Medicare Advantage

HMO or PPO? Delaware Medicare Advantage for 2027: 19 HMO Plans, 19 PPO

DOVER, Del. — For the 2027 plan year, Delaware's Medicare Advantage shelf splits almost evenly between network-first HMO designs and more flexible PPO designs. According to the CMS Medicare Advantage Landscape Source File for CY2027, 38 Medicare Advantage plans are offered statewide from 8 carriers: 11 HMO plans, 8 HMO-POS plans and 19 PPO plans. Grouped together, HMO and HMO-POS come to 19 — the same count as PPO.

That tidy 19-and-19 split is the headline, but the practical story is about how each plan type handles doctors, referrals and out-of-network care. Availability also varies: a plan listed statewide may not be sold in every Delaware county, so the Medicare Plan Finder at medicare.gov is where you confirm what's actually on your doorstep.

How many HMO and PPO Medicare Advantage plans are offered in Delaware for 2027?

Delaware has 38 Medicare Advantage plans for 2027: 11 HMO, 8 HMO-POS and 19 PPO, drawn from 8 carriers, per the CMS CY2027 Landscape Source File. Add HMO and HMO-POS and you get 19 — matching the 19 PPO plans one for one at the statewide level.

That evenness doesn't mean each Delaware county sees the same menu. Medicare Advantage is sold county by county, so a Sussex County resident and a New Castle County resident can see different subsets of the same statewide list. The full plan-by-plan lists are rendered as tables elsewhere on this page; this story sticks to the statewide shape.

What do HMO, HMO-POS, PPO and PFFS mean for Delaware Medicare enrollees in 2027?

In plain terms: HMO plans ask you to use the plan's network and often to pick a primary care physician who coordinates referrals; HMO-POS plans are HMOs with a "point-of-service" option that lets you go outside the network for certain services; PPO plans let you see in-network or out-of-network providers, usually with a higher cost share out of network; and PFFS (Private Fee-for-Service) plans pay any provider who agrees to the plan's terms at the time of service.

For 2027, Delaware's statewide shelf includes HMO, HMO-POS and PPO plans. If a plan type is not represented on the statewide list, you won't find it in Delaware this year regardless of what you read nationally. The Evidence of Coverage for any specific plan is where network rules, referral requirements and out-of-network cost sharing are spelled out.

Which carriers offer HMO, HMO-POS and PPO Medicare Advantage plans in Delaware for 2027?

For 2027 in Delaware, four carriers offer HMO plans — Aetna (CVS Health), AmeriHealth Caritas VIP Care (HMO-D-SNP), HealthSpring and Highmark Blue Cross Blue Shield. Two carriers offer HMO-POS plans: Centene (WellCare) and UnitedHealthcare. Six carriers offer PPO plans: Aetna (CVS Health), Devoted Health, HealthSpring, Highmark Blue Cross Blue Shield, Humana and UnitedHealthcare.

A few names appear in more than one column. Aetna (CVS Health), HealthSpring, Highmark Blue Cross Blue Shield and UnitedHealthcare each offer more than one plan type in Delaware for 2027, which means the carrier logo on the mailer doesn't tell you whether the plan is an HMO, HMO-POS or PPO. Check the plan type on the Summary of Benefits before comparing.

How should a Delaware reader decide whether an HMO or PPO fits their doctors and travel for 2027?

Start with two questions: Are my doctors in the plan's network, and how often do I need care outside Delaware? If your care is concentrated with a few local providers who are all in a given plan's network, an HMO or HMO-POS can be a clean fit. If you split time between Delaware and another state, see specialists in Philadelphia or Baltimore, or want to walk into an out-of-network office without a referral, a PPO's out-of-network allowance may matter more to you.

Two caveats worth putting on paper. First, networks change — a provider in network in 2026 may not be in 2027 — so verify directly with the plan and the doctor's office each fall. Second, HMO-POS plans sit between the two models; the "POS" portion has its own rules about which services qualify and at what cost share. The plan's Evidence of Coverage is the authoritative document.

What should Delaware Medicare enrollees do before December 7, 2026?

Before December 7, 2026, review your current plan's Annual Notice of Change, list the doctors and prescriptions you rely on, and run them through the Medicare Plan Finder at medicare.gov to see which 2027 plans in your county cover them. Any election you make during October 15 – December 7, 2026 takes effect January 1, 2027.

A few practical steps for Delaware households: confirm your ZIP code's county, since plan availability is county-based; call each doctor's office to ask which 2027 Medicare Advantage contracts they'll accept; and if you take brand-name drugs, check each plan's 2027 formulary rather than assuming last year's list carried over. If you don't want to make a change, you don't have to — your current plan simply continues under its 2027 terms.

Where can Delaware residents get free help choosing a 2027 Medicare Advantage plan?

Free, official help is available year-round from Medicare at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week, and online at medicare.gov. The Plan Finder tool at medicare.gov lets you enter your ZIP code and prescriptions and see 2027 plans available in your Delaware county.

For questions about Medicare eligibility and enrollment timing tied to Social Security, the Social Security Administration can be reached at ssa.gov or 1-800-772-1213. These are no-cost public resources.