Medicare Advantage

HMO or PPO? North Carolina Medicare Advantage for 2027: 122 HMO Plans, 56 PPO

RALEIGH, N.C. — For the 2027 plan year, North Carolinians shopping Medicare Advantage will see 179 plans from 16 carriers listed in the CMS Landscape files for the state. The split by plan type matters more than the headline count, because the type — HMO, HMO-POS, PPO or PFFS — shapes how you see doctors, whether you need referrals, and what happens if you travel or go out of network.

HMO or PPO for 2027North Carolina

Statewide, HMO-style plans (HMO plus HMO-POS) account for 122 of those 179 offerings, while PPOs account for 56 and PFFS for 1. Availability is county by county, so a plan on the statewide list may or may not be sold where you live. This explainer walks through what the type labels mean, which carriers offer which type for 2027 in North Carolina, and how to think it through before the Annual Enrollment Period closes on December 7, 2026.

The statewide split by plan type

According to the CMS MA Landscape Source File for CY2027, North Carolina's 179 Medicare Advantage plans break down this way:

• HMO: 76
• HMO-POS: 46
• PPO: 56
• PFFS: 1

Combining HMO and HMO-POS gives 122 HMO-style plans statewide. PPOs make up 56, and a single PFFS plan rounds out the list. The tables on this page show the full plan-by-plan and carrier-by-carrier detail; this article names carriers only where it helps explain a point.

What HMO, HMO-POS, PPO and PFFS mean

These four letters describe how a plan's network and referral rules work. The specifics vary plan by plan, so always check the plan's Evidence of Coverage and provider directory before enrolling.

HMO (Health Maintenance Organization). You generally use the plan's contracted network of doctors and hospitals. Many HMOs ask you to pick a primary care provider and get referrals before seeing specialists. Out-of-network care typically isn't covered except for emergencies and urgent care.

HMO-POS (HMO with a Point-of-Service option). This is an HMO that allows some care outside the network under defined rules. The "point-of-service" option differs by plan — which services, which providers, and under what terms are all set in the plan documents.

PPO (Preferred Provider Organization). PPOs include both in-network and out-of-network coverage. You usually don't need referrals, and you can see providers outside the network, though the rules and cost-sharing for in-network vs. out-of-network care are set by each plan.

PFFS (Private Fee-for-Service). PFFS plans let you see any Medicare-approved provider who agrees to the plan's terms of payment at the time of service. Networks and acceptance work differently than in HMOs and PPOs.

Because this article does not quote premiums, cost-sharing or benefits for any plan, use Medicare.gov's Plan Finder, the plan's own documents, or 1-800-MEDICARE to see what each plan actually covers and charges.

Which carriers offer each type in North Carolina for 2027

From the CMS Landscape file for 2027, the carrier mix by plan type is:

• HMO carriers (14): Aetna (CVS Health), Alignment Health Plan, AmeriHealth Caritas VIP Care, Blue Cross and Blue Shield of North Carolina, Blue Cross Blue Shield (HCSC), Devoted Health, HealthTeam Advantage, Humana, Liberty Medicare Advantage, Longevity Health Plan, NHC Advantage, Provider Partners Health Plans, PruittHealth Premier, and Troy Medicare.
• HMO-POS carriers (5): Alignment Health Plan, Blue Cross and Blue Shield of North Carolina, Centene (WellCare), Humana, and UnitedHealthcare.
• PPO carriers (9): 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, and UnitedHealthcare.
• PFFS carriers (1): Humana.

Several carriers appear in more than one column — for example, Alignment Health Plan, Blue Cross and Blue Shield of North Carolina, and Humana show up across HMO, HMO-POS and PPO lists, while Humana is also the lone PFFS carrier for 2027.

How to decide which type fits your doctors and travel

Plan type is a starting filter, not a verdict. A few questions can help narrow the field:

• Do you want to keep specific doctors or a specific hospital system? Pull each plan's provider directory and confirm your providers are listed and accepting that plan for 2027. In-network status can change between years.
• Do you want referrals or prefer to self-refer to specialists? HMOs more often use referrals; PPOs typically don't. HMO-POS and PFFS have their own rules.
• Do you spend significant time outside North Carolina? PPOs and PFFS plans generally handle out-of-network care differently than HMOs. Check each plan's rules for care received out of state.
• What prescriptions do you take? Each plan has its own drug list (formulary), which you'll want to compare on Medicare.gov's Plan Finder.
• Is the plan actually sold in your county? The 179 figure is statewide. County-level availability is what determines your real choices.

What to do before December 7

The Annual Enrollment Period for 2027 Medicare Advantage runs October 15 – December 7, 2026. A choice made in that window takes effect January 1, 2027. A simple sequence:

1. Make a list of your doctors, hospitals and current prescriptions. 2. Enter your ZIP code at Medicare.gov to see which plans are offered in your county. 3. Filter or sort by plan type (HMO, HMO-POS, PPO, PFFS) based on how you want networks and referrals to work. 4. Open each plan's Summary of Benefits and Evidence of Coverage to confirm the details. 5. Call the plan directly, or 1-800-MEDICARE, with any questions before you enroll.

If you take no action during the Annual Enrollment Period, your existing coverage generally continues under its 2027 terms — which may differ from 2026, so it's still worth a look at the Annual Notice of Change your current plan sends.

Free help

You can compare every 2027 plan available in your county at Medicare.gov, using the official Plan Finder. For questions by phone, 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. Both are free to use.