Medicare Advantage

San Diego's 2027 Medicare Advantage menu: how HMO, HMO-POS and PPO choices stack up

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.

San Diego, fall 2026 — When Medicare's Annual Enrollment Period opens on October 15, San Diego County shoppers will see a 2027 Medicare Advantage lineup that leans heavily toward HMO-style coverage. According to the CMS Medicare Advantage Landscape Source File for 2027, 85 Advantage plans from 15 carriers are offered in San Diego County next year. Of those, 65 are HMO, 15 are HMO-POS, and 5 are PPO. There are no PFFS (Private Fee-for-Service) plans in the county's 2027 lineup.

That mix matters because the plan type — not just the plan name — shapes how you see doctors, whether you need a referral, and what happens if you need care outside the plan's network.

What each plan type actually means

HMO (Health Maintenance Organization). You pick a primary care doctor and use the plan's network of providers and hospitals. In most cases, you need a referral to see a specialist, and care outside the network is not covered except for emergencies and urgent care. HMOs are built around coordinated care inside one network.

HMO-POS (Point of Service). This is an HMO with a limited "point of service" option: you can see certain providers outside the network for specific services, usually at a higher cost-share. The exact out-of-network rules vary plan by plan — the Evidence of Coverage spells them out.

PPO (Preferred Provider Organization). PPOs let you use any Medicare-approved provider that accepts the plan, in or out of network. You usually pay more out of network, and referrals are generally not required. For people who travel often inside the plan's service area or want more flexibility, PPOs are built for that.

PFFS (Private Fee-for-Service). Not sold in San Diego County for 2027. Where PFFS plans are offered, the plan sets payment terms and any willing Medicare provider can decide, visit by visit, whether to accept them.

None of this makes one type "better." The right type depends on your doctors, where you spend time, and how you like to get care.

How San Diego County's 2027 plans split by type

In San Diego County for 2027, HMO and HMO-POS plans together make up 80 of the 85 Advantage options. PPOs are the smaller slice at 5. The table on this page lists every plan by carrier, including which plans are Special Needs Plans (SNPs) for people with specific conditions, dual Medicare-Medicaid eligibility, or certain chronic illnesses.

Which carriers offer which types

For 2027, carriers offering HMO plans in San Diego County are Aetna (CVS Health), Alignment Health Plan, Astiva Health, Blue Shield of California, Centene (WellCare), Champion Heath Plan, Clever Care Health Plan, Community Health Group, Humana, Imperial Health Plan of California, Inc., Kaiser Permanente, Molina Healthcare of California, SCAN Health Plan, and UnitedHealthcare.

Carriers offering HMO-POS plans for 2027 are Aetna (CVS Health), Alignment Health Plan, Champion Heath Plan, Elevance Health (Anthem), and UnitedHealthcare.

Carriers offering PPO plans for 2027 are Alignment Health Plan, Elevance Health (Anthem), and Humana.

Several carriers appear in more than one list because they offer plans of more than one type. The table below shows exactly which plan is which.

What's changing in the lineup

CMS data shows the county's 2027 mix includes 18 new plans, 26 that are not returning from 2026, and 20 that have been renamed. If your plan is on the "not returning" list for 2027, your plan sends you a non-renewal notice and you have an enrollment opportunity to pick something else. If it is renamed or changed, read the Annual Notice of Change (ANOC) that arrived in September — it describes what is different for 2027, including network, drug list, and cost changes.

How to choose a type that fits you

A few questions help narrow things down before you compare specific plans:

• Who are your doctors, and which networks are they in? Check the plan's provider directory, and call the doctor's office to confirm.
• Do you want to see specialists without a referral? That favors a PPO.
• Do you spend time outside the county? Think about out-of-network rules and travel coverage.
• Do you have a chronic condition or qualify for both Medicare and Medi-Cal? A Special Needs Plan may be worth a look; San Diego County has SNPs across several carriers.

Once you've narrowed by type and network, you can compare plan details — premiums, deductibles, copays, drug coverage, extras — on the Medicare Plan Finder.

A few 2027 program facts worth knowing

These apply to Part D drug coverage no matter which Advantage plan type you pick:

• The Part D out-of-pocket cap is $2,400 in 2027 (up from $2,100 in 2026).
• The Part D maximum deductible is $700 in 2027 (up from $615 in 2026).
• The 2027 Part B standard premium and deductible, and the 2027 IRMAA brackets, have not been announced yet. CMS typically publishes them later in the fall.