Medicare Advantage

HMO or PPO? Kentucky Medicare Advantage for 2027: 70 HMO Plans, 52 PPO

FRANKFORT, Ky. — Kentucky Medicare households shopping for 2027 coverage will see 123 Medicare Advantage plans statewide from 11 carriers, according to the Centers for Medicare & Medicaid Services Landscape Source File for CY2027. The split by plan type tilts toward HMO designs: 70 HMO or HMO-POS plans, 52 PPO plans, and 1 Private Fee-for-Service plan. Availability is county by county, so the plans listed statewide are not all offered everywhere.

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

Kentucky has 123 Medicare Advantage plans for 2027 from 11 carriers, split into 31 HMO, 39 HMO-POS, 52 PPO, and 1 PFFS plan, per the CMS MA Landscape Source File for CY2027. Grouped together, HMO and HMO-POS plans total 70, slightly more than the 52 PPO plans statewide.

Those counts are a statewide tally. Each plan is sold county by county, so a Louisville reader and a Pikeville reader will not see the same menu. The statewide numbers describe the shape of the market — a near-even balance between HMO-style and PPO-style designs, with a single PFFS plan on the edges.

What do HMO, HMO-POS, PPO and PFFS mean for networks, referrals and out-of-network care in Kentucky?

In plain terms: an HMO uses a defined network and often asks you to pick a primary care physician and get referrals for specialists; out-of-network care is generally not covered except in emergencies. An HMO-POS (point-of-service) is an HMO with a limited door to out-of-network care for certain services, usually at a higher cost share.

A PPO (preferred provider organization) lets you see in-network or out-of-network providers without a referral, though out-of-network care typically costs more. A PFFS (Private Fee-for-Service) plan sets its own payment terms, and any Medicare-approved provider may choose whether to accept it visit by visit.

These are structural rules set by CMS. What any specific plan pays, charges or covers is in that plan's Evidence of Coverage, not in this article.

Which carriers offer HMO, HMO-POS, PPO and PFFS plans in Kentucky for 2027?

For 2027, Kentucky's HMO carriers are Abilis Health (HMO SNP), Aetna (CVS Health), American Health Advantage of Indiana, Elevance Health (Anthem), Essence Healthcare, HealthSpring, Humana, and Passport Advantage. HMO-POS carriers are Aetna (CVS Health), Centene (WellCare), Elevance Health (Anthem), Humana, and UnitedHealthcare.

PPO carriers for 2027 are Aetna (CVS Health), Centene (WellCare), Devoted Health, Elevance Health (Anthem), Essence Healthcare, HealthSpring, Humana, and UnitedHealthcare. The one PFFS carrier is Humana.

Several carriers appear in more than one category because they file multiple plan types. The full plan-by-plan lists are rendered as tables elsewhere on this page; use those tables to see which plans sit in each category, and then confirm what shows up in your own ZIP code on the Medicare Plan Finder.

How should a Kentucky reader decide which plan type fits their doctors and travel?

Start with the doctors, hospitals and pharmacies you already use. If every provider you want is inside a single HMO network and you are comfortable with a primary-care-centered model, an HMO or HMO-POS may fit. If you split time between, say, Lexington and Florida, or you travel to see specialists outside your county, a PPO's out-of-network allowance may matter more.

Three practical questions help:

• Are my regular providers in the plan's network for 2027?
• Do I want the option to see out-of-network providers without a referral, even at a higher cost share?
• How often am I away from home, and where?

Network status, referral rules and out-of-network cost sharing vary plan by plan. Verify each one in the plan's own directory and Evidence of Coverage, or by calling the plan directly. The Medicare Plan Finder at medicare.gov pulls these details together in one view.

What should Kentucky Medicare households do before December 7, 2026?

The Annual Enrollment Period runs October 15 through December 7, 2026, and the plan you choose during that window takes effect January 1, 2027. Before December 7, review the Annual Notice of Change your current plan mailed in September, then compare it against other 2027 options available in your county.

A short checklist:

• List your prescriptions with doses.
• List your doctors, specialists and preferred hospitals.
• Note any travel patterns across state lines.
• Run those details through the Medicare Plan Finder at medicare.gov, or call 1-800-MEDICARE (TTY 1-877-486-2048), available 24 hours a day, seven days a week.

If nothing changes for you, no action is required to stay in your current plan, provided it is still offered in 2027.

Where can Kentucky residents get free, unbiased help comparing 2027 plans?

Free help is available directly from Medicare. The Medicare Plan Finder at medicare.gov lets you enter your ZIP code, prescriptions and providers to compare the 2027 plans offered in your county side by side. 1-800-MEDICARE (TTY 1-877-486-2048) is staffed 24/7 and can walk through plan details with you.

Each plan also publishes its own Evidence of Coverage, Summary of Benefits and provider and pharmacy directories. Those documents — not any third-party summary — are the authoritative source for what a plan covers and charges in 2027.