Medicare Advantage

Riverside Medicare Advantage for 2027: how HMO, HMO-POS and PPO stack up

Riverside County has 88 Medicare Advantage plans for 2027. Compared with 2026, 17 plans are not coming back, 14 are new, and 52 continuing plans changed in some way you should check before December 7, 20 of them under a new name. This guide covers what those numbers mean for Riverside, not which plan to pick.

Riverside, Calif. — As the Annual Enrollment Period opens Oct. 15, 2026, the Medicare Advantage choices in and around Riverside look a lot like last year in one way: almost every plan is built on an HMO chassis. For plan year 2027, Riverside County will have 88 Medicare Advantage plans from 18 carriers, and 84 of them are HMO or HMO-POS. Only four are PPOs. No PFFS (Private Fee-for-Service) plans are offered in the county for 2027.

That split matters, because the plan "type" sets the rules for which doctors you can see, whether you need referrals, and what happens if you need care away from home.

How do Riverside County's 2027 Medicare Advantage plans split by type?

For 2027, Riverside County will have 69 HMO plans, 15 HMO-POS plans and 4 PPO plans — 88 Medicare Advantage plans in all, from 18 carriers. Counting HMO and HMO-POS together, 84 of the 88 plans use an HMO-style network.

Riverside is in Riverside County, and Medicare Advantage availability is set at the county level, so the same lineup is offered countywide. The full table below lists every plan by carrier; this article is about the plan types, not any one plan.

What does HMO mean for networks and referrals?

An HMO (Health Maintenance Organization) plan generally asks you to pick a primary care doctor and to use doctors, hospitals and labs inside the plan's network. In most HMOs, you also need a referral from your primary care doctor before you can see a specialist. Out-of-network care is usually not covered except for emergencies, urgent care, and out-of-area dialysis.

That is the model behind most of Riverside County's 2027 lineup. Carriers offering HMO plans in the county for 2027 are Aetna (CVS Health), Align Senior Care, Alignment Health Plan, Astiva Health, Blue Shield of California, Centene (WellCare), Champion Heath Plan, Clever Care Health Plan, Elite Health Plan, Inc., Humana, IEHP DualChoice, Imperial Health Plan of California, Inc., Kaiser Permanente, Molina Healthcare of California, SCAN Health Plan and UnitedHealthcare.

What is an HMO-POS, and how is it different?

HMO-POS stands for "HMO with a point-of-service option." It is still an HMO at heart — you pick a primary care doctor and generally stay in network — but the plan carves out a defined set of services you can get from out-of-network providers, usually at a higher share of the cost. The specifics (which services, which providers, how much more) vary plan by plan and are spelled out in each plan's Evidence of Coverage.

Riverside County has 15 HMO-POS plans for 2027. Carriers offering HMO-POS plans in the county are Aetna (CVS Health), Champion Heath Plan, Elevance Health (Anthem), UnitedHealthcare and VillageHealth.

What does a PPO give you that an HMO does not?

A PPO (Preferred Provider Organization) plan still has a network, but it covers out-of-network care at a higher cost share rather than refusing it outright. You generally do not need referrals to see a specialist. That flexibility can matter if you split time between homes, travel often, or want to see providers who are not in a tightly managed network.

Riverside County has 4 PPO plans for 2027, and all of them are offered by Humana. That is the complete PPO roster for the county next year — if a PPO is important to you, that is where the choices are.

What about PFFS plans in Riverside County?

Private Fee-for-Service plans are not being offered in Riverside County for 2027. PFFS is a Medicare Advantage type that pays doctors and hospitals a set rate the plan decides, and providers can choose whether to accept the plan on a visit-by-visit basis. Because no carrier is offering PFFS in the county next year, it is not an option locally.

How should I think about plan type when choosing for 2027?

Start with the people and places you want to use, not the plan type on paper. Make a list of the doctors, specialists and hospitals you want to keep seeing, note the pharmacies you use, and think about where you spend time outside Riverside County. Then check each plan you are considering against that list in the Medicare Plan Finder at medicare.gov or by calling the plan directly.

A few things to keep in mind for 2027:

• The Part D out-of-pocket cap rises to $2,400 in 2027, up from $2,100 in 2026.
• The Part D maximum deductible is $700 in 2027, up from $615 in 2026.
• CMS publishes the 2027 Part B standard premium, Part B deductible, and IRMAA income brackets later in the fall, usually in November.
• In Riverside County, 17 plans are not returning for 2027, 14 are new, and 20 have been renamed. Your plan's Annual Notice of Change explains any change to your coverage.
• The Annual Enrollment Period runs Oct. 15 through Dec. 7, 2026. If you do nothing, your current plan renews for 2027 as described in its ANOC.
• Medicare Advantage Open Enrollment runs Jan. 1 through March 31, 2027, and allows one change if you are already in a Medicare Advantage plan.

No plan type is "better" on its own. An HMO can be a strong fit when your doctors are in network and you prefer the primary-care-coordinated model; an HMO-POS adds a defined out-of-network option; a PPO offers the most flexibility, with a higher cost share for going outside the network. The right answer depends on your doctors, your prescriptions and how you travel.