Medicare Advantage

HMO or PPO? New York Medicare Advantage for 2027: 158 HMO Plans, 66 PPO

ALBANY, N.Y. — For the 2027 plan year, New Yorkers shopping Medicare Advantage will see 224 plans offered statewide from 24 carriers, according to the CMS Medicare Advantage Landscape Source File for CY2027. The lineup tilts toward HMO-style coverage: 158 HMO plans (103 standard HMO plus 55 HMO-POS) and 66 PPO plans. Not every plan is sold in every county — Medicare Advantage availability is set county by county — but the statewide split is a useful starting point for understanding what's on the shelf.

This explainer walks through what the HMO/PPO numbers mean, which carriers offer each type, how to think about networks and travel, and what to do before the Annual Enrollment Period closes on December 7, 2026. Enrollment choices made during the October 15 – December 7, 2026 window take effect January 1, 2027.

The statewide split by type

Across New York for 2027, CMS lists 224 Medicare Advantage plans. By type, that breaks down to:

• 103 HMO plans
• 55 HMO-POS plans
• 66 PPO plans

Grouping HMO and HMO-POS together — because both are built around an HMO network — gives 158 HMO-style plans compared with 66 PPO plans. These counts come straight from the CMS Landscape file and count each plan once statewide, even when the same plan is offered in multiple counties. The full plan-level and carrier-level lists appear in the tables on this page.

What HMO, HMO-POS, PPO and PFFS mean

The plan "type" is really a description of the rules around doctors and hospitals.

• HMO (Health Maintenance Organization): You generally use the plan's network of doctors and hospitals. Many HMOs ask you to pick a primary care provider and get referrals to see specialists. Out-of-network care is typically covered only for emergencies.
• HMO-POS (Point of Service): An HMO with a limited "point of service" option that lets you go outside the network for certain services, under rules the plan spells out.
• PPO (Preferred Provider Organization): You can see in-network or out-of-network providers; out-of-network care is usually covered but under different cost-sharing rules. Referrals are generally not required.
• PFFS (Private Fee-for-Service): A separate type where the plan sets payment terms and providers decide, visit by visit, whether to accept them. CMS does not list any PFFS plans in New York's 2027 mix, so this type is not part of this year's choice set in the state.

None of these labels tells you what a specific plan costs, which doctors are in it, or how it rates. Those details live in each plan's Evidence of Coverage and provider directory, and in the Medicare Plan Finder.

Which carriers offer each type

CMS's 2027 file shows 24 carriers in New York across the three plan types present in the state.

HMO carriers (2027): Aetna (CVS Health), CDPHP Medicare Advantage, Centene (WellCare), ElderServe Health, Elevance Health (Anthem), EmblemHealth, Excellus Health Plan Community Care LLC, Excellus Health Plan, Inc, Hamaspik, Inc., Healthfirst Medicare Plan, Highmark Blue Cross Blue Shield or Highmark Blue Shield, Humana, Independent Health, Longevity Health Plan, MetroPlus Health Plan, MVP HEALTH CARE, Nascentia Health Plus, Senior Whole Health of New York, Trinity Health Plan New York, VillageCareMAX, and VNS Health Medicare.

HMO-POS carriers (2027): Aetna (CVS Health), Centene (WellCare), Elderplan, Elevance Health (Anthem), Excellus Health Plan, Inc, MVP HEALTH CARE, and UnitedHealthcare.

PPO carriers (2027): Aetna (CVS Health), Centene (WellCare), Devoted Health, Healthfirst Medicare Plan, Highmark Blue Cross Blue Shield or Highmark Blue Shield, Humana, Independent Health, MVP HEALTH CARE, and UnitedHealthcare.

A few names — including Aetna (CVS Health), Centene (WellCare), and MVP HEALTH CARE — show up on more than one list, which simply means they offer plans across multiple types. Whether any specific plan from any of these carriers is sold in your county is a separate question, answered through the Plan Finder.

How to decide which type fits your doctors and travel

The HMO/PPO decision usually comes down to three practical questions:

1. Who are your doctors? List your primary care provider, any specialists you see regularly, and your preferred hospital. Then check each plan's directory to see which ones include them. A plan that doesn't include your doctors isn't a fit, regardless of type. 2. How do you feel about referrals? HMOs often require a referral to see a specialist; PPOs generally do not. If you value a care team that coordinates through one primary care provider, an HMO structure can feel natural. If you prefer to self-refer, a PPO may feel easier. 3. How often do you leave your home area? If you travel frequently, split time between residences, or spend extended periods out of state, the way a plan handles out-of-network and out-of-area care matters. PPOs generally offer some out-of-network coverage; HMOs generally reserve out-of-network coverage for emergencies. HMO-POS plans sit in between, with limited out-of-network options defined by the plan.

What to do before December 7

A simple checklist for the weeks leading up to December 7, 2026:

• Write down your doctors, hospitals, and regular prescriptions.
• Note the counties where you spend significant time during the year.
• Go to medicare.gov and use the Plan Finder to see which 2027 plans are offered in your ZIP code.
• Read the Summary of Benefits and, if you want the full rulebook, the Evidence of Coverage for any plan you're seriously considering.
• Confirm with your providers that they will be in-network for 2027.

Your decision becomes effective January 1, 2027.

Free help

You can compare every plan available where you live at medicare.gov using the Plan Finder, or call 1-800-MEDICARE (1-800-633-4227), 24 hours a day, seven days a week. These are the official federal resources and they are free to use.