Medicare 2026

Before December 7: What San Diego Should Check for 2027

San Diego — fall 2026. If you have Medicare and live in San Diego County, this is the season to pay attention. The Annual Enrollment Period runs October 15 through December 7, 2026, and any change you make takes effect January 1, 2027. The federal government has already published some of the key 2027 numbers for prescription drug coverage — but a few important ones, including the Part B premium and the IRMAA income brackets, won't be out until later this fall.

Here is what San Diego residents can act on now, and what to wait for before locking in a decision.

What CMS has confirmed for 2027

Three Part D figures are already set in the regulation and apply to every Part D plan, whether it's a stand-alone drug plan or the drug coverage built into a Medicare Advantage plan:

• Part D out-of-pocket cap: $2,400 in 2027 (it is $2,100 in 2026). Once your out-of-pocket spending on covered drugs hits that cap, you pay $0 for the rest of the calendar year.
• Part D maximum deductible: $700 in 2027 (it is $615 in 2026). Plans can choose a lower deductible, but none can go above this.
• Part D national base beneficiary premium: $41.33 for 2027. This is a formula input CMS uses — it is not what any particular plan charges you.

The coverage gap (the old "donut hole") has been gone since 2025. Part D now has three phases: deductible, initial coverage, and catastrophic. The Medicare Prescription Payment Plan, which lets you spread your drug costs across the calendar year in monthly bills, continues in 2027 and is optional.

What CMS has not announced yet

Two big numbers are still pending for 2027:

• The Part B standard premium and Part B deductible. CMS usually releases these in November.
• The IRMAA income brackets and surcharge amounts for higher-income beneficiaries. These are published alongside the Part B figures. (For reference, in 2026 IRMAA surcharges begin above $109,000 for a single filer.)

We won't guess at these, and you shouldn't rely on anyone else's projection either. When CMS posts them, you'll find the official numbers at medicare.gov.

The letter in your mailbox: your Annual Notice of Change

If you are already in a Medicare Advantage or Part D plan, your insurer sent (or will send) an Annual Notice of Change by late September. It is the single most important piece of mail you'll get this fall. It tells you, for your specific plan:

• Whether the plan is being offered again in 2027, discontinued, or renamed.
• Changes to the monthly premium, deductible, copays and coinsurance.
• Changes to the drug formulary — which medications are covered and on what tier.
• Changes to the provider and pharmacy network.
• Changes to extra benefits like dental, vision, hearing or over-the-counter allowances.

If you do nothing and your plan is offered again next year, you'll be automatically renewed into the 2027 version of it — with every change in that ANOC. If your plan is not being offered in 2027, the notice will explain your options and any special enrollment rights.

How plan availability is shifting in San Diego County

Medicare Advantage plans are approved county by county, so when we talk about availability, we mean San Diego County, not just the city.

For 2026, the county has 93 Medicare Advantage plans from 17 carriers. By type: 68 HMO, 16 HMO-POS, and 9 PPO. 33 are Special Needs Plans (for people with specific conditions, dual Medicare-Medi-Cal eligibility, or who live in an institution). All 93 include drug coverage. According to the CMS Landscape data, no stand-alone Part D plans are listed in the county's Advantage landscape file — people who want drug coverage through Original Medicare should check Plan Finder directly for PDP options.

For 2027, the lineup will move: 26 plans are not returning, 18 are new, and 20 are being renamed in the county. A renamed plan isn't necessarily the same plan with a new label — the benefits can change too. Your ANOC is the source of truth for what's happening to yours.

The table below lists every 2026 Medicare Advantage plan offered in San Diego County, by carrier. Carriers active locally include Aetna, Alignment Health Plan, Astiva Health, Blue Shield of California, Centene (WellCare), Central Health Medicare Plan, Champion Health Plan, Clever Care Health Plan, Community Health Group, Elevance Health (Anthem), Humana, Imperial Health Plan of California, Kaiser Permanente, Molina Healthcare of California, SCAN Health Plan, Sharp Health Plan, and UnitedHealthcare.

A simple review plan before December 7

You don't have to compare 93 plans. You have to compare yours to a short list that fits your situation. A reasonable sequence:

1. Read your ANOC. Flag anything that changes for you: a drug moving tiers, a doctor's group leaving the network, a premium or copay change. 2. List your prescriptions, your regular doctors, and your preferred pharmacies. 3. Use the official Plan Finder at medicare.gov/plan-compare to see how your current plan and a few alternatives price out for your specific drugs. 4. If you want unbiased help, call California's SHIP — the Health Insurance Counseling and Advocacy Program (HICAP) — which offers free one-on-one counseling to San Diego County residents. 5. Make any change by December 7, 2026. If you stay in Medicare Advantage and later change your mind, the Medicare Advantage Open Enrollment Period (January 1 – March 31, 2027) gives you one more switch.