Medicare Advantage

Before AEP: how to pick HMO, HMO-POS or PPO

For 2027, Detroit is looking at 86 Medicare Advantage plans: 12 new, 16 gone since 2026, and 37 still here but changed on premium, deductible, plan type or name, 5 of them under a new name. Below, how the lineup shifted in Wayne County and what to compare, with no plan ranked or recommended.

Fall 2026 — If you live in Detroit and you're sorting through Medicare Advantage choices for 2027, one of the first forks in the road isn't the name of the plan — it's the plan type. HMO, HMO-POS, PPO and PFFS each follow different rules about which doctors you can see, whether you need a referral, and what happens if you get care outside the network. Those rules matter more than almost anything else once you actually use the plan.

Detroit is in Wayne County, where CMS lists 86 Medicare Advantage plans from 16 carriers for 2027. They split by type like this: 32 HMO, 19 HMO-POS and 35 PPO. There are no PFFS (Private Fee-for-Service) plans in the county for 2027, so if you've heard that term, you won't see it on the local shelf this year.

The Annual Enrollment Period runs October 15 through December 7, 2026. A change you make in that window starts January 1, 2027. If you do nothing, your current plan renews for 2027 if it's still offered, with any changes spelled out in your Annual Notice of Change (ANOC).

What each plan type actually means

HMO (Health Maintenance Organization). You pick a primary care doctor and generally use the plan's network for all non-emergency care. Many HMOs require a referral before you see a specialist. Out-of-network care is usually not covered except for emergencies, urgent care and dialysis.

HMO-POS (Point of Service). This is an HMO with a limited door to out-of-network care for certain services. The specifics — which services, at what cost share — vary by plan, so the plan's Evidence of Coverage is where you check.

PPO (Preferred Provider Organization). You can see any Medicare-approved provider that accepts the plan, in or out of network, usually without a referral. Out-of-network care is covered but typically at a higher cost share than in-network.

PFFS (Private Fee-for-Service). PFFS plans let you see any Medicare provider who agrees to the plan's payment terms. No PFFS plans are offered in Wayne County for 2027, so this is background rather than a local option.

None of these types is better than another on its own. The right fit depends on which doctors and hospitals you want to keep, which drugs you take, and whether you spend time outside Michigan.

How Wayne County's 2027 lineup splits

Of the 86 Medicare Advantage plans in the county for 2027:

• HMO: 32 plans. Counting HMO and HMO-POS together, 51 of the 86 plans are HMO-family.
• HMO-POS: 19 plans.
• PPO: 35 plans.
• PFFS: 0 plans.

Year over year, CMS shows some turnover for 2027: 16 plans are not returning, 12 are new, and 5 have been renamed. If your plan is on one of those lists, your ANOC will say so — read it before you decide whether to switch.

Which carriers offer each type in Wayne County

The table below lists every 2027 plan by carrier. At the type level, here's how the 16 carriers line up for the county:

Carriers with HMO plans for 2027: Aetna (CVS Health), Align Senior Care, AmeriHealth Caritas VIP Care, Blue Care Network, Centene (WellCare), HAP CareSource MI Coordinated Health, Health Alliance Plan by Henry Ford Health, Humana, Longevity Health Plan, McLaren Medicare, Molina Healthcare of Michigan, Priority Health Medicare, Trinity Health Plan of Michigan, UnitedHealthcare, and Zing Health.

Carriers with HMO-POS plans for 2027: Aetna (CVS Health), Align Senior Care, Blue Care Network, Centene (WellCare), Health Alliance Plan by Henry Ford Health, Humana, Priority Health Medicare, and UnitedHealthcare.

Carriers with PPO plans for 2027: Aetna (CVS Health), Blue Cross Blue Shield of Michigan, Health Alliance Plan by Henry Ford Health, Humana, Priority Health Medicare, UnitedHealthcare, and Zing Health.

A few patterns to notice without reading anything into them: some carriers offer across all three types, while others stick to one lane. That's a product decision at the carrier level, not a judgment about quality.

How to decide which type fits you

Three questions do most of the work:

1. Who do you want to keep seeing? Make a short list of your doctors, your preferred hospital system, and any specialist you see regularly. Then check each plan's provider directory — not just whether the practice is in-network, but whether your specific physician is. 2. Do you travel or spend part of the year elsewhere? If yes, PPO rules about out-of-network coverage may matter more to you. HMO rules are tighter outside emergencies. 3. What about referrals? Some HMOs require them for specialists; many PPOs don't. If you self-refer to specialists today, that's worth checking before you lock in.

Costs — premiums, deductibles, copays, drug tiers — vary plan by plan, and we can't quote them here. Look them up on the Medicare Plan Finder at medicare.gov or call 1-800-MEDICARE for your situation.

A few program numbers to keep in mind for 2027

Whichever plan type you choose, Part D drug coverage follows the same federal rules. For 2027, CMS has set the Part D out-of-pocket cap at $2,400 (up from $2,100 in 2026) and the maximum Part D deductible at $700 (up from $615 in 2026). The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, are announced later in the fall by CMS.