Medicare Advantage

Before you pick an HMO or PPO in Bernalillo County

People in Albuquerque can choose from 36 Medicare Advantage plans for 2027, against 51 this year. 24 of this year’s plans are gone, 9 are new to Bernalillo County, and 22 that continue have changed their premium, deductible, plan type or name, 9 of them under a new name.

Medicare AdvantageAlbuquerque, NM

If you live in Albuquerque and you are shopping for a Medicare Advantage plan, the first question usually is not which plan to pick — it is what kind of plan you are even looking at. HMO, PPO, PFFS, D-SNP, C-SNP, I-SNP: the alphabet soup can be confusing, and the choice matters more than most people realize because each type sets its own rules for doctors, referrals and travel.

Albuquerque is in Bernalillo County, where the CMS Medicare Advantage Landscape file for plan year 2027 lists 27 Medicare Advantage plans from 6 carriers. That is still a lot to sort through, so this guide walks through what the plan types mean and which carriers offer which types locally. The full roster is in the table below.

What HMO, PPO and PFFS actually mean

These labels describe how a plan handles doctors, hospitals and referrals — not how "good" a plan is.

HMO (Health Maintenance Organization). You pick a primary care doctor and usually stay inside the plan's network. Many HMOs require a referral before you see a specialist. Out-of-network care is generally not covered except in emergencies. Of the 51 plans in Bernalillo County, 24 are HMOs.

HMO-POS (Point of Service). An HMO with a limited ability to go out of network for certain services, usually at a higher cost. Bernalillo County has 1 HMO-POS plan.

PPO (Preferred Provider Organization). You can see any Medicare-approved provider, but you pay less when you stay in network. Referrals are typically not required. Bernalillo County has 26 PPO plans.

PFFS (Private Fee-for-Service). Any Medicare provider who agrees to the plan's terms can treat you. PFFS plans are less common nationally, and none of the 2027 Bernalillo County plans are PFFS.

What Special Needs Plans are

A Special Needs Plan (SNP) is a Medicare Advantage plan built for a specific group of people. You can only enroll if you fit the plan's eligibility rules.

• D-SNP (Dual Eligible). For people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition). For people with a qualifying chronic condition, such as diabetes or certain heart conditions.
• I-SNP (Institutional). For people who live in a nursing home or need a similar level of care.

In Bernalillo County, 17 of the 51 plans are Special Needs Plans, and they show up across most of the local carriers.

Which carriers offer plans in Bernalillo County

Six carriers offer Medicare Advantage plans in the county for 2027. In alphabetical order:

• Blue Cross Blue Shield (HCSC) — 11 plans (HMO, PPO; 2 SNPs)
• CHRISTUS Health Advantage — 2 plans (HMO)
• Devoted Health — 4 plans (HMO; 2 SNPs)
• Humana — 14 plans (HMO, PPO; 4 SNPs)
• Molina Healthcare of Arizona — 1 plan (HMO; 1 SNP)
• Presbyterian Health Plan — 5 plans (HMO; 1 SNP)
• SCAN Health Plan — 4 plans (HMO; 2 SNPs)
• UnitedHealthcare — 10 plans (HMO-POS, PPO; 5 SNPs)

Some carriers focus on one plan type, while others offer a mix. Presbyterian, for example, offers only HMO products locally, while Blue Cross Blue Shield and Humana each offer both HMOs and PPOs. UnitedHealthcare's local lineup includes HMO-POS and PPO designs. The table below lists every 2027 plan by carrier.

How to narrow it down

A few questions can trim a 51-plan list quickly:

• Do you want to keep specific doctors? Check whether they are in the plan's network. PPOs and HMO-POS plans give you more flexibility for out-of-network care; HMOs generally do not.
• Do you travel or split time outside New Mexico? PPOs typically handle routine out-of-area care more easily than HMOs.
• Do you have Medicaid, a qualifying chronic condition, or live in a facility? A Special Needs Plan may be a fit — but only if you qualify.
• Do you take prescription drugs? All 51 Bernalillo County Advantage plans include drug coverage, so you would not need a separate Part D plan while enrolled.

A few 2027 program facts worth knowing

These apply nationwide, not just in Albuquerque:

• The Part D out-of-pocket cap is $2,100 in 2026.
• The Part D maximum deductible is $615.
• The coverage gap ("donut hole") is gone as of 2025 — Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly amounts, at no extra charge.
• IRMAA income-based surcharges start above $109,000 for a single filer in 2026.
• Annual Enrollment: Oct. 15 – Dec. 7. MA Open Enrollment: Jan. 1 – March 31.