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What’s Behind the Medicare Advantage Care Gap for California’s Black Seniors

December 17, 2025

Medicare Advantage, a localized version of federal Medicare insurance offered through private companies, presents significant access disparities for Black seniors in California despite its popularity and growing enrollment. While these plans often provide comprehensive benefits including dental, vision, and transportation services with low or no premiums, Black beneficiaries frequently encounter obstacles such as difficulty accessing specialists, lower-quality plans, and limited availability of Black physicians. The complexity of plan selection, combined with inadequate coverage for chronic conditions common in Black communities, means many seniors struggle to receive necessary care even when insured.

Who is affected

  • Black seniors in California, particularly those aged 65 and older
  • Medicare-only Californians earning 139-200% of the federal poverty level (approximately 650,000 people who are too wealthy for Medi-Cal but financially vulnerable)
  • Joanne Craig, 76, a Kaiser Permanente Senior Advantage member and cancer survivor
  • Jill Baker, 69, of South Los Angeles with UnitedHealth coverage
  • Black Californians experiencing higher mortality rates from cancers and unmanaged chronic conditions
  • Seniors managing chronic illnesses like high blood pressure and diabetes
  • Nearly 5 million Medicare-eligible people in California

What action is being taken

  • Medicare Advantage enrollment is rising
  • The out-of-pocket maximum payment is projected to increase by $100 for Medicare Advantage beneficiaries next year
  • Premiums for outpatient services are likely increasing by an average of $15
  • The number of Medicare Advantage plans being offered is shrinking
  • UnitedHealth phased out its NaviHealth brand in 2024 (which had used algorithms to predict patient facility stays)
  • Both Medicare and Medicare Advantage are currently evolving

Why it matters

  • This issue matters because coverage gaps in Medicare Advantage plans disproportionately harm Black seniors who already face the highest mortality rates from several cancers and are more likely to experience unmanaged chronic conditions. The complexity of navigating Medicare options can be overwhelming for seniors, particularly when they receive extensive information after turning 64, making it difficult to select appropriate coverage. Without adequate access to specialists, medications, and preventive care, many Black seniors cannot properly manage chronic illnesses, leading to worse health outcomes. As one advocate stated, Medicare is "lifesaving for many Black seniors," and any deterioration of the program "is going to cost lives, for sure," making equitable access critical for this vulnerable population.

What's next

  • People who qualify will be allowed to enroll or dis-enroll in Medicare Advantage until March 31, 2026
  • Advocates recommend that seniors research their options and seek guidance from navigators to understand Medicare Advantage plan differences
  • Closing disparities requires better data collection, integration with community-based organizations, and targeted investments in underserved areas
  • Seniors can learn more about coverage options at Medicare.gov and check plan ratings at the California Center on Data, Insights and Innovation
  • Seniors needing assistance can contact the California Department of Aging's Health Insurance Counseling and Advocacy Program (HICAP) at 1-800-434-0222 or visit aging.ca.gov/hicap
  • Some counties offer assistance through local health offices

Read full article from source: The San Diego Voice & Viewpoint