Medicare Advantage

HMO or PPO in Sacramento for 2027: how the county's Medicare Advantage plans split

Sacramento County has 32 Medicare Advantage plans for 2027. Compared with 2026, 13 plans are not coming back, 7 are new, and 23 continuing plans changed in some way you should check before December 7, 9 of them under a new name. This guide covers what those numbers mean for Sacramento, not which plan to pick.

Sacramento, Calif. — Fall 2026. As the Annual Enrollment Period opens Oct. 15, 2026 and runs through Dec. 7, 2026, Sacramento residents weighing a Medicare Advantage plan for 2027 are looking at a lineup that has shifted toward one plan type. Of the 32 Medicare Advantage plans available in Sacramento County for 2027, 29 are HMOs and 3 are HMO-POS plans, according to the CMS Medicare Advantage Landscape Source File. No PPO or PFFS plans are listed in the county's 2027 lineup.

That mix matters, because the plan type — HMO, HMO-POS, PPO or PFFS — sets the rules for which doctors you can see, whether you need a referral, and what happens if you need care away from home.

What the four plan types actually mean

Medicare Advantage plans come in a handful of flavors. The letters after each plan name tell you how its network works.

HMO (Health Maintenance Organization). You pick a primary care doctor and generally use the plan's network. Out-of-network care is usually not covered except in an emergency or for urgent care. Many HMOs require a referral from your primary doctor before you see a specialist.

HMO-POS (HMO with a Point-of-Service option). This is an HMO with a side door. The plan still has a network and may still use referrals, but it lets you get certain services from out-of-network providers — often at a higher cost share. The exact list of services the POS option covers varies by plan.

PPO (Preferred Provider Organization). You can use in-network or out-of-network providers, usually without a referral, though out-of-network care typically costs more. PPOs are more flexible for travel and for seeing a specialist directly.

PFFS (Private Fee-for-Service). You can see any Medicare-approved provider that agrees to the plan's payment terms. Referrals are usually not required, but providers can decide case by case whether to accept the plan.

None of these types is "better." The right choice depends on which doctors you want to keep, whether you travel, and how you prefer to get specialty care.

How Sacramento County's 2027 plans split

For plan year 2027, Sacramento County's Medicare Advantage lineup splits like this, per the CMS Landscape Source File:

• HMO: 29 plans
• HMO-POS: 3 plans
• PPO: 0 plans listed
• PFFS: 0 plans listed

That's a change from the current (2026) lineup, which included PPO plans in the county. If your 2026 plan is a PPO, read your Annual Notice of Change carefully — it will tell you whether your plan is returning for 2027, and if not, what your options are.

The table on this page lists every 2027 plan by carrier and type.

Which carriers offer which type in 2027

Here are the carriers offering each type in Sacramento County for 2027, in alphabetical order.

Carriers offering HMO plans: Aetna (CVS Health), Alignment Health Plan, Blue Shield of California, Centene (WellCare), Elevance Health (Anthem), Imperial Health Plan of California, Inc., Kaiser Permanente, Molina Healthcare of California, SCAN Health Plan.

Carriers offering HMO-POS plans: Aetna (CVS Health), UnitedHealthcare.

Some carriers appear in both columns because they offer more than one type. The full table shows each plan by name.

Referrals, networks and out-of-network care

A few rules of thumb as you compare plans:

• If you want to keep a specific doctor or hospital, check the plan's provider directory before enrolling. Networks can change year to year.
• If you travel often or spend part of the year outside California, ask how the plan handles routine care away from home. HMOs typically cover only emergency and urgent care out of network.
• If you dislike referrals, look closely at how each plan handles specialist access. HMO rules vary; some require referrals, some don't.
• If you have a chronic condition or are dual-eligible for Medicare and Medi-Cal, Sacramento County's 2027 lineup also includes Special Needs Plans (SNPs). Eligibility rules apply.

For the specifics of any plan — premium, copays, drug list, network — use the Medicare Plan Finder at medicare.gov, call 1-800-MEDICARE, or read the plan's Evidence of Coverage.

What else is new for 2027

A couple of program-wide numbers are already confirmed for next year and apply no matter which plan type you pick:

• Part D out-of-pocket cap: $2,400 in 2027 (up from $2,100 in 2026).
• Part D maximum deductible: $700 in 2027 (up from $615 in 2026).

The 2027 Part B standard premium, Part B deductible and IRMAA income brackets have not been announced yet. CMS typically publishes those figures in the fall, usually in November.