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Need a health insurance broker in San Diego? What coverage costs here in 2026, and what the 13.1% increase means for 2027
Written and reviewed by Dick Tracy, licensed health insurance broker (NPN 20414610) · Published September 18, 2026
Quick answer A 40-year-old in San Diego County pays $432 a month for the lowest-cost Bronze plan and $490 for the benchmark Silver in 2026, before any subsidy, according to Covered California's preliminary rate deck dated August 1, 2025. A PPO costs a good deal more: $794 for the Health Net PPO Silver and $843 for Blue Shield's. San Diego's preliminary 2027 average increase is 13.1%, the second highest of California's 19 rating regions. About me, so there is no confusion: I am an independent broker licensed in California, my office is in Buffalo, New York, and I work with San Diegans by phone or Zoom. I educate, you decide.
I'm Dick Tracy, an independent health insurance broker. I hold a California license (NPN 20414610), one of 25 states I'm licensed in, and I work with 80+ carriers. I am not down the street from you: my office is in Buffalo, New York, and I work with San Diegans on the phone or on Zoom. San Diego County is a single rating region, Region 19, so rates are the same countywide, but which plans you can buy still depends on your ZIP. I pull that for your address. No gag clause on me.
for San Diego in 2027
2026, before any subsidy
from Sharp Health Plan
Sources: Covered California, Rates and Plans for 2027 (July 21, 2026), and Qualified Health Plan 2026 Regional Rates by County, preliminary rates as of August 1, 2025, slide 47.
How much is health insurance going up in San Diego in 2027?
More than almost anywhere else in California. In the preliminary 2027 rates Covered California released on July 21, 2026, the statewide average increase was 9.9%. San Diego County came in at 13.1%. Only one region in the state is higher, Region 13 at 14.9%. And this lands on top of an 11.8% increase for 2026.
| Average rate change | 2026 | 2027 (preliminary) |
|---|---|---|
| San Diego County (Region 19) | 11.8% | 13.1% |
| San Diego, if you shop and switch | 2.6% | 2.8% |
| California statewide | 10.3% | 9.9% |
| Sharp Health Plan, overall | 8.6% | 12.3% |
| Blue Shield of California, statewide | 9.1% | 12.5% |
| Health Net, statewide | 15.0% | 13.2% |
Sources: Covered California, Rates and Plans for 2026 (August 14, 2025) and Rates and Plans for 2027 (July 21, 2026), Tables 1 and 2. Carrier rows are overall averages, not San Diego figures. 2027 numbers are preliminary, subject to final state review.
A San Diegan who does nothing faces the 13.1% average. One who shops and moves to the lowest-cost plan in the same metal tier sees about 2.8% on average. That ten-point spread is the argument against auto-renewing. Renewals and plan changes open October 1, and open enrollment runs November 1 through January 31, 2027.
Which health insurance companies sell plans in San Diego, and which are PPO?
Eight products from six carriers in 2026, according to Covered California's rates-by-county deck:
- Blue Shield of California PPO
- Health Net PPO
- Sharp Health Plan HMO, a local plan. Not in every ZIP.
- Kaiser Permanente HMO. Not in every ZIP.
- Anthem Blue Cross HMO
- Molina Healthcare HMO, which set the 2026 benchmark Silver
- Health Net HMO
- Blue Shield of California HMO. Not in every ZIP.
So for PPO health insurance in San Diego you have two names to price: Blue Shield and Health Net. Anthem is an HMO here, and statewide the only carriers with individual PPO members in Covered California's data are those same two (Covered California Active Member Profile, March 2026). San Diego is actually better off than most of the state, where Blue Shield is the only PPO on the shelf. More on my PPO health insurance in California page.
What does health insurance cost in San Diego for a 40-year-old?
These are full-price monthly premiums for one person, before any subsidy, from Covered California's preliminary 2026 rate deck dated August 1, 2025. They were still under state review when published.
| San Diego County, 2026, age 40 | Monthly premium | Plan |
|---|---|---|
| Lowest Bronze, high deductible design | $421 | Kaiser HMO |
| Lowest Bronze | $432 | Kaiser HMO |
| Lowest Silver | $475 | Sharp HMO 2 Premier Copay |
| Benchmark Silver (second-lowest) | $490 | Molina HMO |
| Health Net PPO: Bronze / Silver / Gold | $569 / $794 / $938 | PPO |
| Blue Shield PPO: Bronze / Silver / Gold | $683 / $843 / $1,019 | PPO |
Source: Covered California, Qualified Health Plan 2026 Regional Rates by County, slide 47, San Diego County (Region 19). Preliminary, single 40-year-old, gross premium before any subsidy.
The local plan wins on price: Sharp has the lowest Silver in the county. Blue Shield's PPO Silver is $368 a month more than Sharp's Silver (my arithmetic), which is over $4,400 a year for the right to go out of network. For a 25-year-old the same deck shows a lowest Bronze of $340 and a benchmark Silver of $385. The statewide comparison is on my California monthly cost page. What kind of tank should we build?
Will my San Diego hospital take the plan? Check before you pick
People buy on premium, then learn in February that their doctor's system does not take the plan. My rule: check the hospital's own accepted-plans page before you pick, and match the exact plan name, not just the carrier logo. UC San Diego Health publishes its list in plain language:
| Covered California plan | What UC San Diego Health says |
|---|---|
| Blue Shield of California, IFP Exclusive PPO Network | Full access. Platinum, Gold, Silver and Bronze. |
| Health Net Ambetter PPO | Full access, any metal level. UC San Diego Health "will remain in network until the end of 2026 and is currently in negotiations with this plan for 2027." |
| Anthem Blue Cross HMO | Full access, all metal levels, but "primary care locations are limited." |
| Health Net Ambetter HMO | Limited: "Specialty referrals only, no primary care access." |
| Molina Healthcare | Limited: "Specialty referrals only, no primary care access." |
Source: UC San Diego Health, accepted health plans for Covered California, as read on September 18, 2026. Hospital lists change. Read the page yourself before you enroll.
The benchmark Silver at $490 is a Molina plan, and at this one system Molina means specialty referrals only. And one of the county's two PPOs has a contract that is only confirmed through the end of 2026. None of that shows up in a premium quote.
How should a San Diego small business handle health insurance?
I lay out three routes. The first is a traditional fully insured small group plan. The second is merging the owner and the team into a pre-established ERISA group plan with a nationwide PPO network. The third surprises people: you may not need a group plan at all. I customize the plan based on the situation, and often that means cost-effective customized individual plans instead of a one-size-fits-all group plan. Whichever route, set your contribution as a flat dollar amount per person. A percentage of premium hands your budget to the carrier's next increase. Details are on my small business health insurance in California page.
Self-employed in San Diego: which health insurance route fits you?
California does not let individual major medical plans ask health questions, and short-term plans are banned here. Good if you are sick, expensive if you are healthy. So I sort by situation first, plan second.
Your income qualifies for a subsidy
A subsidized plan or Medi-Cal may be your best deal. I will tell you that straight. The trade-offs: regional networks that are mostly HMO, an income estimate you must get right, repaying credits at tax time if you come in high, and the cliff at 400% of the poverty level. Start with the 2026 subsidy calculator set to California.
Healthy, and you earn too much for help
Start with a pre-established ERISA group plan. ERISA is the 1974 federal law governing employer benefit plans. Group plans already exist under it, and a solo owner can be merged into one. You get group rates and a true nationwide PPO network (the PHCS and MultiPlan type), you own the policy, and your business can be the payer. No employees required, and one simple compliance step I walk you through. The ERISA cheat code is explained here.
A serious diagnosis within the last five years
Guaranteed-issue coverage, for now. Nobody can ask you a health question on a California individual plan. Pick by doctors and hospital first, premium second.
You are covered but one bad year would hurt
Add a second layer, never a substitute. Accident, critical illness, gap and dental are real add-ons. A fixed indemnity plan in California is only ever secondary coverage on top of a real base plan.
The four California doors, in order, are on my health insurance in California for self-employed people page. And do not answer a 13.1% increase by going uninsured. California bills you for that at tax time: see the California health insurance penalty page.
Common questions about working with a health insurance broker in San Diego
How much does health insurance cost in San Diego in 2026?
For one 40-year-old paying full price in San Diego County, the lowest-cost Bronze plan is $432 a month, the lowest Silver is $475 from Sharp Health Plan, and the benchmark Silver is $490. PPO plans cost more: $794 for the Health Net PPO Silver and $843 for the Blue Shield PPO Silver. These are gross premiums before any subsidy from Covered California's preliminary 2026 rate deck dated August 1, 2025.
Do I need a local health insurance broker in San Diego?
You need a broker with a California license. Plans, prices and networks are set by rating region and ZIP code. I pull what is available for your ZIP. I am licensed in California (NPN 20414610), my office is in Buffalo, New York, and I meet by phone or Zoom with the documents on the screen. If sitting across a desk matters to you, I am not the right fit.
Are health insurance rates going up in San Diego in 2027?
Yes. Covered California's preliminary 2027 rates, released July 21, 2026, show a 13.1% average increase for San Diego County, compared with 9.9% statewide. That is the second-highest increase among California's 19 rating regions, behind Region 13 at 14.9%. The same release says a San Diegan who switches to the lowest-cost plan in the same metal tier would see about 2.8% on average.
Who sells PPO health insurance in San Diego?
Blue Shield of California and Health Net, and nobody else in the individual market for 2026. Anthem Blue Cross, Kaiser, Molina and Sharp Health Plan are all HMOs in San Diego County, per Covered California's 2026 rates-by-county deck. For a 40-year-old the Health Net PPO runs $569 Bronze, $794 Silver and $938 Gold a month, and the Blue Shield PPO runs $683, $843 and $1,019, before any subsidy.
Does UC San Diego Health take Covered California plans?
Some of them. UC San Diego Health's own accepted-plans page lists full access for Blue Shield's IFP Exclusive PPO Network, Health Net Ambetter PPO, and Anthem Blue Cross HMO (with limited primary care locations). Health Net Ambetter HMO and Molina are listed as specialty referrals only, with no primary care access. For the Health Net PPO, the page says UC San Diego Health will remain in network until the end of 2026 and is in negotiations for 2027. Check that page yourself before you pick a plan.
What are the options for self-employed health insurance in San Diego?
If your income qualifies for a subsidy, a subsidized plan or Medi-Cal may be the best deal. If you are healthy and earn too much for help, look first at a pre-established ERISA group plan: a solo owner can be merged into one for group rates and a nationwide PPO network, no employees required. If you have had a serious diagnosis in the last five years, take guaranteed-issue coverage for now. The Census Bureau counted 299,736 nonemployer businesses in San Diego County in 2023.
Can an independent health insurance broker help a San Diego small business?
Yes. For a San Diego small business I compare three routes: a traditional fully insured small group plan, merging the owner and employees into a pre-established ERISA group plan with a nationwide PPO network, and dropping the one-size-fits-all group plan in favor of customized individual plans. I also recommend contributing a flat dollar amount per employee, not a percentage of premium, so the carrier's next increase does not automatically become yours.
Thirty minutes on the phone or Zoom, no fee, no hard sell. Bring your ZIP, ages, a rough income number, and the doctors and hospital system you want to keep. I line up the San Diego options that fit, check the network against your hospital's own list, and show you the math. I work from Buffalo, New York, with a California license. I educate, you decide.
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