Medicare Advantage

Before you pick a Medicare Advantage plan in Mesa: how HMO, PPO and SNP options compare

People in Mesa can choose from 92 Medicare Advantage plans for 2027, against 88 this year. 13 of this year’s plans are gone, 17 are new to Maricopa County, and 33 that continue have changed their premium, deductible, plan type or name, 13 of them under a new name.

Medicare AdvantageMesa, AZ

If you live in Mesa and you are shopping for a Medicare Advantage plan, the first fork in the road is not a carrier name or a benefit list. It is the plan type. HMO, HMO-POS, PPO and Special Needs Plans each work in different ways, and understanding those differences up front makes the rest of the decision much easier.

Mesa is in Maricopa County, where CMS lists 79 Medicare Advantage plans for 2027, offered by 16 carriers. All of them include drug coverage. Compared with 2026, 62 plans continue, 17 are new, 13 are not returning and 13 have been renamed; 20 continuing plans change something in their terms, which the ANOC spells out. There are no stand-alone Part D plans on the CMS list for the county, because MA-PD plans bundle Part D in.

What HMO means, in plain English

An HMO — Health Maintenance Organization — is built around a network. You usually pick a primary care doctor, and you generally need to use in-network providers for care to be covered, except in emergencies. Referrals to specialists are common. If you already see doctors who are in the plan's network and you like the idea of one doctor coordinating everything, an HMO can feel simple.

Most of the Maricopa County lineup is HMO. Out of 88 plans, 55 are HMOs. Carriers offering HMO plans in the county include Aetna (CVS Health), Alignment Health Plan, Banner Medicare Advantage, Blue Cross Blue Shield (HCSC), Blue Cross Blue Shield of Arizona, Centene (WellCare), Devoted Health, Elevance Health (Anthem), eternalHealth, Humana, Mercy Care Advantage, Molina Healthcare of Arizona, SCAN Health Plan and Verda Health Plan of Arizona.

HMO-POS: an HMO with a side door

HMO-POS stands for Health Maintenance Organization with a Point-of-Service option. It works like an HMO for most care, but lets you go out-of-network for certain services, typically at a higher cost share. Maricopa County carriers offering HMO-POS plans on the 2027 list include Elevance Health (Anthem), eternalHealth, Gold Kidney Health Plan, SCAN Health Plan and UnitedHealthcare.

If you travel within the state, or you want a little flexibility without moving to a full PPO, HMO-POS is worth understanding.

PPO: more flexibility, different trade-offs

A PPO — Preferred Provider Organization — lets you see any provider that accepts the plan, in-network or out. You pay less when you stay in-network, and more when you go out. Referrals are usually not required. That flexibility often comes with different cost-sharing than an HMO, so it is worth comparing carefully.

Carriers offering PPO plans in Maricopa County for 2027 include Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Devoted Health, Humana and UnitedHealthcare.

A quick note on PFFS: Private Fee-for-Service plans are a fourth Medicare Advantage plan type nationally. They set their own payment terms with providers, who decide visit-by-visit whether to accept them. CMS does not list any PFFS plans in Maricopa County for 2027, so it is not a practical choice locally.

Special Needs Plans: only if you qualify

Special Needs Plans, or SNPs, are Medicare Advantage plans limited to people in a specific situation. There are three kinds:

• D-SNP (Dual Eligible): for people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition): for people with a qualifying chronic illness, such as diabetes, heart conditions, or end-stage renal disease.
• I-SNP (Institutional): for people who live in a nursing home or need that level of care at home.

You cannot simply choose a SNP; you have to meet the eligibility rules. Of the 88 plans in Maricopa County, 36 are SNPs. Nearly every carrier on the list offers at least one, and the table below lists every plan by carrier and type.

How to work through the list

A reasonable order of operations:

1. Check eligibility. If you have Medicaid or a qualifying chronic condition, a SNP may fit. If not, focus on the general HMO, HMO-POS and PPO plans. 2. Think about network fit. Which doctors and hospitals do you use now? Which plans include them? Your providers can usually tell you which plans they accept. 3. Look at drug coverage. Every Medicare Advantage plan on the Maricopa County list is an MA-PD, meaning drug coverage is built in. The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. The maximum Part D deductible is $615 in 2026 and $700 in 2027. The coverage gap ("donut hole") has been eliminated since 2025. 4. Compare details on Medicare.gov. The Plan Finder tool at medicare.gov lets you enter your ZIP code, medications and preferred pharmacies and see full plan-by-plan details, which we cannot publish here.

Important dates to keep in mind

The Annual Enrollment Period runs from Oct. 15 to Dec. 7. Changes you make in that window take effect Jan. 1. If you are already in a Medicare Advantage plan and want to switch to a different one or return to Original Medicare, the Medicare Advantage Open Enrollment Period runs Jan. 1 to March 31. And if your income is above $109,000 as a single filer, IRMAA surcharges apply to your Part B and Part D premiums in 2026.

Also worth knowing: the Medicare Prescription Payment Plan lets you spread your out-of-pocket Part D costs across the year in monthly payments instead of paying them at the pharmacy counter. It is optional, and any Part D or MA-PD plan must offer it.