Medicare Advantage

Before you pick a 2026 Medicare Advantage plan in SF

For 2027, San Francisco is looking at 33 Medicare Advantage plans: 7 new, 12 gone since 2026, and 22 continuing plans that change something in their terms, with 13 of them under a new name. Below, how the lineup shifted in San Francisco County and what to compare, with no plan ranked or recommended.

Medicare AdvantageSan Francisco, CA

San Francisco residents shopping for Medicare Advantage in 2027 have a field to look through — and knowing who offers what, and how the plan types differ, is the first step to narrowing it down.

San Francisco is in San Francisco County, where the Centers for Medicare & Medicaid Services (CMS) lists 33 Medicare Advantage plans from 12 carriers for the 2027 plan year. All 33 include prescription drug coverage. That's a lot to sort through, so this guide walks through the carriers on the ground, the plan types you'll see, and what the Special Needs Plan labels actually mean.

Who offers Medicare Advantage in San Francisco County

Twelve carriers are on the 2027 CMS Landscape file for San Francisco County. Compared with 2026, 7 plans are new, 12 are not returning, 13 have been renamed, and 22 continuing plans change something in their terms — details are in each plan's Annual Notice of Change. Central Health Medicare Plan is not offering plans in the county for 2027. For the full 2027 carrier and plan list, check the Medicare Plan Finder at medicare.gov.

The full plan roster — every plan by name and type — is in the table below on this page. Use it as a starting point, then check each plan's own materials for the details that matter to you personally: network, drug list, and cost sharing.

HMO vs. HMO-POS vs. PPO — the plan types in San Francisco

Of the 51 plans in the county, 40 are HMOs, 6 are HMO-POS, and 5 are PPOs. Here's the plain-English version of what those labels mean:

• HMO (Health Maintenance Organization) — You pick a primary care doctor and generally use the plan's network. Out-of-network care is usually not covered except for emergencies. Most San Francisco County plans are this type.
• HMO-POS (Point of Service) — Like an HMO, but with a "point of service" option that lets you go outside the network for certain services, usually at a higher cost. Aetna, Alignment, Anthem, and UnitedHealthcare have HMO-POS offerings in the county.
• PPO (Preferred Provider Organization) — More flexibility to see out-of-network providers, typically at a higher cost share. Aetna and Humana offer PPO plans in the county.
• PFFS (Private Fee-for-Service) — A separate plan type where the plan sets the terms and any provider who accepts those terms can see you. No PFFS plans are offered in San Francisco County for 2027, but you may see the acronym in general Medicare materials.

None of these is universally "better." The right fit depends on how you use care, which providers you want to keep, and where you travel.

Special Needs Plans (SNPs), explained

Of the 51 plans, 22 are Special Needs Plans. SNPs are Medicare Advantage plans built for people who meet specific eligibility rules. There are three kinds:

• D-SNP (Dual Eligible) — For people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition) — For people with certain qualifying chronic conditions, such as diabetes or cardiovascular conditions.
• I-SNP (Institutional) — For people who live in, or need the level of care provided by, a nursing home or similar facility.

You have to qualify to enroll in an SNP, and the plan's benefits, drug list and network are shaped around the group it serves. Several carriers on the local list — including Alignment Health Plan, Central Health, CCHP, and others — offer one or more SNPs.

All plans include drug coverage

Every one of the 33 Medicare Advantage plans in San Francisco County for 2027 is an MA-PD, meaning Part D drug coverage is built in. That matters because CMS lists 0 stand-alone Part D plans in the area, so if you want an Advantage plan and drug coverage from the same source, the MA-PD route is how it works here.

A few program-level Part D facts to keep in mind for 2027:

• The Part D out-of-pocket cap is $2,100 for 2026.
• The maximum Part D deductible is $615.
• The old coverage gap (the "donut hole") was eliminated in 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly amounts if you choose.
• IRMAA (higher Part B and Part D premiums for higher incomes) begins above $109,000 in income for a single filer in 2026.

Enrollment dates to circle

Two windows drive most Medicare Advantage decisions:

• Annual Enrollment Period: October 15 – December 7. This is when most people join, switch or drop a Medicare Advantage or Part D plan for the coming year.
• Medicare Advantage Open Enrollment Period: January 1 – March 31. If you're already in a Medicare Advantage plan, you can make one change during this window — switch to another MA plan or go back to Original Medicare (and add a stand-alone Part D plan if needed).