Medicare Advantage

HMO or PPO? Nevada Medicare Advantage for 2027: 75 HMO Plans, 23 PPO

CARSON CITY — When Nevadans open the Medicare Plan Finder this fall, they will see a Medicare Advantage field that leans heavily toward HMO designs. For plan year 2027, the CMS Medicare Advantage Landscape file lists 98 Medicare Advantage plans in Nevada from 12 carriers, split 75 HMO (including HMO-POS) to 23 PPO. That ratio shapes almost every other question a shopper will ask — about referrals, about seeing a specialist across the state line, about what happens on a trip to see the grandkids.

HMO or PPO for 2027Nevada

This explainer walks through what each plan type means, which carriers offer which type in Nevada for 2027, and how to think the choice through before the December 7, 2026 deadline.

How many Medicare Advantage plans are offered statewide in Nevada for 2027, and how do they split by type?

Nevada's 2027 Medicare Advantage landscape totals 98 plans from 12 carriers, divided into 53 HMO plans, 22 HMO-POS plans and 23 PPO plans, according to the CMS Landscape Source File for CY2027. Grouped together, HMO and HMO-POS plans account for 75 of the 98 offerings.

Each plan in that count is counted once statewide. Medicare Advantage is sold county by county, so a Clark County resident and a Washoe County resident will not necessarily see the same subset on Medicare.gov. The statewide tally is the ceiling, not the menu in any one ZIP code.

What do HMO, HMO-POS, PPO and PFFS mean for networks, referrals and out-of-network care in Nevada for 2027?

In Nevada for 2027, HMO plans generally require members to use an in-network provider and, in many cases, to get a referral from a primary care doctor before seeing a specialist. Out-of-network care is typically not covered except for emergencies.

HMO-POS — the "point of service" variant — is still an HMO, but with a limited out-of-network option for certain services, usually at a higher cost share. PPO plans (preferred provider organizations) typically let members see any Medicare-approved provider, in or out of network, with lower cost sharing in network and no referral requirement in most cases. PFFS, or private fee-for-service, is a fourth Medicare Advantage design, but it does not appear in the Nevada 2027 landscape data for the plan types listed in this brief. Specific rules, cost shares and provider networks vary by plan and are set out in each plan's Evidence of Coverage and provider directory on Medicare.gov.

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

For 2027, Nevada's HMO carriers include Aetna (CVS Health), Alignment Health Plan, Champion Health Plan, Elevance Health (Anthem), HealthSpring, Humana, Kaiser Permanente, Prominence Health Plan, SCAN Health Plan and Select Health. That is the broadest carrier roster of any plan type in the state.

HMO-POS plans are offered by Centene (WellCare), Champion Health Plan, Elevance Health (Anthem), HealthSpring, Prominence Health Plan and UnitedHealthcare. The PPO column is narrower: Aetna (CVS Health), Humana and UnitedHealthcare. Several carriers appear in more than one column because they offer more than one plan type. The full plan-by-carrier list is rendered as a table on this page; the names above are from the CMS Landscape file for CY2027.

How do I decide which Medicare Advantage plan type fits my doctors and travel in Nevada for 2027?

The practical test for Nevadans weighing an HMO versus a PPO for 2027 is usually two questions: are your current doctors in the plan's network, and how often do you get care outside Nevada? HMO and HMO-POS plans tend to work well when your providers are local and in network; PPO plans tend to work well when you travel often or split time between states.

Make a short list of the doctors, hospitals and pharmacies you actually use. Then check each against a specific plan's directory on Medicare.gov — networks differ not just between carriers but between plans from the same carrier. If you spend winters out of state, ask directly about out-of-area and out-of-network coverage; the answer is in the Evidence of Coverage. Prescription drug coverage, dental, vision and hearing extras also vary plan by plan and should be verified on the Plan Finder, not assumed from the plan type.

What should Nevadans do before December 7, 2026?

Before December 7, 2026, Nevadans should confirm whether their current plan is being offered again in 2027, compare it against other plans available in their county, and enroll or switch if they want a change. The Annual Enrollment Period opens October 15, 2026, and any election made during that window takes effect January 1, 2027.

A short checklist: log in to Medicare.gov and run the Plan Finder for your ZIP code; have your Medicare number and a current drug list ready; check each plan's provider directory for your doctors; read the Annual Notice of Change your current plan mailed you in September. If nothing you have changes and your plan is still offered, you do not have to do anything — but reviewing is still worthwhile.

Where can Nevadans get free help understanding 2027 Medicare Advantage choices?

Two free, official resources are available to every Nevadan: Medicare.gov, which hosts the Plan Finder and plan documents, and 1-800-MEDICARE (1-800-633-4227), which is staffed 24 hours a day. Both are run by the federal Medicare program.

Plan carriers also publish their own Evidence of Coverage, Summary of Benefits and provider directories, which are the authoritative sources for premiums, cost sharing, networks and drug lists.