2017 Medicare Advantage Plans in San Mateo County California

2017 Medicare Advantage Plans in San Mateo County California

There are 2 Medicare Advantage Plans available in San Mateo County CA from 2 health insurance providers and 1 Special Needs Plans available. 1 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $4400 and the highest out of pocket is $4500. The highest rated plan available in San Mateo County received a 5 overall star rating from CMS and the lowest rated plan is 3.5 stars.

(Click the Plan Name for More Details)

Name Monthly
Part D
Type  Gap  Max Out
Overall Rating Formulary
CCHP Senior Program (HMO)
$50.00 $400.00 Local HMO No $4,500 Browse
Kaiser Permanente Senior Advantage Marin San Mateo (HMO)
$106.00 $0.00 Local HMO Yes $4,400 Browse
Return to 2017 Medicare Advantage Plans in California

* Plan Type does not offer Medicare Part D drug coverage.

Medicare Special Needs Plans in San Mateo county California

Plan Name Monthly
Premium C+D
Part D
 Gap  Special Needs
Overall Rating
Senior Advantage Medicare Medi-Cal Plan North (HMO SNP)
(H0524- 030)
   $28.50 $400.00  No Dual-EligibleBrowse

Plan Type Is the type of organization offering the Medicare Plans.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescription Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your provider for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type
  • (EA) Enhanced Alternative may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs.

  • (DS) Defined Standard Benefit
  • (BA) Basic Alternative
  • (AE) Actuarially Equivalent Standard

  • GAP

    In 2017 once you and your plan provider have spent $3700 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") Once you reach the coverage gap you will pay 40% of the plans cost for covered brand-name prescription drugs and 51% on generic drugs unless your plan offers additional coverage.

    Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable

    Source: CMS.

    Data as of September 6, 2016.

    Plans are subject to change as contracts are finalized.

    Includes 2017 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2017, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.