Medicare Advantage

Boise Medicare Advantage for 2027: how the HMO, HMO-POS and PPO choice really works

For 2027, Boise is looking at 27 Medicare Advantage plans: 4 new, 9 gone since 2026, and 15 still here but changed on premium, deductible, plan type or name, 5 of them under a new name. Below, how the lineup shifted in Ada County and what to compare, with no plan ranked or recommended.

Boise, fall 2026 — Shoppers in Ada County looking at Medicare Advantage for 2027 will see the lineup lean one way: of the 27 Medicare Advantage plans offered in the county next year, 11 are PPOs, 8 are HMOs and 8 are HMO-POS plans, according to the CMS Landscape Source File for 2027. No Private Fee-for-Service (PFFS) plans are offered in Ada County for 2027. That split matters, because the plan "type" sets the rules for which doctors you can see, whether you need referrals, and what happens if you get care outside the plan's network.

The Annual Enrollment Period runs October 15 through December 7, 2026, and any change you make takes effect January 1, 2027. If you do nothing, your current plan renews for 2027 as described in its Annual Notice of Change (ANOC).

What is the difference between HMO, HMO-POS, PPO and PFFS Medicare Advantage plans?

Each label is a set of network rules. An HMO (Health Maintenance Organization) generally asks you to use providers in the plan's network and to pick a primary care doctor who gives referrals to specialists. Care outside the network is usually not covered except in emergencies.

An HMO-POS (Health Maintenance Organization with a Point-of-Service option) is an HMO that lets you see some out-of-network providers for certain services, usually at a higher cost share. The specifics — which services, which providers, what you pay — vary by plan.

A PPO (Preferred Provider Organization) has a network with lower cost sharing, but also covers out-of-network care at a higher cost share. Referrals are typically not required.

A PFFS (Private Fee-for-Service) plan sets its own payment terms, and you can see any Medicare provider who agrees to accept the plan. No PFFS plans are offered in Ada County for 2027.

How many Medicare Advantage plans are offered in Ada County for 2027, and how do they split by type?

Ada County — the county Boise is in — has 27 Medicare Advantage plans for 2027 from 7 carriers. By type, that's 8 HMO, 8 HMO-POS and 11 PPO plans. Counting HMO and HMO-POS together as the "HMO family," 16 of the 27 plans have HMO-style rules and 11 are PPOs.

That is a different mix from 2026, when the county had 32 plans (11 HMO, 6 HMO-POS, 15 PPO). The total number of plans is smaller for 2027 and the share of HMO-POS plans is a little bigger. The table on this page lists every 2027 plan by carrier and type.

Which Boise-area carriers offer HMO, HMO-POS and PPO plans for 2027?

Based on the CMS Landscape Source File for 2027 in Ada County:

• Carriers offering HMO plans for 2027: American Health Advantage of Utah, Blue Cross of Idaho, Humana, Molina Healthcare of Utah & Idaho, and St. Luke's Health Plan.
• Carriers offering HMO-POS plans for 2027: PacificSource Medicare and UnitedHealthcare.
• Carriers offering PPO plans for 2027: Blue Cross of Idaho, Humana and UnitedHealthcare.

Some carriers offer more than one plan type, so the carrier list on each line does not add up to seven. We're not naming individual plans here because the plan-by-plan details live in the table below and in the Medicare Plan Finder.

How should Boise shoppers decide between an HMO, HMO-POS and PPO for 2027?

Start with your doctors, your hospital and your prescriptions, not the plan type. The "right" type depends on who you want to see and where you spend time.

A few questions that usually sort it out:

• Are your current providers in the plan's network? Check the plan's online directory or call the plan. If your providers are in-network, an HMO can work well. If some aren't, a PPO or HMO-POS may give you more room.
• Do you want to see specialists without a referral? PPOs typically don't require them. Many HMOs do.
• Do you travel or split time out of state? PPOs cover out-of-network care (at a higher cost share). HMOs usually only cover emergencies out of network. HMO-POS falls in the middle, with limits set by the plan.
• Do you take prescription drugs? In Ada County for 2027, most Medicare Advantage plans include Part D drug coverage, but a few do not. Confirm your drugs are on the plan's formulary before you enroll.

No plan type is cheaper or better across the board. The trade-off is network freedom versus structure, and the premium, copays and extra benefits are set plan by plan.

What 2027 Medicare numbers are already set, and what is still coming?

A few program-level figures for 2027 are already published by CMS:

• The Part D out-of-pocket cap rises to $2,400 in 2027 (up from $2,100 in 2026).
• The Part D maximum deductible is $700 in 2027 (up from $615 in 2026).
• The Part D national base beneficiary premium for 2027 is $41.33 (this is a formula input, not what any specific plan charges).

The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, have not been announced yet. CMS normally publishes them later in the fall.

What should I do during Annual Enrollment 2027 if I already have a plan?

Read your plan's Annual Notice of Change (ANOC), which arrives by late September. It spells out what is changing for 2027 — premiums, cost sharing, drug list, provider network, extra benefits. If you're happy with the changes, you don't have to do anything; your plan renews January 1, 2027.

If you want to compare, the Annual Enrollment Period runs October 15 to December 7, 2026. You can switch Medicare Advantage plans, move between Original Medicare and Medicare Advantage, or change Part D plans. A separate Medicare Advantage Open Enrollment Period runs January 1 to March 31, 2027, for people already in a Medicare Advantage plan who want to change once.

For 2027 in Ada County, CMS data shows 9 plans are not returning, 4 plans are new, and 5 are renamed. If your plan is among those not returning, you'll get a non-renewal letter and will need to pick a new plan or return to Original Medicare.