Medicare Advantage

Before you pick a Medicare Advantage plan in Hialeah: the 2027 carrier and plan-type guide

People in Hialeah can choose from 101 Medicare Advantage plans for 2027, against 115 this year. 30 of this year’s plans are gone, 16 are new to Miami-dade County, and 61 that continue have changed their premium, deductible, plan type or name, 20 of them under a new name.

Medicare AdvantageHialeah, FL

Hialeah shoppers heading into the 2027 Medicare Advantage season have a lot to sort through — not just how many plans are on the shelf, but who sells them and how the plan types actually differ. Hialeah sits in Miami-Dade County, where 16 carriers are offering 81 Medicare Advantage plans for 2027, and those plans come in a mix of HMO, HMO-POS and PPO shapes, with a large share built as Special Needs Plans. Knowing the differences before you shop is often more useful than skimming a long list.

Who's selling Medicare Advantage in Miami-Dade for 2027

Sixteen carriers offer Medicare Advantage plans with drug coverage in the county, and one additional carrier rounds out the 17-carrier total. In alphabetical order, they are Aetna (CVS Health), Align Senior Care, AmeriHealth Caritas VIP Care, Blue Cross Blue Shield (HCSC), Centene (WellCare), Devoted Health, Doctors HealthCare Plans, Elevance Health (Anthem), Florida Blue, Florida Blue HMO, Florida Complete Care, Gold Kidney Health Plan, Humana, Leon Health, Longevity Health Plan, Solis Health Plans and UnitedHealthcare.

How many plans each one offers varies widely. Some carriers list a single plan for the county; others list more than a dozen. The table below lists every plan by carrier so you can see the full lineup side by side. What matters when you're comparing is not the size of a carrier's list, but whether a given plan works with your doctors, covers your medications and fits how you like to get care.

HMO, HMO-POS and PPO: what the labels mean

Every Medicare Advantage plan uses one of a handful of network structures. The label tells you a lot about how the plan works day to day.

• HMO (Health Maintenance Organization). You generally pick a primary care doctor and stay inside the plan's network. Referrals are often required to see specialists. Out-of-network care is usually not covered except in emergencies. In Miami-Dade, 85 of the 115 plans are HMOs.
• HMO-POS (Point of Service). Similar to an HMO, but with a limited "point of service" option to go outside the network for certain services, usually at a higher cost. There are 9 HMO-POS plans in the county.
• PPO (Preferred Provider Organization). More flexibility to see out-of-network providers, though you'll typically pay less in-network. Referrals are usually not required. The county has 21 PPO plans, including regional PPOs that cover a broader area.
• PFFS (Private Fee-for-Service). A less common structure where the plan sets the payment terms and providers decide, visit by visit, whether to accept them. No PFFS plans appear in the Miami-Dade 2027 lineup, but it helps to know the term if you see it elsewhere.

Special Needs Plans, explained

Special Needs Plans (SNPs) are Medicare Advantage plans built for people who fit a specific profile. Sixty-nine of the 115 plans in Miami-Dade are SNPs — a large share of the local market. There are three types you'll see on the roster:

• D-SNP (Dual Eligible). For people who have both Medicare and Medicaid. Benefits and networks are designed to coordinate the two programs.
• C-SNP (Chronic Condition). For people with a qualifying chronic condition, such as diabetes, chronic heart failure or end-stage renal disease. Coverage is tailored to that condition.
• I-SNP (Institutional). For people who live in a nursing home or need a similar level of care.

You can only enroll in a SNP if you meet the eligibility rules. If you don't qualify, you'd shop from the general HMOs and PPOs instead.

How to narrow the list

With more than 100 plans in the county, the useful question isn't "which plan is best," but "which plans match my situation." A few filters most people apply:

• Are your current doctors and hospital in the plan's network?
• Are your prescriptions on the plan's drug list, and at a tier you can afford?
• Do you travel often, or split time between Florida and another state? That may steer you toward a PPO.
• Do you qualify for a SNP based on Medicaid, a chronic condition or an institutional stay?

The plan finder at medicare.gov lets you enter your ZIP code, doctors and prescriptions and compare plans on those specifics. Your local State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling — in Florida that's SHINE.

A few 2027 program facts worth knowing

These apply to everyone shopping this fall, not just Hialeah:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
• The Part D maximum deductible is $615.
• The old "donut hole" coverage gap was eliminated in 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly installments — it's optional and free to opt into.
• IRMAA surcharges on Part B and Part D premiums begin above $109,000 in income for a single filer in 2026.
• Annual Enrollment Period: Oct. 15 – Dec. 7. Medicare Advantage Open Enrollment: Jan. 1 – March 31.