Medicare Advantage

Before you pick a Medicare Advantage plan in San Diego

People in San Diego can choose from 85 Medicare Advantage plans for 2027, against 93 this year. 26 of this year’s plans are gone, 18 are new to San Diego County, and 48 that continue have changed their premium, deductible, plan type or name, 20 of them under a new name.

Medicare AdvantageSan Diego, CA

San Diego shoppers looking at Medicare Advantage for 2027 have a wide field to sort through — and the choice is less about "which plan is biggest" and more about which kind of plan fits how you like to get care. San Diego is in San Diego County, where Medicare Advantage availability is set at the county level. For plan year 2027, the county has 65 Medicare Advantage plans from 15 carriers, and every one of them includes drug coverage.

Before you compare specific plans, it helps to understand the two things that shape your choices most: who the carrier is, and what kind of plan they've built. Here's how those pieces fit together locally.

Who offers Medicare Advantage in San Diego County

Fifteen carriers offer Medicare Advantage plans with drug coverage in the county for 2027. Two carriers from the 2026 roster — Central Health Medicare Plan and Sharp Health Plan — are not offering plans in the county next year. In alphabetical order, the 2026 carriers were: Aetna (CVS Health), 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.

The number of plans each one offers varies quite a bit — from two plans at the low end to sixteen at the high end. A higher count isn't a sign of quality; it usually means the carrier has built several versions of a plan for different needs (for example, a general plan, a Special Needs Plan, and a plan built around specific benefits). The table below lists every plan by carrier.

HMO, HMO-POS and PPO: what the letters mean

Almost every plan in San Diego County falls into one of three types for 2027:

• HMO (Health Maintenance Organization) — 68 plans. You pick a primary care doctor and generally use the plan's network. Care outside the network usually isn't covered except for emergencies. Referrals are often needed to see a specialist.
• HMO-POS (HMO with Point-of-Service) — 16 plans. Works like an HMO, but lets you go outside the network for certain services, usually at a higher cost share. Think of it as an HMO with a side door.
• PPO (Preferred Provider Organization) — 9 plans. You can see any Medicare-approved provider, in or out of network, without a referral. In-network care costs less, but out-of-network is still covered.

You may have heard of a fourth type, PFFS (Private Fee-for-Service). PFFS plans let you see any provider who agrees to the plan's payment terms. None are offered in San Diego County for 2027, so it's not a live option here — but it's worth knowing the name if you're comparing across regions or reading older guides.

Special Needs Plans: 33 of the 93

Special Needs Plans (SNPs) are Medicare Advantage plans limited to people who meet certain criteria. In San Diego County, 33 of the 93 plans are SNPs. There are three flavors:

• D-SNP (Dual Eligible). For people who have both Medicare and Medicaid (Medi-Cal in California).
• C-SNP (Chronic Condition). For people living with a specific qualifying condition — commonly diabetes, cardiovascular disorders, or chronic lung conditions. Each plan spells out which condition it covers.
• I-SNP (Institutional). For people who live in a nursing home or need a nursing-home level of care at home. San Diego's SNP roster for 2027 is made up of D-SNPs and C-SNPs.

SNPs always include Part D drug coverage and tailor their networks and benefits to the group they serve. If you don't meet the eligibility rules, you can't enroll — even if the plan looks appealing on paper.

Drug coverage is baked in

Every one of the 93 plans in the county includes Part D drug coverage. There are no stand-alone Part D plans listed in the local Advantage landscape, so if you choose Medicare Advantage here, your drug benefit comes with it.

A few program-level Part D facts worth knowing for 2027:

• The Part D out-of-pocket cap is $2,100 for the year. Once you hit it, you pay $0 for covered drugs the rest of the year.
• The maximum Part D deductible allowed is $615.
• The old coverage gap ("donut hole") is gone as of 2025; Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly payments instead of paying at the pharmacy counter. It's optional and free to join.

How to actually compare your options

With this many plans, the trick is to narrow before you compare. A few questions that tend to cut the list quickly:

1. Are my doctors in the network? If a specific clinic or medical group matters to you, check each plan's provider directory first. 2. Are my prescriptions on the formulary, and at what tier? The same drug can sit on very different tiers in different plans. 3. Do I want the freedom of a PPO, or am I fine with an HMO's referral structure? 4. Do I qualify for a Special Needs Plan? If you have Medi-Cal or a qualifying chronic condition, an SNP may be built specifically for your situation.

The official Medicare Plan Finder at medicare.gov lets you enter your drugs and providers and see how each plan handles them side by side.

Key dates for 2027

• October 15 – December 7: Annual Enrollment Period. You can join, switch, or drop a Medicare Advantage or Part D plan. Changes take effect January 1.
• January 1 – March 31: Medicare Advantage Open Enrollment. If you're already in an MA plan, you get one chance to switch to another MA plan or return to Original Medicare (with or without a stand-alone Part D plan, though none are offered in this county's landscape).