Medicare Advantage

HMO, PPO or SNP? A Des Moines Reader's Guide

For 2027, Des Moines is looking at 44 Medicare Advantage plans: 17 new, 11 gone since 2026, and 14 still here but changed on premium, deductible, plan type or name, 6 of them under a new name. Below, how the lineup shifted in Polk County and what to compare, with no plan ranked or recommended.

Medicare AdvantageDes Moines, IA

If you live in Des Moines and are sorting through Medicare Advantage options, the first fork in the road isn't a carrier name — it's the plan type. HMO, HMO-POS, PPO, PFFS and Special Needs Plans all work differently, and understanding those labels can save a lot of second-guessing later.

Des Moines is in Polk County, where 38 Medicare Advantage plans are offered for 2027 by ten carriers, according to the CMS Medicare Advantage Landscape Source File. Compared with 2026, 21 plans continue, 17 are new, 11 are not returning, and 6 have been renamed; 8 continuing plans change something in their terms, which the ANOC spells out.

What the plan types actually mean

HMO (Health Maintenance Organization). You pick a primary care doctor and generally use providers in the plan's network. Referrals are often required for specialists. Out-of-network care is usually not covered except for emergencies.

HMO-POS (Point of Service). A twist on the HMO. You still work within a network, but the "point of service" feature lets you go outside it for certain services, usually at higher cost-sharing.

PPO (Preferred Provider Organization). More flexibility. You can see any provider that accepts the plan, in or out of network, without a referral. In-network care costs less, but out-of-network care is still covered at a higher share.

PFFS (Private Fee-for-Service). These plans set the terms of payment and let you see any Medicare provider willing to accept those terms. No PFFS plans are offered in Polk County for 2027.

Special Needs Plans (SNPs). These are Medicare Advantage plans built for a specific group:

• D-SNP — for people with both Medicare and Medicaid (dual eligibles).
• C-SNP — for people with a qualifying chronic condition.
• I-SNP — for people who need an institutional level of care (for example, living in a nursing home).

You have to meet the eligibility rule to enroll in an SNP, and if you no longer qualify, you'll need to switch plans.

Who offers what in Polk County

Ten carriers offer MA-PD plans in the area for 2027. In alphabetical order:

• Aetna (CVS Health) — 8 plans (HMO, HMO-POS, PPO; 1 SNP)
• Centene (WellCare) — 4 plans (HMO-POS; 3 SNPs)
• Elevance Health (Anthem) — 2 plans (HMO-POS; 2 SNPs)
• Humana — 8 plans (HMO, PPO; 3 SNPs)
• Iowa Health Advantage — 2 plans (HMO; 2 SNPs)
• MediGold — 5 plans (HMO, PPO)
• Passport Advantage — 1 plan (HMO; 1 SNP)
• UnitedHealthcare — 6 plans (HMO-POS, PPO; 2 SNPs)
• Wellmark Advantage Health Plan — 2 plans (PPO)

The table below lists every plan by carrier and type. Some carriers stick to one design — Wellmark, for instance, offers only PPOs in Polk County, while MediGold offers HMOs and a PPO. Others, like Aetna and Humana, mix several plan types across their lineup. That variety matters because a carrier you already know may or may not offer the plan shape you want.

How to think about the choice

Start with how you like to get care. If you have a set group of doctors and don't mind a referral to see specialists, an HMO or HMO-POS may fit. If you travel or want to see specialists without referrals, a PPO's flexibility may matter more. If you have both Medicare and Medicaid, a D-SNP may be worth a closer look; if you have a qualifying chronic condition or live in a facility, C-SNP or I-SNP options exist.

Then check networks. Two plans of the same type from the same carrier can still have different provider lists. The Medicare Plan Finder at medicare.gov lets you enter your doctors and drugs to see how each plan handles them.

Drug coverage and 2027 program numbers

Every one of the 38 Medicare Advantage plans in Polk County includes Part D drug coverage. That's useful to know because there are no stand-alone Part D plans available in the county, per the CMS Landscape data — drug coverage in Des Moines is folded into MA-PD plans.

A few program-level Part D facts for 2027:

• The out-of-pocket cap for Part D drugs is $2,100.
• The Part D deductible can be no higher than $615.
• The old coverage gap ("donut hole") has been eliminated since 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments if you choose.
• IRMAA surcharges for higher-income beneficiaries begin above $109,000 in income for a single filer in 2026.

When you can make changes

• Annual Enrollment Period: October 15 – December 7. You can join, switch or drop a Medicare Advantage or Part D plan for the coming year.
• Medicare Advantage Open Enrollment: January 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance to switch to another MA plan or return to Original Medicare (and add a Part D plan).
• Special Enrollment Periods can apply if you move, lose other coverage, or become eligible for Medicaid or Extra Help.