it this way

MA combines benefits through a private plan. Part B premiums still apply; networks, cost-sharing and included benefits vary.

In your walletUp to 3 cards: Medicare, Medigap, Part D1 card you use: the plan’s. Keep your Medicare card safe.

Monthly billsPart B premium + Medigap premium + Part D premiumPart B premium + plan premium (often $0)

Understand the costs—not a price ranking

These categories do not estimate your bill or identify a cheaper option. Compare actual benefits, exclusions and costs before deciding.

Original Medicare

Premiums: Part B, and Part A if not premium-free. Separate drug or supplemental coverage may add premiums.
When you use care: Deductibles and cost-sharing vary by service. Original Medicare has no yearly medical out-of-pocket limit. Medigap may pay specified costs; benefits differ by policy.
What limits do not cover: Medigap is not a universal spending cap. Part D has a separate limit for qualifying covered-drug costs, excluding premiums and noncovered drugs.

Medicare Advantage

Premiums: Keep paying Part B, and Part A if required. An additional MA plan premium may apply; a $0 plan premium does not mean free care.
When you use care: Copayments, coinsurance and deductibles vary. The plan limits qualifying Part A and B out-of-pocket costs; check in-network and out-of-network rules.
What limits do not cover: The medical limit excludes premiums, Part D drugs and noncovered services. Part D has a separate covered-drug limit. Not every MA plan includes Part D.

Medicare.gov ↗

What happens when you…

Tap any piece to see what it covers, what you pay, and what to watch. Or pick a situation below.

Neither path is better for everyone. It depends on your doctors, your prescriptions, your budget, and where you spend time. This explains the pieces; it does not recommend a plan.

Make my Medicare checklist Medicare.gov

Text version of this diagram

Original Medicare — You assemble it from separate pieces

Part A — Hospital: Pays for the hospital bed — inpatient stays, rehab after a hospital stay, and hospice. Inpatient hospital stays, skilled nursing care after a hospital stay, hospice, and some home health care. Usually no monthly premium if you or a spouse paid Medicare taxes for 10 years. A deductible for each hospital stay period, then daily amounts for long stays.
Part B — Medical: Helps cover doctor visits and outpatient care. After the deductible, you usually pay 20% of the approved amount; exceptions apply. Doctor visits, outpatient care, lab tests, preventive services, mental health care, and equipment like walkers and oxygen. A monthly premium (higher earners pay more), a yearly deductible, then generally 20% of the Medicare-approved amount — with no yearly cap on that 20%.
Part D plan — Prescriptions — separate plan: Pays for your prescriptions — but only if you join a separate private drug plan. Prescription drugs, through a private plan you choose and join separately. Each plan has its own list of covered drugs, sorted into tiers. A monthly plan premium, sometimes a deductible, then a copay or percentage per prescription that depends on the drug’s tier. There is a yearly cap on what you pay for covered drugs.
Medigap — Supplement — optional: Helps pay some Original Medicare cost-sharing. What remains depends on the Medigap policy; it does not cover everything. Pays some or most of what Parts A and B leave for you to pay — the hospital deductible and the 20% — depending on the plan letter you choose. Some cover emergency care abroad. A monthly premium to the insurance company, on top of Part B. Plans with the same letter cover the same things, so price and service are what differ.

Medicare Advantage — One bundled plan from a private insurer

Part C plan — One bundled private plan: One private plan that takes over delivering your Medicare — you use its card, its doctors and its rules. MA covers Part A and B benefits, with exceptions such as hospice paid by Original Medicare. Usually use the plan card; keep your Medicare card. You still pay the Part B premium. The plan’s own premium may be $0. You pay copays or a percentage when you use care, with a yearly maximum for medical costs.
Drugs + extras — Usually included: Drug coverage and extras like dental or hearing, built into the same plan. Most plans include drug coverage, and many add benefits Original Medicare does not, such as dental, vision, hearing aids, or a fitness benefit. Each has its own limits. Drug copays by tier, like a Part D plan, with the same yearly drug cap. Extras often have dollar limits or their own networks.
Network & rules — HMO or PPO: You use the plan’s doctors and hospitals. Going outside costs more or is not covered. The plan contracts with specific doctors, hospitals and pharmacies. An HMO usually covers only in-network care (except emergencies) and may require referrals; a PPO lets you go out of network for more money. Lower copays in network; much more, or nothing covered, out of network. Some services need the plan’s approval first (prior authorization).
Yearly cap — Out-of-pocket maximum: A limit for qualifying Part A and B costs under the plan’s rules—not a limit on all spending. A limit on what you pay in a year for covered medical care from the plan. After you reach it, the plan pays 100% of covered medical costs for the rest of the year. Every copay and coinsurance for medical care counts toward it. Premiums and drug costs do not; drugs have their own separate cap.

Medigap cannot be combined with Medicare Advantage. Up to 3 cards: Medicare, Medigap, Part D / 1 card you use: the plan’s. Keep your Medicare card safe.

External resource. Some pages are in English; ask for language assistance if needed.

Local help

Good help, close to home.

Start with free California Medicare counseling. County guides add local resources when they matter.

Get help

Free Medicare counseling

California HICAP offers free, confidential Medicare counseling. Ask the local program about language and appointment availability.

California HICAP

1-800-MEDICARE

Call 1-800-MEDICARE and ask for an interpreter. TTY: 1-877-486-2048.

Call Medicare · 1-800-633-4227 Official information in other languages ↗

External resource. Some pages are in English; ask for language assistance if needed.

Make sense of Medicare.Find your next step.

What brings you here today?

Find your next step in California.

Start Medicare with a clear sequence

Review before changing coverage

Help someone with their Medicare

Two ways to get your Medicare coverage.

Original Medicare

Medicare Advantage

Understand the costs—not a price ranking

Original Medicare

Medicare Advantage

What happens when you…

Original Medicare — You assemble it from separate pieces

Medicare Advantage — One bundled plan from a private insurer

Good help, close to home.

Los Angeles County

San Diego County

Inland Empire

Orange County

Help in any California county

Free Medicare counseling

1-800-MEDICARE