Medicare Under 65 in California
California requires insurers to offer Medicare Supplement policies to people who reached Medicare before 65 through disability. Most states do not. Here is what that means for you.
Medicare before 65, in a state that treats you properly
If you qualified for Medicare before 65 through disability, you have probably already discovered that almost everything written about Medicare assumes you turned 65 last Tuesday. The birthday timelines do not apply to you. The marketing is not aimed at you. In most of the country, insurers are not even required to sell you a Medicare Supplement.
California is different. Under California Insurance Code section 10192.11(d), an issuer selling Medicare Supplement policies in this state must offer them to beneficiaries under 65 who qualify for Medicare through disability. That is a real, enforceable right, and it does not exist in most states.
There are somewhere around five thousand people under 65 on Medicare in Santa Barbara County. As far as we can see, effectively nobody in this market writes for them or works with them deliberately. That seems like a poor reason for them to go without advice.
What the California rule gives you
The core of it is access. A company that sells Medicare Supplement policies here has to make them available to you rather than declining on the grounds of your age or the route by which you reached Medicare.
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Access to the same lettered plans. The benefits inside each letter are set by federal law and they are identical whatever your age. A Plan G is a Plan G.
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An open enrollment period tied to your Part B start date. The federal six month Medigap open enrollment period is defined as the six months beginning with the first month in which you are both 65 or older and enrolled in Part B. California adds a parallel opening for people who reach Medicare before 65 through disability, keyed to their own Part B enrollment. Because the timing depends on exactly when and how your Part B started, we confirm your dates with you rather than work from an assumption.
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The California Birthday Rule. It applies to you as well. Once you hold a supplement, you get at least 60 days each year, on or about your birthday, to move to a policy with equal or lesser benefits with any carrier, without medical underwriting. Details are on the birthday rule page.
Rates for supplements under 65 are higher than rates at 65, sometimes considerably. That is legal and it reflects claims experience rather than any judgement about you. It is also worth comparing across carriers, because the spread between companies at these ages is wider than it is at 65.
The thing most people are never told
When you turn 65, you get a fresh Medicare Supplement open enrollment period. Six months, beginning with the first month in which you are both 65 or older and enrolled in Part B, with guaranteed issue and no health questions, exactly as if you were arriving at Medicare for the first time.
This matters enormously, because supplement rates at 65 are ordinarily far lower than rates under 65. People who have been paying an under 65 rate for years can move onto a standard rate, with any company, without underwriting.
Nobody sends a reminder about this. If you came onto Medicare through disability at 52, put a note in the calendar now for the month you turn 65, or tell us your date of birth and we will hold it for you.
The rest of it still applies
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You still need Part D. A Medicare Supplement does not include prescription drug coverage. You buy a standalone Part D plan alongside it, and the same late enrollment penalty rules apply: it is triggered by 63 or more days without creditable drug coverage, and it is calculated from the national base beneficiary premium.
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Medicare Advantage is open to you too, on the same terms as anyone else, and subject to the same local network reality described on Supplement or Advantage on the Central Coast.
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If you also qualify for Medi-Cal, your options and your enrollment rights are different again, and generally better. CenCal Health administers Medi-Cal managed care in Santa Barbara and San Luis Obispo counties. This is worth a separate conversation rather than a paragraph.
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If you are still working, or covered by a spouse's employer plan, the rules on employer coverage apply to you before 65 as well.
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The rules read differently depending on why you qualified before 65. Not every route onto Medicare under 65 carries identical Medigap rights in California, so we check your specific situation against the statute before you apply rather than after.
How we would rather do this
Plainly, and without the tone people under 65 on Medicare tell us they usually get. You are not a special case to be handled, you are someone with a slightly different set of dates and a set of rights that happen to be better in California than almost anywhere else.
We will tell you what your open enrollment window is, what the market looks like at your age, whether a supplement or an Advantage plan makes more sense given the providers you use, and what is going to change when you turn 65. If the answer is that you should keep what you have for now, that is what we will say.
We would like to hear from you
Call or come in. There is no charge for our time, and no obligation attached to a conversation. If we are not the right people to help with something, we will tell you who is.
Bring your Medicare card, the date your Part B started, and a list of your medications. That is enough to give you a straight answer.
Or call us on (805) 966-4900. There is never a charge for our help.
Under 65 and on Medicare?
You have rights in California that people in most other states do not. We will walk you through them. There is never a charge for our services.