Medicare Advantage

What do HMO, PPO and SNP mean for Knox County?

Knox County has 64 Medicare Advantage plans for 2027. Compared with 2026, 14 plans are not coming back, 19 are new, and 15 continuing plans changed in some way you should check before December 7, 4 of them under a new name. This guide covers what those numbers mean for Knoxville, not which plan to pick.

Medicare AdvantageKnoxville, TN

If you live in Knoxville and you are shopping a Medicare Advantage plan, the letters after each plan name — HMO, HMO-POS, PPO, D-SNP, C-SNP, I-SNP — are doing a lot of the work. They tell you how the plan handles doctors, referrals, out-of-network care and who the plan is designed for. Knowing what those labels mean makes the local lineup a lot easier to sort through.

What the Knox County lineup looks like

According to the CMS Medicare Advantage Landscape file for plan year 2027, Knox County residents can choose from 60 Medicare Advantage plans offered by 11 carriers. Compared with 2026, 41 plans continue, 19 are new, 14 are not returning and 4 are renamed; 11 continuing plans change something in their terms, and the details sit in each plan's Annual Notice of Change. Centene (WellCare) is not offering plans in the county for 2027, while Abilis Health (HMO SNP) and Aetna (CVS Health) are new to the county.

The carriers offering MA-PD plans in the county, in alphabetical order, are American Health Advantage of Tennessee, Blue Cross Blue Shield (HCSC), BlueCare Plus Tennessee, BlueCross BlueShield of Tennessee, Centene (WellCare), Devoted Health, Elevance Health (Anthem), Humana, NHC Advantage and UnitedHealthcare. The table below lists every plan by carrier and type; use it as a map, not a ranking.

HMO: the classic in-network model

An HMO — Health Maintenance Organization — asks you to use doctors, hospitals and other providers inside the plan's network, except in an emergency. You typically pick a primary care doctor, and referrals are often needed to see a specialist. If you value simplicity and your doctors are already in-network, an HMO can be a comfortable fit.

In Knox County, HMO plans come from carriers including American Health Advantage of Tennessee, Devoted Health, Elevance Health (Anthem) and Humana, among others. Names in the roster such as HealthSpring Courage (HMO) or Humana Gold Plus H4461-035 (HMO) are examples of that structure.

HMO-POS: a little room to step outside

HMO-POS stands for HMO with a Point-of-Service option. It works like an HMO most of the time, but allows some out-of-network care for certain services, usually at a higher cost. The Knox County lineup includes HMO-POS plans from Centene (WellCare), Elevance Health (Anthem) and UnitedHealthcare — for example, the Wellcare Assist (HMO-POS) and AARP Medicare Advantage from UHC TC-0002 (HMO-POS) entries in the table.

PPO: more flexibility, different tradeoffs

A PPO — Preferred Provider Organization — lets you see any provider that accepts Medicare, in or out of the plan's network, though staying in-network usually costs less. Referrals are generally not required. If you split time between Knoxville and another area, or you want the freedom to try a specialist without a referral, PPOs are worth a look.

Knox County has PPO plans for 2027 from carriers including Blue Cross Blue Shield (HCSC), BlueCross BlueShield of Tennessee, Devoted Health, Humana and UnitedHealthcare. A note on labels: some PPOs are "Regional PPOs," which cover a wider service area — you will see that in entries such as HumanaChoice R0110-017 (Regional PPO).

PFFS: what about Private Fee-for-Service?

PFFS plans let you see any Medicare-approved provider who agrees to the plan's payment terms. They used to be more common. For 2027, the Knox County Medicare Advantage roster does not include any PFFS plans — only HMO, HMO-POS and PPO designs (plus SNPs built on those chassis). It is worth knowing the term, since Medicare's official materials still list PFFS as one of the plan types.

Special Needs Plans: built for a specific situation

Special Needs Plans are Medicare Advantage plans that limit membership to people who meet certain rules. There are three flavors, and all three appear in Knox County:

• D-SNP (Dual Eligible SNP) — for people who have both Medicare and Medicaid. Examples in the roster include BlueCare Plus (HMO D-SNP), Humana Gold Plus SNP-DE H4461-022 (HMO D-SNP), UHC Dual Complete TN-S001 (HMO-POS D-SNP) and Wellpoint Full Dual Advantage (HMO D-SNP).
• C-SNP (Chronic Condition SNP) — for people with a qualifying chronic condition. Local examples include BlueAdvantage Total Heart and Diabetes (PPO C-SNP), DEVOTED C-SNP CHOICE PLUS 020 TN (PPO C-SNP) and UHC Complete Care TC-0005 (HMO-POS C-SNP).
• I-SNP (Institutional SNP) — generally for people living in a nursing facility or who need that level of care. Local examples include American Health Advantage of Tennessee (HMO I-SNP), Humana Together in Health (PPO I-SNP), NHC Advantage (HMO I-SNP) and Senior Care (HMO I-SNP).

You cannot simply pick a SNP because you like the name — you have to meet the eligibility rules, and the plan will verify. If you qualify, though, SNPs are designed around your situation and coordinate benefits accordingly.

A few Part D facts worth knowing for 2027

Because every Medicare Advantage plan in Knox County includes drug coverage, the Part D rules apply:

• The Part D annual out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
• The maximum Part D deductible a plan can charge is $615.
• The coverage gap (the old "donut hole") has been eliminated as of 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs into level monthly payments across the year.
• IRMAA surcharges — extra Part B and Part D amounts based on income — begin above $109,000 for a single filer in 2026.