Medicare Advantage

St. Louis Medicare Advantage in 2027: what HMO, HMO-POS, PPO and PFFS actually mean for your care

St. Louis city has 80 Medicare Advantage plans for 2027. Compared with 2026, 10 plans are not coming back, 11 are new, and 41 continuing plans changed in some way you should check before December 7, 17 of them under a new name. This guide covers what those numbers mean for St. Louis, not which plan to pick.

ST. LOUIS — As the Annual Enrollment Period for 2027 Medicare coverage opens Oct. 15, 2026, St. Louis city residents shopping Medicare Advantage will see a lineup of 80 plans from 11 carriers — and the first fork in the road is the plan "type" printed next to each name. HMO, HMO-POS, PPO, PFFS: those four letters tell you how the plan handles networks, referrals and care you get outside the plan's doctors.

Nothing changes automatically. If you do nothing by Dec. 7, 2026, your current plan renews for 2027 if it is still offered, with the updates described in your Annual Notice of Change (ANOC). But if you are weighing a switch, understanding the type is often more useful than comparing logos.

How are St. Louis's 2027 Medicare Advantage plans split by type?

In St. Louis city, the 80 Medicare Advantage plans available for 2027 break down as 35 HMO, 19 HMO-POS, 25 PPO and 1 PFFS, according to the CMS Medicare Advantage Landscape file. Counting HMO and HMO-POS together, 54 of the 80 plans use some version of an HMO structure.

Plan availability is set at the county level. St. Louis is an independent city that functions as its own county for Medicare purposes, so these counts apply to anyone with a St. Louis city ZIP code. The table below lists every plan offered in the city for 2027, with its type and whether it includes drug coverage.

What does HMO mean on a Medicare Advantage plan?

An HMO (Health Maintenance Organization) plan generally asks you to use doctors, hospitals and other providers in the plan's network, and often to pick a primary care doctor who gives you referrals to specialists. Care from outside the network usually is not covered except for emergencies, urgent care and out-of-area dialysis.

For 2027 in St. Louis city, HMO plans are offered by Aetna (CVS Health), American Health Advantage of Missouri, Devoted Health, Elevance Health (Anthem), Essence Healthcare, HealthSpring, Humana, NHC Advantage and Provider Partners Health Plans. HMOs can be a good match if your doctors are already in one network and you do not travel for months at a time.

What's the difference between HMO and HMO-POS?

HMO-POS stands for HMO with a "point-of-service" option. It works like an HMO — network first, often with referrals — but adds a limited ability to go out of network for certain services, usually at a higher share of the cost. The rules on what's covered out of network and how much you pay vary a lot by plan, so the Evidence of Coverage is the place to check.

In St. Louis city, 19 of the 80 plans for 2027 are HMO-POS. The carriers offering HMO-POS plans next year are Aetna (CVS Health), Centene (WellCare), Elevance Health (Anthem), Humana and UnitedHealthcare.

What does a PPO mean, and how is it different from an HMO?

A PPO (Preferred Provider Organization) plan has a network, but it also covers care from out-of-network providers who accept Medicare — just at a higher cost share than in-network care. You generally do not need referrals to see specialists. That flexibility matters if you split time between cities, have specialists outside the plan's network, or simply prefer not to route everything through a primary care doctor.

St. Louis city has 25 PPO plans for 2027, offered by Aetna (CVS Health), Centene (WellCare), Elevance Health (Anthem), Essence Healthcare, HealthSpring, Humana and UnitedHealthcare. Some PPOs are "local" and some are "regional"; both are shown as PPO in the plan name.

What is a PFFS plan, and who offers one in St. Louis for 2027?

A PFFS (Private Fee-for-Service) plan lets you see any Medicare-approved provider who agrees to the plan's payment terms and conditions for that visit. There is usually no required primary care doctor and no referral, but a provider can decide, visit by visit, whether to accept the plan. That makes it important to confirm acceptance before each appointment.

In St. Louis city, there is 1 PFFS plan for 2027, offered by Humana. PFFS is the smallest category locally and works differently from HMOs and PPOs — read the plan's materials carefully before enrolling.

How should I decide which plan type fits me?

Start with your doctors and hospitals, your regular prescriptions, and how often you are away from St. Louis. If your providers are all in one network and you rarely travel, an HMO or HMO-POS may feel natural; if you want to see out-of-network providers without a referral, a PPO's rules are built for that; PFFS has its own trade-offs around provider acceptance.

No type is cheaper or better across the board — costs, drug lists and extra benefits vary plan by plan. The Medicare Plan Finder at medicare.gov lets you enter your drugs and pharmacies and compare side by side, and 1-800-MEDICARE can walk you through it. Also note: of the plans offered in St. Louis city in 2026, 10 are not returning for 2027, 11 are new, and 17 have been renamed; your ANOC spells out any changes to your current plan.

What else should St. Louis readers know for 2027?

Two program-wide numbers are already set for 2027: the Part D out-of-pocket cap rises to $2,400 (from $2,100 in 2026), and the Part D maximum deductible rises to $700 (from $615 in 2026). The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, have not been announced yet; CMS publishes those later in the fall.

The Annual Enrollment Period runs Oct. 15 – Dec. 7, 2026, with changes effective Jan. 1, 2027. If you enroll in a Medicare Advantage plan and change your mind, the Medicare Advantage Open Enrollment Period (Jan. 1 – March 31, 2027) gives you one switch.