Medicare Advantage

Before AEP: Augusta's 2027 Medicare Advantage field

People in Augusta can choose from 74 Medicare Advantage plans for 2027, against 84 this year. Seven of this year's plans are gone, 8 are new to Richmond County, and 22 that continue have changed something in their terms, 11 of them under a new name.

Medicare AdvantageAugusta, GA

AUGUSTA, Ga. — If you are sorting through Medicare Advantage options here for 2027, the first thing to get straight is not which plan has which perk. It is the shape of the field: who sells plans, and what kind of plan each one is. Once you understand that, the long list of names gets a lot easier to read.

Augusta is in Richmond County, where 9 insurance carriers offer Medicare Advantage plans for the 2027 plan year, according to the CMS Medicare Advantage Landscape Source File. Between them, they cover the main plan structures Medicare allows — HMO, HMO-POS and PPO — along with Special Needs Plans built for specific groups of people. No carrier in the county is offering a Private Fee-for-Service (PFFS) plan for 2027, so if you have seen that term, it is a plan type that exists nationally but is not on the local menu next year.

Who sells Medicare Advantage in Richmond County

Ten carriers offer Medicare Advantage prescription drug (MA-PD) plans in the county. In alphabetical order, they are:

• Aetna (CVS Health) — 12 plans (HMO, PPO; 4 Special Needs)
• CareSource — 2 plans (HMO; 2 Special Needs)
• Centene (WellCare) — 10 plans (HMO-POS, PPO; 4 Special Needs)
• Clover Health — 4 plans (PPO)
• Devoted Health — 5 plans (PPO; 2 Special Needs)
• Elevance Health (Anthem) — 8 plans (HMO, HMO-POS, PPO; 3 Special Needs)
• Georgia Health Advantage — 2 plans (HMO; 2 Special Needs)
• Humana — 25 plans (HMO, PPO; 7 Special Needs)
• PruittHealth Premier — 3 plans (HMO; 3 Special Needs)
• UnitedHealthcare — 13 plans (HMO-POS, PPO; 9 Special Needs)

The table below lists every plan by carrier, so you can see the exact names side by side. The counts above are just the shape of the field — how many options each carrier brings and what plan types they use.

What HMO, HMO-POS, PPO and PFFS actually mean

The letters after a plan name tell you how the plan handles doctors, hospitals and referrals. Plain-English version:

• HMO (Health Maintenance Organization). You use the plan's network for care, and you usually pick a primary care doctor who coordinates referrals to specialists. Out-of-network care is generally not covered except in an emergency.
• HMO-POS (Point of Service). A network HMO with a limited "point of service" option that lets you go outside the network for certain services, usually at a higher cost share.
• PPO (Preferred Provider Organization). You can see any Medicare-approved provider, in-network or out, without a referral. In-network care costs less; out-of-network care is still covered but typically at a higher share.
• PFFS (Private Fee-for-Service). A plan that pays providers a set rate, and any provider who accepts the plan's terms can see you. As noted, no PFFS plans are offered in Richmond County for 2027.

In the county's 84-plan lineup, PPO plans are the most common structure (52), followed by HMO (18) and HMO-POS (14). That is the split — not a ranking, just the mix on the menu.

Special Needs Plans: who they are for

Of the 84 plans available in the county, 36 are Special Needs Plans (SNPs). SNPs are Medicare Advantage plans that only enroll people who fit a specific category, and their benefits and networks are built around that group.

• D-SNP (Dual Eligible). For people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition). For people with a qualifying chronic condition, such as diabetes, heart disease or end-stage renal disease. The plan name usually spells out which condition it covers.
• I-SNP (Institutional). For people who live in a long-term care setting like a nursing facility, or who need that level of care at home.

If you do not fit one of these categories, an SNP is not an option for you — and that is by design. If you do, an SNP may be worth a closer look because the plan is built around your situation. The plan table shows which entries are D-SNPs, C-SNPs or I-SNPs.

Drug coverage is built in

All 74 Medicare Advantage plans in the county include Part D prescription drug coverage. There are no stand-alone Part D plans listed for Richmond County in the 2027 Landscape data, so if you want prescription coverage and you go the Medicare Advantage route here, it is bundled.

A few Part D program facts to keep in mind for 2027:

• The Part D out-of-pocket cap is $2,100 in 2026 ($2,400 in 2027) for the year. Once your covered drug spending reaches that amount, you pay $0 for covered drugs the rest of the year.
• The Part D maximum deductible is $615 in 2026 ($700 in 2027).
• The old coverage gap ("donut hole") is gone as of 2025; Part D now has three phases (deductible, initial coverage, catastrophic).
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly installments instead of paying at the pharmacy counter. It is optional and free to opt into.

How to use the plan list without getting overwhelmed

A practical order that many people find easier:

1. Start with plan type. Do you want the flexibility of a PPO, or are you comfortable staying inside an HMO network with a primary care doctor coordinating your care? 2. Check if you qualify for an SNP. If you have both Medicare and Medicaid, or a qualifying chronic condition, or you live in an institutional setting, the SNPs on the list are built for you. 3. Then look at the specific plans. Use medicare.gov's Plan Finder to compare the ones that fit your situation on premium, drug list, network and extras. Enter your ZIP code and your prescriptions to see personalized results.

Keep two dates in mind. The Annual Enrollment Period runs Oct. 15 through Dec. 7 — that is when you can join, switch or drop a Medicare Advantage or Part D plan for the coming year. Then, if you are already in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period runs Jan. 1 through March 31, and gives you one chance to change to a different Medicare Advantage plan or drop back to Original Medicare.