Reviewed by Anthony Howe, Licensed Insurance Agent, NPN #20649362. Updated October 23, 2026, with Medicare’s 2027 rule changes.
Medicare’s Annual Enrollment Period, often called Medicare Open Enrollment, runs October 15 to December 7, 2026, for coverage that starts January 1, 2027. For San Diego County residents, from Oceanside and Carlsbad to Escondido, Mira Mesa and Chula Vista, the decision often comes down to one question: which doctors and hospitals do you want to keep using?
Your health system shapes your options
San Diego County’s major health systems include Sharp HealthCare, Scripps Health, UC San Diego Health, Kaiser Permanente, Palomar Health and Tri-City Medical Center. Medicare Advantage plans contract with different systems and medical groups, and those contracts can change from one year to the next. A plan that includes your doctors this year may not include them in 2027.
We’re seeing more of this than usual for 2027: doctors moving between medical groups, and medical groups changing which plans they accept. Finding a new primary care doctor or specialist is a real chore, so it’s worth confirming before December 7 rather than at your first appointment in January. Wait times come up just as often. If your clinic or medical group has been hard to get an appointment with, a plan that uses a different group may be worth comparing.
- Check each doctor by name, not just their medical group.
- Ask about the exact plan. A doctor’s office that “takes Medicare” may mean Original Medicare only, or some Medicare Advantage plans and not others.
- Check the hospital you would want to use, and how the plan covers emergencies outside its network.
- If you split your time between San Diego County and another area, check coverage in both places.
For 2027, the county has 46 Medicare Advantage plans open to anyone, down from 60, and Sharp Health Plan isn’t offering Medicare Advantage at all; our breakdown of CMS’s 2027 San Diego County plan data has the details. Many Medicare Advantage plans here use referrals and prior authorization for specialists, imaging and procedures. Starting in 2027, plans can handle prior authorization electronically, and you may be able to follow a request in the plan’s online portal. The requirement itself stays, so it’s worth knowing which services need approval in each plan you compare.
Medicare Advantage or Original Medicare with a Supplement
Medicare Advantage (Part C) plans are offered by private insurers approved by Medicare. Most include drug coverage and use a network, usually an HMO or PPO. Premiums vary, and some plans charge nothing beyond the Part B premium. A $0-premium plan still has copays, coinsurance and sometimes a deductible as you use care, up to the plan’s yearly out-of-pocket maximum.
Original Medicare (Parts A and B) lets you see any provider in the country that accepts Medicare. On its own it has no yearly cap on what you pay, which is why many people pair it with a Medicare Supplement (Medigap) plan, which helps pay deductibles, copays and coinsurance, and a separate Part D drug plan. Medigap only works alongside Original Medicare; it can’t be added to a Medicare Advantage plan.
Neither approach suits everyone. The comparison usually turns on your doctors, your prescriptions, how often you travel and how you prefer to pay for care: a higher premium with fewer bills, or a lower premium with copays along the way. Our Medicare Advantage vs. Medigap guide for San Diego County compares the two side by side.
California’s Medigap birthday rule
California gives Medigap policyholders a yearly window that most states don’t. For 60 days starting on your birthday, you can switch to another Medigap plan with the same or fewer benefits without answering health questions. It’s separate from the Annual Enrollment Period, so the timing depends on your birthday rather than the calendar.
The birthday rule helps people who already have a Medigap plan. If you’re in a Medicare Advantage plan and considering a move to Original Medicare during AEP, a Medigap insurer can usually ask health questions unless you’re in your Medigap open enrollment period or have a guaranteed right to buy, such as leaving Medicare Advantage within your first year. Settling the Medigap question first avoids being left with Original Medicare and no supplement.
Extra benefits and allowance cards
Dental, vision, hearing, transportation and over-the-counter allowances vary widely between San Diego County plans. Grocery and utility allowances are usually limited to members with qualifying chronic conditions, and for 2027 plans must publish who qualifies. Benefit cards can only be used for eligible items, and unused amounts don’t carry into the next year. Comparing these after you’ve confirmed your doctors and drugs keeps the extras in proportion.
What you can change by December 7
- Move between Original Medicare and Medicare Advantage.
- Switch Medicare Advantage plans.
- Join, switch or drop a Part D drug plan.
For the full checklist, including what to look for in your Annual Notice of Change and the 2027 drug-cost changes, see our Annual Enrollment Period guide and our San Diego drug coverage guide.
Local help
- The Medicare Plan Finder on Medicare.gov, which compares plans using your own drug list and pharmacy.
- 1-800-MEDICARE (1-800-633-4227), available 24 hours a day.
- HICAP, California’s free Medicare counseling program: 1-800-434-0222.
- A licensed agent. Rock Meadow compares plans from the insurers we represent, at no charge to you. Call (760) 654-6760.
Rock Meadow’s office is in Oceanside, and we work with Medicare clients across the county. See Medicare in San Diego and Medicare in Oceanside for local details.
