Plan vs plan · Santa Cruz County, CA · 2027 plan year
Imperial Dynamic Plan (HMO) vs Kaiser Permanente Senior Advantage Santa Cruz (HMO)
Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.
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Imperial Dynamic Plan (HMO)
- Plan premium
- $0 a month
- Yearly limit, in network
- $295
- 2027 star rating
- 4 of 5
- Prior authorization needed for
- 24 services
Kaiser Permanente Senior Advantage Santa Cruz (HMO)
- Plan premium
- $92 a month
- Yearly limit, in network
- $4,900
- 2027 star rating
- 4.5 of 5
- Prior authorization needed for
- 6 services
In most states, including California, you cannot count on getting Medigap later
You can buy any Medigap plan with no health questions in the 6 months that start when you are 65 or older and have Part B. After that, a Medigap company in California can ask about your health. It can say no, or it can charge you more. So if you join a Medicare Advantage plan now, you may not be able to get Medigap later. California has a birthday rule, but it only lets people who already have Medigap switch to another Medigap plan. It does not help you get Medigap after you leave Medicare Advantage.
One exception is the trial right. If you joined Medicare Advantage when you first got Medicare at 65, or you left a Medigap plan to try Medicare Advantage for the first time, you can switch back within 12 months. Then you can buy a Medigap plan with no health questions.
Read about Medigap rights on Medicare.govYour yearly cost, side by side
Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.
Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov
California Department of Insurance, Medicare Supplement rate guide lists $162 to $270 a month for a 65-year-old woman who does not use tobacco. We start at the lowest price. Health questions can raise the price after your first 6 months with Part B.
Original Medicare
With Medigap Plan G at $162 a month and Wellcare Value Script (PDP)
$6,991 a year
- Premiums
- $4,524
- Medical costs
- $292
- Drugs
- $2,175
Most you can pay in a bad year, before drugs: $4,816.
Imperial Dynamic Plan (HMO)
HMO from Imperial Health Plan of California, Inc.
$3,159 a year
- Premiums
- $2,334
- Medical costs
- $285
- Drugs
- $540
Most you can pay in a bad year, before drugs: $2,629.
Kaiser Permanente Senior Advantage Santa Cruz (HMO)
HMO from Kaiser Permanente
$5,222 a year
- Premiums
- $3,618
- Medical costs
- $1,040
- Drugs
- $564
Most you can pay in a bad year, before drugs: $8,518.
With these settings, Imperial Dynamic Plan (HMO) costs about $2,063 less a year than Kaiser Permanente Senior Advantage Santa Cruz (HMO).
Tipping point for Imperial Dynamic Plan (HMO): with this drug use, the plan costs less than Original Medicare with Plan G at every level of medical care.
Tipping point for Kaiser Permanente Senior Advantage Santa Cruz (HMO): with this drug use, if your medical copays and coinsurance in this plan pass $2,809 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $4,900.
These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.
Text us about this comparisonWhat you pay each time you get care
In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: Plan G.
Primary doctor visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Imperial Dynamic Plan (HMO)
$0 copay
Kaiser Permanente Senior Advantage Santa Cruz (HMO)
$0
Specialist visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Imperial Dynamic Plan (HMO)
$0 copay
Prior authorizationKaiser Permanente Senior Advantage Santa Cruz (HMO)
$25
Lab tests
Original Medicare + Medigap Plan G
$0
most Medicare-covered tests
Imperial Dynamic Plan (HMO)
$0 copay
Prior authorizationKaiser Permanente Senior Advantage Santa Cruz (HMO)
$0
MRI or CT scan
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Imperial Dynamic Plan (HMO)
$0 copay
Prior authorizationKaiser Permanente Senior Advantage Santa Cruz (HMO)
$0-$300
Emergency room
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Imperial Dynamic Plan (HMO)
$125
Kaiser Permanente Senior Advantage Santa Cruz (HMO)
$130
Urgent care
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Imperial Dynamic Plan (HMO)
$0 copay
Kaiser Permanente Senior Advantage Santa Cruz (HMO)
$0
Outpatient surgery
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Imperial Dynamic Plan (HMO)
$100
Prior authorizationKaiser Permanente Senior Advantage Santa Cruz (HMO)
$400
Ground ambulance
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Imperial Dynamic Plan (HMO)
$150
Prior authorizationKaiser Permanente Senior Advantage Santa Cruz (HMO)
$350
Hospital stay, 5 days
Original Medicare + Medigap Plan G
$0
Plan G pays the $1,788 Part A deductible
Imperial Dynamic Plan (HMO)
$0
for a 5-day stay
Prior authorizationKaiser Permanente Senior Advantage Santa Cruz (HMO)
$2,000
for a 5-day stay
Prior authorization
See every cost in one table
| What you pay in network | Original Medicare + Medigap Plan G | Imperial Dynamic Plan (HMO) | Kaiser Permanente Senior Advantage Santa Cruz (HMO) |
|---|---|---|---|
| Monthly premium | Part B $209.50 + Medigap Plan G $162 + drug plan $5.30 | $0 (pays back $15 a month of your Part B premium) + Part B $209.50 | $92 + Part B $209.50 |
| Yearly limit on what you pay | You pay the $292 Part B deductible. Plan G pays the rest. | $295 in network | $4,900 in network |
| Medical deductible | $292 Part B. Plan G pays the $1,788 Part A deductible. | $0 | $0 |
| Primary doctor visit | $0, after the $292 yearly Part B deductible | $0 copay | $0 copay |
| Specialist visit | $0, after the $292 yearly Part B deductible | $0 copayPrior authorization | $25 copay |
| Lab tests | $0, most Medicare-covered tests | $0 copayPrior authorization | $0 copay |
| MRI or CT scan | $0, after the $292 yearly Part B deductible | $0 copayPrior authorization | $0-$300 copay |
| X-rays | $0, after the $292 yearly Part B deductible | $0 copayPrior authorization | $0 copay |
| Emergency room | $0, after the $292 yearly Part B deductible | $125 copay | $130 copay |
| Urgent care | $0, after the $292 yearly Part B deductible | $0 copay | $0 copay |
| Outpatient hospital | $0, after the $292 yearly Part B deductible | $100 copayPrior authorization | $0-$400 copay |
| Surgery center | $0, after the $292 yearly Part B deductible | $100 copayPrior authorization | $400 copay |
| Ground ambulance | $0, after the $292 yearly Part B deductible | $150 copayPrior authorization | $350 copay |
| Hospital stay | $0, Plan G pays the $1,788 Part A deductible | $0 per day for days 1-90Prior authorization | $400 per day for days 1-5; $0 per day for days 6-90Prior authorization |
| Skilled nursing facility | $0, Plan G pays days 21-100 | $0 per day for days 1-20; $100 per day for days 21-50; $200 per day for days 51-100Prior authorization | $0 per day for days 1-20; $221 per day for days 21-100 |
| Mental health visit | $0, after the $292 yearly Part B deductible | $0 copayPrior authorization | $0 copay |
| Physical therapy | $0, after the $292 yearly Part B deductible | $0 copayPrior authorization | $0-$25 copayPrior authorization |
| Home health care | $0, Medicare-covered home health | $0 copayPrior authorization | $0 copay |
| Medical equipment | $0, after the $292 yearly Part B deductible | 20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization |
| Part B drugs | $0 after the $292 Part B deductible | 0%-20% coinsurancePrior authorization | $0-$47 copay, 0%-20% coinsurance |
| Drug deductible (Part D) | $700 with Wellcare Value Script (PDP) | $0 | $0 |
| Drug tiers (one month, retail) | Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 40% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $11 copay | Preferred Generic: $0 copayGeneric: $6 copayPreferred Brand: $45 copayNon-Preferred Drug: $90 copaySpecialty Tier: 33% coinsuranceSelect Care Drugs: $0 copay | Preferred Generic: $0 copayGeneric: $5 copayPreferred Brand: $47 copayNon-Preferred Drug: $100 copaySpecialty Tier: 29% coinsuranceVaccines: $0 copay |
Not sure which of these costs apply to you?
Text us what you have now. We will help you read this comparison and check it with Medicare.gov.
A higher drug plan premium is not, by itself, a reason to switch
With Original Medicare, you buy a separate drug plan. In California, 10 drug plans are for sale for 2027, from $5.30 to $252.60 a month. Half of them cost $150.55 a month or less.
- Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
- The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
- A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules, and you may not be able to get Medigap later.
- If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov
Doctors, referrals, and prior authorization
Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.
Original Medicare
- Any doctor or hospital in the U.S. that takes Medicare
- No referrals
- Prior authorization only for a short list of services
Imperial Dynamic Plan (HMO)
HMO
- You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
- You need a referral to see a specialist.
Prior authorization for 24 services
Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs
Kaiser Permanente Senior Advantage Santa Cruz (HMO)
HMO
- You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
- You need a referral to see a specialist.
Prior authorization for 6 services
Physical therapy, Occupational therapy, Medical equipment, Prosthetics, Diabetic supplies, Hospital stay
Extra benefits
| Extra benefit | Original Medicare | Imperial Dynamic Plan (HMO) | Kaiser Permanente Senior Advantage Santa Cruz (HMO) |
|---|---|---|---|
| Dental | No | Comprehensive, up to $4,500 a year | Preventive only |
| Eye exam | No | Yes | Yes |
| Glasses or contacts | No | Yes, $500 allowance | No |
| Hearing aids | No | Yes, up to $500 | No |
| Over-the-counter allowance | No | $480 a year | Yes, limited |
| Fitness benefit | No | Yes | Yes |
| Rides to care | No | Yes | Yes |
| Meals after a hospital stay | No | Yes | No |
| Emergency care abroad | Plan G and Plan N pay 80% after a $250 deductible | Yes | Yes |
| Part B premium giveback | No | $15 a month | No |
What changed for 2027
Imperial Dynamic Plan (HMO)
Renewal Plan with SAE · 2026 plan H5496-012-0
- In-network out-of-pocket maximum down from $296 to $295
- Part B giveback down from $35 to $15
- Yearly OTC allowance down from $560 to $480
- Overall star rating up from 3.5 to 4
Kaiser Permanente Senior Advantage Santa Cruz (HMO)
Renewal Plan · 2026 plan H0524-054-0
- Monthly premium up from $88 to $92
- Specialist visit: $15 copay to $25 copay
- Diagnostic radiology (MRI, CT): $0-$200 copay to $0-$300 copay
- Outpatient hospital: $0-$200 copay to $0-$400 copay
- Ground ambulance: $250 copay to $350 copay
- Inpatient hospital: $230 per day for days 1-5; $0 per day for days 6-90 to $400 per day for days 1-5; $0 per day for days 6-90
- Skilled nursing facility: $0 per day for days 1-20; $100 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
- Rides to care added
- Fitness benefit added
More 2027 plans in Santa Cruz County
- Alignment Health My Choice 001 (PPO), H4961-001 (page for Stanislaus County, CA)
- Alignment Health Sutter Advantage +More (HMO), H3815-021
- Imperial Courage Plan (HMO), H5496-016 (page for Los Angeles County, CA)
County guide: 2027 plans in Santa Cruz CountyState guide: California
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Sources and method
Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. Medigap prices come from California Department of Insurance, Medicare Supplement rate guide, pulled 2026-10-13. They are for ZIP 95076. Totals use typical Medicare-allowed amounts for each service and typical drug prices.
- Imperial Dynamic Plan (HMO) on Medicare.gov · plan website · drug list · doctor directory
- Kaiser Permanente Senior Advantage Santa Cruz (HMO) on Medicare.gov · plan website · drug list · doctor directory
- Medigap prices: California Department of Insurance, Medicare Supplement rate guide
- CMS Plan Benefit Package files, 2027
- CMS 2027 landscape files (premiums and limits)
- CMS 2027 plan crosswalk
- CMS 2027 Star Ratings
- 2026 Medicare Trustees Report: projected 2027 Part A and Part B amounts (Tables V.E1 and V.E2)
- CMS 2026 Part A and Part B amounts
- Medicare.gov: Medigap guaranteed issue rights
These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.
Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.