Medicare Plans in
Santa Cruz County, CA
10 Medicare Advantage Plans Found in Santa Cruz County. See Plans
Santa Cruz County, CA
Medicare Information
For Santa Cruz County’s Medicare beneficiaries, private plans like Medicare Advantage plans offer an alternative to Original Medicare, and Part D plans (PDP) can work alongside your Original Medicare benefits.
Currently, 10 private Medicare plans are available in Santa Cruz County, and coverage is provided through Medicare-approved private companies, following rules set by Medicare.
MA plans, which are also referred to as Medicare Part C, may offer additional benefits that aren't available through Original Medicare.
Part D plans, also referred to as PDPs, cover retail prescription drugs.
Some Medicare Part C plans include coverage for prescription medications. Known as Medicare Advantage Prescription Drug plans, or MAPDs, these plans offer comprehensive coverage for seniors who want to minimize their out-of-pocket costs.
Learn more about some of the Medicare plans in Santa Cruz County, California, including average costs, out-of-pocket expenses and what’s involved in obtaining prescription drug coverage.
The following is HelpAdvisor Editorial Team analysis of data from the 2024 MA Landscape Source Files as well as carrier-provided plan data supplied by SunFire Inc.
Average Cost of Medicare
Plans in Santa Cruz County
Average Cost of Medicare Advantage Plans in Santa Cruz County, California | |
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Average Monthly Premium | $44.30 |
Average in-network out-of-pocket spending limit | $5,795.00 |
Average drug deductible in 2024 (weighted) | $480.00 |
Percentage of plans rated 4 stars or higher | 40.0% |
Average Cost of Medicare Advantage Plans in Santa Cruz County, California |
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Average Monthly Premium $44.30 |
Average in-network out-of-pocket spending limit $5,795.00 |
Average drug deductible in 2021 (weighted) $480.00 |
Percentage of plans rated 4 stars or higher 40.0% |
Learn More About Medicare
Prescription Drug Plans
Plan Type | Description |
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HMO | HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage. |
PPO | Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage. |
PFFS | Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans. |
SNP | Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage. |
Plan Type and Description |
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HMO enrollees typically receive services through in-network providers and must obtain referrals for visits to specialists. However, most plans permit out-of-network care in emergencies or out-of-area dialysis. HMO plans often include prescription drug coverage.
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Members of PPO plans can typically go in or out of network for care, including hospitalization, although visits to non-network providers may cost considerably more. Referrals are usually not needed for visits to specialists, and many PPO plans include prescription drug coverage.
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Private fee-for-service plans determine how much a doctor or facility will be paid for services, and members may seek care from any in or out-of-network provider that agrees to the plan's terms. Some PFFS plans include prescription drug coverage. Otherwise, members may seek coverage for medications through standalone Medicare drug plans, which are also known as Part D plans.
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Special Needs Plans are designed for individuals with specific conditions or medical characteristics. Benefits such as providers and drug formularies are tailored to members' unique needs, and most care is provided by in-network physicians and facilities. SNPs are required to provide prescription drug coverage.
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Some beneficiaries may be eligible for standalone prescription drug plans. Otherwise known as a PDP or Part D plan, a standalone prescription drug plan adds coverage for prescription medications to Original Medicare and some PFFS plans. It’s important to note that some MA plans, such as HMOs, may disenroll members who sign up for a separate drug plan.
Medicare Advantage Plans
Aetna Inc. Medicare Plans in Santa Cruz County, CA
The following table includes cost information and other plan details for Aetna Inc. private Medicare plans available in California in 2024.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Aetna Medicare Core Plan (PPO) | H5521: 425 | $0 | $0 | $5,900 | Yes | 4 out of 5 |
Aetna Medicare Eagle Plus Plan (PPO) | H5521: 369 | $0 | N/A | $6,700 | No | 4 out of 5 |
Aetna Medicare Elite Plan (PPO) | H5521: 372 | $27 | $0 | $5,500 | Yes | 4 out of 5 |
Kaiser Foundation Health Plan, Inc.
Kaiser Foundation Health Plan, Inc. Medicare Plans in Santa Cruz County, CA
The following table includes cost information and other plan details for Kaiser Foundation Health Plan, Inc. private Medicare plans available in California in 2024.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
Senior Advantage Medicare Medi-Cal North P4 (HMO D-SNP) | H8794: 004 | $0 | $545 | $3,400 | Yes | Plan too new to be measured |
Kaiser Permanente Senior Advantage Santa Cruz (HMO) | H0524: 054 | $65 | $0 | $4,900 | Yes | 4 out of 5 |
UnitedHealthcare Medicare Plans in Santa Cruz County, CA
The following table includes cost information and other plan details for UnitedHealthcare private Medicare plans available in California in 2024.
Plan Name | Plan Code | Monthly Premium | Deductible | Out of Pocket Max |
Prescription Drug Coverage |
Medicare Star Rating |
---|---|---|---|---|---|---|
AARP Medicare Advantage from UHC CA-0032 (PPO) | H0294: 040 | $0 | $0 | $6,700 | Yes | 3.5 out of 5 |
UHC Medicare Advantage CA-001A (HMO) | H0543: 183 | $28 | $545 | $8,850 | Yes | 3.5 out of 5 |
AARP Medicare Advantage from UHC CA-0023 (PPO) | H0294: 031 | $44 | $0 | $5,900 | Yes | 3.5 out of 5 |
UHC Canopy Health Medicare Advantage CA-013P (HMO-POS) | H0543: 209 | $46 | $0 | $3,400 | Yes | 3.5 out of 5 |
AARP Medicare Advantage from UHC CA-030P (HMO-POS) | H0543: 229 | $56 | $350 | $6,700 | Yes | 3.5 out of 5 |