Medicare Advantage

Before you pick a carrier in North Las Vegas, know the plan types

People in North Las Vegas can choose from 72 Medicare Advantage plans for 2027, against 74 this year. Eleven of this year’s plans are gone, 9 are new to Clark County, and 33 that continue have changed their premium, deductible, plan type or name, 15 of them under a new name.

If you live in North Las Vegas and you're shopping for Medicare Advantage, the first choice you'll face isn't a carrier — it's a plan type. HMO, HMO-POS, PPO, PFFS and Special Needs Plans (SNPs) each work differently, and the letters in the plan name tell you a lot about how you'll see doctors, whether you need referrals, and who the plan is designed for.

North Las Vegas is in Clark County, where CMS lists 57 Medicare Advantage plans for 2027 from 10 carriers. All of them include prescription drug coverage. Before you compare premiums or benefits with a licensed agent or on Medicare.gov, it helps to understand the categories those 57 plans fall into.

The North Las Vegas lineup at a glance

Of the 57 Medicare Advantage plans available in Clark County for 2027:

• 38 are HMOs
• 21 are HMO-POS (HMO with a Point-of-Service option)
• 15 are PPOs
• 34 are Special Needs Plans (SNPs) — these overlap with the HMO/PPO counts above, because an SNP is still built on an HMO or PPO chassis
• No PFFS (Private Fee-for-Service) plans are offered in the county next year

The 12 carriers offering MA-PD plans in the area, in alphabetical order, are Aetna (CVS Health), Alignment Health Plan, Blue Cross Blue Shield (HCSC), Centene (WellCare), Champion Health Plan, Elevance Health (Anthem), Humana, Kaiser Permanente, Molina Healthcare of Nevada, SCAN Health Plan, Select Health and UnitedHealthcare. The table below lists every plan by carrier.

HMO: the most common shape here

More than half the plans in Clark County are HMOs. In an HMO you generally:

• Pick a primary care doctor
• Get referrals to see specialists
• Use in-network providers, except for emergencies or urgent care

If you like a coordinated approach and don't travel much for care, an HMO can be straightforward. Aetna, Alignment, Champion, Humana, Kaiser Permanente, SCAN and Select Health all offer HMO options in the county.

HMO-POS: a small door to out-of-network care

HMO-POS plans work like HMOs but add a "point-of-service" option that lets you use certain out-of-network providers, usually for specific services and at a higher cost-share. It's a middle ground between a strict HMO and a full PPO. Blue Cross Blue Shield (HCSC), Centene (WellCare), Elevance Health (Anthem) and UnitedHealthcare are among the carriers with HMO-POS plans locally.

PPO: more flexibility, different trade-offs

PPO plans let you see any Medicare-approved provider that accepts the plan, in or out of network, without a referral. Out-of-network care usually costs more. Aetna, Humana and UnitedHealthcare offer PPO plans in Clark County — 15 in total across the market.

PFFS: not in this market for 2027

PFFS (Private Fee-for-Service) plans let you use any Medicare provider willing to accept the plan's terms. They exist nationally but are not part of the 2027 Clark County lineup, so North Las Vegas shoppers won't see them as an option next year.

Special Needs Plans: who they're for

Of the 74 plans, 34 are SNPs. These plans limit enrollment to people who meet specific criteria:

• D-SNP (Dual Eligible): for people who have both Medicare and Medicaid. Carriers with D-SNPs in the county include Aetna, Alignment, Centene (WellCare), Elevance Health (Anthem), Humana, Molina Healthcare of Nevada, Select Health and UnitedHealthcare.
• C-SNP (Chronic Condition): for people with a qualifying long-term condition, such as diabetes, heart disease, kidney disease or certain lung conditions. Aetna, Alignment, Centene (WellCare), Champion Health Plan, Elevance Health (Anthem), Humana, SCAN and UnitedHealthcare offer C-SNPs locally.
• I-SNP (Institutional): for people living in a nursing home or receiving a similar level of care at home. Elevance Health (Anthem) offers an I-SNP in the area.

You have to qualify — and stay qualified — to be in an SNP. If your situation changes (for example, you lose Medicaid), the plan will work with you on next steps.

Drug coverage and 2027 numbers to know

Every one of the 57 MA plans in Clark County includes Part D drug coverage. Whichever plan type you look at, these 2027 program-level figures apply to your drug costs:

• $2,100 — the new Part D out-of-pocket cap for covered drugs
• $615 — the maximum allowable Part D deductible
• The coverage gap ("donut hole") no longer exists — Part D now has three phases
• The Medicare Prescription Payment Plan is available if you'd like to spread drug costs over the year instead of paying big amounts at the pharmacy counter

Higher-income enrollees should also know that IRMAA surcharges start above $109,000 in income for a single filer in 2026.

How to actually narrow it down

A useful order of questions:

1. Do I qualify for a Special Needs Plan (dual eligibility, chronic condition, institutional)? 2. Do I need to see providers outside a set network, or travel often? That points toward PPO or HMO-POS. 3. Am I comfortable with referrals and a set network in exchange for a simpler structure? That points toward HMO. 4. Which of my doctors, hospitals and prescriptions are covered by the plans I'm considering?

The last question is where Medicare.gov's Plan Finder does the heavy lifting — it checks your specific doctors and drugs against each plan.