Medicare Advantage

HMO or PPO? Georgia Medicare Advantage for 2027: 71 HMO Plans, 89 PPO

ATLANTA — Georgians comparing Medicare Advantage for 2027 will see a lineup that leans toward PPOs, with HMOs close behind. According to the CMS Medicare Advantage Landscape Source File for CY2027, the state has 161 Medicare Advantage plans from 12 carriers. By plan type, there are 48 HMOs, 23 HMO-POS plans, 89 PPOs, and 1 PFFS. Counting HMO and HMO-POS together, Georgia has 71 HMO-style plans versus 89 PPOs.

Those figures are statewide. Medicare Advantage is sold county by county, so a plan listed here may not be offered in your ZIP code, and plan availability where you live is what ultimately matters.

The statewide split by type

For plan year 2027, CMS lists 161 Medicare Advantage plans available somewhere in Georgia. The breakdown:

• HMO: 48
• HMO-POS: 23
• PPO: 89
• PFFS: 1

Combined, HMO and HMO-POS come to 71. PPOs account for the largest share by type. The single PFFS plan rounds out the field. These counts come directly from the CMS MA Landscape Source Files for CY2026 and CY2027, which is also how year-over-year comparisons are produced.

What HMO, HMO-POS, PPO and PFFS mean

These four letters describe how a plan handles networks, referrals and care received outside the plan's contracted providers. The specifics vary by plan — always check the plan's own Evidence of Coverage and provider directory — but the general shape of each type is consistent.

• HMO (Health Maintenance Organization): You generally use the plan's network of doctors and hospitals, except for emergencies and urgent care. Many HMOs ask you to pick a primary care physician and get referrals before seeing specialists.
• HMO-POS (Point of Service): An HMO with a point-of-service option that allows some care outside the network under rules the plan sets. The out-of-network rules differ from plan to plan.
• PPO (Preferred Provider Organization): You can use both in-network and out-of-network providers. Referrals are typically not required. Costs and rules for out-of-network care are set by each plan.
• PFFS (Private Fee-for-Service): The plan determines how much it will pay providers and how much you pay. Providers must agree to the plan's terms before treating you, which is different from how HMOs and PPOs contract with their networks.

The full plan and carrier lists are rendered as tables elsewhere on this page; use those to see which plans fall under each type.

Which carriers offer each type in Georgia for 2027

Carriers do not all offer every plan type. For 2027, CMS lists:

• HMO plans from Aetna (CVS Health), Elevance Health (Anthem), Georgia Health Advantage, HealthSpring, Humana, Kaiser Permanente, and PruittHealth Premier.
• HMO-POS plans from Centene (WellCare), Elevance Health (Anthem), Kaiser Permanente, and UnitedHealthcare.
• PPO plans from Aetna (CVS Health), BlueCross BlueShield of Tennessee, Centene (WellCare), Clover Health, Devoted Health, Elevance Health (Anthem), HealthSpring, Humana, and UnitedHealthcare.
• PFFS plans from Humana.

Several carriers appear in more than one column — for example, Aetna (CVS Health), Elevance Health (Anthem), HealthSpring, Humana, Kaiser Permanente, Centene (WellCare) and UnitedHealthcare each show up in multiple plan types — so the carrier name alone doesn't tell you the network rules. The plan type does.

How to decide which type fits your doctors and travel

Plan type is a starting point for matching coverage to how you actually use care. A few questions help narrow things down:

• Who are your doctors, and are they in-network? With an HMO, in-network status is central. With a PPO, out-of-network care is usually available at different cost-sharing. Check each plan's current provider directory before enrolling.
• Do you want to see specialists without a referral? Many HMOs require referrals; many PPOs do not. The plan's documents spell out the rule.
• Do you travel or spend part of the year outside Georgia? PPOs and the PFFS plan generally handle non-emergency care outside the service area differently than HMOs do. HMO-POS plans sit between an HMO and a PPO on this question, with each plan's own rules.
• Do you take specific prescriptions? Each plan has its own drug list. Confirm your medications on each plan's formulary at medicare.gov.
• Is a specific hospital system important to you? Confirm it is contracted with the plan for 2027, since networks can change from year to year.

Because plans are offered county by county, the practical first step is to see which of Georgia's 161 plans are actually sold at your address.

What to do before December 7

The Annual Enrollment Period for 2027 coverage runs October 15 through December 7, 2026. Any Medicare Advantage election you make during that window takes effect January 1, 2027. A short checklist:

1. Make a list of your doctors, hospitals, pharmacies and prescriptions. 2. Enter your ZIP code on the Medicare Plan Finder at medicare.gov to see the plans available in your county. 3. For each plan you're considering, read the Summary of Benefits and the Evidence of Coverage. 4. Verify provider participation directly with the plan and your doctor's office for 2027. 5. Keep a written record of any confirmations you receive.

If you're satisfied with your current coverage, no action is required to stay in it, provided the plan is being offered again in 2027. Your plan's Annual Notice of Change (ANOC) describes what's changing.

Free help

You can compare plans and enroll at medicare.gov using the Plan Finder, which uses CMS Landscape and plan-level data. You can also call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week, with TTY service at 1-877-486-2048. Both resources are free.