Medicare Advantage

HMO or PPO? Illinois Medicare Advantage for 2027: 68 HMO Plans, 66 PPO

SPRINGFIELD — Illinois shoppers comparing Medicare Advantage for 2027 will see the choice tilt, almost evenly, between two familiar formats. According to the CMS Medicare Advantage Landscape Source File for CY2027, 139 Medicare Advantage plans are listed statewide from 12 carriers. Count the HMO family together — plain HMO plus HMO-POS — and it comes to 68. Count the PPO plans and it comes to 66. The remaining slots go to 2 PFFS plans and 3 Cost plans.

HMO or PPO for 2027Illinois

That near-split is the headline of this year's landscape, and it changes how a reader in Rockford, Carbondale or Chicago might think about networks, referrals and travel. Availability is still decided county by county: a plan listed statewide may or may not be offered where you live. The counts below are statewide totals from CMS, not a promise about your ZIP code.

The statewide split by type

From the CMS CY2027 Landscape file, Illinois's 139 Medicare Advantage plans break down as:

• HMO: 44
• HMO-POS: 24
• PPO: 66
• PFFS: 2
• Cost: 3

Grouping HMO and HMO-POS together — they share the same core network logic — gives 68 plans on the HMO side and 66 on the PPO side. Those two formats cover the overwhelming majority of what Illinois Medicare Advantage shoppers will see on screen when they open the Plan Finder.

The full plan-by-plan and carrier-by-carrier breakouts appear in the tables on this page; the paragraphs here only name carriers where they illustrate a point.

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

These are plan types, defined by how they handle networks, referrals and care received outside the network.

• HMO (Health Maintenance Organization). You generally use the plan's network of doctors and hospitals, and you typically pick a primary care physician who coordinates care. Referrals are often required to see specialists. Out-of-network care is usually covered only for emergencies and urgent care.
• HMO-POS (Point of Service). An HMO with a limited "point of service" option that lets you go out of network for certain services, under rules the plan sets. It is still an HMO at its core.
• PPO (Preferred Provider Organization). You can see in-network or out-of-network providers, though out-of-network cost sharing is typically higher. Referrals to specialists generally are not required.
• PFFS (Private Fee-for-Service). The plan — not Medicare — sets what it will pay providers and what you pay. Providers can choose whether to accept the plan's terms visit by visit, so confirming acceptance each time matters.

Cost plans, which show up as 3 in the Illinois count, are a separate, older category with their own rules; a reader who sees one should read the Evidence of Coverage closely.

Which carriers offer each type in Illinois for 2027

Carriers can offer more than one type. From the CMS CY2027 file:

• HMO plans are offered by Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Centene (WellCare), Devoted Health, Essence Healthcare, Humana, Longevity Health, Molina Healthcare of Illinois, Provider Partners Health Plans, and Zing Health.
• HMO-POS plans are offered by Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Centene (WellCare), and UnitedHealthcare.
• PPO plans are offered by Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Devoted Health, Essence Healthcare, Humana, and UnitedHealthcare.
• PFFS plans are offered by Humana.

Several carriers — Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Devoted Health, Essence Healthcare and Humana among them — appear in more than one type column, which is why the plan tables on this page are the right place to see which specific plans sit where.

How to decide which type fits your doctors and travel

Start with the people and places you already use. A few questions do most of the work:

1. Who are your doctors, and which hospital system are they in? Call each provider's billing office and ask which 2027 Medicare Advantage plans they will be in-network for. Networks can change year to year. 2. Do you want to see specialists without a referral? If yes, that pushes you toward PPO. If you prefer a primary care doctor coordinating everything, HMO or HMO-POS fits that pattern. 3. How often do you travel, and where? Snowbirds and frequent out-of-state visitors often weigh PPO's out-of-network coverage more heavily. If you rarely leave your county, an HMO network may feel natural. 4. Do you take specific prescriptions? Drug coverage differs by plan — look each one up on medicare.gov, not by carrier reputation. 5. How do you feel about paperwork and prior authorizations? Both HMOs and PPOs can require prior authorization for certain services; the plan documents spell out which.

There is no universally right answer. The type that fits a 72-year-old in DuPage County who sees three specialists in Chicago may not fit a 68-year-old in Jackson County who drives to Missouri for family visits.

What to do before December 7

The Annual Enrollment Period runs October 15, 2026 through December 7, 2026. A plan selected in that window takes effect January 1, 2027. A simple sequence:

1. Read the Annual Notice of Change your current plan mailed in September — it lists what is changing for 2027. 2. List your doctors, hospitals and prescriptions. 3. Enter them into the Medicare Plan Finder at medicare.gov to see which 2027 plans in your county match. 4. Narrow by type (HMO, HMO-POS, PPO, PFFS) once you see which plans your providers actually accept. 5. Check each finalist's Evidence of Coverage and provider directory before enrolling.

Free help

Two resources are free, nationwide and not tied to any carrier:

• medicare.gov — the official Medicare Plan Finder, with 2027 plans visible by ZIP code and county.
• 1-800-MEDICARE (1-800-633-4227) — 24 hours a day, 7 days a week, including TTY at 1-877-486-2048.

For year-over-year context, the CMS Medicare Advantage Landscape Source Files for CY2026 and CY2027 are the primary public records behind the counts in this article.