Medicare by City: Why Your Location Changes Your Options

Here's something a lot of people don't know: your Medicare options depend heavily on where you live. Two people on the same street in different counties can have completely different plan choices — different carriers, different premiums, different networks. In California, where we have everything from dense urban centers to remote rural communities, that difference is especially significant.

Why Location Matters So Much for Medicare

Medicare Advantage plans are approved and sold county by county. The federal government certifies which private insurers can offer plans in each county, and those carriers build networks specific to that area.

In 2026, California has 402 Medicare Advantage plans statewide — but you'll never see all 402. You see the plans available in your specific ZIP code. In urban markets like Los Angeles and Orange County, beneficiaries can choose from 70+ plans. In rural Central Valley or Sierra Nevada counties, the selection may be as few as 8–12 plans.

• Los Angeles County: 74 plans, 559,000+ enrolled in Medicare Advantage
• Orange County: one of California's most competitive Medicare markets
• San Diego County: strong Kaiser, Sharp, and Scripps networks
• Rural counties: fewer plans, but often strong quality within those plans

California's Medicare Advantage Market in 2026

California is home to over 7 million Medicare beneficiaries — one of the largest populations in the country. The average Medicare Advantage premium is $11/month (vs. $14 nationally). In competitive urban markets, $0-premium plans from top-rated carriers are widely available.

Top carriers by member satisfaction (J.D. Power 2026):

• Kaiser Permanente: 675/1000 score, 4.5 Star CMS rating
• SCAN Health Plan: 672/1000, California nonprofit focused on senior independence
• Alignment Health Plan: 658/1000, tech-forward coordinated care
• UnitedHealthcare, Humana, Blue Shield: available across most CA counties
• Molina, Anthem, Aetna: regional availability varies by county

Major California Medicare Markets at a Glance

Browse Medicare Options in Your California City

What Changes When You Move Within California

If you move to a different county in California, your Medicare Advantage plan may no longer serve your new area. This triggers a Special Enrollment Period — a window to switch to a plan in your new county, even outside the Annual Enrollment Period.

If you've moved recently and haven't updated your Medicare plan, you may be paying for coverage that's out of network — or you may be eligible to switch to a better plan right now.

Meet Sandra — Moving From SF to Thousand Oaks

Original Medicare in California — It Works Everywhere

If you're on Original Medicare (Parts A and B), your coverage is the same everywhere in California — and nationwide. Any Medicare-accepting doctor or hospital will accept your coverage. The trade-off: no annual out-of-pocket maximum, and no extra benefits like dental or vision.

For Californians who split time between cities — say, LA and Palm Springs — Original Medicare plus a Medigap supplement can provide more consistent, flexible coverage than a network-based Advantage plan.

How2Medicare is a free service of J Johnston Insurance, serving Medicare beneficiaries across all of California.