2022 San Mateo County California
Medicare Advantage Plans

There are 20 Medicare Advantage Plans available in San Mateo County CA from 11 different health insurance providers. 16 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $999 and the highest out of pocket is $7550. San Mateo County California residents can also pick from 15 Medicare Special Needs Plans. The best Medicare Advantage plan in San Mateo County California received a 5 overall star rating from CMS and the lowest rated plan is 2.5 stars.



(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)

Name ⇅ Premium Deductible MOOP Gap Plan
Rating
Click
for
Formulary
AARP Medicare Advantage SecureHorizons Plan 1 (HMO)
(H0543-028)
$107.00 $360.00 $4,900 YesBrowse
Formulary
Anthem MediBlue Coordination Plus (HMO)
(H0544-099)
$16.30 $480.00 $7,550 YesBrowse
Formulary
Anthem MediBlue Plus (HMO)
(H0544-096)
$0 $0 $4,900 YesBrowse
Formulary
Blue Shield Inspire (HMO)
(H0504-041)
$0 $0 $4,200 YesBrowse
Formulary
Brand New Day Classic Care II Plan (HMO)
(H0838-037)
$0 $50.00 $999 YesBrowse
Formulary
Brand New Day Classic Choice Plan (HMO)
(H0838-033)
$32.20 $480.00 $7,550 YesBrowse
Formulary
CCHP Senior Program (HMO)
(H0571-001)
$42.00 $0 $6,700 NoBrowse
Formulary
CCHP Senior Value Program (HMO)
(H0571-007)
$0 $0 $7,550 NoBrowse
Formulary
Central Health San Mateo Medicare Plan (HMO)
(H5649-018)
$0 $0 $999 YesBrowse
Formulary
Essence Advantage Gold (HMO)
(H2986-007)
$59.00 $0 $5,900 YesBrowse
Formulary
Essence Advantage Platinum (HMO)
(H2986-004)
$89.00 $0 $4,900 YesBrowse
Formulary
Imperial Strong (HMO)
(H5496-014)
$0 $480.00 $7,550 NoBrowse
Formulary
Imperial Traditional (HMO)
(H5496-007)
$0 $0 $2,999 YesBrowse
Formulary
Imperial Traditional Plus (HMO)
(H5496-009)
$33.20 $480.00 $2,999 YesBrowse
Formulary
Kaiser Permanente Senior Advantage Basic San Mateo (HMO)
(H0524-065)
$25.00 $0 $6,700 YesBrowse
Formulary
Kaiser Permanente Sr Adv Enhanced Marin San Mateo (HMO)
(H0524-031)
$85.00 $0 $4,900 YesBrowse
Formulary
My Choice (PPO)
(H4961-003)
$97.00 $0 $4,200 YesNABrowse
Formulary
SCAN Classic (HMO)
(H5425-078)
$0 $0 $4,500 YesBrowse
Formulary
Sutter Advantage (HMO)
(H3815-023)
$48.00 $0 $3,900 YesBrowse
Formulary


Return to 2022 Medicare Advantage Plans in California





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
Brand New Day Valor Care Plan (HMO)
(H0838-048)
$0 Local HMO * $4,500





2022 Medicare Special Needs Plans in San Mateo county California

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Align Connect (HMO C-SNP)     $0 $480.0  No Gap Coverage Chronic or Disabling ConditionToo New
Align Premier (HMO I-SNP)     $26.70 $480.0  No Gap Coverage InstitutionalToo New
Align Thrive (HMO I-SNP)     $0 $480.0  No Gap Coverage InstitutionalToo New
Brand New Day Bridges Care Plan (HMO C-SNP)     $0 $0  Some Generics Chronic or Disabling Condition
Brand New Day Bridges Choice Plan (HMO C-SNP)     $33.20 $480.0  Some Generics Chronic or Disabling Condition
Brand New Day Embrace Care Plan (HMO C-SNP)     $0 $0  Some Generics Chronic or Disabling Condition
Brand New Day Embrace Choice Plan (HMO C-SNP)     $33.20 $480.0  Some Generics Chronic or Disabling Condition
Brand New Day Harmony Care Plan (HMO C-SNP)     $0 $100.0  Some Generics Chronic or Disabling Condition
Brand New Day Harmony Choice Plan (HMO C-SNP)     $33.20 $480.0  Some Generics Chronic or Disabling Condition
Brand New Day Select Care II Plan (HMO I-SNP)     $0 $0  Some Generics Institutional
Brand New Day Select Choice II Plan (HMO I-SNP)     $33.20 $480.0  Some Generics Institutional
Imperial Senior Value (HMO C-SNP)     $0 $0  Many Chronic or Disabling Condition
Kaiser Permanente Sr Adv Medicare Medi-Cal (HMO D-SNP)     $31.40 $480.0  No Gap Coverage Dual-Eligible
SCAN Balance (HMO C-SNP)     $0 $0  Some Generics Chronic or Disabling Condition
SCAN Heart First (HMO C-SNP)     $0 $0  Some Generics Chronic or Disabling Condition



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

  • 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
  • Many - Many Generics and Some Brands
  • Some - Some Generics and Few Brands

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 1, 2021.
Plans are subject to change as contracts are finalized.
Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2022, 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.


*Licensed Agent Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY users should call 1-877-486-2048) 24 hours a day/7 days a week to get information on all of your options.

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