Medicare Open Enrollment is an opportunity to make sure your coverage still fits your health needs, prescriptions, doctors, and budget. With several Medicare Advantage plans leaving San Diego County for 2027, this year’s review is especially important.
The Annual Enrollment Period runs from October 15 through December 7, 2026. Medicare Advantage and Part D plan changes made during this period generally take effect January 1, 2027.
1) Your Health Needs Have Changed
Your medical needs can change from one year to the next. An upcoming surgery, a new diagnosis, or more frequent specialist visits may make it worthwhile to reconsider your coverage.
In our own family, Alexa’s mother chose a Medicare Supplement Plan G when she became eligible for Medicare. That coverage helped make her expenses more predictable when she needed knee replacement surgery. With Plan G, Medicare-covered services generally have little or no additional medical cost sharing after the annual Part B deductible is met. Now that Alexa’s mom isn’t expecting major surgery, she has selected an Advantage plan. Medicare Advantage plans offer lower monthly plan premiums, but have copays, provider networks, prior authorization requirements, and the annual maximum out-of-pocket limit. The right choice depends on you and your upcoming year.
2) Your Prescription Drugs Have Changed
Many of our clients choose an inexpensive prescription drug plan that works well for their generic medications. But a new prescription can change which plan offers the best value. Even if your medications stay the same, your plan can change its premiums, covered drug list, pharmacy network, and cost sharing. A medication that was affordable this year may cost more next year.
For 2027, important Part D limits include:
- A $2,400 annual out-of-pocket cap for covered Part D prescription drugs, up from $2,100 in 2026. Premiums and drugs your plan does not cover do not count toward this cap.
- A maximum allowed deductible of $700, up from $615 in 2026. Some plans have a lower deductible or no deductible.
Give HealthyMarks Medicare a call before choosing your coverage. We can compare your medications, dosages, and preferred pharmacies to help you find a Part D Prescription Drug Plan that fits your needs.
Major Changes for Medicare 2027 – Sharp, Scripps, UCSD
Major Medicare changes are coming to San Diego in 2027. Sharp Health Plan is ending its individual Sharp Direct Advantage plans, and several Medicare Advantage PPO plans from Aetna, Alignment, and Humana are also being discontinued. Affected members will need new coverage effective January 1, 2027. Sharp patients may be able to keep their doctors through certain UnitedHealthcare Medicare Advantage plans or Original Medicare with a Medicare Supplement policy. Keep your plan’s non-renewal notice, as you may qualify for special enrollment opportunities and rights to purchase certain Medicare Supplement policies without medical underwriting. HealthyMarks Medicare can help you sign up for a new Sharp Medicare Plan.
For patients who want to keep access to UCSD or Scripps Clinic and Scripps Coastal doctors, Original Medicare with a Medicare Supplement plan remains an option to consider. Certain Medicare Advantage HMO arrangements also provide access to UCSD specialists and hospitals, but require an affiliated primary care doctor, referrals, and authorizations. Scripps patients using PPO out-of-network benefits should review their options carefully as several of those plans are ending. HealthyMarks Medicare can help you compare coverage, confirm access to your doctors, and understand your enrollment deadlines.
HealthyMarks Medicare Can Help
HealthyMarks Medicare can help you review your current coverage and compare your options for 2027. Whether your health needs have changed, your prescriptions cost more, or your Sharp Direct Advantage plan is ending, we can walk you through the next steps.
Contact HealthyMarks during October 15–December 7 so we can help you prepare for coverage beginning January 1, 2027.
Keaton Marks is the owner and CEO at HealthyMarks including the medicare team. Keaton was born and raised in Encinitas. He often rode his bike through town and to the local beaches like Moonlight. Keaton knows it is important to have a local resource, someone who understands the area, the hospitals and networks of doctors. Keaton is proud to be a local Medicare broker who is able to assist the people in his town when selecting medicare plans.
Keaton believes one thing above all else: “Medicare is confusing… but it doesn’t have to be! That is where HealthyMarks Medicare comes in” Please contact me with any questions.