Medicare Advantage

Durham 2027 Medicare Advantage: who sells what, and which plan types you'll see

For 2027, Durham is looking at 69 Medicare Advantage plans: 6 new, 11 gone since 2026, and 25 still here but changed on premium, deductible, plan type or name, 9 of them under a new name. Below, how the lineup shifted in Durham County and what to compare, with no plan ranked or recommended.

Medicare AdvantageDurham, NC

DURHAM, N.C. — If you are shopping a Medicare Advantage plan in Durham for 2027, the first thing worth knowing is who is actually selling in your ZIP code and what kind of plan they are offering. Medicare Advantage availability is set at the county level, and Durham sits in Durham County, where 11 carriers are offering plans for the 2027 plan year. The table below lists every plan by carrier, its plan type (HMO, HMO-POS or PPO, and whether it is a Special Needs Plan), and whether it includes drug coverage.

This story is a plain-language guide to that lineup. It does not rank plans, quote premiums or copays, or single any plan out. For those details, use the official Medicare Plan Finder at medicare.gov or the plan's own documents.

What's on offer in Durham County for 2027

CMS lists 74 Medicare Advantage plans in Durham County for the 2026 plan year, from 12 carriers. Every plan on the county roster this year comes with prescription drug coverage built in — there are no MA-only plans on Durham's 2026 list, and there are no stand-alone Part D plans listed separately for the county.

By plan type, the mix looks like this:

• 25 HMO plans
• 19 HMO-POS plans
• 30 PPO plans (a mix of local PPO and Regional PPO)

Twenty-eight of the 74 are Special Needs Plans. Those are limited-enrollment plans for people who qualify — most commonly D-SNPs for people with both Medicare and Medicaid, C-SNPs for people with certain chronic conditions such as diabetes or heart disease, and I-SNPs for people living in a nursing home or a similar institutional setting.

The carriers selling in Durham County

Eleven carriers appear on Durham County's 2027 Medicare Advantage lineup. Listed alphabetically, with the plan-type mix each one offers:

• Aetna (CVS Health) — 7 plans (HMO, PPO; 2 are Special Needs Plans)
• Blue Cross and Blue Shield of North Carolina — 7 plans (HMO, HMO-POS, PPO; 1 SNP)
• Blue Cross Blue Shield (HCSC), marketed as HealthSpring — 8 plans (HMO, PPO; 2 SNPs)
• Centene (WellCare) — 9 plans (HMO-POS, PPO; 4 SNPs)
• Experience Health — 1 plan (HMO)
• HealthTeam Advantage — 2 plans (PPO)
• Humana — 19 plans (HMO, HMO-POS, PPO; 6 SNPs)
• Liberty Medicare Advantage — 3 plans (all HMO SNPs)
• Longevity Health Plan — 1 plan (HMO I-SNP)
• PruittHealth Premier — 1 plan (HMO I-SNP)
• Troy Medicare — 2 plans (HMO; 1 SNP)
• UnitedHealthcare — 14 plans (HMO-POS, PPO; 7 SNPs)

The full plan names — for example, Blue Medicare Enhanced (HMO-POS), Wellcare Simple (HMO-POS), Humana Gold Plus H1036-335 (HMO-POS), or AARP Medicare Advantage from UHC NC-0016 (PPO) — are listed in the table on this page.

What the plan-type labels mean

The letters next to each plan name describe how the network works, not how good the plan is.

• HMO: You pick a primary care doctor and generally stay in network, with referrals for specialists.
• HMO-POS: An HMO with a "point of service" option that lets you go out of network for certain services, usually at a higher cost.
• PPO: More flexibility to see out-of-network providers, though in-network care usually costs less. Regional PPOs cover a multi-state region set by CMS.
• D-SNP, C-SNP, I-SNP: Special Needs Plans, limited to people who meet the eligibility rules.

Every 2027 Durham County plan on the roster includes Part D drug coverage, so you would not add a separate stand-alone drug plan on top of one of these.

2027 Part D rules that apply no matter which plan you pick

Some Medicare rules are set at the program level and apply to any Medicare Advantage plan with drug coverage:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once your covered drug spending hits that amount, you pay $0 for covered drugs the rest of the year.
• The Part D maximum deductible is $615 in 2026 and $700 in 2027. Individual plans may set a lower deductible.
• The old coverage gap, or "donut hole," was eliminated in 2025. Part D now has three phases: deductible, initial coverage and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your out-of-pocket drug costs across the calendar year in monthly amounts, at no added cost. You have to opt in.
• IRMAA — the income-related surcharge on Part B and Part D — starts above $109,000 in income for a single filer in 2026.

Dates to keep on the fridge

• Oct. 15 – Dec. 7, 2026: Medicare Annual Enrollment Period. Any change you make takes effect Jan. 1, 2027.
• Jan. 1 – March 31, 2027: Medicare Advantage Open Enrollment. If you are already in a Medicare Advantage plan on Jan. 1, you get one chance to switch to a different Medicare Advantage plan or drop back to Original Medicare (and add a stand-alone Part D plan).

Outside those windows, you generally need a Special Enrollment Period — for example, if you move, lose other coverage, or become eligible for Medicaid.

How to compare Durham plans without guessing

The county roster tells you what is available. It does not tell you what a specific plan will cost you, whether your doctor is in network, or whether your prescriptions are on the plan's formulary. For that, use the official tools:

• Medicare Plan Finder at medicare.gov — enter your ZIP code, your drug list and your preferred pharmacy to see plan-by-plan costs and coverage.
• 1-800-MEDICARE (1-800-633-4227), 24/7, for help by phone.
• North Carolina SHIIP, the state's free State Health Insurance Assistance Program, offers one-on-one counseling with trained volunteers who do not sell insurance. Call 1-855-408-1212.

Star Ratings, published by CMS, are one more piece of information you may see on Plan Finder. They rate contracts on quality and member experience, and they can change year to year.