Sharp Health Plan's Medicare Advantage changes for 2027

If you have an individual Medicare Advantage plan through Sharp Health Plan, part of the Sharp HealthCare delivery system and San Diego’s only local, nonprofit health plan, you may have heard that coverage is changing and wondered what it means for your care.

Beginning Jan. 1, 2027, Sharp Health Plan will no longer offer individual Medicare Advantage plans. Sharp Health Plan Medicare Advantage members will need to change plans during the Annual Election Period (AEP), which runs through Dec. 7.

However, Sharp Health Plan will continue to offer employer-sponsored group retiree Medicare Advantage plans to eligible retiree groups, such as CalPERS, SDPEBA, Teamsters and Sharp HealthCare retirees. What’s more, Sharp HealthCare will continue to provide care for patients who have Original Medicare or individual Medicare Advantage plans purchased through United Healthcare.

How the health care industry is changing

According to Chris Howard, Sharp HealthCare president and CEO, Sharp Health Plan made this decision after more than a decade in the individual Medicare Advantage market because of ongoing reimbursement pressures, rising health care costs and regulatory changes. These challenges, he says, have made continuing to offer individual Medicare Advantage plans financially unsustainable for the organization.

“As a nonprofit health plan, Sharp Health Plan remains committed to offering high-quality, high-value coverage that is sustainable, supports appropriate reimbursement for its provider network, and strengthens Sharp HealthCare for the future,” Howard says. “This change does not mean Sharp HealthCare is leaving Medicare.”

Sharp will continue to care for people with Medicare

Sharp HealthCare, San Diego’s leading health care system with five acute-care hospitals, five specialty hospitals and three affiliated medical groups, will continue to serve people with Medicare. Sharp has historically served more Medicare patients than any other health care provider in the San Diego region and remains committed to them.

The organization will still accept Original Medicare, individual Medicare Advantage plans available through United HealthCare, and certain employer-sponsored group retiree plans. However, if you have an individual Medicare Advantage plan through Sharp Health Plan, you will need to select new coverage for 2027.

Understanding your options

Choosing new Medicare coverage is an important decision, particularly when you want to stay connected to the doctors and hospitals you know and trust. Resources are available as you sort through your choices.

“We will provide members with clear information and support as they consider their coverage options,” Howard says.

He recommends you start by reviewing the Medicare plans available to you and checking which plans will allow you to continue receiving care at Sharp. You can compare available plans on the Medicare website or by calling 1-800-MEDICARE (1-800-633-4227).

Before choosing a new plan, confirm:

• Whether your doctors, specialists and hospitals are in the plan’s network

• Whether your prescriptions are covered by the plan

• Which pharmacies are in the plan’s network

• How the plan handles prior authorizations and ongoing care

You can also complete Sharp Health Plan’s online form to connect with a licensed Medicare broker partner who can help you compare available plans, understand your coverage options, and find a plan that fits your health care needs and budget.

“We are proud of our longstanding commitment to Medicare patients,” Howard says. “With the right information and support, you can choose the coverage that continues to best meet your needs.”

Visit sharp.com/medicare to see which Medicare Advantage plans will be accepted by Sharp HealthCare in 2027 or contact your doctor or medical group with questions about accepted plans.