Medicare Advantage Plans in Santa Clara County, CA:
Your Complete 2026 Guide
For 2026, residents of Santa Clara County, CA can choose from 26 Medicare Advantage plan options. Of these, 18 cost nothing beyond the Part B premium. Enrollment in the County stands at approximately 92,166, with 58% of plans achieving 4 stars or better. This page and its statistics exclude Special Needs Plans (SNPs). See Medicare Special Needs Plans available in Santa Clara County, CA.
Last update: . Enrollment data last updated: May 2, 2026
* CMS rates Medicare Advantage plans annually using a 5-star system. Data sources
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow members to choose care from both in-network and out-of-network providers. While using out-of-network doctors or hospitals usually means higher costs, PPOs may appeal to people who want more flexibility in how they access their healthcare.
- Total PPO Plans
- 3
- Average Premium
- $93.00/mo
- Beneficiaries Enrolled
- 1,935
- $0 Premium PPOs
- 1
- Average MOOP
- $4,833
- Most Popular PPO
- Alignment Health Advantage PPO (PPO) with 955 enrollees
- PPOs Without Drug Coverage
- 1
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Aetna Medicare Eagle | $0 | $6,750 | N/A | H5521 369 0 | |
| Aetna Medicare Enhanced | $204 | $4,900 | $615 | H5521 676 0 | |
| Alignment Health Advantage PPO | $75 | $2,850 | $0 | H8832 002 0 |
- What is the average monthly premium for PPO plans in Santa Clara?
- On average, PPO plans in Santa Clara cost $93.00 per month.
- Which PPO plan has the highest enrollment in Santa Clara?
- The most popular PPO in Santa Clara is Alignment Health Advantage PPO (PPO), covering 955 beneficiaries.
- How many PPO plans in Santa Clara do not include prescription drug coverage?
- 1 PPO plans available in Santa Clara do not include Part D benefits.
Medicare Advantage HMO Plans
HMO plans are designed around a set network of doctors and hospitals. Staying within that network is usually required for coverage, but this arrangement often results in lower overall costs, including both premiums and out-of-pocket expenses, for plan members.
What is the total number of HMO plans offered in Santa Clara?
There are 18 HMO plans in 2026, covering 83,551 beneficiaries.
How much do HMO plans cost on average in Santa Clara?
The average HMO premium is $12.06, with 14 costing $0.
What is the top HMO by enrollment in Santa Clara?
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO) is the most popular HMO plan in Santa Clara, with 41,725 enrollees.
What is the number of HMO plans without Part D coverage in Santa Clara?
2 HMO plans in Santa Clara do not include prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO-POS plans are structured like HMOs, requiring in-network care for the lowest costs, but they also permit some use of out-of-network doctors and hospitals. Those services are generally more expensive, but the added access can be valuable for people who don’t want to be fully limited to a single network.
- Total HMO-POS Plans
- 5
- Average Premium
- $27.20/mo
- Beneficiaries Enrolled
- 6,680
- $0 Premium HMO-POS
- 3
- Average MOOP
- $3,000
- Most Popular HMO-POS
- Anthem Prime (HMO-POS) with 2,973 enrollees
- HMO-POS Without Drug Coverage
- 0
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| AARP Medicare Advantage from UHC CA-10 | $0 | $3,500 | $440 | H0543 193 0 | |
| Aetna Medicare Enhanced | $65 | $3,900 | $300 | H0523 083 0 | |
| Aetna Medicare Enhanced Extra | $71 | $3,900 | $615 | H4982 030 0 | |
| Anthem Medicare Advantage | $0 | $2,899 | $0 | H0544 108 0 | |
| Anthem Prime | $0 | $800 | $0 | H4161 010 0 |
What is the average monthly premium for HMO-POS plans?
On average, HMO-POS plans in Santa Clara cost $27.20 per month.
Which HMO-POS plan is most popular in Santa Clara?
The leading HMO-POS in Santa Clara is Anthem Prime (HMO-POS), with 2,973 members.
How many HMO-POS plans in Santa Clara do not include drug coverage?
There are 0 HMO-POS plans in Santa Clara without Part D benefits.
The table below shows the quality ratings for Medicare Advantage plans offered in Santa Clara County, CA for 2026.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 14 | 58% |
| 3 Stars | 10 | 42% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 2 | 8% |
| Average Rating | 3.75 | |
Medicare Advantage comes with strict enrollment windows. By knowing when and how to sign up, you’ll avoid missed deadlines and keep your healthcare coverage aligned with your needs.
Key Medicare Enrollment Periods
- Initial Enrollment Period (IEP): This seven-month window starts three months before the month you turn 65 and ends three months after. It’s the first time you can sign up for Medicare and, if you choose, a Medicare Advantage plan. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): Each year from January 1 through March 31, you may change to another Medicare Advantage plan or drop your plan and return to Original Medicare. Learn more
- Annual Enrollment Period (AEP): This yearly window, running October 15 to December 7, gives you the opportunity to join, switch, or drop Medicare Advantage and Part D plans. Learn more
- Special Enrollment Periods (SEPs): Outside the standard enrollment dates, you may qualify for a Special Enrollment Period if specific circumstances apply, including relocation or coverage loss. Learn more
Enrollment Options Explained
- Talk with a Licensed Agent: Licensed agents at HealthCompare can explain your Medicare Advantage choices. Reach them at 1-833-748-3201 (TTY 711), Monday–Friday 5am–6pm and Saturday 6am–5pm PST.
- Contact the Plan Provider Directly: Enrollment can also be completed by calling the plan provider’s customer service line or visiting their official website.
- Use Medicare.gov: The official Medicare website, Medicare.gov, lets you review available plans and complete enrollment online.
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Los Altos, Mountain View, Sunnyvale, Palo Alto, Stanford, Alviso, Campbell, Cupertino, Gilroy, Los Gatos, Milpitas, Morgan Hill, San Martin, Santa Clara, Saratoga, San Jose, and all other areas of Santa Clara County, California.
Plans Offered for Enrollment through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, HealthSpring℠, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 13, 2025
- CMS.gov, Medicare Advantage/Part D Contract and Enrollment Data — Last accessed May 2, 2026
Some facts and percentages shown on this page (such as average premiums, distribution of plan types, and percentage of $0 premium plans) are calculated by Medicare.org using data from the CMS Landscape file, Plan Benefits Package (PBP) files and Part C & D Performance files. All underlying values originate from CMS, and calculations are refreshed whenever CMS issues updated data. Enrollment counts and rankings (such as Top 3 plans by enrollment) are derived from CMS monthly enrollment files and aggregated at the county level.
Medicare.org separates Medicare Advantage (MA/MAPD) plans and Special Needs Plans (SNPs) into different pages for clarity. As a result, plan counts, percentages, and other calculations shown here may differ from the aggregate totals published in the CMS Landscape files. All plan availability and benefit details originate from CMS.
Learn more about how we use CMS data.
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
Some facts and percentages shown on this page (such as average premiums, distribution of plan types, and percentage of $0 premium plans) are calculated by Medicare.org using data from the CMS Plan Benefits Package (PBP) files and Part C & D Performance files. All underlying values originate from CMS, and calculations are refreshed whenever CMS issues updated data.
To explore how 2026 Medicare Advantage plans available in Santa Clara County compare with plans offered elsewhere, you can search the Medicare Advantage plan directory to review options nationwide using the same authoritative data sources.
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.
Page content independently curated and maintained by David W. Bynon, Medicare Technical Operator, using a standardized, data-driven methodology designed for accurate, non-commercial Medicare plan interpretation and resolution.