Medicare Advantage

Does San Francisco Have a PPO Option for 2027?

For 2027, San Francisco is looking at 46 Medicare Advantage plans: 7 new, 12 gone since 2026, and 35 still here but changed on premium, deductible, plan type or name, 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.

San Francisco — Fall 2026. When the Annual Enrollment Period opens Oct. 15, 2026, San Francisco shoppers choosing 2027 Medicare Advantage coverage will see a lineup that leans heavily toward one plan type. In San Francisco County, 46 Medicare Advantage plans from 12 carriers are offered for 2027, and all but two of them are HMOs or HMO-POS plans. That mix shapes big practical questions — which doctors you can see, whether you need a referral, and what happens if you get care outside the network.

Here is how the county's 2027 plans split by type, and what each type actually means for you.

How the 2027 plans split by type

Medicare Advantage plans come in a few flavors, and the mix in San Francisco County is lopsided. For 2027:

• HMO: 38 plans
• HMO-POS: 6 plans
• PPO: 2 plans
• PFFS: none offered in the county

Add the two HMO flavors together and 44 of the 46 plans — about 96% — are HMO-based. The table below lists every plan by carrier and type.

What each plan type actually means

HMO (Health Maintenance Organization). You pick a primary care doctor, use the plan's network of doctors and hospitals, and usually need a referral to see a specialist. Out-of-network care generally isn't covered except in emergencies or urgent care. HMOs are built around coordinated care inside a defined network.

HMO-POS (HMO with a Point-of-Service option). Mostly works like an HMO, but adds a limited "point of service" benefit that lets you get certain services out of network, usually at a higher cost share. The exact services covered out of network vary plan by plan, so check the Evidence of Coverage.

PPO (Preferred Provider Organization). You can see any Medicare-approved provider who accepts the plan, in or out of network, usually without a referral. In-network care typically costs less than out-of-network care, but out-of-network care is covered.

PFFS (Private Fee-for-Service). Any provider who agrees to the plan's terms can see you. There are no PFFS plans in San Francisco County for 2027, so this one is not an option here.

None of these types is "better" than another. Which one fits depends on your doctors, how often you travel, and whether you want the structure of a primary care gatekeeper or the flexibility to go wider.

Which carriers offer which type in San Francisco County

Based on the 2027 Landscape data for the county:

• HMO plans are offered by Aetna (CVS Health), Align Senior Care, Alignment Health Plan, CCHP (Chinese Community Health Plan), Centene (WellCare), Elevance Health (Anthem), Imperial Health Plan of California, Inc., Kaiser Permanente, San Francisco Health Plan and SCAN Health Plan.
• HMO-POS plans are offered by Aetna (CVS Health), Alignment Health Plan, Elevance Health (Anthem) and UnitedHealthcare.
• PPO plans are offered by Humana.

That last line is worth re-reading if you want PPO flexibility: Humana is the only PPO carrier in the county for 2027. If you want a true out-of-network benefit, that is where to look.

Referrals, networks and travel: the practical trade-offs

Think about your real life rather than the plan brochure:

• Do you already have a primary care doctor and specialists you want to keep? Check whether they are in a given plan's network before you fall in love with the plan.
• Do you want to skip referrals? PPOs usually don't require them. HMOs usually do. HMO-POS plans fall in between.
• Do you spend part of the year outside the Bay Area? PPOs generally cover out-of-network care (at a higher cost share). HMOs generally do not, except for emergencies and urgent care.
• Do you want tightly coordinated care inside one system? An HMO built around a specific medical group may feel more organized.

Networks and referral rules are set at the plan level. The specifics for any individual plan live in that plan's provider directory and Evidence of Coverage, not in the plan type label.

What is changing for 2027 in the county

Compared with 2026, San Francisco County goes from 51 plans and 13 carriers to 46 plans and 12 carriers. The data shows 12 plans not returning, 7 new plans and 13 renamed plans for 2027. If you are already enrolled, your plan's Annual Notice of Change (ANOC), mailed in the fall, spells out exactly what is changing for your plan — including network, referrals, drugs covered and cost sharing.

A few 2027 program-level numbers are already set: the Part D out-of-pocket cap rises to $2,400 in 2027 (up from $2,100 in 2026), and the Part D maximum deductible rises to $700 (up from $615). The 2027 Part B standard premium, deductible and IRMAA income brackets have not yet been announced; CMS typically publishes those later in the fall.

How to use this during AEP

The Annual Enrollment Period runs Oct. 15 – Dec. 7, 2026, and any change you make takes effect Jan. 1, 2027. If you do nothing, your current plan simply renews for 2027 if it's being offered.

A sensible order of operations:

1. Read your ANOC when it arrives. 2. Decide which plan type fits your life — network tolerance, referrals, travel. 3. Use the Medicare Plan Finder at medicare.gov to compare specific plans against your doctors and prescriptions. 4. Call the plan directly to confirm your providers are in network for 2027.