Medicare Advantage

Your San Jose Medicare checklist: five things to review before Dec. 7

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. — It's fall 2026, and the envelopes have started landing in mailboxes across the South Bay. If you're on Medicare, the one marked "Annual Notice of Change" is the piece of paper that matters most this month. It tells you how your current plan is changing for 2027 — and you have until December 7, 2026 to switch if the new version no longer fits.

Here is a plain-English checklist to work through before that deadline.

1. Read the Annual Notice of Change first

The ANOC is the booklet (or PDF) your Medicare Advantage or Part D plan sends every September. It compares this year's plan to next year's, side by side. Flip to the pages that show:

• The monthly premium for 2027.
• The deductible and the copays or coinsurance for primary care, specialists, hospital stays, and the ER.
• Any change to extra benefits like dental, vision, hearing, OTC, or fitness.
• The drug formulary tiers and the pharmacy network.

If something important is moving in a direction you don't like, that's your signal to compare other options. If the plan still fits, you don't have to do anything — it will renew January 1.

2. Check your doctors and hospitals for 2027

Networks change every year. Before December 7, confirm that:

• Your primary care doctor is still in-network for 2027.
• Any specialists you see — cardiology, oncology, orthopedics — are still contracted.
• The hospital you'd want to use (for many San Jose residents that's Kaiser, Stanford, Good Samaritan, Regional Medical Center, O'Connor, or El Camino) is still in your plan's hospital network for next year.

Call the plan directly and ask about 2027, not 2026 — the directory on the website may still show the current year. If you have Original Medicare with a Medigap policy, your doctor list doesn't change with the calendar; this step is for Advantage members.

3. Price out your prescriptions on the 2027 formulary

Drug coverage is where surprises hide. For each medication you take, check:

• Is it still on the formulary for 2027?
• What tier is it on, and did the tier change?
• Are there new rules — prior authorization, step therapy, quantity limits?
• Is your pharmacy still a "preferred" pharmacy next year?

Two program-wide numbers help frame the math. For 2027, CMS has confirmed the Part D out-of-pocket cap rises to $2,400 (from $2,100 in 2026) and the maximum Part D deductible is $700 (from $615 in 2026). Once you hit the cap, you pay $0 for covered drugs the rest of the year. If your drug costs are heavy early in the year, the Medicare Prescription Payment Plan lets you spread them into monthly installments at no extra charge.

4. Know what's on the table in Santa Clara County

San Jose is in Santa Clara County, where CMS's 2026 Landscape file lists 46 Medicare Advantage plans from 12 carriers — 38 HMOs, 5 HMO-POS plans, and 3 PPOs. Twenty of those are Special Needs Plans (for people with certain chronic conditions, both Medicare and Medi-Cal, or living in a care facility), and all 46 include drug coverage.

The carriers offering plans in the county, in alphabetical order, are Aetna (CVS Health), Align Senior Care, Alignment Health Plan, Astiva Health, Blue Shield of California, Central Health Medicare Plan, Elevance Health (Anthem), Imperial Health Plan of California, Kaiser Permanente, Santa Clara Family Health Plan, SCAN Health Plan, and UnitedHealthcare. The table below lists every plan by name and type. These are 2026 counts; CMS releases the 2027 Landscape in October, and you'll be comparing 2027 plan details on Medicare's Plan Finder.

5. Use the official tools, not a cold call

The best places to compare, in order:

• Medicare.gov Plan Finder — enter your ZIP code and your drug list and it shows every plan available to you, with next year's prices once CMS loads them in October.
• 1-800-MEDICARE — open 24/7 for personalized questions about your situation.
• Your plan's member services line — the number is on the back of your card; they can confirm whether your doctor or drug is in for 2027.

Two 2027 numbers aren't out yet: the standard Part B premium and deductible and the IRMAA income brackets that add a surcharge for higher earners. CMS typically announces those in November. In the meantime, the 2026 IRMAA surcharges still begin above $109,000 in income for a single filer.

If you miss December 7

The Medicare Advantage Open Enrollment Period runs January 1 through March 31, 2027. During that window, if you're already in a Medicare Advantage plan, you can switch to a different Advantage plan or drop back to Original Medicare (and add a Part D plan). It is not a second chance for everyone — people on Original Medicare generally can't use it to pick up an Advantage plan — but it's a safety net if January brings a surprise.