Medicare Advantage

Boston Medicare Advantage for 2027: how the HMO, HMO-POS and PPO choices compare

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.

BOSTON, fall 2026 — If you live in Boston and are weighing a Medicare Advantage plan for 2027, the first fork in the road is not the insurer. It is the plan type. For the coming year, the plans sold in Suffolk County — the county Boston sits in — fall almost entirely into two shapes: HMO (including HMO-POS) and PPO. There are no Private Fee-for-Service (PFFS) plans in the local 2027 lineup.

That matters because plan type sets the ground rules for how you see doctors, whether you need a referral, and what happens when you get care outside the plan's network. The Annual Enrollment Period runs October 15 through December 7, 2026, and any choice you make takes effect January 1, 2027.

How Boston's 2027 plans split by type

Suffolk County's 2027 Medicare Advantage lineup breaks down this way:

• HMO: 32 plans
• HMO-POS: 8 plans
• PPO: 10 plans
• PFFS: 0 plans

Counting HMO and HMO-POS together, 40 of the county's 50 Medicare Advantage plans are HMO-style. PPOs make up the rest. The full roster of plans by carrier appears in the table below.

What each plan type actually means

Here is the plain-English version of each type. These are program-level rules from Medicare — individual plans spell out their own networks, referral rules and cost sharing in their Evidence of Coverage.

HMO (Health Maintenance Organization). You pick a primary care provider and generally use doctors, hospitals and labs in the plan's network. Out-of-network care usually isn't covered except for emergencies, urgent care and dialysis when you're traveling. Many HMOs require a referral from your primary care provider before you see a specialist.

HMO-POS (HMO with a Point-of-Service option). Same HMO backbone, but with a limited ability to go out-of-network for certain services. The plan decides which services qualify and what you pay. It's a middle ground, not a full PPO.

PPO (Preferred Provider Organization). You can see any Medicare-approved provider who agrees to treat you. In-network care typically costs less; out-of-network care is covered but usually at a higher share. PPOs generally don't require referrals.

PFFS (Private Fee-for-Service). You can see any Medicare-approved provider who accepts the plan's terms. No PFFS plans are offered in Suffolk County for 2027, so this one is theory, not an option here.

Which Boston-area carriers offer each type for 2027

These come from the CMS Medicare Advantage Landscape file for plan year 2027. Alphabetical, with no ranking implied:

Carriers offering HMO plans in Suffolk County for 2027: Blue Cross Blue Shield of Massachusetts, Commonwealth Care Alliance Massachusetts, Commonwealth Care Alliance, Inc., eternalHealth, Fallon Health, Mass General Brigham Health Plan, Molina Healthcare of Massachusetts, Tufts Health Plan, UnitedHealthcare.

Carriers offering HMO-POS plans in Suffolk County for 2027: Aetna (CVS Health), Blue Cross Blue Shield of Massachusetts, Mass General Brigham Health Plan, UnitedHealthcare.

Carriers offering PPO plans in Suffolk County for 2027: Blue Cross Blue Shield of Massachusetts, eternalHealth, Humana, Tufts Health Plan, UnitedHealthcare.

A few carriers show up in more than one column because they offer more than one type. The table below lists every plan by carrier and type.

How to decide between HMO, HMO-POS and PPO

The honest answer is that no type is "better." Four questions tend to settle it:

1. Who are your doctors? Pull up your current providers on the Medicare Plan Finder at medicare.gov and check whether they're in the plan's network. For an HMO or HMO-POS, in-network is where almost all your care has to happen. 2. Do you travel or spend part of the year outside Massachusetts? A PPO's out-of-network coverage can matter if you split time between places. HMOs still cover emergencies and urgent care anywhere in the U.S. 3. How do you feel about referrals? If you prefer a primary care provider to coordinate specialist visits, an HMO fits. If you'd rather book specialists directly, PPOs typically let you. 4. What about prescriptions? Every Medicare Advantage plan in Suffolk County for 2027 includes drug coverage, but formularies differ by plan. Check each drug you take on the Plan Finder.

What's changing in Suffolk County for 2027

Year to year, the local lineup shifts. For 2027 in Suffolk County, 14 plans are not returning, 12 new plans are being offered, and 3 plans have been renamed. If you're already enrolled, your plan's Annual Notice of Change (ANOC), mailed in September, lists what's different for next year — premiums, drug list, provider network, copays, extra benefits. It's the single most useful document to read before December 7.

Two 2027 drug-coverage numbers are already confirmed by CMS and apply across all Part D and MA-PD plans: the Part D out-of-pocket cap rises to $2,400 (up from $2,100 in 2026), and the Part D maximum deductible rises to $700 (up from $615 in 2026). The 2027 Part B standard premium and the 2027 IRMAA income brackets haven't been announced yet; CMS typically publishes them later in the fall.

If you do nothing

Nothing dramatic happens. If your 2026 plan is offered again in 2027, you stay in it with the changes described in the ANOC. If your plan isn't being offered next year, you'll get a non-renewal notice and have a Special Enrollment Period to pick a new one. You also have the Medicare Advantage Open Enrollment Period from January 1 through March 31, 2027, which lets you switch MA plans or move back to Original Medicare once.