Medicare Advantage

HMO, PPO or Special Needs Plan? Sorting Tempe's Medicare Advantage choices

People in Tempe can choose from 79 Medicare Advantage plans for 2027, against 88 this year. 13 of this year's plans are gone, 17 are new to Maricopa County, and 20 that continue have changed something in their terms, 13 of them under a new name.

If you live in Tempe and you're weighing a Medicare Advantage plan for 2027, the first question isn't really which plan — it's which type of plan. HMO, HMO-POS, PPO and Special Needs Plans all work a little differently, and understanding those differences up front makes the rest of the shopping much easier.

Tempe is in Maricopa County, where 16 carriers are offering Medicare Advantage plans for 2027. Together, those carriers put 79 plans on the county menu. That's a lot to sort through, but most of the sorting comes down to a handful of plan-type rules set by Medicare itself.

How the Tempe-area menu breaks down

Every Medicare Advantage plan available in Maricopa County for 2027 includes prescription drug coverage. There are no PFFS (Private Fee-for-Service) plans in the county mix next year; the choices are HMO, HMO-POS and PPO, plus Special Needs Plans built on top of those structures.

By the numbers, the county has:

• 55 HMO plans
• 16 HMO-POS plans
• 17 PPO plans
• 36 Special Needs Plans (a subset of the above, restricted by eligibility)

The full roster is in the table below, listed alphabetically by carrier, with plan type shown for each.

The 16 carriers serving Maricopa County

In alphabetical order, the carriers offering Medicare Advantage plans in the county for 2026 are: Aetna (CVS Health) with 9 plans; Alignment Health Plan with 5; Banner Medicare Advantage with 3; Blue Cross Blue Shield (HCSC) with 6; Blue Cross Blue Shield of Arizona with 3; Centene (WellCare) with 6; Devoted Health with 10; Elevance Health (Anthem) with 5; eternalHealth with 4; Gold Kidney Health Plan with 3; Humana with 14; Mercy Care Advantage with 3; Molina Healthcare of Arizona with 1; SCAN Health Plan with 6; UnitedHealthcare with 8; and Verda Health Plan of Arizona with 2.

Some carriers offer only HMOs; others mix in HMO-POS or PPO options. The plan-type notes in the table below show which is which.

What an HMO actually is

A Medicare Advantage HMO (Health Maintenance Organization) asks you to use a defined network of doctors and hospitals. You generally pick a primary care doctor, and you usually need a referral to see a specialist. Out-of-network care is typically not covered except for emergencies and urgent care.

HMOs are the largest slice of the Maricopa County menu — 55 of the 88 plans. Carriers with HMO-only lineups in the county include Alignment Health Plan, Banner Medicare Advantage, Blue Cross Blue Shield of Arizona, Centene (WellCare), Mercy Care Advantage, Molina Healthcare of Arizona and Verda Health Plan of Arizona.

HMO-POS: an HMO with a side door

HMO-POS stands for "HMO with a Point-of-Service option." It works like an HMO — network, primary care doctor, referrals — but adds limited coverage for certain services from out-of-network providers, usually at a higher cost share. The rules for what qualifies for the POS benefit are set by the plan.

You'll see HMO-POS plans from carriers such as Elevance Health (Anthem), eternalHealth, Gold Kidney Health Plan, SCAN Health Plan and UnitedHealthcare among the 16 HMO-POS plans in the county.

PPO: more flexibility, different math

A Medicare Advantage PPO (Preferred Provider Organization) lets you use out-of-network providers for covered services without a referral, though you'll usually pay more than you would in-network. There's no primary care doctor requirement.

Seventeen PPOs are offered in the county. Carriers with PPO plans on the 2026 menu include Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Devoted Health, Humana and UnitedHealthcare.

Special Needs Plans (SNPs): eligibility comes first

Special Needs Plans are restricted Medicare Advantage plans. You can't just enroll — you have to qualify. There are three flavors:

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

Of the 88 Medicare Advantage plans in Maricopa County, 36 are SNPs. Nearly every carrier on the county roster offers at least one SNP; you can spot them in the table below by looking for D-SNP, C-SNP or I-SNP after the plan name.

If you don't meet the eligibility rules for a specific SNP, it's not an option for you — no matter how attractive it looks on paper.

A note on PFFS plans

Private Fee-for-Service (PFFS) plans are a fourth Medicare Advantage plan type nationally. In a PFFS, the plan sets the payment terms and any provider who accepts those terms can see you. PFFS plans are not part of the 2027 Maricopa County menu, so if you're shopping in Tempe, you'll be choosing among HMO, HMO-POS, PPO and SNP options.

How to narrow it down

A few questions worth thinking through before you scroll the table:

• Do you travel often or spend part of the year outside Arizona? PPO rules may fit that pattern better than HMO rules.
• Do you already have doctors you want to keep? Check whether they're in each plan's network before anything else.
• Do you qualify for Medicaid, have a qualifying chronic condition, or live in a nursing facility? A SNP may be built for your situation.
• Do you take prescription drugs? Every Maricopa County MA plan for 2027 includes drug coverage, and the Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027, with a maximum deductible of $615 in 2026 and $700 in 2027.