Medicare Costs in Los Angeles vs. the National Average

If you’re approaching age 65 in Los Angeles, you already know this truth: living here costs more.

Housing in LA runs roughly 133% higher than the national average.
Groceries cost more. Gas costs more. Almost everything does.

So it’s a reasonable question — does Medicare cost more in Los Angeles too?

The answer is yes and no.

Some Medicare costs are identical nationwide. Others — especially prescription drug coverage — are significantly higher in California, and that difference can quietly add thousands of dollars a year to your retirement budget if you don’t understand it upfront.

Let’s walk through what Los Angeles seniors actually pay in 2026 — with clear numbers, real examples, and no marketing spin.

What’s the Same Everywhere: Medicare Part A & Part B

These costs are set by the federal government. Living in Los Angeles does not change them.

Medicare Part A (Hospital Insurance)

• Monthly premium: $0 for most people (if you or your spouse paid Medicare taxes for at least 10 years)

   

• Hospital deductible: $1,736 per benefit period

   

• Daily copay after 60 days: $434 per day (days 61–90)

   

Medicare Part B (Medical Insurance)

• Monthly premium: $202.90 for most people

   

• Annual deductible: $283

   

• Coinsurance: 20% of Medicare-approved costs for most services

   

Important reality check: Original Medicare has no annual out-of-pocket maximum. That 20% coinsurance can add up quickly during a serious illness, which is why most people add either a Medicare Advantage plan or a Medigap (Medicare Supplement) plan.

Where Los Angeles Costs Start to Vary: Medicare Advantage

Medicare Advantage plans are offered by private insurance companies, so premiums and benefits vary by location.

2026 Medicare Advantage Snapshot (National Averages)

• Average premium: $14 per month

   

• Roughly two-thirds of plans charge $0 premiums

   

• Maximum out-of-pocket limit (in-network): up to $9,250

   

What This Means in Los Angeles

Los Angeles seniors typically have dozens of Medicare Advantage options, many with $0 premiums. However, plan availability and provider networks vary by ZIP code — West LA, the San Fernando Valley, and the South Bay can look very different.

The real cost differences come down to:

• Doctor and hospital networks (UCLA Health, Cedars-Sinai, Kaiser Permanente, local medical groups)

   

• Prescription drug coverage, which is usually included

   

• Extra benefits like dental, vision, hearing, fitness, and over-the-counter allowances

   

Medicare Advantage can be extremely cost-effective in California — as long as your doctors and hospitals are in the plan’s network.

Where LA Costs REALLY Differ: Prescription Drug Coverage (Part D)

This is where many California seniors are caught off guard.

If you choose Original Medicare plus a standalone Medicare Part D prescription drug plan, California is one of the most expensive states in the country.

2026 Standalone Part D Premiums

• National average (enrollee-weighted): about $34.50 per month

   

• California average (simple average of plans offered): about $108 per month

   

That’s more than three times higher.

Important clarification:
The California figure reflects the average of all standalone Part D plans offered in the state, not where most people actually enroll. Still, it highlights how expensive California’s Part D market is compared to the rest of the country.

Why This Matters

If you’re pairing Original Medicare with a Medigap plan in California, your prescription drug coverage alone can cost:

• $70–$75 more per month

   

• $850–$900 more per year
  than the national average.

   

This is one of the biggest reasons Medicare Advantage plans often look dramatically cheaper on paper in California — drug coverage is bundled, and plan rebates help keep premiums low.

Medigap (Medicare Supplement) Costs in Los Angeles

Medigap plans are standardized by Medicare — but premiums are not.

Typical 2026 Los Angeles Medigap Premium Ranges

Plan G

• Approximately $180–$260 per month

   

• After paying the $283 Part B deductible, most Medicare-approved services are covered in full

   

Plan N

• Approximately $120–$200 per month

   

• Lower premiums, with small copays for some office visits and emergency room use

   

Two insurance companies can charge $50–$80 per month difference for the exact same Medigap plan. That’s $600–$960 per year — purely based on carrier choice.

California advantage: The Birthday Rule allows many Medigap enrollees to switch plans annually (equal or lesser benefits) without medical underwriting, helping protect against long-term rate increases.

A Quick Note on IRMAA (Higher-Income Medicare Surcharges)

For some Los Angeles retirees, Medicare costs can be higher due to IRMAA — the Income-Related Monthly Adjustment Amount.

IRMAA applies if your income was above certain levels and affects:

• Medicare Part B, and

   

• Medicare Part D (even if drug coverage is included in a Medicare Advantage plan)

   

Key point:
Your 2026 Medicare premiums are based on your 2024 income. A one-time event — such as selling a home, selling a business, or taking a large retirement distribution — can increase Medicare costs for a full year.

Simplified 2026 IRMAA Overview (Single Filers)

Important: The Part D surcharge is added on top of your plan premium, whether you’re in a standalone Part D plan or a Medicare Advantage plan.

What LA Seniors Actually Pay: Three Real-World Scenarios

Scenario 1: Medicare Advantage ($0 Premium Plan)

• Part B premium: $202.90

   

• Medicare Advantage premium: $0

   

• Drug coverage: included

   

• Total monthly premium: ~$203

   

• Annual medical out-of-pocket maximum: up to $9,250

   

Scenario 2: Original Medicare + Plan G + Standalone Part D (California)

• Part B premium: $202.90

   

• Medigap Plan G: ~$220

   

• Standalone Part D: ~$108

   

• Total monthly premium: ~$531

   

• Predictable medical costs, higher monthly commitment

   

Scenario 3: Higher-Income Retiree (IRMAA Applies)

• Part B with IRMAA: ~$689.90

   

• Medigap Plan G: ~$220

   

• Part D + IRMAA: ~$190+

   

• Total monthly premium: $1,100+

   

The Los Angeles Medicare Cost Reality

Here’s the big takeaway:

In California, standalone Part D premiums are a major cost driver. That’s why Medicare Advantage often looks far less expensive than Original Medicare with Medigap — especially in Los Angeles.

There is no one-size-fits-all answer. The right choice depends on:

1. Your doctors and hospitals

    

2. Your prescriptions

    

3. Your budget and cash-flow comfort

    

4. Your tolerance for provider networks

    

5. Your income level

    

What doesn’t work is choosing a plan based only on national averages without understanding California’s unique pricing.

Bottom Line for Los Angeles Seniors

Medicare Part B costs the same everywhere — but total Medicare costs in Los Angeles can vary dramatically depending on how you build your coverage.

California’s unusually high standalone Part D premiums make informed planning especially important. Understanding these numbers before you enroll can save you thousands of dollars over time.

The good news? Los Angeles is one of the most competitive Medicare markets in the country. With the right guidance, you can find coverage that protects both your health and your retirement savings.

Common Medicare Cost Questions from Los Angeles Seniors

Does Medicare cost more in Los Angeles than other parts of the country?

Some Medicare costs are the same everywhere, while others can vary. Medicare Part A and Part B costs are set federally and do not change based on where you live. Costs can differ for Medicare Advantage plans, Medigap plans, and standalone Medicare Part D prescription drug plans because those are offered by private insurance companies and priced by region.

Why are standalone Medicare Part D premiums higher in California?

California has some of the highest standalone Part D premiums in the country due to regional pricing, prescription drug utilization patterns, and how insurance companies structure their plans in the state. This doesn’t mean every plan is expensive, but the overall market tends to be higher than the national average.

Is Medicare Advantage usually cheaper than Medigap in Los Angeles?

For many Los Angeles seniors, Medicare Advantage plans often have lower monthly premiums than Original Medicare paired with a Medigap plan and standalone Part D coverage. However, Medicare Advantage plans use provider networks and cost-sharing, while Medigap plans generally offer more predictable out-of-pocket costs. The right choice depends on your doctors, prescriptions, and budget.

Does IRMAA apply if I enroll in a Medicare Advantage plan?

Yes. If IRMAA applies to you, it can increase your Medicare costs even if your prescription drug coverage is included in a Medicare Advantage plan. The Part D portion of IRMAA is added separately and is not included in the plan’s advertised premium.

If I rarely go to the doctor, should I still worry about Medicare costs?

Even healthy retirees should plan ahead. Medicare costs are often lowest when you don’t need care — but unexpected health issues can change that quickly. Choosing coverage involves balancing monthly premiums, potential out-of-pocket costs, and access to doctors and hospitals you trust.

Can I change my Medicare coverage if my needs or budget change?

In most cases, you can review and change your Medicare coverage each year during the Annual Enrollment Period from October 15 to December 7. California also offers additional consumer protections, such as the Medigap Birthday Rule, which can make switching supplement plans easier for some people.

What’s the biggest mistake LA seniors make when choosing Medicare?

Relying on national averages or a friend’s recommendation without looking at their own doctors, prescriptions, and local plan options. Los Angeles is a unique Medicare market, and a plan that works well elsewhere may not be the best fit here.