Medicare Advantage

How Sacramento County Stacks Up for Medicare in 2026

People in Elk Grove can choose from 32 Medicare Advantage plans for 2027, against 38 this year. 13 of this year’s plans are gone, 7 are new to Sacramento County, and 23 that continue have changed their premium, deductible, plan type or name, 9 of them under a new name.

If you live in Elk Grove and you're weighing your Medicare choices for 2027, it helps to zoom out. Plan availability isn't set city by city — it's set at the county level, and that means your neighbors a few miles up or down I-5 may see a slightly different lineup than you do. Looking at the wider Sacramento region gives you a clearer picture of how many options are on the table and how the local market compares.

Why availability is a county story

Medicare Advantage and Part D plans are approved and priced by service area, and in California those service areas are drawn along county lines. Elk Grove is in Sacramento County, so when you shop on Medicare.gov, the tool uses your ZIP code to pull the county's lineup.

That's why two people who both say they live "near Sacramento" can end up looking at different menus. A reader in Elk Grove sees the Sacramento County list. A reader across the county line in Placer, Yolo, El Dorado, or San Joaquin sees a different one.

What the Sacramento County numbers look like for 2027

Here's the area-level snapshot for the county Elk Grove belongs to, based on CMS Landscape data for 2027:

• 38 Medicare Advantage plans are available in Sacramento County.
• 9 carriers offer Medicare Advantage plans that include drug coverage (MA-PD).
• 0 stand-alone Part D drug plans show up in the county's MA-PD landscape file — people who want drug coverage through Original Medicare would look at the separate Part D plan list on Medicare.gov.
• The county is home to roughly 243,370 residents age 65 and older, which is one reason the market here is competitive.

These are simple counts. They don't tell you which plan fits your doctors, your prescriptions, or your budget — that comparison has to happen on Medicare.gov or with a trusted counselor.

How nearby areas compare

If you're helping a parent in another part of the metro, or you're thinking about moving, remember that crossing a county line can change your plan menu. Placer, Yolo, El Dorado, Sutter, and San Joaquin counties each have their own approved lineups, their own participating carriers, and their own provider networks.

The practical takeaway: when someone tells you "there are X plans in Sacramento," that number applies to Sacramento County. It's a useful benchmark, not a promise about what's available at a specific address.

What Star Ratings mean (and don't mean) here

CMS gives each Medicare Advantage and Part D contract a Star Rating on a 1-to-5 scale, based on things like customer service, member experience, and how well the plan manages chronic conditions. In the Sacramento County MA-PD landscape for 2027, the count of contracts rated 4 stars or higher is listed as 0 in the current file — but ratings are updated over the plan year, and a rating attaches to the whole contract, not to a single benefit.

Use Star Ratings as one input among several. They're a quality signal, not a shopping shortcut.

How to decide from here

A good way to move from "38 plans in the county" to "the plan for me" is to work through a short list:

1. Write down your doctors, hospitals, and pharmacies. 2. List your prescriptions with dosages. 3. Note what matters most to you — predictable costs, travel coverage, dental, or something else. 4. Run all of that through the Plan Finder at Medicare.gov, which will filter the county's lineup to plans that actually fit. 5. If you want a human to walk through it with you, California's SHIP program (called HICAP) offers free, unbiased counseling.

Also keep the calendar in mind. The Annual Enrollment Period runs October 15 through December 7 for changes that take effect January 1. If you're already in a Medicare Advantage plan and want to switch once more, the Medicare Advantage Open Enrollment Period runs January 1 through March 31.

A few 2027 program facts worth knowing

These apply nationwide, no matter which county you live in:

• Part D has a $2,400 annual out-of-pocket cap for covered drugs in 2027.
• The Part D deductible can be no higher than $700 in 2027.
• The old "donut hole" coverage gap is gone; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs into monthly payments if that helps your cash flow.
• IRMAA surcharges, which raise Part B and Part D premiums for higher earners, start above $109,000 in income for a single filer in 2026.