Medicare Advantage Plans for Contra Costa County
Click here for the Medicare Advantage plans chart.
Medicare Advantage (MAPD) plans are private insurance plans approved and subsidized by Medicare. They offer equivalent benefits to Medicare and are an alternative way of receiving Medicare coverage. You must have both Parts A and B of Medicare to join a Medicare Advantage plan and pay the same premiums, and any applicable income related surcharges and late enrollment penalties as those on Original Medicare.
All but two of the Medicare Advantage plans in Contra Costa County are HMO’s. That means you must use the plan’s network providers and get referrals from your primary care physician for specialists. Generally any specialists must be part of the same physician’s group (IPA) as your primary care physician. Joining a Medicare Advantage plan means you may not use your Medicare card outside the plan. Starting in 2024 there are two PPO plans available. With a PPO plan you can see providers who are outside the network for an additional cost.
Unless you are in your initial Medicare enrollment period or a special enrollment period, you can only join or leave a plan at certain times. Open enrollment occurs each year between October 15th and December 7th. An exception to this rule is offered for a 5-Star Plan (none available in Contra Costa in 2024), and for those who qualify for a C-SNP or I-SNP (chronic or institutionalized) special needs plan.
Specialized Medicare Advantage Plans
The Medicare Advantage Plans shown on this page are considered “general” plans, appropriate for most people. However, there are specialized Medicare Advantage Plans available for those who meet specific criteria. The information for those plans are can be found on different pages.
Plans for people with Medicare and Full Scope Medi-Cal (full Duals)
Plans for people with chronic conditions or who are receiving institutional care
Premium Reduction Plans for those covered under non-Medicare insurance such as VA
You may have heard about “flex cards” (OTC/Flex Card Credit). Many of the plans in Contra Costa County offer a Flex Card. See the chart to find the plans with this benefit. This article will tell you more about Flex Cards.
Considerations When Choosing a Plan
Choosing the best plan for you can be confusing. Click here for things to consider when choosing a Medicare Advantage Plan. You can also contact HICAP for help in choosing a plan.
2023 Medicare Advantage Plans
If you have difficulty reading or interpreting this chart, please contact us.
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