Medicare Advantage

Does Louisville need an HMO or a PPO next year?

Jefferson County has 67 Medicare Advantage plans for 2027. Compared with 2026, 13 plans are not coming back, 13 are new, and 23 continuing plans changed in some way you should check before December 7, 9 of them under a new name. This guide covers what those numbers mean for Louisville, not which plan to pick.

Louisville, Ky. — As the Annual Enrollment Period opens Oct. 15, 2026 and runs through Dec. 7, 2026, Jefferson County residents choosing a Medicare Advantage plan for 2027 will again see the lineup split largely between HMO, HMO-POS and PPO designs. The letters next to a plan name are not marketing jargon — they tell you how the plan handles networks, referrals and care you get outside the plan's doctors.

The 2027 split in Jefferson County

Louisville sits in Jefferson County, where Medicare plan availability is set. For 2027, CMS lists 67 Medicare Advantage plans from 10 carriers in the county. By type, that is 15 HMO plans, 18 HMO-POS plans and 34 PPO plans. Counting HMO and HMO-POS together, 33 of the 67 plans are HMO-family, and 34 are PPO.

No PFFS (Private Fee-for-Service) plans are offered in the county for 2027. If you have heard the term, that is why — it is a legitimate Medicare Advantage plan type nationally, just not one you will find on the Louisville menu this year.

The table below lists every plan available in the county, along with its type.

What HMO means

An HMO (Health Maintenance Organization) plan generally asks you to use doctors, hospitals and other providers inside the plan's network. Many HMO plans also ask you to pick a primary care provider and get a referral before you see a specialist. Outside of emergencies and urgent care, care you get out of network usually is not covered.

That structure can be a good fit if your doctors are already in the plan's network and you do not travel often. It can be a poor fit if you split time between states or want to see out-of-network specialists without extra steps.

For 2027 in Jefferson County, carriers offering HMO plans include Abilis Health (HMO SNP), Aetna (CVS Health), American Health Advantage of Indiana, Elevance Health (Anthem), Essence Healthcare, Humana and Passport Advantage.

What HMO-POS means

HMO-POS stands for HMO with a Point-of-Service option. It works like an HMO — a defined network, often a primary care provider, sometimes referrals — but adds a limited ability to go out of network for certain services, usually at a higher cost share. Each plan sets its own rules for which services qualify and what you pay.

If a plain HMO feels too tight but you do not need the full flexibility of a PPO, HMO-POS can be a middle ground. The specific point-of-service rules live in the plan's Evidence of Coverage.

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

What PPO means

A PPO (Preferred Provider Organization) plan has a network too, but it generally covers out-of-network care — just at a higher share of the cost than in-network. PPOs typically do not require referrals to see specialists.

That added flexibility matters if you travel, spend part of the year outside Kentucky, or want the option to see a provider who is not in the network. The trade-off is that out-of-network cost sharing can be meaningfully higher, so it is worth checking the plan's documents before assuming any provider is covered the way you expect.

For 2027, carriers offering PPO plans in Jefferson County include Aetna (CVS Health), Centene (WellCare), Devoted Health, Elevance Health (Anthem), Essence Healthcare, Humana and UnitedHealthcare.

How to think about picking a type

The right plan type depends on your doctors, your prescriptions and how you live — not on which type sounds best in the abstract. A few practical questions can narrow the field:

• Are the doctors and hospitals you already use in the plan's network? Confirm with the plan's directory.
• Do you want to be able to see specialists without a referral?
• Do you spend time outside the Louisville area or travel often?
• How does the plan handle your prescriptions? All 67 plans in the county include drug coverage.

The Medicare Plan Finder at medicare.gov lets you enter your doctors and medications and compare specific plans side by side. For 2027, CMS has also confirmed program-level drug figures: the Part D out-of-pocket cap is $2,400 (up from $2,100 in 2026), and the Part D maximum deductible is $700 (up from $615 in 2026).

What is changing for 2027

In Jefferson County, 13 plans are not returning for 2027, 13 are new, and 9 are being renamed. If you are already in a Medicare Advantage plan, your Annual Notice of Change (ANOC) spells out exactly what is changing about your plan — including whether it is still being offered, whether its type is changing, and whether your doctors remain in network. Nothing happens automatically to a plan member who does nothing: your plan renews if it is being offered next year, with the changes in the ANOC.

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