California is the largest Medicare Advantage market in the country by enrollee count and one of the most competitive on premium. About 3.6 million Californians had a Medicare Advantage plan in 2026, roughly 51% of the state's Medicare-eligible population, in line with the national average. That competition pushes the average monthly premium down to $11, well below the national MA average of $14.
What makes California different: Kaiser Permanente dominates Southern and Northern California (closed-network HMO model, strong Star Ratings) — confirm your doctors are in-network before enrolling, while UnitedHealthcare, Humana, Anthem Blue Cross, and Blue Shield of California compete for the PPO and broad-network HMO market. Rural counties in the Central Valley and Sierra Nevada have fewer plan choices (sometimes only 8-12 plans) and slightly higher premiums than urban counties.
This guide covers the 2026 California Medicare Advantage market: how many plans, which carriers, what to look for when shopping, and the key enrollment dates. Annual Election Period is October 15 - December 7, 2026, with coverage starting January 1, 2027.
2026 Medicare Advantage Market Overview in California
In 2026, California has 402 Medicare Advantage plans available, with 3,600,000 beneficiaries enrolled (51% MA penetration). The average monthly premium is $11 and the statewide average Star Rating is 4.1.
Top Medicare Advantage carriers in California (2026)| Carrier | Plans | Avg Star Rating | Avg Premium |
|---|
| Kaiser Permanente | 50 | 4.5 | $12/mo |
| UnitedHealthcare | 80 | 4.0 | $9/mo |
| Humana | 55 | 4.0 | $8/mo |
| Anthem Blue Cross | 60 | 3.8 | $14/mo |
| Blue Shield of California | 40 | 4.0 | $17/mo |
| SCAN Health Plan | 30 | 4.5 | $5/mo |
| Aetna | 50 | 3.5 | $18/mo |
| Alignment Healthcare | 25 | 4.0 | $7/mo |
Source: KFF Medicare Advantage 2026 Spotlight, CMS Medicare Plan Finder Q4 2025
Plan Types in California: HMO vs PPO vs SNP
Medicare Advantage plan-type breakdown in California| Plan Type | Plans Available | Avg Premium | Best For |
|---|
| HMO | 241 | $8/mo | Lower premiums, willing to use network providers |
| PPO | 121 | $22/mo | Flexibility to see out-of-network providers |
| Special Needs Plan (SNP) | 35 | $0/mo | Dual-eligible (Medi-Cal + Medicare), chronic conditions, institutional |
| Medical Savings Account (MSA) | 5 | $0/mo | High-deductible plan with bank account; uncommon in CA |
HMO plans dominate California: about 60% of all MA plans. PPO grew faster in 2025-2026 due to network flexibility demand.
Source: KFF Medicare Advantage 2026 Spotlight, CMS Medicare Plan Finder
County-Level Variance in California
Plan availability varies sharply by California county. Urban counties have 70-110 plans to choose from; rural Central Valley and Sierra counties may have only 12-25. Premiums also vary, with rural areas typically $10-20 higher per month due to lower competition.
Plan count and average premium by county in California| County | Plans Available | Avg Premium |
|---|
| Los Angeles County | 110 | $8/mo |
| San Francisco County | 70 | $12/mo |
| Fresno County | 55 | $14/mo |
| Mono County | 18 | $28/mo |
| Modoc County | 14 | $31/mo |
Plan counts and premiums are from CMS Medicare Plan Finder Q4 2025. Run a personalized search at medicare.gov to see exact plans for your ZIP code.
Source: CMS Medicare Plan Finder Q4 2025
What to Look For in a Medicare Advantage Plan in California
Picking a Medicare Advantage plan in California is not just about premium. Here's what matters for shopping in 2026:
- Provider network. Confirm your primary care physician, specialists, and preferred hospital are all in-network before enrolling. California networks vary by county, sometimes dramatically.
- Prescription drug coverage (formulary). Most MA plans include Part D. Check that your specific medications are on the plan's formulary at the tier you can afford. The 2026 Part D out-of-pocket cap is $2,100 across all plans.
- Star Ratings. CMS rates plans 1-5 stars annually on quality of care, member experience, and customer service. 4-star and 5-star plans get bonus payments from CMS that fund richer benefits. In CA, Kaiser and SCAN consistently score 4.5+ stars.
- Extras (dental, vision, hearing, fitness, transportation). MA plans differ widely on supplemental benefits. SCAN and Alignment offer generous dental and hearing aid coverage; UnitedHealthcare offers SilverSneakers fitness; some plans cover Uber/Lyft rides to medical appointments.
- Maximum out-of-pocket (MOOP). MA plans cap your annual in-network out-of-pocket spending. The 2026 federal MOOP ceiling for in-network MA is $9,250 (down $100 from $9,350 in 2025); many California plans set it lower ($4,500 to $7,500). Original Medicare has no MOOP.
- Prior authorization burden. MA plans can require prior authorization for surgeries, advanced imaging, and specialist referrals. If you have a chronic condition or expect significant care, ask how often the plan requires PA and check denial rates published by CMS.
Key Medicare Dates in California
Medicare and Medicare Advantage have several enrollment windows. Miss them and you may face delays or late penalties.
- Annual Election Period (AEP): October 15 - December 7, 2026 — Switch between Original Medicare and MA, change MA plans, or change Part D plans. Coverage starts January 1, 2027.
- Medicare Advantage Open Enrollment Period (MA OEP): January 1 - March 31, 2026 — If you're already in an MA plan, you can switch to a different MA plan or return to Original Medicare. One switch only.
- Initial Enrollment Period (IEP): 7-month window around your 65th birthday — Starts 3 months before your 65th birthday month, includes the birth month, and runs 3 months after. Enroll in Medicare Parts A and B, then choose MA or Original + Part D.
- Special Enrollment Periods (SEPs): Varies by qualifying event — Triggered by moving out of your plan's service area, losing employer coverage, qualifying for Medi-Cal (dual eligible), or other life events. Typically a 2-3 month window.
Notable Extras in California Plans
California Medicare Advantage plans offer several state-specific extras worth knowing about:
- Dual-eligible D-SNPs (Medi-Cal + Medicare): California has multiple Dual Special Needs Plans (D-SNPs) for residents who qualify for both Medi-Cal and Medicare. These typically have $0 premiums, $0 copays for primary care, and zero out-of-pocket prescription costs. Check medicare.gov Plan Finder for the D-SNPs offered in your county.
- Transportation benefits: Many California MA plans include 30-60 free one-way rides per year to medical appointments via Uber Health, Lyft, or local providers, especially valuable in transit-light counties.
- OTC and food allowances: Several California MA carriers offer $50-$150/month allowances for over-the-counter health products and, in select dual-eligible plans, grocery cards. Check the plan's Evidence of Coverage for specifics.
- Integrated Kaiser Permanente system: Kaiser's HMO model integrates doctors, hospitals, pharmacy, and lab under one umbrella. If you live within a Kaiser service area and value coordinated care over choice of doctor, this is the dominant CA option.
Medicare Advantage vs Original Medicare in California
Original Medicare (Parts A and B) plus a Medigap supplement and a standalone Part D drug plan gives you nationwide provider freedom and no prior authorization for most services, but your monthly premium for Medigap + Part D in California typically runs $200-$400/month. Medicare Advantage plans bundle hospital, medical, and usually drug coverage into one plan with average premiums of $11/month statewide, but the trade-off is a defined network and prior authorization for many services.
If you split time between California and another state, or you need access to a specialist outside your county, Original Medicare + Medigap is usually the better fit. If you spend all your time in California and want lower premiums plus extras like dental, vision, and transportation, Medicare Advantage usually wins on total cost.
One California-specific quirk: under federal rules, you can switch from Medicare Advantage back to Original Medicare during AEP or MA OEP, but Medigap carriers are not required to sell you a policy at that point unless you have a guaranteed issue right. California has stronger consumer protections than most states (annual Medigap birthday rule lets you switch Medigap plans on your birthday without medical underwriting), but the right to buy Medigap when leaving MA is still limited. Plan accordingly.
How Star Ratings work and why they matter in California
CMS publishes Medicare Advantage Star Ratings every October, rating plans 1 to 5 stars based on roughly 40 quality measures: how well plans manage chronic conditions, customer service ratings, member complaints, and Part D drug safety. Plans rated 4 stars or higher receive quality bonus payments from CMS, which often translate to richer benefits the next plan year.
California is one of the top-rated MA states. The statewide weighted-average Star Rating for 2026 is 4.1, compared to a national average closer to 3.8. Kaiser Permanente and SCAN Health Plan are the highest-rated California carriers, both consistently at 4.5 stars or higher. A small number of California plans hold the rare 5-star rating, which triggers a Special Enrollment Period allowing you to switch into them any time of year.
Medi-Cal and dual eligibility in California
If you qualify for Medi-Cal (California's Medicaid program) and Medicare at the same time, you are dual eligible. Dual-eligible Californians can enroll in a Dual Special Needs Plan (D-SNP), which coordinates both programs into one plan and typically has $0 premiums, $0 copays, and zero prescription costs. California offers multiple D-SNPs in 2026, varying by county.
Dual eligibility also unlocks a special enrollment right: dual-eligible beneficiaries can change MA plans (or move between MA and Original Medicare) once per quarter in Q1, Q2, and Q3, plus another time during AEP. If your Medi-Cal status changes, you also get a Special Enrollment Period.
Frequently Asked Questions
How many Medicare Advantage plans are available in California in 2026?
California has 402 Medicare Advantage plans available statewide in 2026, per the KFF Medicare Advantage 2026 Spotlight, down from 421 in 2025. The exact number available to you depends on your county and ZIP code. Urban counties like Los Angeles offer 100+ plans; rural counties like Modoc or Mono may have only 14-18 plans. Run a ZIP-code search at medicare.gov to see your exact options.
What is the average Medicare Advantage premium in California for 2026?
The statewide weighted-average Medicare Advantage premium in California is about $11 per month in 2026, well below the national MA average of $14. Many California HMO plans charge $0 monthly premium, especially in competitive markets like Los Angeles, Orange County, and the Bay Area. Premiums tend to be higher ($25-$50/mo) for PPO plans with broader networks.
When can I sign up for Medicare Advantage in California?
The main enrollment window is the Annual Election Period (AEP) from October 15 to December 7, 2026, for coverage starting January 1, 2027. You can also enroll during your 7-month Initial Enrollment Period around your 65th birthday, or during a Special Enrollment Period triggered by events like moving, losing employer coverage, or qualifying for Medi-Cal. Existing MA enrollees can switch plans during the MA Open Enrollment Period (January 1 - March 31, 2026).
Who has the best Medicare Advantage plans in California?
Kaiser Permanente leads California in Star Ratings (consistently 4.5+ stars) and total enrollment. SCAN Health Plan is another standout (4.5 stars, California-based nonprofit, generous extras). UnitedHealthcare and Humana offer the broadest networks for those who don't want a closed HMO. The best plan for you depends on your doctors, your medications, and whether you value low premium or wide network.
Can I switch from Medicare Advantage back to Original Medicare in California?
Yes. You can switch back during the Annual Election Period (October 15 - December 7) or the Medicare Advantage Open Enrollment Period (January 1 - March 31). However, returning to Original Medicare does not automatically guarantee you can buy a Medigap policy: Medigap insurers in California are generally not required to sell you a plan outside your initial Medigap open enrollment window, except under specific guaranteed issue rights. California's annual Medigap birthday rule lets you switch among Medigap plans without underwriting, but doesn't apply when first leaving MA. Plan ahead.
What is the difference between an HMO and a PPO in California Medicare Advantage?
HMOs (241 of California's 402 plans, about 60%) require you to use in-network providers and usually need a referral to see a specialist. They offer lower premiums (average $8/mo) and Kaiser Permanente is the dominant HMO. PPOs (121 plans, about 30%) let you see out-of-network providers at a higher cost share and don't require referrals, but charge higher premiums (average $22/mo). Choose HMO for lower cost in network; choose PPO for flexibility.
Does Medicare Advantage cover prescription drugs in California?
Most California Medicare Advantage plans (about 87%) include Part D prescription drug coverage built in. These are called MA-PD plans. The 2026 Part D annual out-of-pocket maximum is $2,100 across all plans (set by the Inflation Reduction Act). Always check the plan's formulary to confirm your specific medications are covered, and at what tier.
Are dental, vision, and hearing covered by Medicare Advantage in California?
Most California Medicare Advantage plans include some level of dental, vision, and hearing benefits, which Original Medicare does not cover. Coverage varies widely: some plans cover only cleanings and exams, while others cover crowns, hearing aids, and prescription eyewear. SCAN Health Plan and several Kaiser plans offer the most generous packages. Always check the Evidence of Coverage for annual limits and what's actually covered.
