Newsroom · San Diego County, California

Is Humana Leaving Medicare Advantage in San Diego for 2027?

No. Humana is staying in San Diego County for 2027, with six plans where it had seven. Two plans end on December 31, and they held 3,474 county members in September. For the 4,208 members in the largest plan that continues, the premium stays $0 and the yearly cap on what they can be asked to pay goes from $1,900 to $3,000.

Medicare On Main Data Desk

Published October 12, 2026 · 7 min read · Reviewed by Brian Penner

I pulled Humana's San Diego County rows out of the CMS 2026 and 2027 landscape files on October 12 and matched them by contract and plan number, not by name. This post reports what those files show and is just as plain about what they do not show. Carrier and health-system names are factual reporting, not endorsement or criticism. Nothing here is a recommendation, and we do not offer every plan available in your area.

Humana's plans with drug coverage in San Diego County, 2026 and 2027

Sources: CMS CY2026 and CY2027 landscape files, San Diego County rows, matched by Contract Plan ID on October 12, 2026; CMS Monthly Enrollment by Contract/Plan/State/County, September 2026. "Cap" is the file's in-network maximum out-of-pocket; "drug ded." is the Part D deductible. Premiums are the consolidated Part C + D premium; everyone also pays the Part B premium. A $0 premium does not mean a plan has no costs. Listing a plan is not a recommendation.

Sources: CMS landscape files · CMS September 2026 enrollment · CMS 2027 Star Ratings data tables.

If you are in HumanaChoice (PPO) or Gold Plus H5619-148

Neither plan number appears anywhere in the CMS 2027 file. The plans are being discontinued. Your Medicare is not ending, and nothing changes before December 31, 2026.

Read the letter before anything else. When a plan number disappears, one of two things has happened. Either the plan has ended and you must choose new coverage, or the insurer has combined it into another of its plans and will move you there unless you choose otherwise. The CMS file cannot tell those apart. Your letter can. What a non-renewal letter has to say is covered here.

If the letter says the plan is ending and you are not being moved, these are your dates:

• October 15 – December 7. Choose a new plan in the Annual Enrollment Period and it starts January 1, with no gap (Medicare.gov).
• December 8 – February 28. A Special Enrollment Period for members of discontinued plans (42 CFR § 422.62(b)(1)). A plan chosen in January starts February 1; one chosen in February starts March 1.
• If you do nothing, you are in Original Medicare on January 1 with no drug plan and no yearly cap.
• Medigap with no health questions is available to you if you go to Original Medicare, in a window that runs from 60 days before your plan ends to 63 days after: November 1, 2026 through March 4, 2027 (Medicare.gov).

The whole calendar, date by date, is in this post written for Sharp members. The dates are the same for you. The Medigap rules in California, including which plan letters are guaranteed, are in the Medigap post.

HumanaChoice members: there are three PPOs left

A PPO pays part of the bill when you see a doctor outside its network, usually at a higher cost to you. An HMO generally does not, outside of emergencies and urgent care away from home (Medicare.gov on PPOs; on HMOs). If that is why you chose HumanaChoice, the 2027 shelf is short. San Diego County had six general PPOs with drug coverage in 2026. It has three in 2027:

Source: CMS CY2027 landscape file, San Diego County, general plans (not Special Needs Plans) with Part D, plan type PPO. Ten more plans are HMO-POS, a type that covers some services out of network; which services is in each plan's Evidence of Coverage, not in the CMS file. Listing a plan is not a recommendation.

HumanaChoice had a $0 premium and a $5,700 cap. None of the three is a straight match. The one at $0 has a higher cap, the one with a lower cap costs $160 a month, and the third has a cap of $9,850. The file does not describe who each plan is built for, its copays, or its network, so read the Summary of Benefits before reading anything into a name.

The other route that keeps your choice of doctors is Original Medicare with a Medigap policy and a stand-alone drug plan. There is no network; any provider who takes Medicare can see you. It comes with a monthly Medigap premium, and for a member of a plan that ended, the health questions are waived inside the window above.

If you are in Gold Plus H5619-016

Your plan continues. What you received is an Annual Notice of Changes, and three numbers lead it.

The cap, which CMS calls the in-network maximum out-of-pocket, is the ceiling on your copays and coinsurance for covered Part A and Part B services in a calendar year. It is not a bill, and most members never reach it. It is what a hard year costs: a hospital stay, a surgery, a course of cancer treatment. On this plan that worst case is $1,100 higher in 2027.

Some context from the same file. In 2026, 12 of the county's 54 general plans with drug coverage had a cap below this plan's $1,900. In 2027, 15 of 41 have a cap below $3,000. The plan moved from the lower third of the county toward the middle.

The Part D deductible went the other way, from $615 to $200. That is what you pay for prescriptions before the plan's drug copays begin, and many plans waive it on their lower tiers. If you take a brand-name drug, a lower deductible can matter more in an ordinary year than the cap does. Which tier your prescriptions are on is in the 2027 formulary, not in the CMS file.

If you are in Gold Plus Giveback or a USAA Honor plan

All three of these continue with the same cap.

• Gold Plus Giveback H5619-150 (HMO). The Part D deductible goes from $0 to $700. If you fill brand-name prescriptions, check the formulary to see which tiers the deductible applies to before you assume the plan costs the same.
• USAA Honor Giveback with Rx (PPO), H5525-057. The Part D deductible goes from $615 to $700.
• The two USAA Honor Giveback plans without drug coverage. No change in the cap either year:

Sources: the same CMS landscape and enrollment files. Plans without Part D are generally chosen by people who get prescriptions somewhere else, such as the VA. The size of a "giveback," a reduction in the Part B premium, is not in the landscape file and is not quoted here.

The new Gold Plus plan

Humana Gold Plus H3767-001 (HMO) has no 2026 row and a 2027 row for San Diego County: $0 premium, $3,300 cap, $200 Part D deductible. It sits on a different contract, H3767, which CMS lists as too new to have a Star Rating.

That is all the file says. It shares a name with H5619-016 and has a different cap, and two plans from one insurer can differ in copays, extras and doctors as well. If you are choosing between them, put the two Summaries of Benefits side by side and look up your own doctors in each directory.

If your plan is Sharp Direct Advantage and you are looking at Humana

Around 19,700 San Diego County members of Sharp Health Plan are choosing new coverage this fall because Sharp Direct Advantage is being discontinued. One fact to hold first: Sharp HealthCare's accepted-plans page, read October 12, lists Original Medicare, all Medigap plans, TRICARE for Life, Sharp Health Plan and a set of UnitedHealthcare plans. It does not name Humana. That page is Sharp's list, not Humana's directory, so check both, and look up each doctor by name in the plan's 2027 provider directory before you enroll, not after.

If keeping your Sharp doctors is the point, the routes that do that are in the doctors post. The full county list of what left and what arrived is on the San Diego County reference page.

A plan that changed is not a plan that ended

The December 8 – February 28 Special Enrollment Period and the no-health-questions Medigap window belong to members of plans that ended. For Humana in this county, that means HumanaChoice H5525-077 and Gold Plus H5619-148 members whose letter says so. A higher cap or a higher drug deductible on a plan that continues opens neither one.

If you are in a continuing plan, your windows are the ones everyone has: October 15 to December 7, and one more switch between January 1 and March 31 if you are in a Medicare Advantage plan on January 1. If you want to leave a continuing plan for Original Medicare and a Medigap policy, the insurer may in most cases ask health questions and may decline. Get a decision on the Medigap application before you give up the plan you have.

What I would do this week

1. Find the mailing from Humana and confirm whether it is an Annual Notice of Changes or a letter saying the plan is ending.
2. Match the plan number, not the name, to your card. The digits after the H are what matter here.
3. If your plan is ending, list your doctors and decide whether seeing them out of network is something you need. That decides whether you are looking at three plans or forty-one.
4. Check your prescriptions against the 2027 formulary, tier by tier. Three of these plans have a different drug deductible next year.
5. Choose before December 7 if you can, so the new coverage starts January 1 with no gap.

How we know all this: the Medicare On Main Data Desk frames every article with public data — here, the CMS CY2026 and CY2027 landscape files compared by Contract Plan ID on October 12, 2026, the CMS September 2026 county enrollment file, the CMS 2027 Star Ratings data tables published October 8, 2026, Sharp HealthCare's accepted-plans page read the same day, 42 CFR § 422.62, and Medicare.gov's pages on plan notices, HMOs, PPOs, enrollment periods and Medigap. Copays, formularies, extra benefits, givebacks and networks are not in any CMS file and are deliberately not described; your Annual Notice of Changes or non-renewal letter and Humana's plan documents are the authority on those. Medicare On Main is a licensed independent insurance agency. We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. Not connected with or endorsed by the U.S. government or the federal Medicare program. Mentioning a carrier or a health system is factual reporting, not endorsement or criticism. This is education, not advice; confirm your plan, costs and eligibility with the plan, a licensed agent, HICAP or Medicare.gov.