Medicare Advantage

Before you pick a Medicare Advantage plan in New York City: how HMO, HMO-POS and PPO differ for 2027

New York County has 61 Medicare Advantage plans for 2027. Compared with 2026, 20 plans are not coming back, 6 are new, and 13 continuing plans changed in some way you should check before December 7, 2 of them under a new name. This guide covers what those numbers mean for New York City, not which plan to pick.

New York City, fall 2026 — If you live in New York City and are weighing a Medicare Advantage plan for 2027, the first question is not which plan, but which type of plan. New York City is in New York County, where the 2027 lineup breaks down into 61 Medicare Advantage plans from 15 carriers, split across HMO, HMO-POS and PPO designs. No plans in the county are set up as Private Fee-for-Service (PFFS) for 2027.

The type of plan you choose sets the rules for which doctors you can see, whether you need referrals, and what happens if you get care outside the plan's network. Those rules matter more day-to-day than almost any brochure feature. Here is how the types split locally — and what each one actually means.

How New York County's 2027 plans split by type

For plan year 2027, New York County's Medicare Advantage menu looks like this:

• HMO: 34 plans
• HMO-POS: 15 plans
• PPO: 12 plans

That is 49 plans built on an HMO chassis (HMO plus HMO-POS) and 12 built as PPOs. There are no PFFS plans offered in the county for 2027. The table on this page lists every plan by carrier.

A few plans are not returning for 2027, a handful are new, and a couple have been renamed. If your plan is one of them, your ANOC will say so.

What HMO means

An HMO (Health Maintenance Organization) is built around a network. You generally pick a primary care doctor, and that doctor coordinates your care — including referrals to specialists in most cases. Out-of-network care is usually not covered except for emergencies, urgent care and dialysis away from home.

HMOs tend to work well if your doctors are already in the plan's network and you do not travel often for routine care. Before you join one, check the plan's provider directory for your doctors and the hospitals you'd want to use.

Carriers offering HMO plans in New York County for 2027 include Aetna (CVS Health), Centene (WellCare), ElderServe Health, Elevance Health (Anthem), EmblemHealth, Hamaspik, Inc., Healthfirst Medicare Plan, Humana, Longevity Health Plan, MetroPlus Health Plan, Senior Whole Health of New York, VillageCareMAX and VNS Health Medicare.

What HMO-POS means

HMO-POS stands for HMO with a "point-of-service" option. It works like an HMO most of the time, but it lets you go outside the network for certain services — often at a higher cost share and sometimes only for specific types of care. The exact rules vary by plan, so read the Evidence of Coverage before you count on using out-of-network benefits.

Carriers offering HMO-POS plans in New York County for 2027 are Centene (WellCare), Elderplan, Elevance Health (Anthem) and UnitedHealthcare.

What PPO means

A PPO (Preferred Provider Organization) gives you more flexibility. You generally do not need referrals, and the plan covers out-of-network care from Medicare-approved providers who agree to treat you — usually at a higher cost share than in-network care. That flexibility can matter if you split your time between New York City and another state, or if you want to see a specialist directly.

Carriers offering PPO plans in New York County for 2027 are Aetna (CVS Health), Centene (WellCare), Healthfirst Medicare Plan, Humana and UnitedHealthcare.

What about PFFS?

Private Fee-for-Service plans let you see any Medicare-approved provider who agrees to the plan's payment terms. They are a separate Medicare Advantage category, but no PFFS plans are offered in New York County for 2027. If you have seen PFFS mentioned in general Medicare materials, that is why it is not part of your local choice.

How to decide between types

Three questions do most of the work:

1. Who are your doctors, and which plans include them? Start with the Medicare Plan Finder at medicare.gov and the plan's own provider directory. 2. How often do you need care outside New York City? Regular out-of-area care usually points toward a PPO. 3. Are you comfortable going through a primary care doctor for specialist referrals? If yes, an HMO or HMO-POS may fit; if you want to self-refer, a PPO is more flexible.

A few program-level facts to keep in mind as you compare: for 2026, the Part D out-of-pocket cap is $2,100 and the maximum Part D deductible is $615. For 2027, the Part D out-of-pocket cap rises to $2,400 and the maximum Part D deductible to $700. CMS publishes the 2027 Part B premium, Part B deductible and IRMAA income brackets later in the fall.