Medicare Advantage

Before You Enroll in a San Jose D-SNP, Read This

People in San Jose can choose from 36 Medicare Advantage plans for 2027, against 46 this year. 15 of this year’s plans are gone, 5 are new to Santa Clara County, and 31 that continue have changed their premium, deductible, plan type or name, 13 of them under a new name.

San Jose, Calif. — For people in San Jose who have both Medicare and Medi-Cal, the 2027 plan year brings a small but focused menu of Dual Special Needs Plans (D-SNPs). Three D-SNPs will be offered across Santa Clara County for 2027, and the fall Annual Enrollment Period — October 15 through December 7, 2026 — is when most people review their options. Dual-eligible residents, though, don't have to wait for fall: they get extra chances to switch during the year.

What a D-SNP is, in plain terms

A Dual Special Needs Plan is a type of Medicare Advantage plan built for people who qualify for both Medicare and Medicaid (called Medi-Cal in California). These plans include Part D drug coverage and are designed to coordinate with the help Medi-Cal already provides, so your two sets of benefits work together instead of in parallel.

D-SNPs are not the only Special Needs Plans in the county. For 2027, Santa Clara County will also have 12 Chronic Condition SNPs (C-SNPs) for people with certain health conditions, and 2 Institutional SNPs (I-SNPs). The full roster — including non-SNP Medicare Advantage plans — is in the table below.

The three D-SNPs in Santa Clara County for 2027

San Jose is in Santa Clara County, where Medicare plan availability is set. For 2027, three carriers each offer one D-SNP:

• Anthem Full Dual Advantage Aligned (HMO D-SNP) — Elevance Health (Anthem)
• Kaiser Permanente Dual Complete North P23 (HMO D-SNP) — Kaiser Permanente
• DualConnect (HMO D-SNP) — Santa Clara Family Health Plan

All three are HMO D-SNPs and all include drug coverage. For costs, provider networks, drug lists and benefits, use the Medicare Plan Finder at medicare.gov, call 1-800-MEDICARE, or read each plan's Evidence of Coverage.

Who qualifies: full vs. partial dual eligibility

To join a D-SNP, you must have Medicare (Parts A and B) and some form of Medi-Cal. California categorizes dual-eligible residents into groups that generally fall into two buckets:

• Full-benefit dual eligible: You have Medicare and full Medi-Cal benefits. Medi-Cal may help pay Medicare premiums and cost-sharing and also covers services Medicare doesn't, such as long-term services and supports.
• Partial-benefit dual eligible: You have Medicare and a Medicare Savings Program through Medi-Cal (for example, QMB, SLMB or QI) that helps with some Medicare costs, but you don't have full Medi-Cal benefits.

Each D-SNP is designed for specific eligibility categories, so not every dual-eligible person fits every plan. The California Department of Health Care Services (DHCS) — the state's Medi-Cal agency — is the office that confirms your category. The plan will also verify your status before you can enroll.

How often you can change plans

Most people change Medicare Advantage or Part D plans during two windows:

• Annual Enrollment Period: October 15 – December 7, 2026, for coverage starting January 1, 2027.
• Medicare Advantage Open Enrollment Period: January 1 – March 31, 2027, when someone already in a Medicare Advantage plan can switch once.

Dual-eligible people and people who get Extra Help with drug costs generally have additional opportunities. Current rules give this group a monthly chance to make certain changes — for example, joining an integrated D-SNP that aligns Medicare and Medi-Cal, or moving back to Original Medicare and picking up a stand-alone Part D plan. These rules have shifted in recent years, so confirm what applies to you by calling 1-800-MEDICARE (TTY 1-877-486-2048) before you make a change.

How to confirm your eligibility

Three practical steps:

1. Check your Medi-Cal status. Contact the Santa Clara County Social Services Agency or log in at BenefitsCal.com to see your current Medi-Cal category. 2. Check your Medicare status. Sign in at medicare.gov or call 1-800-MEDICARE to confirm your Parts A and B effective dates and whether you have Extra Help. 3. Match that to a plan. When you look at a D-SNP on the Medicare Plan Finder, each plan page lists the eligibility categories it accepts. If you're unsure whether you fit, the plan can run an eligibility check before you enroll.

What's changing for 2027, countywide

Beyond D-SNPs, Santa Clara County's broader Medicare Advantage lineup is shifting too. For 2027, 15 plans are not returning, 5 are new, and 13 have been renamed. If your current plan is affected, your Annual Notice of Change (ANOC) — mailed in late September — spells out exactly what's different for next year. If you do nothing and your plan is still offered, it renews automatically with those changes.

A few program-level numbers worth knowing: 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 in 2027 (up from $615 in 2026). CMS typically announces the 2027 Part B premium, deductible and IRMAA income brackets later in the fall.