Newsroom · San Diego County, California

SCAN Medicare Advantage San Diego 2027: What Is Changing?

SCAN Health Plan is staying in San Diego County for 2027. Three of its five general plans continue, two end, and one new plan with Costco in its name arrives. For the 18,054 county members in SCAN Alta, the premium stays $0 and the yearly cap on what they can be asked to pay goes from $500 to $900.

Medicare On Main Data Desk

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

I pulled SCAN Health Plan'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. 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.

SCAN's general plans 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 SCAN Alta, Classic or Select

Your plan continues. What you received in the mail is an Annual Notice of Changes, and the figures above are the three it leads with.

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. Most members never reach it. It is what a hard year costs: a hospital stay, a surgery, a course of cancer treatment. So read the change as a change in your worst case. On Alta that worst case is $400 higher in 2027. On Classic it is $800 higher, and on Select $1,050 higher.

Some context from the same file. San Diego County's 2027 shelf has 41 general Medicare Advantage plans with drug coverage, down from 54, with caps running from $295 to $9,850. Five of them have a cap below $900. In 2026 only two plans in the county sat below Alta's $500. A cap of $900 is still near the low end of the county; it is no longer almost alone there.

The Part D deductible is the other number that moved. It is what you pay for prescriptions before the plan's drug copays begin, and many plans waive it on their lower tiers. The file says each of these plans has at least one tier with no deductible. It does not say which tier your prescriptions are on. That is in the 2027 formulary.

What the file cannot show you at all: copays for office visits, the hospital and imaging; dental, vision and hearing extras; and which doctors are in the network. The Annual Notice of Changes prints this year beside next year, line by line. Read its cost tables for the services you actually used in 2026. Medicare Plan Compare shows copays and estimated drug costs for every plan in the county.

If you are in SCAN Affirm or SCAN MyChoice

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. And the Medigap rules in California, including which plan letters are guaranteed, are in the Medigap post.

The new SCAN Costco plan

SCAN Costco Medicare Advantage (HMO), plan H5425-145, has no 2026 row and a 2027 row for San Diego County: $0 premium, $900 cap, $370 Part D deductible. Those are the same three numbers SCAN Alta carries for 2027.

That is all the CMS file says. It does not show copays, extras, or whether the two plans use the same doctors. Two plans from one insurer can share a premium and a cap and still differ in every line a member uses. If you are weighing one against the other, put the two Summaries of Benefits side by side and look up your own doctors in each directory.

SCAN's Special Needs Plans

SCAN also has four plans in the county for people with specific chronic conditions or with both Medicare and Medi-Cal. All four continue.

Sources: the same CMS landscape and enrollment files. C-SNPs enroll people with a qualifying chronic condition; D-SNPs enroll people who have both Medicare and Medi-Cal, and what a D-SNP member actually pays depends on their Medi-Cal coverage, not on the cap shown here.

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

Around 19,700 San Diego County members of Sharp Health Plan are choosing new coverage this fall because Sharp Direct Advantage is being discontinued. A $0 plan with a $900 cap will be on many of their lists. Two facts to hold first:

• Every SCAN plan here is an HMO. In an HMO you generally get your care from doctors and hospitals in the plan's network, except in an emergency or for urgent care away from home (Medicare.gov).
• Sharp's own list does not name SCAN. 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. That page is Sharp's list, not SCAN's directory, so check both: look up each doctor by name in SCAN'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 SCAN, that means Affirm and MyChoice members whose letter says so. A higher cap on Alta, Classic or Select 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 SCAN and confirm whether it is an Annual Notice of Changes or a letter saying the plan is ending.
2. Match the plan name and number on it to your card. SCAN has eight plans in this county for 2027 and several names are close.
3. Read the cost table for the services you used in 2026. The cap matters in a hard year; the copays matter every year.
4. Check your prescriptions against the 2027 formulary, tier by tier, now that the deductible is higher.
5. If you want to compare, do it before December 7, with your doctors' names in hand.

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, enrollment periods and Medigap. Copays, formularies, extra benefits and networks are not in any CMS file and are deliberately not described; your Annual Notice of Changes and SCAN Health Plan'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, a retailer 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.