Medicare Basics in California

As a trusted healthcare provider serving California, BASS Medical Group is committed to helping our patients navigate the complexities of Medicare. With over 6.8 million Medicare beneficiaries in California—the largest number of any U.S. state—understanding your options is crucial for making informed healthcare decisions.

What is Medicare?

Medicare is a federal health insurance program primarily designed for:

• People 65 years or older
• Certain individuals under 65 with specific disabilities
• People of any age with End-Stage Renal Disease (ESRD)

The Four Parts of Medicare

Part A (Hospital Insurance)

‍Covers:

• Inpatient hospital care
• Skilled nursing facility care
• Hospice care
• Some home health care

Part B (Medical Insurance)

‍Covers:

• Outpatient care
• Preventive services
• Medical supplies
• Doctor's services

Part C (Medicare Advantage)

‍An alternative to Original Medicare offered by private companies. California residents have access to 465 Medicare Advantage plans in 2025, offering additional benefits like dental, vision, and hearing coverage

Part D (Prescription Drug Coverage)

‍Helps cover the cost of prescription medications. California residents can choose from 18 standalone prescription drug plans.

Enrollment Periods in California

Californians can enroll in Medicare during these periods:

1. Initial Enrollment Period (IEP): A 7-month period around your 65th birthday.
2. General Enrollment Period (GEP): January 1 - March 31 each year.
3. Special Enrollment Periods: Available in certain circumstances, such as moving or losing other coverage.

Additionally, California has a unique "Birthday Rule" for Medigap policies, allowing beneficiaries to switch plans around their birthday without medical underwriting.

Medi-Cal and Dual Eligibility

For low-income residents, California offers Medi-Cal, the state’s Medicaid program, which can work alongside Medicare for those who qualify as "dual eligibles" or "Medi-Medis." These individuals may benefit from Dual Special Needs Plans (D-SNPs), which combine Medicare and Medi-Cal benefits into one plan, offering coordinated care and additional services.

How to Enroll

You can enroll in Medicare through:

• The Social Security website (fastest method)
• Calling Social Security at 800-772-1213
• Visiting your local Social Security office

Costs in California

While most people don’t pay a premium for Part A, Part B typically requires a monthly premium. For Californians, the average monthly premium for a Medicare Advantage plan in 2025 is $12.48, down from $16.25 in 2024. Costs for Parts C and D vary depending on the plan.

Why Choose BASS Medical Group?

At BASS Medical Group, we are proud to serve patients across Northern California. While we participate in Medicare and many other insurance plans, we encourage patients to contact their insurance provider or Medicare directly to verify specific coverage details.

Our team is here to help you navigate your healthcare options and provide high-quality, patient-centered care. Whether you’re exploring Original Medicare, Medicare Advantage plans, or dual eligibility with Medi-Cal, we’re here to support you every step of the way.

For more information about how BASS Medical Group works with Medicare or to schedule an appointment, please contact us today.

Medical Disclaimer: The information provided in this blog is for educational purposes only and is not intended as medical advice. BASS Medical Group does not endorse any specific claims or treatments mentioned. Individual results may vary, and it is essential to consult with a qualified healthcare professional before making any changes to your health regimen or treatment plan. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Medicare/Medi-Cal Disclaimer: We may not offer every plan available in your area and certain options may be limited to certain persons. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.