Medicare 2026

San Francisco Medicare enrollment for 2027: your window, your choices, where to get help

SAN FRANCISCO — Fall 2026 brings the yearly chance for people with Medicare to look at their coverage and decide if it still fits. The Annual Enrollment Period runs October 15 through December 7, 2026, and any change made in that window takes effect January 1, 2027. If you do nothing, your current plan simply renews for next year — as long as it is still offered — with any updates spelled out in the Annual Notice of Change (ANOC) your plan mailed you.

San Francisco is in San Francisco County, where the Centers for Medicare & Medicaid Services (CMS) lists 51 Medicare Advantage plans from 13 carriers for the 2026 plan year. The 2027 lineup will look a little different: in this county, 12 plans are not returning, 7 are new, and 13 have been renamed. Your plan's ANOC will tell you exactly what applies to you.

What you can actually change between Oct. 15 and Dec. 7

The Annual Enrollment Period (AEP) is the one time of year almost anyone with Medicare can make these moves:

• Join a Medicare Advantage plan (Part C) if you have Original Medicare.
• Switch from one Medicare Advantage plan to another.
• Drop a Medicare Advantage plan and go back to Original Medicare — and, if you want drug coverage, add a stand-alone Part D plan.
• Join, switch or drop a Part D prescription drug plan.

Whatever you choose during the window, new coverage begins January 1, 2027. If you make more than one change before December 7, the last one on file is what takes effect.

A note on Part D in San Francisco County: CMS lists 0 stand-alone Part D plans for 2026 in this county. The Medicare Advantage plans available locally all include drug coverage. If you want a separate Part D plan, use medicare.gov's Plan Finder to see what's offered for 2027 once the new data is loaded in October.

What's set for 2027 — and what isn't yet

CMS has published several Part D figures for 2027:

• Part D out-of-pocket cap: $2,400 in 2027 (up from $2,100 in 2026). Once your out-of-pocket drug spending hits that amount, you pay $0 for covered drugs the rest of the year.
• Part D maximum deductible: $700 in 2027 (up from $615 in 2026). Plans can set a lower deductible, but not higher.
• Part D national base beneficiary premium: $41.33 for 2027. This is a formula input CMS uses — not what any specific plan charges.

The coverage gap (the old "donut hole") was eliminated in 2025, so Part D now has three phases: deductible, initial coverage, and catastrophic.

A few 2027 numbers are not out yet. CMS usually announces the Part B standard premium and deductible in the fall, often in November, along with the IRMAA income brackets that add a surcharge for higher earners. For reference, in 2026 those IRMAA surcharges start above $109,000 in income for a single filer.

The San Francisco County lineup, at a glance

The 51 Medicare Advantage plans available locally come from 13 carriers and break down this way:

• By type: 40 HMO, 6 HMO-POS, 5 PPO
• Special Needs Plans (SNPs): 22 (for people with certain chronic conditions, both Medicare and Medi-Cal, or who live in an institutional setting)
• With drug coverage: 51

The carriers offering MA-PD plans in the county 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.

A quick word on star ratings: CMS rates contracts on a 1-to-5 scale for quality and member experience. In San Francisco County, 0 contracts are currently rated 4 stars or higher in the data we're using. Ratings are a tool to compare plans — not a reason to pick one on their own.

Local help in San Francisco — free and unbiased

You do not have to figure this out alone, and you do not need to pay anyone to help you compare.

• California's SHIP program is called HICAP (Health Insurance Counseling and Advocacy Program). It offers free, one-on-one Medicare counseling from trained volunteers who do not sell insurance. In San Francisco, HICAP services are coordinated through the Department of Disability and Aging Services. Call 1-800-434-0222 to find a counselor near you.
• 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week, for help from Medicare directly.
• medicare.gov/plan-compare lets you enter your ZIP code and your drugs, then see the plans available for 2027 side by side once the new data is live.
• San Francisco public libraries and several community centers host enrollment events each fall; HICAP keeps the current schedule.

A simple checklist before December 7

1. Read your ANOC. The notice from your current plan explains what's changing for 2027 — premium, drug list, network, extra benefits. 2. List your drugs and your doctors. Plan Finder uses these to flag what's covered and in-network. 3. Think about how you used care this year. More specialist visits? New prescriptions? That changes which plan features matter. 4. Compare on medicare.gov or with a HICAP counselor — not just by what a mailer or TV ad says. 5. Make your change before December 7, 2026. If you make no change and your plan is renewing, you keep it.

If your plan is one of the 12 not returning to San Francisco County in 2027, you'll receive a non-renewal notice from the plan. In that case, you have a Special Enrollment Period to pick a new plan — but using the AEP window is the simplest way to make sure you have coverage on January 1.