Speak with a licensed insurance agent

1-833-641-4938

TTY user 711 Mon-Fri : 8am-9pm EST

SCAN Medicare Advantage Plans 2027 California

Reviewed by Russell Noga, Licensed Medicare Insurance Broker (all 50 states) | Last updated October 8, 2026

SCAN Health Plan grows in California for 2027, adding a SCAN Costco co-branded HMO in 17 California counties and expanding Sutter Senior Advantage from 6 to 10 counties. California overall moves from 402 to 394 plans.

SCAN is a not-for-profit plan focused on older adults. In San Diego and Orange counties, Sharp and Providence members leaving Medicare Advantage may want to compare SCAN with other remaining options. HICAP offers free counseling.

See SCAN Medicare Advantage plans 2027 and is SCAN leaving Medicare Advantage.

✔ Licensed across all 50 states

✔ Built on CMS 2027 data

✔ No-cost plan comparison

Key Highlights

✔

SCAN Costco HMO in 17 CA counties.

✔

Sutter Senior Advantage: 6 to 10 counties.

✔

California: 394 plans.

✔

Nationally, the average 2027 Medicare Advantage premium is $12 a month, down from $14.37 (CMS).

✔

The Annual Enrollment Period is October 15 to December 7, 2026.

Compare plans and enroll online

SCAN in California for 2027

SCAN California Change Detail
SCAN Costco co-branded HMO New in 17 California counties (and 2 in Nevada)
Sutter Senior Advantage (SCAN) Grows from 6 to 10 counties
SCAN footprint 38 counties across CA, AZ, NV, TX, NM, WA plus new Oregon

Benefits SCAN Plans May Offer

SCAN Plans May Include

✔

Hospital and medical coverage matching Original Medicare Part A and B

✔

Part D prescription drug coverage on most plans

✔

Routine dental, vision and hearing benefits

✔

Fitness programs and over-the-counter allowances

✔

Telehealth visits and care coordination programs

✔

A yearly out-of-pocket maximum on every plan

Benefits are not offered by every plan. They differ by plan and county and may change for 2027. Review the Evidence of Coverage for each plan before enrolling.

How to Explore Medicare Advantage Plans

What to Check for 2027

Key Takeaway

New SCAN plans may not have a star rating yet. Confirm your medical group and drugs before enrolling.

Keep an eye out: a non-renewal letter will arrive if your plan is ending. You stay covered through December 31, 2026. Taking no action sends you back to Original Medicare with no drug coverage.

Guaranteed issue: when your Medicare Advantage plan exits your area, you can generally purchase certain Medicare Supplement plans with no health questions asked, up until 63 days after that coverage ends.

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

California Market Changes

Other California Changes 2027 Detail
California plan count 402 to 394; average premium about $14.12
Sharp Health Plan Leaving individual MA in San Diego County
Providence Health Plan Leaving MA, including Orange County
Alignment Health Expanding, including the Central Valley
Blue Shield of California Continuing in 16 counties

Who SCAN May Fit in California

SCAN May Fit If

✔

Your doctors and medical group are in SCAN’s network

✔

You are a Sharp or Providence member needing a new plan in a SCAN county

✔

You want a plan focused on older adults

Compare Others If

✔

Your doctors are outside SCAN’s network

✔

You need a PPO

✔

SCAN does not serve your county

Cost and Benefits of Advantage Plans

How Medicare Advantage Works

Medicare Advantage, sometimes called Part C, lets you receive your Medicare benefits through a Medicare-approved private insurer. These plans cover everything Original Medicare Part A and Part B cover, with the exception of hospice care, which Original Medicare continues to pay for. Most also bundle Part D drug coverage, and many may tack on extras like routine dental, vision and hearing benefits.

In exchange, SCAN plans generally use networks of doctors and hospitals, and may require referrals or prior authorization for some services. Every Medicare Advantage plan has a yearly out-of-pocket maximum for covered medical care, which Original Medicare does not have. You keep paying your Part B premium, plus your plan’s premium if it has one.

Feature HMO PPO
Out-of-network care Not covered except emergencies and urgent care Covered at a higher cost
Referrals for specialists Usually required Usually not required
Premiums Usually lower Usually higher
Out-of-pocket maximum In-network limit In-network limit plus a higher combined limit
Best for Lower costs, local care Flexibility, travel, keeping specific doctors

Pros and Cons of Medicare Advantage

Advantages

✔

Often a low or $0 premium

✔

A yearly out-of-pocket maximum

✔

Drug coverage usually included

✔

Dental, vision and hearing benefits may be included in many plans

✔

One card and one plan

Tradeoffs

✔

Networks; except for emergencies, HMOs require in-network care

✔

Prior authorization and referrals are common

✔

Copays add up if you use a lot of care

✔

Plans and networks can change every year

✔

Moving to Medigap later may involve health questions

SCAN Drug Coverage for 2027

Most SCAN Medicare Advantage plans include Part D drug coverage. Each plan has its own formulary, drug tiers and pharmacy network, and plans commonly charge less at preferred pharmacies and through mail order. For 2027, any plan’s Part D deductible can be up to $700, and the out-of-pocket cap on covered drugs is $2,400.

Tier Typical Drugs Typical Cost
Tier 1 Preferred generics Lowest copay
Tier 2 Generics Low copay
Tier 3 Preferred brand-name drugs Moderate copay
Tier 4 Non-preferred drugs Higher copay or coinsurance
Tier 5 Specialty drugs Highest coinsurance

Each plan sets its own tiers. Review every plan’s formulary.

A drug you take may not be on a plan’s 2027 formulary, or it may come with a rule such as prior authorization. Even then, you have options:

If Your Drug Is Not Covered

1

Request a transition fill. During the first 90 days of a new plan or plan year, plans generally have to provide a temporary supply of a drug you already take, giving you time to change drugs or ask for an exception.

2

Talk to your doctor about other options. A covered drug from the same class could work just as well for less money.

3

Ask for a tiering or formulary exception. Your doctor sends a statement explaining why you need the drug or a lower copay. Plans have to decide within set time limits.

4

Challenge a denial. When the plan turns you down, you have the right to appeal through several levels of review.

See steps to appeal a Medicare Part D denial.

If Your Plan Is Ending

If your SCAN plan will not be offered in your county for 2027, you should have received a non-renewal notice in early October. Your coverage does not stop right away: it continues through December 31, 2026, so you have time to choose.

If Your Plan Is Ending

1

Review your non-renewal letter. It verifies that your plan is ending and lays out your choices.

2

Write down your doctors and drugs. Comparing replacement plans requires them.

3

Compare your 2027 plan choices. Look at networks, drug coverage and the out-of-pocket maximum, not only the premium.

4

Pick a plan by December 31 to avoid a gap. If you enroll during Annual Enrollment by December 7, your coverage starts January 1, 2027.

5

Rely on your Special Enrollment Period if necessary. If your plan is ending, you generally have until the end of February 2027 to make a choice.

If you take no action: on January 1, 2027, you go back to Original Medicare, and you will have no drug coverage unless you pick a Part D plan. Being without drug coverage may result in a late enrollment penalty.

Medigap rights: if your Medicare Advantage plan exits your area, you generally get a guaranteed issue right, lasting up to 63 days after your coverage ends, to purchase certain Medicare Supplement plans with no health questions.

How to Compare SCAN Plans for 2027

How to Compare

1

Review your Annual Notice of Change. It spells out every 2027 change to the plan you have now.

2

Verify your doctors and hospitals. Make sure every provider is in the 2027 network, not only the 2026 network.

3

Review your prescriptions. Verify every drug, the tier it falls on and any step therapy or prior authorization rules.

4

Look at the full annual cost. Total up the premium, usual copays and drug costs, and review the out-of-pocket maximum.

5

Look at star ratings. Medicare scores plans on quality and service using a 1 to 5 star scale.

6

Sign up by December 7. Coverage under your new plan begins January 1, 2027.

2027 Enrollment Dates

Enrollment Period Dates What You Can Do
Annual Enrollment Period October 15 to December 7, 2026 Join, change or drop a Medicare Advantage or Part D plan effective January 1, 2027
Medicare Advantage Open Enrollment January 1 to March 31, 2027 In Medicare Advantage, you can change to another plan or go back to Original Medicare one time
Initial Enrollment Period 7 months around your 65th birthday month Sign up for Medicare and choose your first plan
Special Enrollment Periods Varies Switch plans after events such as a move, a loss of other coverage or your plan exiting your area

Annual Enrollment is when most people make changes. If you like your current plan, no action is needed; it renews on its own. Even so, review your Annual Notice of Change, since networks, premiums, copays and drug lists can all change on January 1.

Special Needs Plans

Special Needs Plans (SNPs) are Medicare Advantage plans designed for particular groups. Their benefits, networks and drug lists are shaped around the members they serve, and many come with care coordinators. In 2027, SNPs are one of the few places large insurers are adding plans, even while cutting PPOs.

Type Who Qualifies What Is Different
Dual Special Needs Plan (D-SNP) People with both Medicare and Medicaid Coordinates both programs; costs are often very low, with extra benefits
Chronic Condition SNP (C-SNP) People who have qualifying conditions like diabetes, heart failure or chronic lung disease Doctors, drugs and programs designed around the condition
Institutional SNP (I-SNP) People who live in a nursing home or need that level of care at home Care delivered where the member lives

Turning 65 in 2027

When you turn 65 in 2027, you get a seven-month Initial Enrollment Period: the three months before your birthday month, the birthday month itself and the three months that follow. If you sign up in the first three months, coverage begins on the first day of your birthday month.

Turning 65 Checklist

✔

Enroll in Part A and Part B, unless you have qualifying employer coverage and decide to postpone Part B

✔

Choose between Medicare Advantage and Original Medicare plus Medigap

✔

Enroll in a drug plan, or a Medicare Advantage plan that includes drugs, to avoid a late Part D penalty

✔

If you go with Medigap, purchase during your six-month Medigap Open Enrollment Period

Star Ratings

Each fall, Medicare gives every Medicare Advantage and Part D plan a rating of 1 to 5 stars, based on factors such as preventive care, how well chronic conditions are managed, member complaints, customer service and accuracy of drug pricing. You can see the ratings in Medicare Plan Finder.

Using Star Ratings

✔

Ratings of 4 stars or more are generally a good indicator of quality and service

✔

A special enrollment period lets you move into a five-star plan once during the year

✔

A new plan may not have a rating yet, and that alone isn’t a bad sign

✔

Ratings reflect the plan as a whole, not how well it covers your particular doctors and drugs

Medicare Advantage or Medigap?

Medicare Advantage Original Medicare + Medigap
Monthly premium Often low or $0 (2027 average $12, CMS) Higher; varies by plan letter, age and ZIP
Doctors Usually a network Any provider in the U.S. that accepts Medicare
Costs when you get care Copays and coinsurance up to a yearly maximum Low and predictable; on Plan G, little or nothing once the Part B deductible is met
Drug coverage Usually included Add a separate Part D plan
Dental, vision, hearing Many plans may include some coverage Not included
Changing later Every year during Annual Enrollment Health questions in most states once your Medigap Open Enrollment Period ends

Help Paying Medicare Costs

When your income and savings are limited, two programs can greatly lower your Medicare costs:

Medicare Savings Programs

✔

Run by your state Medicaid office

✔

May cover your Part B premium, and in some cases deductibles and coinsurance

✔

Income and asset limits vary by state

Extra Help (Part D)

✔

Run by Social Security

✔

Lowers Part D premiums, deductibles and copays

✔

Those enrolled in a Medicare Savings Program qualify automatically

If you qualify for both Medicare and full Medicaid, you may also be able to join a Dual Special Needs Plan. See help for low-income Part D beneficiaries.

Reading Your Annual Notice of Change

Check Every Line

✔

Your 2027 premium and deductible

✔

Doctor, specialist and hospital stay copays

✔

The out-of-pocket maximum

✔

Updates to your formulary, drug tiers and coverage rules

✔

Whether your doctors, hospitals and pharmacy stay in network

✔

Updates to dental, vision, hearing and other extras

The Annual Notice of Change must reach members by September 30. It is the most useful single document you receive each fall, since it spells out exactly how your plan will change on January 1.

Special Enrollment Periods

Outside of the fall and early-year windows, changing plans generally requires a Special Enrollment Period. Typical reasons include:

You May Qualify If

✔

Your plan is leaving your area or ending

✔

You move outside your plan’s service area

✔

You lose employer or union coverage

✔

Your Medicaid status changes, or you qualify for a Medicare Savings Program or Extra Help

✔

You want to join a 5-star plan, once a year

Every Special Enrollment Period has a separate time limit, so move as soon as the event occurs.

Prior Authorization and Referrals

Prior authorization is required by most Medicare Advantage plans for certain services, including some surgeries, advanced imaging, skilled nursing stays and some drugs. While your doctor usually submits the request, ask whether a scheduled service needs approval so you are not caught off guard by a denial.

You or your doctor can appeal a denied request. Medicare rules give plans deadlines for decisions, and those deadlines are shorter when a wait could seriously harm your health.

Emergency, Urgent and Out-of-Area Care

Emergency and urgent care are covered by every Medicare Advantage plan anywhere in the U.S., whether in or out of network, and an emergency does not require prior approval. Routine care while traveling is different: HMOs generally do not cover it, and PPOs cover out-of-network care at a higher cost.

If you’re away from home for months each year, ask every plan how it covers care where you stay. This is among the most frequent reasons people change plans partway through the year.

Appeals and Complaints

You have the right to appeal if your plan denies a service, a drug or payment for care. The denial notice from the plan explains the process. Appeals have several levels, beginning with the plan and moving on to independent reviewers.

If your issue isn’t about coverage, such as wait times or customer service, you can file a grievance with your plan. For help, you can also reach out to 1-800-MEDICARE or your State Health Insurance Assistance Program.

The 2027 Part B Premium

Of the major figures, only the Part B premium is not published alongside the plans. CMS typically announces it in November. Projections in the 2026 Medicare Trustees Report put the 2027 standard premium at about $209.50 a month and the deductible at about $292, up from $202.90 and $283 in 2026. You continue paying it even with Medicare Advantage.

Getting Help

You do not need to compare plans by yourself, and help should not cost you anything. Here are the free options:

Free Help Comparing Plans

✔

Available any time: Medicare Plan Finder on Medicare.gov

✔

1-800-MEDICARE (1-800-633-4227), reachable 24 hours a day on all seven days of the week

✔

Your State Health Insurance Assistance Program (SHIP), which provides free, unbiased counseling

✔

A licensed agent or insurance broker, who can compare plans across several insurers for free

Gather your Medicare card, a list of your drugs and doses, your doctors and your preferred pharmacies before you call. That way a long conversation becomes a quick one.

Bottom Line

The Bottom Line

SCAN expands in California for 2027. Compare its HMOs with other plans in your county during Annual Enrollment.

Compare plans and enroll online

Frequently Asked Questions

➤ Is SCAN expanding in California for 2027?

Yes. SCAN adds a SCAN Costco co-branded HMO in 17 California counties and 2 Nevada counties, and Sutter Senior Advantage, offered with SCAN, grows from 6 to 10 counties. Check Medicare Plan Finder for your ZIP code to see which SCAN plans you can choose.

➤ What is the SCAN Costco Medicare Advantage plan?

It is a new SCAN HMO co-branded with Costco for 2027, offered in 17 California and 2 Nevada counties. As a new plan it may not have a star rating, so check its network, drug costs and out-of-pocket maximum carefully.

➤ What is Sutter Senior Advantage?

Sutter Senior Advantage is a Medicare Advantage plan offered by SCAN with Sutter Health, and it grows from 6 to 10 California counties for 2027. It may fit people who already use Sutter doctors and hospitals.

➤ How many Medicare Advantage plans does California have for 2027?

California has 394 Medicare Advantage plans for 2027, down from 402, with an average premium of about $14.12. Choices vary widely by county, from many plans in large metro areas to few in rural counties.

➤ I am a Sharp or Providence member. Is SCAN an option?

It can be, if SCAN serves your county and your doctors are in its network. Sharp is leaving individual MA in San Diego County and Providence is leaving MA, including Orange County, so those members get a Special Enrollment Period and generally Medigap guaranteed issue rights.

➤ Where can Californians get free Medicare help?

HICAP (Health Insurance Counseling and Advocacy Program) gives free, unbiased Medicare counseling in California. Counselors can compare SCAN with other plans for your ZIP code and explain your rights if your current plan is ending.

➤ Do SCAN plans include dental, vision and hearing?

Many SCAN Medicare Advantage plans may include dental, vision and hearing benefits, but not all plans offer all benefits and amounts vary by plan and county. Check each plan’s 2027 Evidence of Coverage for annual limits, networks and copays before you enroll.

➤ How do star ratings help me compare plans?

Medicare rates Medicare Advantage and Part D plans from 1 to 5 stars on quality and member experience, and higher-rated plans generally score better on care and service. New plans may not have a rating yet, so also compare networks, drug costs and the out-of-pocket maximum.

➤ When can I change SCAN plans for 2027?

You can change during Annual Enrollment, October 15 to December 7, 2026, and the new plan starts January 1, 2027. If you are already in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period, January 1 to March 31, 2027, also allows one change.

Have Questions?

Speak with a licensed insurance agent

1-833-641-4938

TTY users 711

Mon-Fri: 8am-9pm ET

Find & Compare Plans Online

Speak with a licensed insurance agent

1-833-641-4938TTY 711

Mon-Fri: 8am-9pm ET

ZRN Health & Financial Services, LLC, a Texas limited liability company

( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.