Medicare 2026

Before You Renew in San Francisco: 2027 Medicare Facts

SAN FRANCISCO — Fall 2026 is here, and that means Medicare's Annual Enrollment Period is about to open. From October 15 through December 7, 2026, people with Medicare can review, switch, or keep their coverage for 2027. Any change made in that window takes effect January 1, 2027.

Some of the 2027 numbers are already confirmed by the Centers for Medicare & Medicaid Services (CMS). Others — including the 2027 Part B premium and the IRMAA income brackets — are still to come later this fall. Here is what San Francisco residents can know now, and what to watch for.

The 2027 Part D figures CMS has confirmed

CMS has locked in three Part D numbers for 2027:

• Part D out-of-pocket cap: $2,400 in 2027, up from $2,100 in 2026. Once your out-of-pocket spending on covered drugs reaches that amount, you pay $0 for covered Part D drugs for the rest of the calendar year.
• Part D maximum deductible: $700 in 2027, up from $615 in 2026. This is the most a stand-alone Part D or Medicare Advantage drug plan can charge as a deductible; plans may charge less.
• 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. Your plan's actual premium is set by the plan.

The coverage gap, often called the "donut hole," was eliminated as of 2025, so Part D now has three phases: deductible, initial coverage, and catastrophic.

If paying drug costs all at once is hard, the Medicare Prescription Payment Plan lets you spread covered Part D out-of-pocket costs across the calendar year in monthly bills. It does not lower the total — it smooths the timing.

What CMS has not announced yet

Two important 2027 figures are still pending:

• The 2027 Part B standard premium and Part B deductible.
• The 2027 IRMAA income brackets and surcharges (the extra amount higher-income enrollees pay on top of Part B and Part D premiums).

CMS normally releases these later in the fall, often in November. We are not going to estimate them, and you should be careful about anyone who does. For reference, IRMAA in 2026 begins above $109,000 in income for a single filer; the 2027 threshold will be published with the rest of the Part B figures.

Your Annual Notice of Change is the single most important letter

If you already have a Medicare Advantage plan or a stand-alone Part D plan, your insurer must send you an Annual Notice of Change (ANOC) by late September 2026. It explains, in writing, exactly what is changing in your plan for 2027 — premium, deductible, copays, drug list, provider network, extra benefits, and service area.

Nothing happens to you automatically that you need to react to in a panic: if your plan is offered again in 2027, it renews on January 1 with the changes described in the ANOC. But if the ANOC shows something that no longer fits — a drug moved to a higher tier, a doctor leaving the network, a benefit removed — the Annual Enrollment Period is the time to act.

Read the ANOC alongside your current plan's Evidence of Coverage, and keep an eye on:

• Your regular prescriptions (are they still on the formulary, and at what tier?).
• Your doctors and hospitals (UCSF, Sutter, Dignity, Kaiser, CPMC, and others each have their own contracts with each plan).
• Any extra benefits you actually use (dental, vision, OTC, transportation).

How plan availability is moving in San Francisco County

San Francisco is in San Francisco County, where Medicare plan availability is set. For the 2026 plan year, CMS lists 51 Medicare Advantage plans from 13 carriers in the county, all of them including drug coverage. By plan type, that is 40 HMO, 6 HMO-POS, and 5 PPO plans, with 22 of them Special Needs Plans (D-SNP, C-SNP, or I-SNP).

Carriers offering MA-PD in San Francisco County for 2026 include Aetna (CVS Health), Align Senior Care, Alignment Health Plan, CCHP (Chinese Community Health Plan), Centene (WellCare), Central Health Medicare Plan, Elevance Health (Anthem), Humana, Imperial Health Plan of California, Kaiser Permanente, San Francisco Health Plan, SCAN Health Plan, and UnitedHealthcare. The table below lists every plan offered in the county.

One quirk worth knowing locally: CMS shows 0 stand-alone Part D plans in the San Francisco County service area for 2026. In practice, San Francisco residents who want drug coverage typically get it through a Medicare Advantage plan that includes Part D, or by shopping stand-alone PDPs available at the region/state level on Medicare.gov.

For 2027, the Landscape data points to 12 plans not returning, 7 new plans, and 13 renamed plans in the county. That doesn't tell you which specific plan is doing what — that's what the ANOC and the 2027 Plan Finder will show when the final 2027 Landscape is published. If a plan is not returning, enrollees get a non-renewal notice and have a Special Enrollment Period in addition to AEP.

Star Ratings, briefly

CMS gives Medicare Advantage and Part D contracts a quality rating from 1 to 5 stars. For the current rating cycle, the Landscape file shows 0 contracts rated 4 stars or higher attached to plans in San Francisco County. Star Ratings are one input among many — they do not replace checking whether your doctors and drugs are covered.

What to do between now and December 7, 2026

• Read your ANOC when it arrives in September.
• Make a short list: current prescriptions, current doctors, hospitals you want in-network.
• Use the Plan Finder at Medicare.gov once the 2027 plans load (usually in early October) to compare options side by side.
• If you want free, unbiased help, California's SHIP program is called HICAP (Health Insurance Counseling and Advocacy Program) and offers free one-on-one Medicare counseling to San Francisco residents.
• Call 1-800-MEDICARE (1-800-633-4227) for official answers, 24/7.

If you do nothing and your plan is offered in 2027, your coverage renews January 1 with the changes in the ANOC. You also have the Medicare Advantage Open Enrollment Period from January 1 – March 31, 2027 to make one change if you are already in a Medicare Advantage plan.