Medicare Advantage

HMO, PPO, PFFS or SNP: how Buffalo plans differ

Erie County has 60 Medicare Advantage plans for 2027. Compared with 2026, 21 plans are not coming back, 11 are new, and 18 continuing plans changed in some way you should check before December 7, 3 of them under a new name. This guide covers what those numbers mean for Buffalo, not which plan to pick.

Medicare AdvantageBuffalo, NY

If you live in Buffalo and you're weighing Medicare Advantage for 2027, the first choice isn't which carrier — it's which type of plan fits how you get care. HMO, HMO-POS, PPO, PFFS and Special Needs Plans all sit under the Medicare Advantage umbrella, but they work differently on networks, referrals and who can enroll. Buffalo is in Erie County, where 11 carriers offer Medicare Advantage plans, and the mix includes all of these types.

How the Buffalo-area market is laid out

Erie County has 57 Medicare Advantage plans available for 2027. That's important locally, because if you want Advantage plus drugs bundled together, the roster is substantial; if you want Original Medicare plus a stand-alone Part D, you'd look at that market separately.

By type, Erie County's 70 MA plans break down like this: 27 HMO, 18 HMO-POS, 21 PPO and 4 PFFS. Twenty-four of the 70 are Special Needs Plans.

The 11 carriers offering plans in the county, in alphabetical order, are Aetna (CVS Health), Centene (WellCare), Excellus Health Plan Community Care LLC, Excellus Health Plan, Inc, Highmark Blue Cross Blue Shield or Highmark Blue Shield, Humana, Independent Health, MVP Health Care, Nascentia Health Plus, UnitedHealthcare and VNS Health Medicare. The table below lists every plan by carrier and type.

HMO and HMO-POS: network-first plans

A Health Maintenance Organization (HMO) plan usually asks you to use doctors and hospitals in the plan's network, and often to pick a primary care doctor who coordinates referrals. If you go outside the network for non-emergency care, the plan typically won't pay.

HMO-POS ("point of service") is a close cousin. It works mostly like an HMO but lets you get certain services outside the network under defined rules. The details vary plan by plan, so read the Evidence of Coverage before you assume a specialist or facility is covered.

In Erie County, the HMO and HMO-POS categories together account for 45 of the 70 plans. Carriers offering HMO or HMO-POS designs here include Aetna, Centene (WellCare), both Excellus entities, Highmark, Humana, Independent Health, MVP Health Care, Nascentia Health Plus, UnitedHealthcare and VNS Health Medicare.

PPO: more flexibility, different tradeoffs

A Preferred Provider Organization (PPO) plan also has a network, but you can generally see out-of-network providers who accept Medicare — you'll usually pay more when you do, and some services still need prior approval. PPOs typically don't require a primary care referral to see a specialist.

Erie County's PPO options for 2027 come from carriers that include Aetna, Centene (WellCare), Excellus Health Plan, Inc, Highmark, Humana, Independent Health, MVP Health Care and UnitedHealthcare.

PFFS: a smaller, different animal

Private Fee-for-Service (PFFS) plans work on a "terms and conditions" model. Any provider who accepts Medicare and agrees to the plan's payment terms for that visit can treat you. There's no traditional network in the HMO or PPO sense, but providers can decide visit-by-visit whether to accept the plan.

PFFS is the smallest slice locally: 4 of the 70 plans in Erie County are PFFS, all from Centene (WellCare).

Special Needs Plans: eligibility comes first

Special Needs Plans (SNPs) are Medicare Advantage plans built for specific groups. You can't enroll unless you meet the eligibility rule for that plan.

• D-SNP (Dual Eligible): for people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition): for people diagnosed with a qualifying chronic condition, such as diabetes or certain cardiovascular disorders.
• I-SNP (Institutional): for people who live in, or need the level of care provided by, a long-term care facility.

Erie County's SNP options for 2027 come from carriers that include Aetna, Centene (WellCare), Excellus Health Plan Community Care LLC, Humana, Independent Health, Nascentia Health Plus, UnitedHealthcare and VNS Health Medicare. Because eligibility is strict, an SNP that's right for one neighbor may not be available to you at all.

A few 2027 facts to keep in mind

Whichever plan type you consider, the Part D side of Medicare Advantage follows the same national rules in 2026: the Part D out-of-pocket cap is $2,100, the maximum Part D deductible is $615, and the old "donut hole" has been eliminated — Part D now has three phases. The optional Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly amounts instead of paying at the pharmacy counter. Higher-income enrollees may also pay IRMAA surcharges, which begin above $109,000 in income for a single filer in 2026.