Bay Area · 9 counties · open to everyone
What does my Medicare Advantage plan cost?
Premium, max-out-of-pocket, drug deductible and star rating for each Bay-Area Medicare Advantage plan — plus what it charges for the services that matter at discharge (SNF, home health, DME, therapy, ambulance). Figures are from CMS plan filings for 2026; always confirm with the plan before deciding, and check whether a facility is in-network separately. For programs that help pay, see Who can pay.
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Medi-Cal (managed care)
Medi-Cal managed-care benefits are standardized statewide — most members pay $0 for covered services (SNF, home health, DME, therapy). There is no per-plan cost-share grid to publish. Extra in-home/respite/transition help is available via CalAIM Community Supports — see the “Who can pay” money layer.
Medicare Advantage plans
46 in Santa ClaraAetna Medicare Eagle (PPO)
Aetna Medicare · PPO
Premium / mo
$Not Applicable
Max out-of-pocket
$6,750.00
Drug deductible
$Not Applicable
What it costs at discharge
- Inpatient hospital (acute)
- $430/day days 1–4, $0/day days 5–90
- Skilled nursing facility (SNF)
- $10/day days 1–20, $218/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $20 copay
- Occupational therapy
- $20 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $265 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Alameda, San Francisco, San Mateo, Santa Clara
Aetna Medicare Enhanced (PPO)
Aetna Medicare · PPO
Premium / mo
$204.00
Max out-of-pocket
$4,900.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- $300/day days 1–7, $0/day days 8–90
- Skilled nursing facility (SNF)
- $10/day days 1–20, $218/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $30 copay
- Occupational therapy
- $30 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $285 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· San Mateo, Santa Clara
Kaiser Permanente Sr Adv Basic Santa Clara (HMO)
Kaiser Permanente · HMO
Premium / mo
$15.00
Max out-of-pocket
$6,000.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $320/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $150/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $300 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Kaiser Permanente Sr Adv Enhanced Santa Clara (HMO)
Kaiser Permanente · HMO
Premium / mo
$95.00
Max out-of-pocket
$3,900.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $260/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $100/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $300 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
AARP Medicare Advantage from UHC CA-10 (HMO-POS)
UnitedHealthcare · HMO-POS
Premium / mo
$0.00
Max out-of-pocket
$3,500.00
Drug deductible
$440.00
What it costs at discharge
- Inpatient hospital (acute)
- $195/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $218/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $275 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Santa Clara
Alignment Health BreathEasy (HMO C-SNP)
Alignment Health Plan · HMO C-SNP
Premium / mo
$12.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- see plan
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 — covered in full
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, Santa Clara
Alignment Health Clarity (HMO C-SNP)
Alignment Health Plan · HMO C-SNP
Premium / mo
$12.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- see plan
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 — covered in full
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, Santa Clara
Alignment Health Harmony (HMO)
Alignment Health Plan · HMO
Premium / mo
$0.00
Max out-of-pocket
$3,400.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $100/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $100/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $200 copay
- Ground ambulance
- $175 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, San Francisco, San Mateo, Santa Clara
Alignment Health Heart & Diabetes (HMO C-SNP)
Alignment Health Plan · HMO C-SNP
Premium / mo
$0.00
Max out-of-pocket
$1,499.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $100/day days 1–3, $0/day days 4–90
- Skilled nursing facility (SNF)
- $0/day days 1–31, $50/day days 32–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $100 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, Santa Clara
Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)
Alignment Health Plan · HMO C-SNP
Premium / mo
$12.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- $275/day days 1–6, $0/day days 7–90
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 — covered in full
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, Santa Clara
Alignment Health Heart & Diabetes Care (HMO C-SNP)
Alignment Health Plan · HMO C-SNP
Premium / mo
$0.00
Max out-of-pocket
$1,990.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $100/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $20/day days 1–20, $100/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $200 copay
- Ground ambulance
- $100 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, Santa Clara
Alignment Health Heart & Diabetes Choice (HMO C-SNP)
Alignment Health Plan · HMO C-SNP
Premium / mo
$0.70
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- $225/day days 1–6, $0/day days 7–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $50/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $200 copay
- Ground ambulance
- $175 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, Santa Clara
Alignment Health Honor+ Plan (HMO)
Alignment Health Plan · HMO
Premium / mo
$0.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- see plan
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 — covered in full
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, San Mateo, Santa Clara
Alignment Health My Choice CalCare (HMO)
Alignment Health Plan · HMO
Premium / mo
$0.00
Max out-of-pocket
$3,499.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $100/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $20/day days 1–20, $100/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $200 copay
- Ground ambulance
- $175 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, Santa Clara
Alignment Health Silicon (HMO C-SNP)
Alignment Health Plan · HMO C-SNP
Premium / mo
$12.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- see plan
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 — covered in full
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Santa Clara
Alignment Health Sutter Advantage +More (HMO)
Alignment Health Plan · HMO
Premium / mo
$49.00
Max out-of-pocket
$4,900.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $275/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $10/day days 1–20, $160/day days 21–57, $0/day days 58–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $325 copay
- Ground ambulance
- $250 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Alignment Health smartHMO (HMO)
Alignment Health Plan · HMO
Premium / mo
$0.00
Max out-of-pocket
$3,999.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- $200/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $20/day days 1–20, $100/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $200 copay
- Ground ambulance
- $100 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Santa Clara
Alignment Health the ONE (HMO)
Alignment Health Plan · HMO
Premium / mo
$0.00
Max out-of-pocket
$3,400.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $0/day days 1–4, $100/day days 5–10, $0/day days 11–90
- Skilled nursing facility (SNF)
- $0 — covered in full
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $200 copay
- Ground ambulance
- $75 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Blue Shield Inspire (HMO)
Blue Shield of California · HMO
Premium / mo
$58.00
Max out-of-pocket
$5,300.00
Drug deductible
$425.00
What it costs at discharge
- Inpatient hospital (acute)
- $275/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $200/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $10 copay
- Occupational therapy
- $10 copay
- Outpatient hospital services
- $300 copay
- Ground ambulance
- $285 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Kaiser Permanente Dual Complete North P2 (HMO D-SNP)
Kaiser Permanente · HMO D-SNP
Premium / mo
$0.00
Max out-of-pocket
$9,250.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $475/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $214/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 copay
- Ground ambulance
- $400 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· San Mateo, Santa Clara
Kaiser Permanente Dual Complete North P23 (HMO D-SNP)
Kaiser Permanente · HMO D-SNP
Premium / mo
$0.00
Max out-of-pocket
$9,250.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $475/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $214/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 copay
- Ground ambulance
- $400 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
SCAN Balance (HMO C-SNP)
SCAN Health Plan · HMO C-SNP
Premium / mo
$0.00
Max out-of-pocket
$750.00
Drug deductible
$250.00
What it costs at discharge
- Inpatient hospital (acute)
- $0 — covered in full
- Skilled nursing facility (SNF)
- $0/day days 1–20, $50/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $100 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
SCAN Classic (HMO)
SCAN Health Plan · HMO
Premium / mo
$0.00
Max out-of-pocket
$799.00
Drug deductible
$250.00
What it costs at discharge
- Inpatient hospital (acute)
- $0 — covered in full
- Skilled nursing facility (SNF)
- $0/day days 1–20, $50/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $95 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
SCAN MyChoice (HMO)
SCAN Health Plan · HMO
Premium / mo
$0.00
Max out-of-pocket
$1,299.00
Drug deductible
$250.00
What it costs at discharge
- Inpatient hospital (acute)
- $50/day days 1–3, $0/day days 4–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $50/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $95 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
SCAN Strive (HMO C-SNP)
SCAN Health Plan · HMO C-SNP
Premium / mo
$0.00
Max out-of-pocket
$9,250.00
Drug deductible
$250.00
What it costs at discharge
- Inpatient hospital (acute)
- see plan
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 — covered in full
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Alameda, San Francisco, San Mateo, Santa Clara
Astiva Health C-SNP WOW - NorCal (HMO C-SNP)
Astiva Health · HMO C-SNP
Premium / mo
$12.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- $0 — covered in full
- Skilled nursing facility (SNF)
- $0/day days 1–20, $218/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- $200 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Astiva Health Premier Plan - NorCal (HMO)
Astiva Health · HMO
Premium / mo
$0.00
Max out-of-pocket
$1,500.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $0 — covered in full
- Skilled nursing facility (SNF)
- $0/day days 1–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $150 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Astiva Health Savings Plan - NorCal (HMO)
Astiva Health · HMO
Premium / mo
$0.00
Max out-of-pocket
$3,000.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $0 — covered in full
- Skilled nursing facility (SNF)
- $0 — covered in full
- Home health
- $0 — covered in full
- Physical / speech therapy
- $25 copay
- Occupational therapy
- $25 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $160 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
DualConnect (HMO D-SNP)
Santa Clara Family Health Plan · HMO D-SNP
Premium / mo
$10.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- see plan
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 — covered in full
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Santa Clara
Imperial Courage Plan (HMO)
Imperial Health Plan of California, Inc. · HMO
Premium / mo
$Not Applicable
Max out-of-pocket
$2,999.00
Drug deductible
$Not Applicable
What it costs at discharge
- Inpatient hospital (acute)
- $150/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $200/day days 21–100
- Home health
- $10 copay
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- $10 copay
- Outpatient hospital services
- $200 copay
- Ground ambulance
- $150 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, Sonoma
Imperial Dynamic Plan (HMO)
Imperial Health Plan of California, Inc. · HMO
Premium / mo
$0.00
Max out-of-pocket
$296.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $0/day days 1–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $100/day days 21–50, $200/day days 51–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $100 copay
- Ground ambulance
- $150 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, Sonoma
Imperial Senior Value (HMO C-SNP)
Imperial Health Plan of California, Inc. · HMO C-SNP
Premium / mo
$0.00
Max out-of-pocket
$296.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $0/day days 1–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $100/day days 21–50, $200/day days 51–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $100 copay
- Ground ambulance
- $150 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Contra Costa, Marin, Napa, San Francisco, San Mateo, Santa Clara, Solano, Sonoma
Aetna Medicare Enhanced (HMO-POS)
Aetna Medicare · HMO-POS
Premium / mo
$65.00
Max out-of-pocket
$3,900.00
Drug deductible
$300.00
What it costs at discharge
- Inpatient hospital (acute)
- $400/day days 1–7, $0/day days 8–90
- Skilled nursing facility (SNF)
- $20/day days 1–20, $218/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $300 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Aetna Medicare Enhanced Extra (HMO-POS)
Aetna Medicare · HMO-POS
Premium / mo
$71.00
Max out-of-pocket
$3,900.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- $400/day days 1–7, $0/day days 8–90
- Skilled nursing facility (SNF)
- $20/day days 1–20, $218/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $300 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Anthem Full Dual Advantage Aligned (HMO D-SNP)
Anthem Blue Cross · HMO D-SNP
Premium / mo
$0.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- see plan
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 copay
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· San Francisco, Santa Clara
Anthem Medicare Advantage (HMO-POS)
Anthem Blue Cross · HMO-POS
Premium / mo
$0.00
Max out-of-pocket
$2,899.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $95/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $218/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $225 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Anthem Prime (HMO-POS)
Anthem Blue Cross Partnership Plan · HMO-POS
Premium / mo
$0.00
Max out-of-pocket
$800.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $0 copay
- Skilled nursing facility (SNF)
- $0/day days 1–20, $218/day days 21–100
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 copay
- Ground ambulance
- $200 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Central Health Classic Care Plan III (HMO)
Central Health Medicare Plan · HMO
Premium / mo
$0.00
Max out-of-pocket
$2,999.00
Drug deductible
$125.00
What it costs at discharge
- Inpatient hospital (acute)
- $195/day days 1–6, $0/day days 7–90
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $0 — covered in full
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara, Solano
Central Health Dual Access Plan (HMO D-SNP)
Central Health Medicare Plan · HMO D-SNP
Premium / mo
$0.00
Max out-of-pocket
$9,250.00
Drug deductible
$550.00
What it costs at discharge
- Inpatient hospital (acute)
- see plan
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 copay
- Physical / speech therapy
- $55 copay
- Occupational therapy
- $35 copay
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Contra Costa, San Francisco, San Mateo, Santa Clara, Solano
Central Health Embrace Care Plan (HMO C-SNP)
Central Health Medicare Plan · HMO C-SNP
Premium / mo
$0.00
Max out-of-pocket
$1,900.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- $0/day days 1–5, $150/day days 6–9, $35/day days 10–90
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $0 — covered in full
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara, Solano
Central Health Embrace Choice Plan (HMO C-SNP)
Central Health Medicare Plan · HMO C-SNP
Premium / mo
$0.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- see plan
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Santa Clara, Solano
Central Health Valor Care Plan (HMO)
Central Health Medicare Plan · HMO
Premium / mo
$Not Applicable
Max out-of-pocket
$4,400.00
Drug deductible
$Not Applicable
What it costs at discharge
- Inpatient hospital (acute)
- $150/day days 1–6, $0/day days 7–90
- Skilled nursing facility (SNF)
- see plan
- Home health
- $0 copay
- Physical / speech therapy
- $0 copay
- Occupational therapy
- $0 copay
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $0 — covered in full
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· San Francisco, San Mateo, Santa Clara
Advantage Care (HMO)
Align Senior Care · HMO
Premium / mo
$0.00
Max out-of-pocket
$1,900.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $0 copay
- Skilled nursing facility (SNF)
- $0/day days 1–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $125 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, San Mateo, Santa Clara
Alignment Health Advantage PPO (PPO)
Alignment Health Plan · PPO
Premium / mo
$75.00
Max out-of-pocket
$2,850.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $75/day days 1–5, $0/day days 6–90
- Skilled nursing facility (SNF)
- $0/day days 1–20, $50/day days 21–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $200 copay
- Ground ambulance
- $100 copay
- Durable medical equipment (DME)
- $0 — covered in full
Verified · 161d agoCMS plan filing· Santa Clara
Premier Care (HMO I-SNP)
Align Senior Care · HMO I-SNP
Premium / mo
$0.00
Max out-of-pocket
$1,900.00
Drug deductible
$0.00
What it costs at discharge
- Inpatient hospital (acute)
- $0 copay
- Skilled nursing facility (SNF)
- $0/day days 1–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- $0 — covered in full
- Occupational therapy
- $0 — covered in full
- Outpatient hospital services
- $0 — covered in full
- Ground ambulance
- $125 copay
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, San Mateo, Santa Clara
Senior Care (HMO I-SNP)
Align Senior Care · HMO I-SNP
Premium / mo
$12.00
Max out-of-pocket
$9,250.00
Drug deductible
$615.00
What it costs at discharge
- Inpatient hospital (acute)
- $235/day days 1–10, $0/day days 11–90
- Skilled nursing facility (SNF)
- $0/day days 1–100
- Home health
- $0 — covered in full
- Physical / speech therapy
- 20% coinsurance
- Occupational therapy
- 20% coinsurance
- Outpatient hospital services
- 20% coinsurance
- Ground ambulance
- 20% coinsurance
- Durable medical equipment (DME)
- 20% coinsurance
Verified · 161d agoCMS plan filing· Alameda, Marin, San Francisco, San Mateo, Santa Clara
Source: CMS Medicare Advantage / Part D Landscape + Plan Benefit Package filings (a curated set of discharge-relevant benefit categories). Cost-shares can have conditions, day limits, and prior-authorization requirements not shown here — confirm specifics with the plan.