Medicare Advantage

Allegheny County's 2027 plans: 42 HMO, 18 HMO-POS, 35 PPO

People in Pittsburgh can choose from 95 Medicare Advantage plans for 2027, against 96 this year. Nine of this year’s plans are gone, 8 are new to Allegheny County, and 46 that continue have changed their premium, deductible, plan type or name, 11 of them under a new name.

PITTSBURGH — Fall 2026. As the Annual Enrollment Period opens Oct. 15, 2026, Pittsburgh residents sorting through next year's Medicare Advantage choices will see the same three letters again and again on plan cards: HMO, PPO, and the hybrid HMO-POS. The letters are not marketing. They decide whether you need a referral to see a specialist, whether an out-of-town doctor is covered, and how tightly your plan's network is drawn.

Pittsburgh is in Allegheny County, where CMS lists 95 Medicare Advantage plans from 16 carriers for 2027. The split by type: 42 HMO plans, 18 HMO-POS plans and 35 PPO plans. (Counting HMO and HMO-POS together, that is 60 HMO-style plans.) No Private Fee-for-Service, or PFFS, plan is on the 2027 list for the county.

Here is what each type actually means, and which carriers are offering which in Allegheny County next year.

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

In plain English, the plan type sets the rules for which providers you can see and what happens if you go outside the plan's network.

• HMO (Health Maintenance Organization): You pick a primary care doctor and generally must use providers in the plan's network. Many HMOs require a referral before you can see a specialist. Out-of-network care is usually not covered except for emergencies, urgent care and out-of-area dialysis.
• HMO-POS (HMO with Point-of-Service): An HMO with a limited out-of-network option for certain services. The plan's Evidence of Coverage spells out which services qualify and what you pay.
• PPO (Preferred Provider Organization): You can see any Medicare-approved provider who accepts the plan. Staying in network costs less; going out of network is allowed but costs more. Referrals typically are not required.
• PFFS (Private Fee-for-Service): The plan sets the payment terms, and any provider who accepts those terms can treat you. PFFS is uncommon, and for 2027 no PFFS plan is on Allegheny County's lineup.

None of these types is universally cheaper or better. The right choice depends on which doctors and hospitals you want to keep using, whether you spend part of the year out of state, and your prescriptions.

How many HMO, HMO-POS and PPO plans are offered in Allegheny County for 2027?

For 2027, Allegheny County has 42 HMO plans, 18 HMO-POS plans and 35 PPO plans — 95 Medicare Advantage plans in all, from 16 carriers. Compared with the 2026 lineup (96 plans, with 40 HMO, 19 HMO-POS, 36 PPO and 1 PFFS), the mix is close to the same, with the single PFFS plan dropping off.

Across the county, CMS also notes that for 2027, 9 plans are not returning, 8 are new, and 11 have been renamed. If you are already enrolled, your plan's Annual Notice of Change — mailed in September — tells you whether your plan is one of them and how its benefits and costs are changing for next year.

The full table on this page lists every 2027 plan by carrier and type. Below is just which carriers offer which type.

Which carriers offer HMO plans in Pittsburgh for 2027?

For 2027 in Allegheny County, these carriers offer HMO plans (listed alphabetically): Aetna (CVS Health), American Health Advantage of Pennsylvania, Devoted Health, Geisinger Gold, HealthSpring, Highmark Blue Cross Blue Shield or Highmark Blue Shield, Highmark Wholecare Medicare Assured, Humana, Jefferson Health Plans, Perennial Advantage, Provider Partners Health Plans, UPMC for Life, UPMC for Life Complete Care, and VISTA Health Plan Inc.

HMO is the most common plan type in the county next year, and it is where many of the Special Needs Plans (SNPs) sit — plans designed for people who are dually eligible for Medicare and Medicaid, have certain chronic conditions, or live in a nursing home.

Which carriers offer HMO-POS and PPO plans in Pittsburgh for 2027?

For 2027 in Allegheny County, the carriers offering HMO-POS plans are Aetna (CVS Health), Centene (WellCare), Highmark Blue Cross Blue Shield or Highmark Blue Shield, and UnitedHealthcare.

The carriers offering PPO plans are Aetna (CVS Health), Devoted Health, HealthSpring, Highmark Blue Cross Blue Shield or Highmark Blue Shield, Humana, UnitedHealthcare, and UPMC for Life.

A few carriers appear on both lists because they offer more than one plan type. The table below shows exactly which plan from each carrier is HMO, HMO-POS or PPO, so you can match a plan name to its network rules.

How should Pittsburgh readers decide between an HMO and a PPO for 2027?

Start with your doctors, not the brochure. On Medicare.gov's Plan Finder, enter your ZIP code, your prescriptions and your preferred providers; the tool will show which specific plans count them as in-network. A few questions worth answering before you commit:

• Do you want to keep seeing specific doctors or use a specific hospital system in or around Pittsburgh? Check each plan's provider directory for 2027 — networks can change year to year.
• Do you mind getting a referral from a primary care doctor before seeing a specialist? HMOs typically require one; PPOs typically do not.
• Do you travel, spend winters elsewhere, or split time with family out of state? A PPO's out-of-network coverage can matter in that case; an HMO generally covers only emergency and urgent care outside its service area.
• Do you take brand-name drugs? Each plan has its own formulary, and the 2027 Part D rules (a $2,400 out-of-pocket cap and a $700 maximum deductible) apply across Medicare drug coverage, but the specific tiers and copays are set by the plan.

Nothing happens automatically if you decide to stay put. Your 2026 plan simply renews on Jan. 1, 2027, with the changes in its ANOC. You have until Dec. 7, 2026 to switch, and a second window — Medicare Advantage Open Enrollment, Jan. 1 to March 31, 2027 — lets people already in a Medicare Advantage plan make one more change.