Medicare Advantage

San Francisco's 2027 Dual Special Needs Plans: six D-SNPs, and how often you can switch

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 — If you have both Medicare and Medicaid (called Medi-Cal in California), you have a special kind of Medicare Advantage plan built just for you: a Dual Special Needs Plan, or D-SNP. For 2027, six D-SNPs will be sold in San Francisco County, from six different carriers. The Annual Enrollment Period runs October 15 through December 7, 2026, and any choice you make in that window starts January 1, 2027. The good news for dual-eligible residents: your chances to switch are not limited to the fall.

What a D-SNP is, in plain terms

A Dual Special Needs Plan is a type of Medicare Advantage plan designed for people who qualify for both Medicare and Medicaid. These plans must include prescription drug coverage, and they are built to coordinate the two programs so you have fewer gaps and less paperwork. In California, Medicaid is called Medi-Cal, and the state is moving toward tighter alignment between D-SNPs and Medi-Cal managed care plans.

San Francisco is in San Francisco County, where Medicare Advantage plan availability is set at the county level. For 2027, 6 of the 46 Medicare Advantage plans in the county are D-SNPs. The county also has 13 Chronic Condition SNPs (C-SNPs) and 2 Institutional SNPs (I-SNPs), which serve different groups.

The six D-SNPs in San Francisco for 2027

Six carriers will each offer one D-SNP in the county next year. In alphabetical order by carrier:

• Alignment Health Duals+ 030 (HMO D-SNP) — Alignment Health Plan (renamed; was Alignment Health CalPlusDuals)
• CCHP Senior Select Program (HMO D-SNP) — CCHP (Chinese Community Health Plan)
• Wellcare Health Net Dual Liberty (HMO D-SNP) — Centene (WellCare) (renamed; was Wellcare Dual Liberty)
• Anthem Full Dual Advantage Aligned (HMO D-SNP) — Elevance Health (Anthem)
• Kaiser Permanente Dual Complete North P19 (HMO D-SNP) — Kaiser Permanente
• SFHP Care Plus (HMO D-SNP) — San Francisco Health Plan

The table below lists every Medicare Advantage plan in the county, including these D-SNPs. For costs, provider networks, drug formularies, and extra benefits, check the Medicare Plan Finder at medicare.gov, call 1-800-MEDICARE, or read the plan's own Evidence of Coverage.

Who qualifies: full vs. partial dual eligibility

"Dual eligible" is an umbrella term. In practice, people fall into two broad groups:

• Full dual eligible: You have Medicare and you qualify for full Medi-Cal benefits. Medi-Cal generally helps pay your Medicare premiums and cost-sharing, and covers services Medicare does not, such as long-term care in many cases.
• Partial dual eligible: You have Medicare and qualify for one of the Medicare Savings Programs (such as QMB, SLMB, or QI), which help with Medicare premiums and sometimes cost-sharing, but you do not get full Medi-Cal benefits.

Each D-SNP is approved to serve certain dual-eligible categories. Some only accept full duals; others accept a broader mix. The California Department of Health Care Services (DHCS) is the agency that confirms your Medi-Cal status and level. If you are not sure which category you are in, ask your county Medi-Cal office or call 1-800-MEDICARE for help sorting it out before you pick a plan.

How often you can change plans

Most people with Medicare can only change plans during the Annual Enrollment Period (October 15 – December 7) or the Medicare Advantage Open Enrollment Period (January 1 – March 31). People with Medicaid or Extra Help have more flexibility.

Under current CMS rules, if you have both Medicare and Medi-Cal (or you receive Extra Help with Part D), you generally have a monthly Special Enrollment Period that lets you:

• Join an integrated D-SNP, or
• Leave a Medicare Advantage plan and return to Original Medicare with a stand-alone Part D plan.

The specific rules about which switches are allowed each month have been changing in recent years as CMS pushes toward more integrated dual plans. Before you make a move, confirm the current rules by calling 1-800-MEDICARE (TTY 1-877-486-2048) or checking medicare.gov. If you do nothing, your current plan simply renews for 2027 if it is still offered, with any changes spelled out in the Annual Notice of Change (ANOC) your plan mailed in September.

What else is changing for 2027

A few program-wide numbers are already confirmed for 2027 and apply to everyone with Part D, including D-SNP members:

• The Part D out-of-pocket cap rises to $2,400 in 2027 (up from $2,100 in 2026).
• The Part D maximum deductible rises to $700 in 2027 (up from $615 in 2026).
• The Part D national base beneficiary premium is $41.33 for 2027 — that is a formula input, not what any single plan charges.

Many dual-eligible residents also get Extra Help, which lowers or eliminates Part D costs, so these caps may matter less to you personally. The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, had not been announced as of September 2026; CMS typically publishes those in the fall.

In San Francisco County overall for 2027, CMS data shows 12 plans not returning, 7 new plans, and 13 renamed plans across all Medicare Advantage offerings. Two of this year's D-SNPs — the Alignment and Wellcare plans — appear on the renamed list, so if you are enrolled in either one, your ANOC will explain what stayed the same and what changed.

How to confirm your eligibility and compare

Three steps help most people get this right:

1. Confirm your Medi-Cal status. Contact your county Medi-Cal office or DHCS to verify whether you are full or partial dual eligible. The answer determines which D-SNPs can accept you. 2. Compare the plans side by side. Use the Medicare Plan Finder at medicare.gov, where you can enter your ZIP code, your drugs, and your doctors. The tool shows every plan available to you, including D-SNPs. 3. Call for personalized help. 1-800-MEDICARE is open 24 hours a day, 7 days a week, and can answer questions specific to your situation.