Medicare Advantage

Does your St. Petersburg plan let you see out-of-network docs?

Pinellas County has 118 Medicare Advantage plans for 2027. Compared with 2026, 29 plans are not coming back, 18 are new, and 47 continuing plans changed in some way you should check before December 7, 17 of them under a new name. This guide covers what those numbers mean for St. Petersburg, not which plan to pick.

ST. PETERSBURG — As the Annual Enrollment Period for 2027 Medicare coverage opens Oct. 15, 2026, the first choice most shoppers face is not a carrier or a benefit — it is a plan type. The letters next to each Medicare Advantage plan name (HMO, HMO-POS, PPO, PFFS) decide how you see doctors, whether you need referrals and what happens if you need care out of network.

St. Petersburg is in Pinellas County, where Medicare Advantage plans for 2027 split into three of those four categories. According to the CMS Landscape Source File for 2027, the county has 118 Medicare Advantage plans from 17 carriers: 76 HMOs, 17 HMO-POS plans and 25 PPOs. No PFFS (Private Fee-for-Service) plan is on the 2027 Pinellas County lineup.

What do HMO, HMO-POS, PPO and PFFS mean in Medicare Advantage?

In Medicare Advantage, the plan type sets the network rules. An HMO (Health Maintenance Organization) asks you to use the plan's network of doctors and hospitals and often to pick a primary care doctor who gives referrals to specialists. Out-of-network care is generally not covered except in an emergency.

An HMO-POS (Point of Service) is an HMO with a small door open: you can go to certain providers outside the network for certain services, usually at a higher cost share. A PPO (Preferred Provider Organization) gives you both in-network and out-of-network coverage, usually without referrals, though you pay more when you go outside the network. A PFFS (Private Fee-for-Service) plan sets its own payment terms and lets you see any Medicare provider who agrees to those terms; no PFFS plans are offered in Pinellas County for 2027.

Each plan's exact rules — which doctors are in network, whether a referral is needed, and what you pay out of network — live in its Evidence of Coverage and provider directory, not in the plan type label.

How many Medicare Advantage plans in St. Petersburg are HMOs for 2027?

Of the 118 Medicare Advantage plans available in Pinellas County for 2027, 76 are HMOs. HMOs are the largest group on the local lineup, and they come from a wide field of insurers.

Carriers offering HMO plans in the county for 2027 include Aetna (CVS Health), Align Senior Care, BayCare Health Plans, Centene (WellCare), Devoted Health, Elevance Health (Anthem), Florida Blue HMO, Florida Complete Care, HealthSpring, Humana, Longevity Health Plan, SECUR Health Plan, Solis Health Plans and Ultimate Health Plans. The full table on this page lists each plan by name.

How many HMO-POS plans are offered in Pinellas County for 2027?

Pinellas County has 17 HMO-POS plans for 2027. These sit between a pure HMO and a PPO: you generally use a network, but the plan allows a defined out-of-network option for certain services.

For 2027, HMO-POS plans in the county are offered by Aetna (CVS Health), Centene (WellCare), Florida Complete Care, Gold Kidney Health Plan and UnitedHealthcare. If seeing a provider outside a carrier's main network matters to you, the specific point-of-service rules differ by plan, so check the Evidence of Coverage before you enroll.

How many PPO plans are available in St. Petersburg for 2027?

Pinellas County has 25 PPO plans on the 2027 Medicare Advantage lineup. PPOs are the second-largest group and are often considered by people who travel, split time between states, or want more flexibility to see specialists without a referral.

Carriers offering PPO plans in the county for 2027 are Aetna (CVS Health), Devoted Health, Florida Blue, Humana and UnitedHealthcare. Out-of-network cost sharing and whether a provider will accept the plan vary by plan, so a PPO's flexibility is only as useful as the providers willing to bill it.

How do I pick between an HMO and a PPO in St. Petersburg?

Start with your doctors and your prescriptions, not the plan type. Look up each plan on the Medicare Plan Finder at medicare.gov and confirm that your current providers are listed in that plan's network and that your drugs are on its formulary. Then decide whether you want the structure of an HMO (lower-friction when you stay in network, usually with referrals) or the flexibility of a PPO (out-of-network coverage, usually without referrals).

Two practical questions help: Do you travel enough that you might need non-emergency care outside the Tampa Bay area? And do you want a primary care doctor coordinating referrals, or do you prefer to book specialists directly? Your answers point you to a type before you compare individual plans.

What should I do during the 2026 Annual Enrollment Period?

The Annual Enrollment Period runs Oct. 15 through Dec. 7, 2026, and any change you make takes effect Jan. 1, 2027. If you do nothing, your current plan renews for 2027 if it is still offered — with the changes spelled out in the Annual Notice of Change (ANOC) your plan mails in the fall.

A few housekeeping notes for the county's 2027 lineup: 29 plans from 2026 are not returning, 18 are new, and 17 have been renamed. If your plan is in one of those groups, your ANOC will say so. For 2027, the Part D out-of-pocket cap rises to $2,400 (from $2,100 in 2026) and the Part D maximum deductible rises to $700 (from $615). CMS typically announces the 2027 Part B premium and deductible and the 2027 IRMAA income brackets later in the fall.