Newsroom · San Diego County, California

Sharp Direct Advantage vs UHC Sharp Medicare Advantage 2027

If your Sharp Direct Advantage letter arrived, the plan most people are being pointed toward has "Sharp" in its name and a different insurer behind it. Here is what the two actually look like side by side, using only what the CMS plan files can show: premium, cap, drug deductible, plan type, stars and members. And, just as important, a plain list of what those files cannot show, so you know what still has to be read before December 7.

Medicare On Main Data Desk

Published October 7, 2026 · 9 min read · Reviewed by Brian Penner

This is the fourth post in our series on Sharp Direct Advantage ending. We covered the exit (is Sharp Direct Advantage ending in 2027?), the county's full list of departing plans (22 plans ending in San Diego County), how to keep your Sharp doctors (Rees-Stealy versus Sharp Community and the UnitedHealthcare plans) and the Medigap door (Medigap without health questions in California). This one answers the question people ask once they have read the letter: "the UnitedHealthcare plan with Sharp in the name, how different is it, really?" The honest answer has two halves. The CMS landscape file shows a handful of numbers, and we lay them out exactly. Everything else, including the things that decide whether a plan fits you, lives in documents the file does not contain. Carrier and health-system names are factual reporting, not endorsement or criticism; nothing here is a recommendation; we do not offer every plan available in your area.

The side-by-side, from the files only

Sources: CMS CY2026 and CY2027 landscape files, San Diego County rows, compared by Contract ID and Plan ID on October 7, 2026; CMS Monthly Enrollment by Contract/Plan/State/County, September 2026. "Cap" is the file's in-network maximum out-of-pocket. Star Ratings are the 2026 overall ratings; 2027 ratings are blank in the file until CMS publishes them. The Part D out-of-pocket threshold is a federal figure that applies to every drug plan, not a difference between these two. Listing a plan is not a recommendation.

Read the cap row first. A Sharp Direct Advantage member has been carrying a $2,900 ceiling on in-network medical costs. Each UHC Sharp plan carries $4,450 for 2027, and that is not a Sharp-versus-UnitedHealthcare difference so much as a 2027 difference: the same three plans were $3,300, $2,900 and $2,900 in 2026 and all moved to $4,450 in the new file. For a $0-premium member, that $1,550 is the entire file-visible cost of the change. For a Platinum member it is offset by $744 a year in premium that goes away ($62 times twelve). Whether you ever reach either cap depends on copays and on your year, and copays are the first thing on the list below.

Plan by plan, with members

Sources: the two landscape files and the September 2026 CPSC enrollment file above. Sharp Health Plan also reported 2,450 members on an employer-group plan (H5386-801) in the county, which is outside this comparison. The UHC Sharp Complete Care plans (-214, $0 / $4,450 and -246, $0 / $9,850) are chronic-condition Special Needs Plans for people with cardiovascular disease, heart failure or diabetes and are not general-enrollment plans.

Two things stand out. Most Sharp Direct Advantage members, 10,102 of 17,247, were on VIP, a $0 plan. And the UHC Sharp plans are not new or small: 38,204 San Diego County residents were already on the three general plans in September, more than twice the Sharp Direct Advantage individual membership, with ValueRx CA-12P the largest at 20,804. CA-026P is the one to read carefully: it was "AARP Medicare Advantage from UHC CA-026P" in 2026 and carries the Sharp name for 2027 under the same plan number, so it is a renamed continuing plan, not a new one.

HMO versus HMO-POS: what the letters mean, and what they do not tell you

Sharp Direct Advantage is an HMO. The UHC Sharp plans are HMO-POS. Medicare.gov describes an HMO as a plan where you generally get care from the network except for emergency care, out-of-area urgent care and temporary out-of-area dialysis, and adds: "Some HMOs are Point-of-Service (HMOPOS) plans that may allow you to get some services out-of-network for a higher copayment or coinsurance." UnitedHealthcare's provider page for these plans says the same thing in its own words: point-of-service plans "include all the features of HMO plans plus the ability to go outside the contracted network for certain health care services - typically at a higher cost," and, in the same paragraph, "Specialist referrals are required with these plans."

So the honest reading is: HMO-POS is an HMO with a door, and the file does not say how wide the door is. "Certain health care services" and "typically at a higher cost" are the plan's phrases; the services, the cost share and any annual limit on out-of-network spending are in the Evidence of Coverage. Medicare.gov is also clear that both types normally require a primary-care doctor and specialist referrals ("In most cases, you have to get a referral to use a specialist in HMO Plans"). If the referral step is what you want to be rid of, that is a reason to price the Medigap door, not a reason to prefer one HMO over another.

What the CMS file cannot show you

This is the half of the comparison most write-ups skip. The landscape file is an inventory, not a benefit summary. Every row below is something that could matter more than the cap and is not in the file.

Sources: the landscape file's own column list; UHCprovider.com for the referral sentence; Sharp's accepted-plans page and Sharp Rees-Stealy's page for the network notes; Medicare Plan Compare for copays and drug costs by plan. We have deliberately not quoted a single copay or drug tier here, because none is in a public CMS file and we will not type one from memory.

The practical consequence: put your 2026 Sharp Direct Advantage Evidence of Coverage next to the 2027 UHC Sharp Evidence of Coverage for whichever plan you are considering, and go line by line through primary care, specialist, inpatient hospital, outpatient surgery, imaging, and your drug tiers. That is a one-hour job and it is the real comparison. The table above is what you can know before you do it.

The drug side

In the file the two look nearly identical: both "Enhanced Alternative," both with a tier that is not subject to the deductible, deductibles of $350 and $355. Two federal numbers move for everyone in 2027 regardless of plan, per Medicare.gov: no drug plan may have a deductible above $700 (the 2026 limit was $615), and the out-of-pocket threshold where catastrophic coverage begins rises from $2,100 to $2,400. Both UHC Sharp plans sit well under the deductible limit. What the file does not show is whether your drugs are on the 2027 formulary, on which tier, with what prior-authorization or quantity rules, and at which pharmacies; run them through Plan Compare before December 7, because a tier change on one drug can outweigh the whole cap difference.

Nothing is automatic between these two

One question comes up in almost every conversation: "won't they just move me?" No. 42 CFR § 422.530 defines a crosswalk as "the movement of enrollees from one plan ... to another plan ... under a contract between the MA organization and CMS." It is a within-insurer mechanism. Sharp Health Plan (H5386) and UnitedHealthcare of California (H0543) are different organizations with different contracts, so there is no rule under which a Sharp Direct Advantage member becomes a UHC Sharp member without enrolling. The October 2 letter is a non-renewal notice under § 422.506; it may describe other plans, but describing is not enrolling. A member who does nothing is in Original Medicare on January 1 with no drug plan and no cap.

Where this comparison sits among the three doors

Sources: Medicare.gov, Joining a plan; 42 CFR § 422.62(b)(1); Medicare.gov Medigap guaranteed-issue rights (60 days before to 63 days after the plan ends: November 1, 2026 – March 4, 2027; Plans A, B, D, G, K, L, or C and F if eligible before 2020). California's own Medigap rules, including the separate birthday rule, are in the Medigap post.

A UHC Sharp plan is one option inside door one, not the whole door: the county's 2027 shelf has 41 general plans from 14 insurers, and the San Diego County reference page lists what left and what arrived. The point of this post is narrower. If you are weighing the plan with Sharp in its name because it feels like the closest thing to what you had, the file says it is close on premium and drug deductible, $1,550 apart on the cap, different on plan type, and silent on everything else.

What I would do this week

1. Pull both Evidence of Coverage documents. Your 2026 Sharp Direct Advantage one is in your member portal or the mailing from last fall; the 2027 UHC Sharp one for the plan you are considering is on UnitedHealthcare's site. Compare copays line by line.
2. Check your doctors by name in UnitedHealthcare's 2027 directory and with the office. "Sharp" in the plan name is not a guarantee about any individual physician, and Sharp's own page still says "through the end of 2026."
3. Run your prescriptions through Medicare.gov Plan Compare for each UHC Sharp plan and for the stand-alone drug plans, so the Medigap door is priced on the same page.
4. Decide what the $1,550 is worth to you. If a $2,900-type ceiling was the reason you chose Sharp Direct Advantage, high-deductible Medigap Plan G (a $2,950 ceiling in 2026) is the closest shape on the shelf; if the $0 premium was the reason, a UHC Sharp plan keeps it.
5. Enroll between October 15 and December 7. Nothing here happens on its own, and a December 8 to 31 enrollment is the last one that still starts January 1.

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 ID and Plan ID on October 7, 2026, the CMS September 2026 county enrollment file, Medicare.gov's HMO and Part D cost pages, UnitedHealthcare's provider-facing page for the UHC Sharp plans, Sharp HealthCare's accepted-plans pages, and the text of 42 CFR §§ 422.530, 422.506 and 422.62. Mentioning a carrier or a health system is factual reporting, not endorsement or criticism; "the plan is being discontinued" describes the file, not a judgment, and nothing here is a recommendation of one plan over another. Copays, formularies, networks and supplemental benefits are not in any CMS file and are deliberately not described. This is education, not advice; confirm plans, costs and eligibility with the plan, a licensed agent, HICAP or Medicare.gov. We take no payment from any carrier to feature a plan.