Medicare Advantage

Is Your San Francisco Plan Changing on January 1, 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 is open-enrollment season for Medicare, and the plan you have today may not look the same on January 1, 2027. Between now and December 7, 2026, people on Medicare in San Francisco can switch Medicare Advantage plans, move back to Original Medicare, or stay put. The question most readers ask is simple: how do I actually compare what's out there?

San Francisco is in San Francisco County, where the Centers for Medicare & Medicaid Services (CMS) sets plan availability. For 2027, the county's lineup has shifted a bit — some plans are leaving, some are new, and others are being renamed. Here is a calm way to work through it before the deadline.

What's on offer in San Francisco County for 2027

For plan year 2027, San Francisco County residents can choose from 46 Medicare Advantage plans offered by 12 carriers. By plan type, that breaks down to 38 HMOs, 6 HMO-POS plans and 2 PPOs. All 46 include prescription drug coverage.

Special Needs Plans (SNPs) are a big part of the local picture — 21 in all. That includes 6 Dual Eligible SNPs (for people with both Medicare and Medi-Cal), 13 Chronic Condition SNPs (for conditions like diabetes or heart disease), and 2 Institutional SNPs (for people living in a nursing facility or who need that level of care).

The carriers offering 2027 plans in the county are Aetna (CVS Health), Align Senior Care, Alignment Health Plan, CCHP (Chinese Community Health Plan), Centene (WellCare), Elevance Health (Anthem), Humana, Imperial Health Plan of California, Kaiser Permanente, San Francisco Health Plan, SCAN Health Plan and UnitedHealthcare. The table below lists every plan.

What's new, what's leaving

A handful of things change in the county year over year, and 2027 is no exception:

• 7 new plans are being offered for the first time in San Francisco County.
• 12 plans that were sold in 2026 are not returning for 2027. If yours is one of them, you'll get a non-renewal notice and you need to pick a new plan during this window to avoid defaulting to Original Medicare.
• 13 plans are being renamed. The plan is still there, but the name on your card or paperwork may be different.

Compared with 2026, the county has one fewer carrier and five fewer plans overall. Even if your plan is returning under the same name, costs, drug lists and provider networks can still change — which is why the ANOC matters.

Step 1: Read the Annual Notice of Change

If you already have a Medicare Advantage plan, your insurer must mail you an Annual Notice of Change by the end of September. It spells out what is different about your plan for 2027: premium, deductible, copays, drug tiers, provider network, and extra benefits like dental or vision.

Read it with a highlighter. The questions to ask yourself:

• Is my monthly premium changing?
• Are my regular prescriptions still covered, and in the same tier?
• Are my doctors and hospitals still in-network?
• Did any extra benefit I actually use get smaller?

If nothing in the ANOC bothers you, you don't have to do anything — your plan rolls over on January 1, 2027.

Step 2: Make your own short list

Write down what matters most to you before you start comparing. A useful list looks something like this:

• Doctors and hospitals you want to keep seeing (UCSF, Sutter, Dignity, Kaiser, Chinese Hospital, SF Health Network, your primary care clinic).
• Prescriptions you take, with dose and frequency.
• Pharmacies you prefer — a neighborhood pharmacy, a chain, or mail order.
• Plan type you want. HMOs ask you to stay in-network and often use a primary care doctor as a gatekeeper. HMO-POS plans allow some out-of-network use. PPOs give you more flexibility to see out-of-network providers, usually at a higher cost.
• Any SNP eligibility. If you have Medi-Cal, a chronic condition like diabetes or heart failure, or you live in a nursing facility, a Special Needs Plan may be designed for your situation.

Step 3: Use the Medicare Plan Finder

The best place to compare apples to apples is the Medicare Plan Finder at medicare.gov. Log in with your Medicare account so your drug list and pharmacy preferences save as you go. Then:

1. Enter your ZIP code and choose Medicare Advantage. 2. Type in each of your prescriptions, with the dose. 3. Pick up to three pharmacies — one in your neighborhood, one chain, and mail order is a reasonable mix. 4. Narrow the results by plan type (HMO, HMO-POS, PPO) if you have a preference. 5. Open two or three plans side by side and look at estimated yearly drug cost, monthly premium, in-network copays, and the drug coverage details.

You can also call 1-800-MEDICARE (TTY 1-877-486-2048), 24 hours a day, 7 days a week, to walk through options with a representative.

Step 4: Check doctors and hospitals directly

The Plan Finder is strong on drugs and costs, but provider networks move around during the year. Before you enroll, confirm your doctors and hospitals two ways:

• Search the plan's own online provider directory on the carrier's website.
• Call your doctor's billing office and ask, by plan name, whether they will be in-network for 2027.

If a specialist, a hospital system, or a specific clinic is non-negotiable for you, this step is worth the phone call.

Step 5: Confirm your drugs and your pharmacy

Each plan has its own formulary (drug list) and its own preferred pharmacies. The same medication can sit in different tiers in different plans, which changes what you pay. In the Plan Finder, you'll see:

• Whether each of your drugs is covered.
• Which tier it's on.
• Whether there's a prior authorization or quantity limit.
• Estimated cost at each pharmacy you selected.

A quick note on 2027 drug costs: the Part D out-of-pocket cap rises to $2,400 in 2027 (it's $2,100 in 2026), and the Part D maximum deductible moves to $700 (from $615 in 2026). These are program-wide limits set by CMS, not plan-specific prices.

A few program dates and figures to keep straight

• Annual Enrollment Period: October 15 – December 7, 2026. Changes take effect January 1, 2027.
• Medicare Advantage Open Enrollment: January 1 – March 31, 2027, if you're already in an Advantage plan and want one more switch.
• 2027 Part B premium, Part B deductible, and IRMAA income brackets: CMS publishes these later in the fall, usually in November.
• Medicare Prescription Payment Plan: an optional way to spread your drug costs into monthly payments across the year, available through your Part D or Advantage drug plan.