Medicare Advantage

Before you pick a Medicare Advantage plan in Providence: how the four carriers and plan types compare

For 2027, Providence County has 18 Medicare Advantage plans: 0 new, 1 gone since 2026, and 8 continuing plans with changes in their terms, 4 of them under a new name. Below, how the lineup shifted in Providence County and what to compare, with no plan ranked or recommended.

Providence is in Providence County, where Medicare says 18 Medicare Advantage plans will be offered for the 2027 plan year. All 18 include prescription drug coverage. Four carriers are behind those plans, and each one takes a slightly different approach to plan design.

What's on the table in Providence for 2027

Here they are, listed alphabetically, with the counts CMS publishes for the county:

• Aetna (CVS Health): 4 plans (HMO-POS and PPO)
• Blue Cross & Blue Shield of Rhode Island: 6 plans (HMO and HMO-POS, including 1 Special Needs Plan)
• Neighborhood Health Plan of Rhode Island: 2 plans (HMO, both Special Needs Plans)
• UnitedHealthcare: 11 plans (HMO-POS and PPO, including 6 Special Needs Plans)

The full plan-by-plan roster is in the table on this page. The order above matches the source data and is not a ranking.

HMO vs. HMO-POS: the network rules

An HMO (Health Maintenance Organization) uses a set network of doctors and hospitals. You usually pick a primary care doctor, and you often need a referral to see a specialist. Care outside the network is generally not covered except for emergencies.

An HMO-POS (Point of Service) is an HMO with a small door left open. It lets you get some services outside the network, usually at a higher cost. It is still built around an in-network primary care relationship.

In Providence County, 4 of the 23 plans are HMOs and 13 are HMO-POS. Blue Cross & Blue Shield of Rhode Island's BlueCHiP for Medicare Core is the county's straight HMO offering, and the BlueCHiP for Medicare Access, Enhanced, Essential and Extra plans are HMO-POS. Aetna's Prime Care and UnitedHealthcare's AARP Medicare Advantage HMO-POS plans round out that group.

PPO: more flexibility, different trade-offs

A PPO (Preferred Provider Organization) does not require a primary care doctor or referrals, and it covers out-of-network care, though typically at a higher share of the cost. If you split your time between states or want more freedom to see specialists directly, a PPO may fit better — but the trade-off is usually higher premiums or cost-sharing.

Six of the county's 23 plans are PPOs. Aetna offers PPO options including Aetna Medicare Eagle Giveback, Aetna Medicare Enhanced and Aetna Medicare Signature. UnitedHealthcare offers a PPO in the AARP Medicare Advantage lineup as well.

PFFS: a plan type worth knowing about

A PFFS (Private Fee-for-Service) plan sets its own payment terms with any Medicare provider willing to accept them. You are not tied to a network the way you are with an HMO, but you have to confirm each time that a provider will take the plan.

No PFFS plans are on the Providence County list for 2027, but it is a plan type Medicare allows nationally, and it can show up in other counties or in future years.

Special Needs Plans: who they are for

Special Needs Plans (SNPs) are Medicare Advantage plans built for specific groups. There are three kinds:

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

You have to meet the eligibility rules to enroll, and if you lose eligibility, you generally lose the plan. In Providence County, 9 of the 23 plans are SNPs. Blue Cross & Blue Shield of Rhode Island offers BlueRI for Duals, and Neighborhood Health Plan of Rhode Island offers Neighborhood Dual CONNECT and Neighborhood INTEGRITY for Duals — all D-SNPs. UnitedHealthcare's SNP lineup for the county includes UHC Complete Care (C-SNP), several UHC Dual Advantage and UHC Dual Complete plans (D-SNPs), and UHC Nursing Home Plan (I-SNP).

Program-level facts to bring with you

Whichever plan type you look at, some rules apply across all Medicare drug coverage in 2027:

• Part D has a $2,100 out-of-pocket cap on covered drugs for the year.
• The maximum Part D deductible a plan can charge is $615.
• The old coverage gap ("donut hole") is gone; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the calendar year in monthly amounts, if you opt in.
• IRMAA surcharges for higher-income enrollees start above $109,000 in income for a single filer in 2026.

Providence County has a sizable population age 65 and older, and the four MA-PD carriers listed above are what CMS shows for 2027. Stand-alone Part D plans are not shown in this county's 2027 landscape data, so drug coverage for people choosing Medicare Advantage here comes bundled with the plan. Every one of the 18 MA plans in the county includes drug coverage.

How to decide, without guessing

A useful order of operations:

1. Start with your doctors and hospitals. Ask each one which Medicare Advantage plans they participate in for 2027. That alone narrows the field quickly. 2. Match the plan type to how you use care. HMO if you are fine with a network and referrals; HMO-POS if you want a small out-of-network door; PPO if flexibility matters most. 3. Check the drug list (formulary) for each medication you take, since coverage differs by plan. 4. If you have Medicaid, a qualifying chronic condition or live in a nursing facility, look at whether a D-SNP, C-SNP or I-SNP fits your situation. 5. Note the dates. The Annual Enrollment Period runs October 15 through December 7, 2026, for coverage that starts January 1, 2027. If you are already in a Medicare Advantage plan, you also have the January 1 through March 31 Medicare Advantage Open Enrollment Period to make one change.