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Medicare Advantage in Orange County, CA

As of April 2026, 337,204 of the county's 601,565 Medicare-eligible people are enrolled in a Medicare Advantage plan, a penetration of 56.0% (up 9,636 enrollees, +2.9%, versus April 2025). The three largest parent organizations hold 61.4% of the county's MA enrollment. For plan year 2026, the CMS Landscape lists 104 MA and Special Needs plans in the county from 17 parent organizations, 79 of them with a $0 consolidated premium.

MA enrolled
337,204
MA enrolled
Medicare eligibles
601,565
Medicare eligibles
MA penetration
56.0%
MA penetration
2026 plans on offer
104
2026 plans on offer

Enrollment and eligibles: CMS MA State/County Penetration, report month 2026-04-01. County keys: FIPS 06059, SSA 05400. Plans on offer: CMS 2026 Landscape, MA + SNP categories.

Who holds the market

Parent organizations by MA enrollment in the county, April 2026. Standalone Part D plans are excluded. Share = the parent's enrollees divided by the county's MA enrolled from the penetration file (the two CMS files can differ slightly; the denominator is stated, not assumed). A cell CMS suppressed (under 11 members) is counted as a bounded unknown, never as zero.

Kaiser Foundation Health Plan, Inc.
86,106
25.5%
43 plan rows, 33 suppressed
SCAN Group
84,077
24.9%
43 plan rows, 22 suppressed
UnitedHealth Group, Inc.
36,917
10.9%
225 plan rows, 201 suppressed
Orange County Health Authority
18,924
5.6%
3 plan rows, 1 suppressed
CVS Health Corporation
17,081
5.1%
104 plan rows, 89 suppressed
California Physicians' Service
16,884
5.0%
22 plan rows, 12 suppressed
Elevance Health, Inc.
15,483
4.6%
80 plan rows, 64 suppressed
Astiva Health Holdings Incorporated
13,515
4.0%
4 plan rows
Humana Inc.
13,287
3.9%
99 plan rows, 87 suppressed
Clever Care Health Plan, Inc.
11,577
3.4%
4 plan rows
Alignment Healthcare USA, LLC
8,677
2.6%
40 plan rows, 24 suppressed
Centene Corporation
5,725
1.7%
16 plan rows, 7 suppressed
+ 75 other parent organizations with small or fully suppressed county enrollment, together between 1,534 and 5,484 members (mostly employer-group and out-of-area plans).

What is on offer for 2026

From the CMS Landscape file for plan year 2026: distinct plans by type, how many carry a $0 consolidated premium, and the range of in-network maximum out-of-pocket (MOOP). A published premium of "Not Applicable" is left out of the premium statistics, not treated as $0.

lowest premium
$0
lowest premium
median premium (n=98)
$0
median premium (n=98)
lowest MOOP
$199
lowest MOOP
highest MOOP
$9,250
highest MOOP
HMO MA
44 plans
38 at $0
14 parents
HMO C-SNP SNP
21 plans
13 at $0
9 parents
HMO-POS MA
12 plans
10 at $0
3 parents
HMO-POS C-SNP SNP
9 plans
8 at $0
3 parents
PPO MA
8 plans
3 at $0
3 parents
HMO I-SNP SNP
5 plans
4 at $0
3 parents
HMO D-SNP SNP
5 plans
3 at $0
4 parents

The plans people are in

The largest plans in the county by April 2026 enrollment, with their 2026 premium and MOOP as published. Enrollment is the April 2026 CPSC file; premium and MOOP are the 2026 Landscape; the two describe different moments and are labelled so.

SCAN Classic (HMO)
H5425-007 · HMO · SCAN Group
55,548 enrolled
$0.00
$199.00 MOOP
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
H0524-003 · HMO · Kaiser Foundation Health Plan, Inc.
52,818 enrolled
$0.00
$699.00 MOOP
AARP Medicare Advantage from UHC CA-005P (HMO-POS)
H0543-169 · HMO-POS · UnitedHealth Group, Inc.
24,701 enrolled
$0.00
$800.00 MOOP
CalOptima Health OneCare Complete (HMO D-SNP)
H5433-001 · HMO D-SNP · Orange County Health Authority · Dual-Eligible
18,663 enrolled
$12.00
$9,250.00 MOOP
SCAN Venture (HMO)
H5425-084 · HMO · SCAN Group
10,786 enrolled
$0.00
$1,000.00 MOOP
SCAN Balance (HMO C-SNP)
H5425-034 · HMO C-SNP · SCAN Group · Chronic or Disabling Condition
9,037 enrolled
$0.00
$199.00 MOOP
Humana Gold Plus H5619-021 (HMO)
H5619-021 · HMO · Humana Inc.
7,506 enrolled
$0.00
$410.00 MOOP
Astiva Health Savings Plan (HMO)
H1993-001 · HMO · Astiva Health Holdings Incorporated
7,003 enrolled
$0.00
$3,045.00 MOOP
Blue Shield Inspire (HMO)
H0504-043 · HMO · California Physicians' Service
6,307 enrolled
$0.00
$599.00 MOOP
Blue Shield 65 Plus (HMO)
H0504-015 · HMO · California Physicians' Service
6,239 enrolled
$0.00
$1,500.00 MOOP
Clever Care Longevity (HMO)
H7607-014 · HMO · Clever Care Health Plan, Inc.
5,909 enrolled
$0.00
$500.00 MOOP
Kaiser Permanente Sr Advantage LA, Orange Value (HMO)
H0524-078 · HMO · Kaiser Foundation Health Plan, Inc.
5,778 enrolled
$0.00
$1,999.00 MOOP
Anthem Select (HMO-POS)
H0544-058 · HMO-POS · Elevance Health, Inc.
5,282 enrolled
$0.00
$800.00 MOOP
Kaiser Permanente Dual Complete South P1 (HMO D-SNP)
H8794-001 · HMO D-SNP · Kaiser Foundation Health Plan, Inc. · Dual-Eligible
5,008 enrolled
$0.00
$9,250.00 MOOP
Aetna Medicare Signature (PPO)
H5521-419 · PPO · CVS Health Corporation
4,992 enrolled
$0.00
$6,350.00 MOOP

Star Ratings of the contracts offered here

CMS rates contracts, not counties or plans. The overall Star Rating below is the contract's rating as carried in the 2026 Landscape file (which reflects the July 2026 update); it applies to every plan under that contract nationally and says nothing county-specific.

H3815 Alignment Healthcare USA, LLC · 4.0 · 16 plans hereH5425 SCAN Group · 4.0 · 10 plans hereH0543 UnitedHealth Group, Inc. · 4.0 · 7 plans hereH0544 Elevance Health, Inc. · 3.0 · 7 plans hereH5649 Molina Healthcare, Inc. · 3.0 · 7 plans hereH6170 Champion Health Plans-USA, LLC. · Not Enough Data Available · 7 plans hereH4161 Elevance Health, Inc. · 3.0 · 5 plans hereH1993 Astiva Health Holdings Incorporated · 4.0 · 4 plans hereH5525 Humana Inc. · 3.5 · 4 plans hereH7607 Clever Care Health Plan, Inc. · 4.0 · 4 plans hereH0504 California Physicians' Service · 4.0 · 3 plans hereH0523 CVS Health Corporation · 3.0 · 3 plans hereH0562 Centene Corporation · 3.5 · 3 plans hereH3274 Curana Health Holdings, LLC · Not Enough Data Available · 3 plans hereH5496 Imperial Health Plan of California · 3.5 · 3 plans hereH5521 CVS Health Corporation · 4.5 · 3 plans hereH5619 Humana Inc. · 3.0 · 3 plans hereH0524 Kaiser Foundation Health Plan, Inc. · 4.5 · 2 plans hereH5087 Centene Corporation · 3.5 · 2 plans hereH8794 Kaiser Foundation Health Plan, Inc. · 4.0 · 2 plans here

Method and limits

  • Enrollment, eligibles and penetration are the CMS MA State/County Penetration file for 2026-04-01; the carrier mix is the CMS Monthly Enrollment by Contract/Plan/State/County (CPSC) file for the same month, restricted to MA contracts (H, R and E contract numbers; standalone Part D S-contracts excluded).
  • CMS suppresses any cell under 11 members. Those cells are shown as a range and excluded from shares; they are never zero. Parent rollups use the parent organization CMS publishes, not name matching.
  • Plans on offer are the CMS 2026 MA/Part D Landscape file, MA and SNP categories, counted as distinct contract-plan pairs. Premiums and MOOP are the published strings cast to numbers; "Not Applicable" is excluded from statistics.
  • Year-over-year compares the same report month one year earlier. Plan year, report month and retrieval date are three different clocks and are labelled separately.
  • A negotiated benefit or premium here is what a plan publishes, not what any individual pays; this page is not eligibility or enrollment advice.
  • Data from the Centers for Medicare & Medicaid Services public files, cleaned and joined by Vlada. CMS does not endorse this page or Vlada Health. County identity is the CMS SSA county code (05400); the FIPS code (06059) is shown for reference and can cover more than one SSA cell.

Receipts

Every section above is one read-only query over the Vlada substrate, run through the same tool an agent would call. The query, the engine's query id, the response hash and the bytes scanned are recorded so the numbers can be re-run.

cohort_header query 39345610 · 78,820 bytes · 2026-09-15
SELECT fips, ssa, state_name, county_name, eligibles, enrolled, penetration FROM medicare_silver.ma_state_county_penetration WHERE report_month = DATE '2026-04-01' AND enrolled IS NOT NULL ORDER BY enrolled DESC LIMIT 10

tables: medicare_silver.ma_state_county_penetration · response_hash 46c5bdb36b49f942d989d0332628ef6190af4a31bed0642bd0aabd7016625b9e

prior_year_header query 0f647cea · 52,763 bytes · 2026-09-15
SELECT ssa, eligibles, enrolled, penetration FROM medicare_silver.ma_state_county_penetration WHERE report_month = DATE '2025-04-01' AND ssa IN ('05200', '03060', '45610', '14141', '10120', '05400', '05470', '05430', '33590', '10050')

tables: medicare_silver.ma_state_county_penetration · response_hash 9eef69df7c6b1bca210fd38e43e960277bb92c200774f2b76cea644361c9b39d

parents_by_county query d65db597 · 2,555,853 bytes · 2026-09-15
SELECT county_ssa, parent_org_raw, SUM(enrollment_count) AS enrolled, COUNT(*) AS plan_rows, SUM(CASE WHEN enrollment_count IS NULL THEN 1 ELSE 0 END) AS suppressed_rows, SUM(enrollment_lower_bound) AS lower_bound, SUM(enrollment_upper_bound) AS upper_bound FROM medicare_silver.enrollment_monthly_county WHERE report_month = DATE '2026-04-01' AND contract_id NOT LIKE 'S%' AND county_ssa IN ('05200', '03060', '45610', '14141', '10120', '05400') GROUP BY county_ssa, parent_org_raw HAVING SUM(enrollment_count) >= 500 ORDER BY county_ssa, enrolled DESC LIMIT 2000

tables: medicare_silver.enrollment_monthly_county · response_hash cf5000bc9516517f22267b59df04cf0594590473a6f009c3f5fb56f7bef584a0

parents_tail query 4d364f07 · 2,555,853 bytes · 2026-09-15
SELECT county_ssa, COUNT(*) AS parents, SUM(lower_bound) AS lower_bound, SUM(upper_bound) AS upper_bound FROM (SELECT county_ssa, parent_org_raw, SUM(enrollment_count) AS enrolled, SUM(enrollment_lower_bound) AS lower_bound, SUM(enrollment_upper_bound) AS upper_bound FROM medicare_silver.enrollment_monthly_county WHERE report_month = DATE '2026-04-01' AND contract_id NOT LIKE 'S%' AND county_ssa IN ('05200', '03060', '45610', '14141', '10120', '05400', '05470', '05430', '33590', '10050') GROUP BY county_ssa, parent_org_raw) t WHERE enrolled IS NULL OR enrolled < 500 GROUP BY county_ssa LIMIT 2000

tables: medicare_silver.enrollment_monthly_county · response_hash ed8bbf3c4d1d1d95c33348e63f60c8b4936a006afe04a196d93276c87edea1cb

landscape_plans:CA-Orange query 59d74f61 · 531,082 bytes · 2026-09-15
SELECT contract_id, plan_id, segment_id, plan_name, plan_type, parent_org_name, snp_type, category, consolidated_premium, moop_in_network, overall_star_rating FROM medicare_silver.fact_ma_landscape WHERE report_year = 2026 AND category IN ('MA','SNP') AND state = 'CA' AND county = 'Orange' ORDER BY contract_id, plan_id, segment_id LIMIT 2000

tables: medicare_silver.fact_ma_landscape · response_hash d89a6580fd50a2a5bf8b5f16b157f65224304fbbc71208238cc50ce6d1576113

top_plans_enrollment:05400 query ac6f683c · 2,587,279 bytes · 2026-09-15
SELECT contract_id, plan_id, parent_org_raw, enrollment_count, enrollment_lower_bound, enrollment_upper_bound FROM medicare_silver.enrollment_monthly_county WHERE report_month = DATE '2026-04-01' AND contract_id NOT LIKE 'S%' AND county_ssa = '05400' ORDER BY enrollment_count DESC NULLS LAST LIMIT 45

tables: medicare_silver.enrollment_monthly_county · response_hash 91aa1c7fa6c0ab736ca979610b72d93e2cbeca81d032904f0ce9dbcddad4063a

Generated 2026-09-15 · cohort rule: the 10 largest counties by MA enrollment at the 2026-04-01 report month, SSA-keyed · run these queries yourself · get_market_share · get_landscape