Medicare Advantage

HMO or PPO? Ohio Medicare Advantage for 2027: 133 HMO Plans, 47 PPO

COLUMBUS, Ohio — When Ohioans open the Medicare Plan Finder this fall to look at 2027 coverage, they'll find 180 Medicare Advantage plans statewide from 20 carriers, according to the CMS Medicare Advantage Landscape Source File for CY2027. The biggest question many shoppers ask first isn't about a specific plan — it's about the plan type. HMO or PPO? That single choice shapes how you see doctors, whether you need referrals, and what happens when you travel.

Here's how Ohio's 2027 lineup breaks down by type, and what each type means in plain English.

The statewide split by type

For 2027, Ohio has 180 Medicare Advantage plans from 20 carriers. Grouped by type:

• HMO: 83 plans
• HMO-POS: 50 plans
• PPO: 47 plans

Combining HMO and HMO-POS, which both sit under the HMO umbrella, Ohio has 133 HMO-family plans and 47 PPO plans statewide for 2027. That's roughly a three-to-one tilt toward HMO-style coverage, though every county has its own mix. The full plan and carrier tables on this page show which plans and carriers fall into each category.

What HMO, HMO-POS, PPO and PFFS mean

These acronyms describe how a plan handles its provider network.

• HMO (Health Maintenance Organization): You generally use in-network doctors and hospitals, and you typically pick a primary care physician who coordinates your care. Many HMOs require a referral to see a specialist. Out-of-network care is usually only covered in an emergency.
• HMO-POS (HMO with a Point-of-Service option): An HMO with a limited door to out-of-network care for certain services. The specifics — which services, what cost-sharing — vary plan by plan and are described in each plan's Evidence of Coverage.
• PPO (Preferred Provider Organization): You can see both in-network and out-of-network providers, usually without a referral. Out-of-network care generally costs more than in-network care. PPOs can be local (certain counties) or regional.
• PFFS (Private Fee-for-Service): A separate plan type in which the plan sets the payment terms and providers decide, visit by visit, whether to accept them. Ohio's 2027 Landscape data for this article does not list PFFS plans in the HMO/HMO-POS/PPO totals above; shoppers interested in PFFS should check the Plan Finder for their county.

The practical difference: HMOs lean on a defined network and often a referral process; PPOs trade some of that structure for broader provider access, usually at a different cost.

Which carriers offer each type in Ohio for 2027

Ohio shoppers will see familiar and newer names across the three types for 2027.

Carriers offering HMO plans include Aetna (CVS Health), American Health Advantage of Indiana, CareSource MyCare Ohio (HMO D-SNP), Centene (WellCare), Communicare Advantage, Devoted Health, Elevance Health (Anthem), HealthSpring, Humana, Medical Mutual of Ohio, MediGold, Molina Healthcare of Ohio, Perennial Advantage, SummaCare Medicare Advantage Plans, The Health Plan, UPMC for Life, Valor Health Plan, and Zing Health.

Carriers offering HMO-POS plans include Aetna (CVS Health), Elevance Health (Anthem), Humana, Medical Mutual of Ohio, Perennial Advantage, PrimeTime Health Plan, SummaCare Medicare Advantage Plans, and UnitedHealthcare.

Carriers offering PPO plans include Aetna (CVS Health), Devoted Health, Elevance Health (Anthem), HealthSpring, Humana, Medical Mutual of Ohio, The Health Plan, and UnitedHealthcare.

Some carriers show up on more than one list because they offer more than one type of plan. Whether any specific plan is sold in your county is a separate question — the Plan Finder answers it by ZIP code.

How to decide which type fits your doctors and travel

A few questions tend to settle the HMO-vs.-PPO decision quickly:

1. Who are your doctors, and what network are they in? Call the office, or check each plan's provider directory for 2027. A plan type only matters if your doctors participate. 2. Do you want to see specialists without a referral? HMOs often route you through a primary care physician; PPOs generally don't require referrals. HMO-POS plans sit in the middle. 3. How often are you out of Ohio? Snowbirds and frequent travelers often weigh PPOs more heavily because out-of-network care is typically covered (at a different cost share). HMOs usually cover only emergencies away from home. 4. Do you prefer a tightly coordinated care team or more provider flexibility? Both approaches are legitimate — it's a preference, not a right answer. 5. Are you eligible for a Dual Eligible Special Needs Plan (D-SNP)? If you have both Medicare and Medicaid, D-SNP options (such as CareSource MyCare Ohio) are worth asking about.

What to do before December 7

The Annual Enrollment Period runs October 15 – December 7, 2026. A choice made during that window takes effect January 1, 2027. A simple checklist:

• Make a short list of your doctors, hospitals, and prescriptions.
• Enter your ZIP code at medicare.gov to see which plans are offered in your county.
• Filter by plan type (HMO, HMO-POS, PPO) and compare the Summary of Benefits and Evidence of Coverage for the plans that interest you.
• Confirm your providers are in-network for the plan year 2027, not just the current year.
• Review the Part D drug list for each plan if you take prescriptions.

If you keep your current plan, read the Annual Notice of Change your carrier mails each fall — things can shift from one year to the next.

Free help

• Medicare Plan Finder: medicare.gov — compare plans by ZIP code, see provider directories and drug lists.
• 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week; TTY 1-877-486-2048.
• Your plan's Evidence of Coverage and provider directory for the exact 2027 rules.