Medicare Advantage

HMO or PPO? Massachusetts Medicare Advantage for 2027: 75 HMO Plans, 22 PPO

BOSTON — When Massachusetts residents open the Medicare Plan Finder this fall to look at 2027 coverage, the first fork in the road is usually plan type. According to the CMS Medicare Advantage Landscape Source File for CY2027, the state's 97 Medicare Advantage plans from 12 carriers break down into 64 HMO plans, 11 HMO-POS plans and 22 PPO plans. Grouped together, the HMO family (HMO plus HMO-POS) accounts for 75 of the 97 plans statewide.

Those statewide counts are a snapshot of what carriers filed. The plans you can actually enroll in depend on your county, and each plan is offered county by county. This explainer walks through what the HMO/PPO split means, which carriers offer each type, and how to think through the choice before the Annual Enrollment Period closes December 7, 2026.

The statewide split by plan type

The CMS Landscape file for 2027 shows 97 Massachusetts Medicare Advantage plans overall. By type, that is 64 HMO, 11 HMO-POS and 22 PPO. Adding HMO and HMO-POS together, 75 of the 97 plans sit in the HMO family and 22 sit on the PPO side.

Twelve carriers participate statewide. Some offer only one plan type; others offer two or three. The counts above come from the statewide Landscape data and do not tell you which plans are offered in your specific county — that part lives in the Medicare Plan Finder.

What HMO, HMO-POS, PPO and PFFS mean

These labels describe how a plan is structured around a network of doctors and hospitals.

• HMO (Health Maintenance Organization): You generally pick a primary care provider inside the plan's network and use in-network providers for your care. Many HMOs ask you to get a referral before seeing a specialist. Out-of-network care is usually not covered except in emergencies.
• HMO-POS (HMO with a Point-of-Service option): An HMO that allows some out-of-network care under defined rules spelled out in the plan's Evidence of Coverage. The specifics vary plan to plan.
• PPO (Preferred Provider Organization): You can see in-network or out-of-network providers, usually without a referral. Out-of-network care is typically covered under different terms than in-network care.
• PFFS (Private Fee-for-Service): A separate Medicare Advantage structure in which the plan sets payment terms with providers who agree to accept them. No PFFS plans appear in the Massachusetts 2027 Landscape data in this block.

None of these labels say anything about cost, benefits, drug lists or star ratings. For those details, check each plan's Evidence of Coverage and provider directory.

Which carriers offer each type in 2027

On the HMO side (not HMO-POS), the 2027 Landscape lists Blue Cross Blue Shield of Massachusetts, Commonwealth Care Alliance Massachusetts, Commonwealth Care Alliance, Inc., eternalHealth, Fallon Health, Health New England Medicare Advantage Plans, Mass General Brigham Health Plan, Molina Healthcare of Massachusetts, Tufts Health Plan and UnitedHealthcare.

For HMO-POS, the carriers are Aetna (CVS Health), Blue Cross Blue Shield of Massachusetts, Mass General Brigham Health Plan and UnitedHealthcare.

For PPO, the carriers are Aetna (CVS Health), Blue Cross Blue Shield of Massachusetts, eternalHealth, Health New England Medicare Advantage Plans, Humana, Tufts Health Plan and UnitedHealthcare.

Several carriers appear in more than one column. Aetna (CVS Health), for example, shows up under both HMO-POS and PPO. Blue Cross Blue Shield of Massachusetts and UnitedHealthcare appear across all three categories. Humana appears only on the PPO side. Being on a statewide list does not mean every plan from that carrier is sold in your county.

How to decide which type fits your doctors and travel

A good way to work through the choice is to start with the people and places you already rely on:

1. List your providers. Write down your primary care doctor, specialists, preferred hospital and any ongoing therapists or clinics. 2. Check each plan's network. For any plan you're considering, use the Medicare Plan Finder at medicare.gov and the plan's own provider directory to confirm those names are in-network. 3. Think about referrals. If you value seeing specialists without an extra step, note that HMO plans often require a referral while PPOs typically do not. HMO-POS sits in between and varies. 4. Think about travel. If you spend part of the year outside Massachusetts or visit family out of state, pay attention to how each plan handles out-of-network and out-of-area care. PPO rules differ from HMO rules here. 5. Read before you enroll. The plan's Evidence of Coverage spells out what is covered, under what rules and at what share of cost.

The right type is the one that lines up with the way you actually use care — not simply the type with the most plans in the state.

What to do before December 7

The Annual Enrollment Period for 2027 coverage runs October 15 – December 7, 2026. Any Medicare Advantage choice you make in that window takes effect January 1, 2027.

A few steps most people find useful:

• Enter your ZIP code at medicare.gov to see which of the 97 statewide plans are actually offered in your county.
• Filter by plan type if you already know whether an HMO-family or PPO structure fits you better.
• For each shortlisted plan, check the current year's Annual Notice of Change (if you're already enrolled) and the 2027 Evidence of Coverage.
• Confirm your doctors, hospitals and regular prescriptions directly with the plan.

There's no need to rush the decision — the deadline is a date on the calendar, not a countdown.

Free help

Two free, unbiased resources are available year-round:

• Medicare.gov — the official Medicare Plan Finder, with county-level availability, plan documents and comparison tools.
• 1-800-MEDICARE (1-800-633-4227) — available 24 hours a day, 7 days a week, for questions about plans, enrollment periods and your Medicare record.