Medicare Advantage

Before you pick a Medicare Advantage plan in Columbus: how HMO, PPO, PFFS and SNP choices differ

People in Columbus can choose from 79 Medicare Advantage plans for 2027, against 92 this year. 27 of this year’s plans are gone, 14 are new to Franklin County, and 28 that continue have changed their premium, deductible, plan type or name, 5 of them under a new name.

COLUMBUS, Ohio — If you are shopping for a Medicare Advantage plan in Columbus this fall, the first thing to sort out is not price or perks. It is the plan type. HMO, HMO-POS, PPO, PFFS and the various Special Needs Plans each work differently, and the letters on the plan name tell you a lot about how you would use the coverage day to day.

Columbus is in Franklin County, where CMS lists 74 Medicare Advantage plans for 2027 from 12 carriers. Almost every plan type you can get in Medicare Advantage shows up here, which is good news for choice — and a good reason to slow down before you enroll.

What the Columbus-area lineup looks like

For plan year 2027, CMS's Medicare Advantage Landscape Source File shows 74 MA plans available to people living in Franklin County, from 12 carriers. Compared with 2026, 60 plans continue, 14 are new, 27 are not returning, and 5 have been renamed; 23 of the continuing plans change something in their terms, and those changes are spelled out in each plan's Annual Notice of Change.

Every one of the 92 plans includes Part D prescription drug coverage. That is why you will not see any stand-alone Part D plans marketed here as a companion to MA — they are built in.

The table below lists every plan by carrier, along with its type. Use it as a reference while you read the rest of this piece; the point of this article is to help you understand what those type labels mean before you start comparing.

HMO: the in-network plan

An HMO (Health Maintenance Organization) plan asks you to use doctors, hospitals and pharmacies that are in the plan's network, except in an emergency. Many HMOs also ask you to pick a primary care doctor and get a referral before seeing a specialist.

Of the 92 Franklin County plans, 37 are HMOs. If you already have doctors you like and they are all in the plan's network, an HMO can be a straightforward fit. If you travel a lot or split time between two states, the in-network rule matters more.

HMO-POS stands for HMO with a Point-of-Service option. It is an HMO with a limited ability to go out-of-network for certain services, usually at a higher cost. Franklin County has 17 of these.

PPO: more flexibility, different math

A PPO (Preferred Provider Organization) plan also has a network, but it will pay something toward care from providers outside the network. You usually pay more out-of-pocket for out-of-network care, and you typically do not need a referral to see a specialist.

If you value being able to see a provider who is not in-network — even at a higher cost — a PPO is the type of plan built for that. Some PPOs are local and some are regional, which cover a wider geographic footprint. The Franklin County lineup for 2027 continues to include PPOs alongside HMOs and other plan types.

PFFS: the least common type

A PFFS (Private Fee-for-Service) plan sets its own payment terms with providers. You can see any Medicare-approved doctor or hospital that agrees to accept the plan's payment terms, appointment by appointment. There is no network in the traditional sense, but there is no guarantee a given provider will accept the plan either.

PFFS plans have become rare. Franklin County has exactly 1 PFFS plan in the 2026 lineup.

Special Needs Plans: only for people who qualify

Special Needs Plans (SNPs) are Medicare Advantage plans built for specific groups. You have to meet the eligibility rules to enroll. There are three kinds:

• D-SNP (Dual Eligible SNP) — for people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition SNP) — for people with certain chronic conditions, such as diabetes or heart conditions.
• I-SNP (Institutional SNP) — for people who live in a nursing home or need that level of care at home.

Of the 92 plans in Franklin County, 30 are SNPs. In the roster you will see names ending in "D-SNP," "C-SNP" or "I-SNP" — that suffix is your first clue whether the plan is even open to you.

If you have Medicaid in Ohio, the state's MyCare Ohio program also shapes some of the D-SNP options here, which is why several plan names include "MyCare Ohio."

What to check before you pick a type

Once you know what the plan-type letters mean, three practical questions do most of the sorting:

1. Are my doctors and hospitals in the plan's network? This matters more with HMOs than PPOs, but it matters with both. 2. Are my prescriptions on the plan's formulary, and at what tier? The Part D annual out-of-pocket drug cap is $2,100 in 2026 and $2,400 in 2027. The maximum Part D deductible is $615 in 2026 and $700 in 2027. The old "donut hole" coverage gap is gone (Part D now has three phases). The Medicare Prescription Payment Plan also lets you spread drug costs across the year in monthly installments if you choose. 3. Do I qualify for a Special Needs Plan? If you have Medicaid, a qualifying chronic condition, or need institutional-level care, an SNP may be designed around your situation.

Star Ratings from CMS are another data point — they measure quality and member experience on a 1-to-5 scale — but they are one input, not a scoreboard.

Deadlines and where to get unbiased help

The Annual Enrollment Period runs from Oct. 15 through Dec. 7 each year. Changes made during that window take effect Jan. 1. If you are already enrolled in a Medicare Advantage plan, the Medicare Advantage Open Enrollment Period from Jan. 1 through March 31 lets you make one change — switch to another MA plan or return to Original Medicare.

Higher-income enrollees should also know that IRMAA surcharges on Part B and Part D premiums kick in above $109,000 in income for a single filer in 2026 (higher for joint filers).

For personalized help, the best places to start are:

• Medicare.gov — the official Plan Finder lets you enter your ZIP code and your prescriptions.
• 1-800-MEDICARE — 24/7, and they can answer plan-specific questions.
• Ohio SHIP (OSHIIP) — the Ohio Senior Health Insurance Information Program offers free, unbiased counseling from trained volunteers.