With 391 Medicare Advantage options from 41 insurers, California has significantly more plan choices than the national average, suggesting a highly competitive market where insurers often lower premiums to attract members. Approximately 83% of local MA plans charge $0 beyond the standard Part B premium, reflecting strong price competition. With 3 hospitals within 25.0 miles, verifying your preferred hospital is in-network is especially important here. We've organized the CMS data below to help you cross-reference plan costs, quality ratings, and local provider access. Compare plans below, and when you're ready, enroll directly at Medicare.gov.
📊 Direct from CMS🚫 No agents or commissions✓ Just the data, no sales pitch
Data freshness: CMS data as of February 2026 •
ACS data as of 2023 •
Reviewed & approved on 2026-02-16 Reviewed by:Wes Ward, Founder & Data Lead •
View our methodology
Important: We are not affiliated with Medicare or any government agency. This site displays publicly available CMS data to help you compare plans. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).
Important: Plan availability, benefits, and CMS Star Ratings shown here come directly from CMS public files. Plan details can change—always verify with the insurer and at Medicare.gov.
Part C Plans
391
Part D Plans
12
Top MA Star
4.5
Top Drug Star
3.5
Medicare Eligibility in California
Approximately 6,154,628 residents (15.1% of the population) in California are 65 or older and likely Medicare-eligible. Whether you're approaching 65, already enrolled, or a caregiver comparing options, the plan data below is organized to help you evaluate Part C (Medicare Advantage) and Part D (prescription drug) coverage side by side.
The median household income in California is $108,618 (44.5% above the National Average), which may affect eligibility for Extra Help with Part D drug costs.
Part C: Medicare Advantage Plans
Medicare Advantage (Part C) replaces Original Medicare through private insurers who bundle hospital, medical, and often drug coverage into a single plan. California's 391 Medicare Advantage plans are predominantly HMO-based (361 HMO vs. 30 PPO), meaning most require referrals and in-network care. 324 plans offer $0 monthly premiums. The average local star rating is 3.6 out of 5, with the top plan earning 4.5 ★.
Top Medicare Advantage Plans in California
We organize CMS plan data into separate leaderboards so you can compare based on what matters most to you. Part C premiums in California range from $0 to $247/month. Among rated plans, 203 plans rated 4+ stars.
Lower premiums can save money, but check total costs including deductibles, copays, and MOOP.
Plan Name
Insurer
Monthly Premium
MOOP
Star Rating
Kaiser Permanente Senior Advantage La, Orange Co. (HMO)
Kaiser Permanente
$0.00/mo
$699
4.0 ★
Scan Classic (HMO)
Scan Health Plan
$0.00/mo
$199
4.0 ★
Kaiser Permanente Senior Advantage San Diego (HMO)
Kaiser Permanente
$0.00/mo
$1,800
4.0 ★
Scan Classic (HMO)
Scan Health Plan
$0.00/mo
$199
4.0 ★
Anthem Full Dual Advantage Aligned (HMO D-SNP)
Anthem Blue Cross
$0.00/mo
$9,250
3.0 ★
Lowest Maximum Out-of-Pocket (MOOP)
MOOP caps your financial risk. Once you hit this limit, the plan covers 100% of covered services for the rest of the year.
Plan Name
Insurer
MOOP (In-Network)
Premium
Star Rating
Scan Classic (HMO)
Scan Health Plan
$199
$0.00/mo
4.0 ★
Scan Classic (HMO)
Scan Health Plan
$199
$0.00/mo
4.0 ★
Scan Balance (HMO C-SNP)
Scan Health Plan
$199
$0.00/mo
4.0 ★
Scan Affirm Partnered With Included Lgbtq+ Health (HMO)
Scan Health Plan
$199
$0.00/mo
4.0 ★
Champion Ally (HMO)
Champion Heath Plan
$199
$0.00/mo
N/A
Plan Type Mix in California
HMO plans require referrals and in-network care. PPO plans offer more flexibility. SNP (Special Needs Plans) serve specific populations. MAPD plans include drug coverage.
Plan Type
Count
Percentage
Description
HMO
174
44.5%
Requires referrals; in-network only
HMO-POS
70
17.9%
HMO with some out-of-network options
HMO D-SNP
48
12.3%
Medicare Advantage plan
HMO C-SNP
40
10.2%
Medicare Advantage plan
PPO
27
6.9%
No referrals; in and out-of-network
HMO-POS C-SNP
21
5.4%
Medicare Advantage plan
HMO I-SNP
6
1.5%
Medicare Advantage plan
PPO D-SNP
2
0.5%
Medicare Advantage plan
HMO-POS I-SNP
2
0.5%
Medicare Advantage plan
PPO C-SNP
1
0.3%
Medicare Advantage plan
Choosing the Right Medicare Advantage Plan
The best Part C plan depends on your doctors, medications, and budget. Key factors to evaluate:
Provider network: Verify your doctors and hospitals in California are in-network before enrolling
Total cost: A $0 premium may have higher copays—calculate your annual cost
Star Ratings: 4+ stars indicate above-average quality and member satisfaction
41 insurance companies offer Medicare Advantage plans in California. Below, we group plans by insurer so you can compare options from each company. More insurers generally means more competition and better benefits for consumers.
Kaiser Permanente
Avg Star Rating
4.2 ★
48 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Kaiser Permanente Dual Complete South P10 (HMO D-SNP)
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Part D: Prescription Drug Plans (PDP)
Part D covers prescription drugs through standalone plans for those on Original Medicare, or as part of a Medicare Advantage bundle. Among the 12 standalone Part D plans in California, some offer $0 annual deductibles while others charge up to the 2026 maximum of $590. 2 plans are at or below the regional premium benchmark, making them eligible for Low Income Subsidy auto-enrollment. The 2026 $2,000 out-of-pocket cap means drug costs are now more predictable regardless of which plan you choose, but formulary coverage still varies significantly—always verify your medications are covered before enrolling.
Part D Formulary Notice: Each Part D plan has its own formulary (list of covered drugs). The same medication may be on different tiers—or not covered at all—depending on the plan. Always check that your specific medications are covered before enrolling.
2026 Out-of-Pocket Cap: Thanks to the Inflation Reduction Act, your total out-of-pocket drug costs are capped at $2,000 per year in 2026. Once you reach this limit, you pay nothing more for covered Part D drugs for the rest of the year. This eliminates the old "donut hole" coverage gap that previously caused higher costs.
Low Income Subsidy (LIS / Extra Help): If you have limited income and resources, you may qualify for Extra Help paying Part D costs. Visit SSA.gov or call 1-800-MEDICARE.
Top Part D Drug Plans in California
We organize Part D plans by CMS Star Ratings, premiums, and deductibles so you can find the best fit for your prescription needs. Part D premiums in California range from $0 to $228/month. Remember: all Part D plans now cap your annual out-of-pocket drug costs at $2,000 thanks to the Inflation Reduction Act.
Highest CMS Star Ratings (Part D)
Part D Star Ratings measure drug pricing, customer service, member complaints, and pharmacy access.
The deductible is what you pay out-of-pocket before the plan starts covering drug costs. The 2026 maximum Part D deductible is $590. Many plans offer $0 deductible options.
Plan Name
Insurer
Drug Deductible
Monthly Premium
Star Rating
Humana Premier Rx Plan (PDP)
Humana
$0
$172.90/mo
3.0 ★
Blue Shield Rx Enhanced (PDP)
Blue Shield Of California
$0
$227.80/mo
3.0 ★
Aarp Medicare Rx Preferred From Uhc (PDP)
Unitedhealthcare
$130
$165.40/mo
2.0 ★
Humana Value Rx Plan (PDP)
Humana
$601
$104.60/mo
3.0 ★
Healthspring Assurance Rx (PDP)
Healthspring
$615
$0.00/mo
2.5 ★
Understanding drug tiers: Part D plans organize medications into 5 cost tiers — Tier 1 (Preferred Generic) is cheapest; Tier 5 (Specialty) is most expensive. Two plans with the same premium can have very different costs for your drugs depending on tier placement. Learn more about drug tiers →
Choosing the Right Part D Drug Plan
The right Part D plan depends on your specific medications. Key factors to evaluate:
Formulary: Verify your drugs are covered before enrolling
Preferred pharmacies: Lower copays at certain locations—check your pharmacy is in-network
Total annual cost: Premium + deductible + copays for your drugs
Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.
Ready to Enroll in California?
Compare plans side-by-side at Medicare.gov or speak with a licensed Medicare specialist.
Pharmacy data from CMS. Network participation varies by plan—always verify with your specific Part D plan.
Local Healthcare Access in California
Before choosing a plan, consider the healthcare infrastructure in California. Medicare Advantage plans restrict you to in-network hospitals, so understanding local hospital quality helps you pick the right plan — not just the cheapest one.
Note: The facilities below do not indicate which providers are in-network for any specific plan. Always verify network status with your plan before enrolling.
Hospitals Nearby
3
within 25.0 miles
Top-Rated Hospitals in California
If hospital access matters to your plan choice, check quality ratings before you enroll. These are the highest CMS-rated hospitals in California — click a hospital name to see its full profile and verify it's in your plan's network.
Many Medicare Advantage and some Part D plans now include telehealth benefits, making routine check-ins and prescription refills easier from home. But telehealth requires reliable internet—here's a look at connectivity in California. For official guidance on virtual visits, see Telehealth.HHS.gov from the U.S. Department of Health & Human Services.
Check Internet Providers at Your Address
Telehealth works best with reliable internet. Use this tool (provided free by ISP Reports) to see what's available at your address.
Opens ISP Reports in a new tab. This is not a paid relationship. Special thank you to ISP Reports for allowing free use of their address tool.
Understanding California's demographics helps contextualize why insurers offer the plans they do. Areas with more seniors and higher incomes tend to attract more insurer competition, while areas with higher Medicaid enrollment may have more Dual-Eligible Special Needs Plans (D-SNP) available.
Total Population
40,697,496
Population 65+
6,154,628
15.1% of total
Median Age
39
0.8 years older than the national average
Median Income
$108,618
44.5% above the National Average
On Medicare
5,515,993
13.6% of residents
On Medicaid
9,281,603
22.8% of residents
Uninsured
2,782,777
6.8% of residents
Social Security Recipients
11,253,716
27.7% of population
Demographic data from U.S. Census Bureau American Community Survey (2023).
View full California demographics (BestNeighborhood.org).
Local Medicare FAQ: California
Common decision points based on California's specific plan market and local healthcare landscape.
How does California's Medicare Advantage market compare?
California has 391 Medicare Advantage plans from 41 insurers. This is significantly above the national average of approximately 57 plans per area, indicating a highly competitive local market. More competition typically means lower premiums and better supplemental benefits for beneficiaries. The local mix includes 361 HMO and 30 PPO plans. Plan availability updates annually during the Medicare Annual Enrollment Period (October 15 – December 7).
Should I choose an HMO or PPO Medicare Advantage plan in California?
With 3 hospitals nearby, a PPO plan may offer valuable flexibility if your preferred providers aren't all in the same network. HMO plans (361 available) cost less but limit your choices. In California, HMO plans dominate the market, which often means more competitive HMO pricing. Always verify your doctors are in-network before enrolling in any plan.
What's the real cost of $0 premium plans in California?
324 plans (83% of available options) in California charge $0 beyond the standard Part B premium. This high percentage reflects strong insurer competition in the area. However, $0 premium doesn't mean $0 cost. These plans may have higher copays, coinsurance, or out-of-pocket maximums. In California, maximum out-of-pocket limits range from $199 to an average of $4,094. We recommend calculating your total expected annual cost (premium + copays + drug costs) rather than choosing based on premium alone.
How does the 2026 $2,000 drug cap affect California beneficiaries?
The Inflation Reduction Act capped annual out-of-pocket drug spending at $2,000 starting in 2025, eliminating the old "donut hole" coverage gap. This applies to all 12 standalone Part D plans in California.
What this means locally:
Cost predictability — No matter which of the 12 Part D plans you choose, your drug costs are capped at $2,000/year
$0 deductible options — Some local plans offer $0 deductibles, meaning coverage starts immediately
Low-income options — 2 plans meet the regional benchmark for Extra Help/LIS eligibility
While the out-of-pocket cap standardizes maximum costs, formulary coverage still varies significantly between plans. A drug that costs $5/month on one plan's formulary might cost $50 on another. Always check that your specific medications are covered and compare tier placement before enrolling.
Wes Ward is the founder of InsuranceDataNow.org and reviews all content for data accuracy and methodology compliance.
With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to consumer data tools. He is also a co-founder of BestNeighborhood.org, CrimeGrade.org, and ISPReports.org.
Role: Reviews and approves all content for data accuracy, source verification, and methodology compliance.
InsuranceDataNow is an advertising-supported publisher based in South Jordan, Utah. We are not affiliated with or endorsed by Medicare or the U.S. government.
TPMO 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 (24 hours a day/7 days a week) to get information on all of your options.
Sources
CMS Medicare Plan Finder Data (Part C & D):cms.gov
CMS Provider Directory: Hospital and pharmacy data from data.cms.gov
American Community Survey: Demographic data from census.gov
BestNeighborhood.org: Community demographic profiles for California from bestneighborhood.org
All data is sourced from official government databases and trusted third-party providers. Data is updated regularly—see page header for last refresh dates.