Medicare Advantage

Before you pick a Medicare Advantage plan in Boston: how the 2027 choices break down

For 2027, Boston is looking at 50 Medicare Advantage plans: 12 new, 14 gone since 2026, and 24 still here but changed on premium, deductible, plan type or name, 3 of them under a new name. Below, how the lineup shifted in Suffolk County and what to compare, with no plan ranked or recommended.

Medicare AdvantageBoston, MA

BOSTON — If you are shopping for a Medicare Advantage plan here this fall, the first thing worth knowing is not a price or a benefit. It is the shape of the market: who sells plans, and what kinds of plans they sell. Once you can tell an HMO from a PPO from a Special Needs Plan, the long list of options gets a lot easier to sort through.

Boston sits in Suffolk County, and Medicare Advantage availability is set at the county level. For plan year 2027, Suffolk County has 47 Medicare Advantage plans offered by 11 carriers, according to the CMS Medicare Advantage Landscape Source File. All 47 include prescription drug coverage. Compared with 2026, 35 plans continue, 12 are new, 14 are not returning and 3 are renamed; 21 of the continuing plans change something in their terms, and those changes are spelled out in each plan's Annual Notice of Change. The full list of plans and carriers is in the table below on this page.

Who sells Medicare Advantage in Boston for 2027

Eleven carriers offer Medicare Advantage plans in Suffolk County for 2027. In alphabetical order, they are Aetna (CVS Health), Blue Cross Blue Shield of Massachusetts, Commonwealth Care Alliance Massachusetts, Commonwealth Care Alliance, Inc., eternalHealth, Fallon Health, Humana, Mass General Brigham Health Plan, Molina Healthcare of Massachusetts, Tufts Health Plan and UnitedHealthcare.

The number of plans each carrier offers varies. Aetna, Commonwealth Care Alliance Massachusetts and Commonwealth Care Alliance, Inc. each offer 1 plan. eternalHealth and Molina Healthcare of Massachusetts each offer 3 plans. Fallon Health and Humana each offer 5. Mass General Brigham Health Plan offers 6. Blue Cross Blue Shield of Massachusetts and UnitedHealthcare each offer 7. Tufts Health Plan offers 13. Please note that plan count is not a measure of quality — it just tells you how many doors that carrier has open.

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

Medicare Advantage plans come in a few flavors, and the letters matter more than they look.

• HMO (Health Maintenance Organization). You pick a primary care doctor and generally stay inside the plan's network. Most non-emergency care outside the network is not covered. Referrals are often required to see specialists.
• HMO-POS (Point of Service). An HMO with a small door cut into the wall. You can go outside the network for certain services, usually at a higher cost. Suffolk County has 5 HMO-POS plans.
• PPO (Preferred Provider Organization). More flexibility. You can see out-of-network providers who accept the plan, though you pay more than you would in-network, and referrals typically are not required. Suffolk County has 16 PPO plans.
• PFFS (Private Fee-for-Service). These plans set their own payment terms, and any provider who agrees to those terms can treat you. PFFS plans are not part of the Suffolk County lineup for 2027, but you may see them in other markets or in older mail.

The right plan type for you usually comes down to how attached you are to specific doctors and how much you travel.

Special Needs Plans, briefly

Sixteen of the 52 plans in Suffolk County are Special Needs Plans, or SNPs. These are Medicare Advantage plans built for people in specific situations, and you have to qualify to enroll.

• D-SNP (Dual Eligible) is for people who have both Medicare and Medicaid. The SNPs listed in Suffolk County for 2027 are D-SNPs.
• C-SNP (Chronic Condition) is for people living with a qualifying chronic condition, such as diabetes or heart failure.
• I-SNP (Institutional) is for people who live in a nursing facility or need that level of care at home.

SNPs typically coordinate care more closely and tailor drug coverage to the condition or population they serve. If you think you might qualify, that is a conversation to have with your State Health Insurance Assistance Program (SHIP) counselor before you enroll.

How to narrow the list without getting overwhelmed

With 52 plans to look at, most people do better by filtering, not by reading every plan front to back.

1. Start with plan type. Do you want the flexibility of a PPO, the structure of an HMO, or does a SNP fit your situation? 2. List your doctors and pharmacies. Then check each plan's network on medicare.gov's Plan Finder before you look at anything else. 3. List your medications. Because every Suffolk County MA plan for 2027 includes drug coverage, the formulary — the plan's drug list — matters as much as the premium. 4. Then, and only then, compare costs and extra benefits. Trying to compare 47 sets of numbers before you have narrowed by network and drugs is how people end up in the wrong plan.

A few 2027 program facts worth knowing

These apply to Medicare nationwide, not to any one plan:

• Part D has an out-of-pocket cap of $2,100 in 2026 and $2,400 in 2027. Once you hit it, you pay nothing for covered drugs the rest of the year.
• The Part D deductible can be no higher than $615 in 2026 ($700 in 2027).
• The old "donut hole" coverage gap has been eliminated since 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly amounts instead of paying at the pharmacy counter.
• IRMAA — the income-related surcharge on Part B and Part D — starts above $109,000 in income for a single filer in 2026.

When you can make a change

The Annual Enrollment Period runs Oct. 15 through Dec. 7. This is when almost anyone with Medicare can join, switch or drop a Medicare Advantage plan or Part D plan for the following year.

If you are already in a Medicare Advantage plan on Jan. 1, you get one more chance: the Medicare Advantage Open Enrollment Period, Jan. 1 through March 31, when you can switch to a different MA plan or drop back to Original Medicare.