Medicare Advantage

Before you pick a Medicare Advantage plan in Chicago: how HMO, HMO-POS, PPO and PFFS differ in 2027

For 2027, Chicago is looking at 67 Medicare Advantage plans: 6 new, 17 gone since 2026, and 30 still here but changed on premium, deductible, plan type or name, 9 of them under a new name. Below, how the lineup shifted in Cook County and what to compare, with no plan ranked or recommended.

Fall 2026 — If you live in Chicago and are sizing up Medicare Advantage for 2027, the first fork in the road isn't the plan name. It's the plan type. Chicago is in Cook County, where CMS lists 67 Medicare Advantage plans from 12 carriers for 2027, and they split into four types: HMO, HMO-POS, PPO and PFFS. Each type sets its own rules on networks, referrals and what happens if you see a doctor outside the plan.

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 simply renews for 2027 if it is still offered, with whatever changes are spelled out in your Annual Notice of Change (ANOC).

The 2027 split by plan type in Cook County

For plan year 2027, CMS lists 67 Medicare Advantage plans in Cook County from 12 carriers. By type:

• HMO: 31 plans
• HMO-POS: 11 plans
• PPO: 24 plans
• PFFS: 1 plan

Counting HMO and HMO-POS together, roughly two in three plans sit on the HMO side of the fence (42 of 67), and most of the rest are PPOs. The table below lists every plan available in the county for 2027.

A quick note on year-to-year change: 17 plans are not returning for 2027, 6 are new, and 9 have been renamed. If your plan is one of those, your ANOC — the notice your carrier mails each fall — will explain what's changing.

What HMO means for your care

An HMO (Health Maintenance Organization) plan is built around a network of doctors, hospitals and other providers who have contracted with the plan. You generally pick a primary care doctor, and that doctor coordinates your care — including referrals to specialists.

With a standard HMO, out-of-network care is typically not covered except in emergencies, urgent care, or out-of-area dialysis. If staying in network fits how you already see your doctors, an HMO can be a straightforward way to go.

For 2027 in Cook County, carriers offering HMO plans include Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Centene (WellCare), Devoted Health, Essence Healthcare, HealthSpring, Humana, Longevity Health, Molina Healthcare of Illinois, Provider Partners Health Plans and Zing Health.

HMO-POS: an HMO with a point-of-service door

HMO-POS stands for "Health Maintenance Organization with a Point-of-Service option." It works like an HMO — you usually have a primary care doctor and a network — but the "POS" piece lets you get certain services from out-of-network providers, typically at a higher cost share. The specifics vary plan by plan, so read the plan's Evidence of Coverage before you assume a particular doctor or service is covered out of network.

For 2027 in Cook County, carriers offering HMO-POS plans include Aetna (CVS Health), Centene (WellCare), HealthSpring and UnitedHealthcare.

PPO: more freedom to go out of network

A PPO (Preferred Provider Organization) plan also has a network, but it covers care from out-of-network providers who accept Medicare — usually at a higher cost share than in-network care. PPOs generally do not require referrals to see specialists.

If you split time between Chicago and another city, or you want the flexibility to see a specialist outside the network without jumping through hoops, a PPO's rules may fit better. Flexibility, though, doesn't automatically mean lower or higher cost — that depends on the specific plan.

For 2027 in Cook County, carriers offering PPO plans include Aetna (CVS Health), Devoted Health, Essence Healthcare, HealthSpring, Humana and UnitedHealthcare.

PFFS: a different model, one plan in the county

PFFS stands for Private Fee-for-Service. These plans set the terms, and you can see any Medicare-approved provider who agrees to accept the plan's payment terms and conditions for that visit. There is no required primary care doctor and no referrals. The catch is that providers can decide visit by visit whether to accept the plan, so it is wise to confirm before each appointment.

For 2027 in Cook County, there is 1 PFFS plan, offered by Humana.

How to pick between types (without picking a plan)

Plan type is a frame, not a verdict. Two questions tend to settle it faster than a spreadsheet:

• Are the doctors and hospitals you already use in the plan's network? Check each plan's directory on medicare.gov or with the plan directly.
• How much do you travel, and how do you want to handle care away from home? HMOs are tightest; HMO-POS adds a limited out-of-network door; PPOs cover out-of-network care at a higher share; PFFS depends on the provider accepting the plan.

A few 2027 program-level numbers that apply across plan types: the Part D out-of-pocket cap is $2,400 for 2027 (up from $2,100 in 2026), and the Part D maximum deductible is $700 for 2027 (up from $615 in 2026). CMS announces the 2027 Part B standard premium, Part B deductible and IRMAA income brackets later in the fall — typically in November — so those pieces will be public before December 7.