Medicare Advantage

HMO or PPO? Missouri Medicare Advantage for 2027: 121 HMO Plans, 51 PPO

JEFFERSON CITY — Missouri Medicare shoppers looking at 2027 Medicare Advantage will see a familiar split: more HMO-style plans than PPO-style plans statewide, with a sliver of PFFS. According to the CMS Medicare Advantage Landscape Source File for CY2027, Missouri has 174 Medicare Advantage plans from 12 carriers for the 2027 plan year. By plan type, that breaks down to 72 HMO, 49 HMO-POS, 51 PPO and 2 PFFS. Combining HMO with HMO-POS, there are 121 HMO-family plans across the state.

Those statewide counts are the ceiling, not the menu in any one ZIP code. Medicare Advantage plans are sold county by county, so the number actually available where you live will be smaller than the state total.

How are Missouri's 2027 Medicare Advantage plans split between HMO and PPO?

Missouri's 2027 Medicare Advantage landscape includes 72 HMO plans, 49 HMO-POS plans, 51 PPO plans and 2 PFFS plans, for a total of 174 plans from 12 carriers, according to the CMS CY2027 Landscape Source File. HMO and HMO-POS together make up 121 plans, and PPO plans account for 51.

That mix tells you something about the shape of the market, not what's on your personal shortlist. A plan listed statewide may not be sold in your county, and two neighbors in different counties can see very different options. The table on this page lists each 2027 plan by name, carrier and type; use it alongside the Medicare Plan Finder to see which ones serve your address.

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

In plain terms: HMOs lock you into a network, PPOs let you go outside it at higher cost, HMO-POS adds a limited out-of-network option to an HMO, and PFFS pays providers on the plan's terms rather than through a traditional network.

• HMO (Health Maintenance Organization): You generally use in-network doctors and hospitals, often pick a primary care physician, and may need a referral to see a specialist. Out-of-network care is typically covered only in emergencies.
• HMO-POS (Point of Service): An HMO with a "point of service" feature that lets you get certain services out of network, usually at a higher cost share and sometimes only for specific service categories.
• PPO (Preferred Provider Organization): You can see any Medicare-approved provider who accepts the plan. In-network care costs less; out-of-network care is covered but costs more. Referrals are usually not required.
• PFFS (Private Fee-for-Service): The plan sets the payment terms, and providers decide visit by visit whether to accept them. In Missouri's 2027 landscape, PFFS is a small slice — 2 plans.

Specific rules, cost sharing and provider lists vary by plan and are spelled out in each plan's Evidence of Coverage and provider directory.

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

For 2027, Missouri's 12 Medicare Advantage carriers are distributed across plan types as follows, per the CMS Landscape file.

• HMO carriers: Aetna (CVS Health), American Health Advantage of Missouri, Cox HealthPlans, Devoted Health, Elevance Health (Anthem), Essence Healthcare, HealthSpring, Humana, NHC Advantage, Provider Partners Health Plans.
• HMO-POS carriers: Aetna (CVS Health), Centene (WellCare), Elevance Health (Anthem), Humana, UnitedHealthcare.
• PPO carriers: Aetna (CVS Health), Centene (WellCare), Devoted Health, Elevance Health (Anthem), Essence Healthcare, HealthSpring, Humana, UnitedHealthcare.
• PFFS carriers: Humana.

Some carriers appear on more than one list because they offer more than one plan type. Which specific plans each carrier sells in your county is on the plan table on this page.

How should Missouri Medicare shoppers decide which plan type fits their doctors and travel?

Start with the people and places you already use, then match the plan type to that pattern. The 2027 Missouri lineup includes 121 HMO-family plans and 51 PPOs, so most shoppers will have both styles to compare in some form.

A few practical questions to work through:

• Who are your doctors? Pull your current primary care physician, specialists, pharmacy and preferred hospital. On medicare.gov's Plan Finder, you can see which plans list them in network. If your providers are concentrated in one Missouri health system, an HMO may fit. If they're spread across systems or state lines, a PPO's out-of-network coverage may matter more.
• How much do you travel? Snowbirds, long road trips and family visits across state lines can make out-of-network access important. PPO and HMO-POS plans handle that differently from standard HMOs.
• Do you want referrals or not? HMOs often route specialist visits through a primary care doctor. PPOs typically don't.
• How predictable is your care? If your health needs are stable and local, a tighter network may feel fine. If they're changing, flexibility can be worth more.

The plan details — premiums, deductibles, copays, drug lists, extra benefits and star ratings — belong in the Medicare Plan Finder at medicare.gov, in a call to 1-800-MEDICARE, or in each plan's own Evidence of Coverage. Those are the authoritative places to compare.

What should Missouri Medicare members do before December 7, 2026?

Use the Annual Enrollment Period, which runs October 15 – December 7, 2026, to review your 2027 options; the choice you make during that window takes effect January 1, 2027.

A simple checklist:

1. Read the Annual Notice of Change your current plan mails in September 2026 if you already have Medicare Advantage or a Part D plan. 2. List your doctors, hospitals, pharmacies and regular prescriptions. 3. Enter your ZIP code at medicare.gov to see which of Missouri's 2027 plans are actually sold in your county. 4. Compare plan types — HMO, HMO-POS, PPO or PFFS — against how you actually use care. 5. Confirm your providers and drugs on each finalist plan before you enroll.

Where can Missouri residents get free help with 2027 Medicare Advantage choices?

Free, official help for Missouri Medicare questions is available from Medicare itself. Call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, seven days a week, or use the Plan Finder and plan comparison tools at medicare.gov.

Those tools let you enter your ZIP code, your prescriptions and your providers, then see which 2027 plans are offered in your county and how they compare on the details this article does not cover.