Medicare Advantage

Does Reno Lean HMO or PPO for Medicare in 2027?

People in Reno can choose from 42 Medicare Advantage plans for 2027, against 47 this year. Twelve of this year’s plans are gone, 7 are new to Washoe County, and 23 that continue have changed their premium, deductible, plan type or name, 11 of them under a new name.

RENO, Nev. — Fall 2026. As the Annual Enrollment Period opens Oct. 15 and runs through Dec. 7, 2026, people shopping Medicare Advantage in Reno will find the 2027 lineup leans heavily toward HMO-style coverage. In Washoe County, where Reno sits, 42 Medicare Advantage plans from 9 carriers are on the shelf for 2027: 22 HMOs, 9 HMO-POS plans and 11 PPOs. No Private Fee-for-Service (PFFS) plans are offered in the county next year.

That split matters because the plan "type" shapes the everyday rules — which doctors you can see, whether you need a referral, and what happens if you need care out of town.

How do Washoe County's 2027 Medicare Advantage plans split by type?

For 2027, Washoe County has 42 Medicare Advantage plans from 9 carriers. By type, that is 22 HMO plans, 9 HMO-POS plans and 11 PPO plans. Counting HMO and HMO-POS together, 31 of the 42 plans use an HMO structure.

No PFFS (Private Fee-for-Service) plans are offered in the county for 2027, so if you've heard that term, it isn't part of the Reno-area choice set this year. Plan availability is set at the county level by CMS, so the same menu applies across Reno, Sparks and the rest of Washoe County.

What does HMO mean for Reno Medicare Advantage members?

An HMO (Health Maintenance Organization) plan asks you to get care from doctors, hospitals and other providers in the plan's network, and it typically asks you to pick a primary care doctor and get a referral before seeing a specialist. Out-of-network care is generally not covered except in emergencies or urgent care.

HMOs are the largest slice of the 2027 Reno-area menu. Carriers offering HMO plans in Washoe County for 2027 are Aetna (CVS Health), Alignment Health Plan, Champion Health Plan, Elevance Health (Anthem), Humana, Kaiser Permanente and Prominence Health Plan. The table on this page lists each plan.

What is an HMO-POS plan, and who offers one in the county?

HMO-POS (Point of Service) is an HMO with a small door built in. You still use the plan's network for most care, but the "point of service" option lets you see certain out-of-network providers for specific services, usually at a higher cost share. The exact rules — which services, what you'll pay — are spelled out in each plan's Evidence of Coverage.

Washoe County has 9 HMO-POS plans for 2027. Carriers offering HMO-POS plans are Centene (WellCare), Champion Health Plan, Prominence Health Plan and UnitedHealthcare.

What does a PPO plan change about networks and referrals?

A PPO (Preferred Provider Organization) plan has a network like an HMO, but you can go outside it for covered services — usually at a higher share of cost — without needing a referral. For people who travel, split time between homes, or want more flexibility to see out-of-network specialists, that structure matters.

Washoe County has 11 PPO plans for 2027, offered by three carriers: Aetna (CVS Health), Humana and UnitedHealthcare. "PPO" doesn't automatically mean lower or higher cost; it describes the network rules, not the price tag.

Which plan type is right for Reno-area shoppers?

There is no single right answer — the right type depends on your doctors, your travel pattern and your comfort with referrals. A good way to work through it:

• Make a list of the doctors and hospitals you want to keep. Then check each plan's provider directory to confirm they're in-network.
• Think about travel. If you spend part of the year away from Reno, out-of-network rules matter more.
• Decide how you feel about referrals. HMOs usually require one for a specialist; most PPOs do not.
• Check the drug list (formulary) if you take regular prescriptions. In Washoe County, most Medicare Advantage plans include Part D drug coverage, but not all of them do.

The Medicare Plan Finder at medicare.gov lets you enter your doctors and prescriptions and see how each plan handles them.

What's changing for 2027, and when do I need to decide?

The Annual Enrollment Period runs Oct. 15 through Dec. 7, 2026. Any change you make takes effect Jan. 1, 2027. If you don't do anything, your current plan renews — with whatever changes are described in the Annual Notice of Change (ANOC) your plan mailed in September.

In Washoe County, the 2027 landscape includes some turnover from 2026: 12 plans are not returning, 7 are new, and 11 have been renamed. A rename doesn't necessarily mean the plan changed under the hood, but the ANOC is where the specifics live.

A few program-level numbers for 2027 are already set by CMS:

• Part D out-of-pocket cap: $2,400 in 2027 (up from $2,100 in 2026).
• Part D maximum deductible: $700 in 2027 (up from $615 in 2026).
• Part D national base beneficiary premium: $41.33 for 2027 (a formula input, not what any specific plan charges).

The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, hadn't been announced as of this writing. CMS typically publishes those figures in the fall, usually in November.