2019 Medicare Advantage Plans in
San Diego County California

There are 28 Medicare Advantage Plans available in San Diego County CA from 12 different health insurance providers. 10 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3000 and the highest out of pocket is $6700. San Diego County California residents can also pick from 16 Medicare Special Needs Plans. The highest rated plan available in San Diego County received a 5 overall star rating from CMS and the lowest rated plan is 3 stars


(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)
Name ⇅ Premium Deductible MOOP Gap Click
for
Formulary
Plan
Rating
Sign
Up
Aetna Medicare Choice Plan (PPO)
$73.00 $0 $6,000 YesBrowse
Formulary
Enroll
Aetna Medicare Select Plan (HMO)
$0 $0 $3,400 YesBrowse
Formulary
Enroll
Alignment Health Plan CalPlus (HMO)
$30.50 $415.00 $6,700 NoBrowse
Formulary
Enroll
Alignment Health Plan Platinum (HMO)
$0 $0 $3,400 YesBrowse
Formulary
Blue Shield 65 Plus (HMO)
$0 $0 $3,399 YesBrowse
Formulary
Enroll
Blue Shield Promise AdvantageOptimum Plan (HMO)
$0 $0 $3,400 YesBrowse
Formulary
Enroll
Blue Shield Promise Coordinated Choice Plan (HMO)
$34.80 $415.00 $6,700 YesBrowse
Formulary
Enroll
Brand New Day Classic Care I Plan (HMO)
$0 $0 $3,400 YesBrowse
Formulary
Brand New Day Classic Care II Plan (HMO)
$0 $0 $3,400 YesBrowse
Formulary
Brand New Day Classic Choice Medi-Medi Plan (HMO)
$34.80 $415.00 $6,700 NoBrowse
Formulary
Health Net Healthy Heart (HMO)
$0 $0 $3,000 NoBrowse
Formulary
Enroll
Health Net Seniority Plus Sapphire (HMO)
$34.80 $340.00 $6,700 NoBrowse
Formulary
Enroll
Health Net Seniority Plus Sapphire Premier (HMO)
$34.80 $285.00 $6,700 NoBrowse
Formulary
Enroll
Health Net Seniority Plus Sapphire Premier II (HMO)
$34.80 $280.00 $6,700 NoBrowse
Formulary
Humana Gold Plus H5619-016 (HMO)
$0 $0 $3,200 NoBrowse
Formulary
Enroll
Humana Value Plus H5619-037 (HMO)
$33.30 $415.00 $6,700 NoBrowse
Formulary
Enroll
Kaiser Permanente Senior Advantage San Diego (HMO)
$0 $0 $4,900 YesBrowse
Formulary
Scripps Classic offered by SCAN Health Plan (HMO)
$0 $0 $3,400 NoBrowse
Formulary
Enroll
Scripps Plus offered by SCAN Health Plan (HMO)
$34.80 $415.00 $6,700 NoBrowse
Formulary
Enroll
Scripps Signature offered by SCAN Health Plan (HMO)
$74.00 $0 $4,000 YesBrowse
Formulary
Enroll
Sharp Direct Advantage Gold Card (HMO)
$0 $0 $3,400 NoBrowse
Formulary
Sharp Direct Advantage Platinum Card (HMO)
$66.00 $0 $3,300 NoBrowse
Formulary


Return to 2019 Medicare Advantage Plans in California





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
Sign Up





2019 Medicare Special Needs Plans in San Diego county California

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Click
for
Formulary
Anthem MediBlue ESRD (PPO SNP)
(H8552- 028)
    $34.80 $130.0  Yes Chronic or Disabling ConditionBrowse
Formulary
Blue Shield Promise TotalDual Plan (HMO SNP)
(H5928- 009)
    $34.80 $415.0  No Dual-EligibleBrowse
Formulary
Brand New Day Bridges Care Plan (HMO SNP)
(H0838- 028)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Bridges Choice Medi-Medi Plan (HMO SNP)
(H0838- 029)
    $34.80 $415.0  No Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Embrace Care Plan (HMO SNP)
(H0838- 039)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Embrace Choice Medi-Medi Plan (HMO SNP)
(H0838- 040)
    $34.80 $415.0  No Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Harmony Care Plan (HMO SNP)
(H0838- 032)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Harmony Choice Plan (HMO SNP)
(H0838- 020)
    $34.80 $415.0  No Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Select Care Plan (HMO SNP)
(H0838- 041)
    $34.80 $415.0  No InstitutionalBrowse
Formulary
Fresenius Total Health (PPO SNP)
(H9312- 002)
    $34.80 $415.0  No Chronic or Disabling ConditionNABrowse
Formulary
Health Net Jade (HMO SNP)
(H0562- 114)
    $0 $0  No Chronic or Disabling ConditionBrowse
Formulary
Health Net Seniority Plus Amber I (HMO SNP)
(H0562- 055)
    $34.80 $320.0  No Dual-EligibleBrowse
Formulary
Health Net Seniority Plus Amber II (HMO SNP)
(H0562- 110)
    $34.80 $300.0  No Dual-EligibleBrowse
Formulary
Molina Medicare Options Plus (HMO SNP)
(H5810- 001)
    $15.20 $415.0  No Dual-EligibleBrowse
Formulary
Scripps Heart First offered by SCAN Health Plan (HMO SNP)
(H5425- 055)
    $26.00 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
(H0524- 029)
    $34.80 $0  No Dual-EligibleBrowse
Formulary



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 2019 once you and your plan provider have spent $3820 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 25% of the plans cost for covered brand-name prescription drugs and 37% 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 5, 2018.
Star Rating as of October 10, 2018.
For More Information on Ratings Please See the CMS Tech Notes.
Plans are subject to change as contracts are finalized.
Includes 2019 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2019, 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.


Call For A licensed Sales Agent

1-855-492-4169

  • Mon-Fri 8:30am-8:00pm


Call to Enroll!