Medicare Advantage

Toledo Medicare Advantage in 2027: how HMO, HMO-POS and PPO plans divide the lineup

People in Toledo can choose from 87 Medicare Advantage plans for 2027, against 99 this year. 31 of this year’s plans are gone, 19 are new to Lucas County, and 28 that continue have changed their premium, deductible, plan type or name, 4 of them under a new name.

TOLEDO — As the Annual Enrollment Period opens Oct. 15, 2026, Toledo residents weighing a Medicare Advantage plan for 2027 will see a lineup split fairly evenly between HMO and PPO designs — and understanding what those letters mean matters more than any marketing on a mailer.

Toledo is in Lucas County, where CMS lists 87 Medicare Advantage plans from 14 carriers for 2027. By plan type: 37 HMOs, 20 HMO-POS plans and 30 PPOs. (Counting HMO-POS with HMO, the HMO family totals 57.) No PFFS — private fee-for-service — plans appear on the Lucas County lineup for 2027.

What does HMO, HMO-POS, PPO and PFFS actually mean in Medicare Advantage?

These are the four Medicare Advantage plan types, and they describe how you get care, not what the plan costs.

• HMO (Health Maintenance Organization): You use the plan's network of doctors and hospitals. Out-of-network care usually isn't covered except for emergencies. Many HMOs ask you to pick a primary care doctor and get a referral to see a specialist.
• HMO-POS (Point of Service): An HMO with a limited out-of-network option for certain services. The plan spells out which services qualify and what you pay.
• PPO (Preferred Provider Organization): You can see any Medicare-approved provider who accepts the plan. In-network care generally costs less; out-of-network care is covered but typically at a higher share.
• PFFS (Private Fee-for-Service): A plan that pays providers a set rate; providers choose whether to accept it visit by visit. None are offered in Lucas County for 2027.

Which type fits best depends on your doctors, the hospitals you use, and whether you travel. No type is universally cheaper or better.

How are Toledo's 2027 Medicare Advantage plans split by type?

Of the 87 Medicare Advantage plans in Lucas County for 2027, HMOs make up the largest single group at 37, followed by PPOs at 30 and HMO-POS plans at 20. If you combine the two HMO variants, the HMO family (57) outnumbers PPOs (30) by roughly two to one.

The table below lists every plan offered in Lucas County for 2027, with its carrier and plan type, so you can see the full picture at a glance.

Which carriers offer HMO plans in Lucas County for 2027?

Twelve carriers offer at least one HMO plan in Lucas County for 2027: Aetna (CVS Health), CareSource MyCare Ohio (HMO D-SNP), Centene (WellCare), Communicare Advantage, Devoted Health, Elevance Health (Anthem), Humana, Molina Healthcare of Ohio, Perennial Advantage, SummaCare Medicare Advantage Plans, Valor Health Plan and Zing Health.

Several of these HMOs are Special Needs Plans (SNPs) built for people with Medicaid, a chronic condition, or who live in an institutional setting. SNPs are open only to people who meet those conditions.

Which carriers offer HMO-POS plans in Lucas County for 2027?

Seven carriers offer HMO-POS plans in Lucas County for 2027: Aetna (CVS Health), Elevance Health (Anthem), Humana, Medical Mutual of Ohio, Perennial Advantage, SummaCare Medicare Advantage Plans and UnitedHealthcare.

HMO-POS plans look and work like HMOs most of the time; the "point of service" piece adds a defined way to use certain services outside the network. The Evidence of Coverage spells out exactly which services qualify.

Which carriers offer PPO plans in Lucas County for 2027?

Six carriers offer PPO plans in Lucas County for 2027: Aetna (CVS Health), Devoted Health, Elevance Health (Anthem), Humana, Medical Mutual of Ohio and UnitedHealthcare.

PPOs are often attractive to people who travel, split time between homes, or want the ability to see a specialist without a referral. The trade-off is that out-of-network providers usually mean higher cost sharing, and some providers may not accept the plan at all. Always confirm acceptance before an appointment.

What is changing in Toledo's lineup for 2027, and what should I do by Dec. 7?

Compared with 2026, the Lucas County lineup includes 19 new plans, 31 plans that are not returning, and 4 plans that were renamed. If your current plan is one of those that isn't being offered again, your carrier is required to tell you. If it's returning — even with changes — you'll get an Annual Notice of Change (ANOC) in September that lists what's different for 2027.

Here are the dates and figures to keep in mind:

• Annual Enrollment Period: Oct. 15 – Dec. 7, 2026. Changes take effect Jan. 1, 2027.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31, 2027 (one switch for those already in an MA plan).
• Part D out-of-pocket cap: $2,400 in 2027 (up from $2,100 in 2026).
• Part D maximum deductible: $700 in 2027 (up from $615 in 2026).
• Part B 2027 premium and deductible, and 2027 IRMAA brackets: CMS publishes these later in the fall.

If you do nothing during the window and your plan is offered again, it renews automatically with the changes in your ANOC.

How do I decide between an HMO and a PPO for 2027?

Start with your doctors. Make a list of the providers and hospitals you want to keep using, then check each plan's network directory to see who's in. If every doctor you need is in a plan's HMO network and you don't travel often, an HMO may be a comfortable fit. If you want more flexibility — a specialist out of town, a second opinion at a different hospital system, or care while traveling — a PPO's out-of-network coverage may matter more.

Then look at the specifics on medicare.gov's Plan Finder: premium, deductible, drug formulary, copays for the services you actually use, and the plan's rules on referrals and prior authorization. The right plan is the one that fits your care, not the one with the loudest ad.