Medicare Advantage

HMO, PPO, PFFS or SNP: What the Labels Mean

People in Charlotte can choose from 89 Medicare Advantage plans for 2027, against 94 this year. 19 of this year’s plans are gone, 14 are new to Mecklenburg County, and 28 that continue have changed their premium, deductible, plan type or name, 10 of them under a new name.

Medicare AdvantageCharlotte, NC

CHARLOTTE, N.C. — If you are shopping for a Medicare Advantage plan here this fall, the first decision is not really "which plan." It is which kind of plan, and which carrier's version of that kind fits how you like to get care. Charlotte is in Mecklenburg County, where 12 insurers are offering Medicare Advantage plans for 2027, and they come in several different shapes — HMO, HMO-POS, PPO, PFFS and a group of Special Needs Plans built for specific situations.

Understanding those labels up front makes the rest of the search a lot easier.

Who is selling Medicare Advantage in Mecklenburg County

Twelve carriers are offering Medicare Advantage plans in the county for 2027. In alphabetical order, they are Aetna (CVS Health), Alignment Health Plan, Blue Cross and Blue Shield of North Carolina, Blue Cross Blue Shield (HCSC), Centene (WellCare), Devoted Health, HealthTeam Advantage, Humana, Liberty Medicare Advantage, Longevity Health Plan, Provider Partners Health Plans, and UnitedHealthcare. Alignment Health Plan is new to the county for 2027; 14 plans are new, 19 are not returning, and 10 have been renamed.

The number of plans each carrier offers varies. Humana and UnitedHealthcare each list 21 plans. Aetna, Centene and Devoted Health each list 9. Blue Cross and Blue Shield of North Carolina and Blue Cross Blue Shield (HCSC) each list 8. Liberty Medicare Advantage and Provider Partners Health Plans each list 3. HealthTeam Advantage lists 2, and Longevity Health Plan lists 1.

A bigger lineup does not mean better — it usually means the carrier is slicing its offerings for different budgets, chronic conditions or dual-eligible members. The table below lists every plan by carrier so you can see the full picture.

HMO vs. HMO-POS: the network is the trade-off

An HMO (Health Maintenance Organization) asks you to use doctors and hospitals in the plan's network, and usually to pick a primary care doctor who refers you for specialist care. In exchange, HMOs are often built around lower cost-sharing. If you go outside the network for anything other than an emergency, you generally pay the full bill.

An HMO-POS (Point of Service) is an HMO with a small door cracked open. It lets you go out of network for certain services, usually at higher cost. In the county, 32 plans are HMOs and 26 are HMO-POS. If you travel a lot within North Carolina, or you want the freedom to occasionally see a doctor outside the network, an HMO-POS may be a better fit than a straight HMO.

PPO: more flexibility, different rules

A PPO (Preferred Provider Organization) also has a network, but you can generally see any Medicare-approved provider who agrees to bill the plan. You pay less when you stay in network and more when you go out. Referrals for specialists are usually not required.

PPOs have been the largest slice of the Charlotte-area market. Some are local PPOs and some are Regional PPOs, which cover a wider service area. If you split time between homes, see specialists at multiple health systems, or simply want fewer gatekeeping steps, a PPO tends to give you more room to move.

PFFS: the smallest category

A PFFS (Private Fee-for-Service) plan sets its own payment terms with providers. You can go to any Medicare provider who agrees to accept the plan's terms — provider by provider, visit by visit. PFFS remains a niche option in the county for 2027 and is worth understanding only if a PFFS is specifically what you are looking for.

Special Needs Plans: only if you qualify

Special Needs Plans (SNPs) are Medicare Advantage plans limited to people who meet specific criteria. There are three types, and 38 of the county's 94 plans are SNPs:

• D-SNPs are for people who have both Medicare and Medicaid ("dual eligible").
• C-SNPs are for people living with certain chronic conditions, such as diabetes, heart conditions or certain cardiovascular disorders.
• I-SNPs are for people who live in a nursing home or need a similar level of care at home.

SNPs are not "better" plans — they are plans built around one population. If you do not meet the eligibility rule, you cannot enroll. If you do, they are often worth a close look because the benefits and care coordination are designed for that group.

How to narrow it down

A useful order of operations in Charlotte:

1. Start with the plan type. Do you want the tighter network of an HMO, the flexibility of a PPO, or something in between? 2. Check whether you qualify for an SNP. If you have both Medicare and Medicaid, a qualifying chronic condition, or you live in a nursing home, an SNP may fit better than a general plan. 3. Look at drug coverage. All 79 Medicare Advantage plans in the county for 2027 include Part D. The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. The Part D maximum deductible is $615 in 2026 and $700 in 2027. The old coverage gap is gone. The optional Medicare Prescription Payment Plan lets you spread drug costs across the year. 4. Then compare specific plans — premiums, copays, provider networks and drug lists — on medicare.gov's Plan Finder, where the details are current and personalized to your ZIP code and medications.

Note: Higher-income enrollees pay IRMAA surcharges on Part B and Part D. For 2026, those surcharges start above $109,000 in income for a single filer.

Key dates

• Oct. 15 – Dec. 7: Annual Enrollment Period. You can join, switch or drop a Medicare Advantage or Part D plan.
• Jan. 1 – March 31: Medicare Advantage Open Enrollment. If you are already in a Medicare Advantage plan, you can switch to a different one or return to Original Medicare once during this window.