Medicare Advantage

How HMO, PPO and SNP plans differ in Shelby County

For 2027, Memphis is looking at 74 Medicare Advantage plans: 12 new, 11 gone since 2026, and 30 still here but changed on premium, deductible, plan type or name, 7 of them under a new name. Below, how the lineup shifted in Shelby County and what to compare, with no plan ranked or recommended.

MEMPHIS — If you are shopping for a Medicare Advantage plan in Memphis this year, the first choice is not really which company to pick. It is which kind of plan fits how you like to get care. HMO, HMO-POS, PPO, PFFS and Special Needs Plans all sit under the Medicare Advantage umbrella, but they work differently once you use them.

Memphis is in Shelby County, where 11 carriers offer Medicare Advantage next year and the CMS Landscape file lists 67 Medicare Advantage plans for 2027, all of them including drug coverage. That is a lot to sort through, so it helps to start by understanding the plan types before you compare names.

Who sells Medicare Advantage in Shelby County

Eleven carriers file Medicare Advantage plans in the county for 2027. In alphabetical order, they are Abilis Health, Aetna (CVS Health), American Health Advantage of Tennessee, Blue Cross Blue Shield (HCSC), BlueCare Plus Tennessee, BlueCross BlueShield of Tennessee, Devoted Health, Elevance Health (Anthem), Humana, UnitedHealthcare and Zing Health. Centene (WellCare) is not offering plans in the county for 2027.

The number of plans each carrier offers varies. Some file a single plan; others file more than a dozen. The table below lists every plan by carrier, so you can see the full picture without us reciting it here. What matters at this stage is that you will see the same plan-type labels — HMO, HMO-POS, PPO, and SNP variations — repeat across carriers.

HMO plans: network-first, referral-based

Of the 73 Medicare Advantage plans in Shelby County, 29 are HMOs and another 19 are HMO-POS. A traditional HMO (Health Maintenance Organization) asks you to use doctors and hospitals inside the plan's network, and often to get a referral from a primary care doctor before you see a specialist. Out-of-network care is generally not covered except in an emergency.

HMO-POS stands for "Point of Service." It works like an HMO for most care but allows some services outside the network, usually at a higher cost. If you like the idea of one doctor coordinating everything but want a little flexibility, HMO-POS sits between a strict HMO and a PPO.

PPO plans: more flexibility, different trade-offs

A PPO (Preferred Provider Organization) lets you see any provider that accepts Medicare, in or out of the plan's network, without a referral. Staying in-network usually costs less, and going out costs more.

PPOs come in two flavors on the CMS list: local PPOs and regional PPOs. Both work the same way for you as a member — the "regional" label just describes the service area.

PFFS plans: a note

You will not see any Private Fee-for-Service (PFFS) plans on the 2027 Shelby County list. It is still worth knowing what they are, because they exist elsewhere and come up in Medicare guides. A PFFS plan sets its own payment terms with providers, and any doctor who accepts those terms can treat you. There is no network in the HMO/PPO sense, but not every provider will agree to a given plan's terms.

Special Needs Plans: only if you qualify

Of the 73 plans in the county, 29 are Special Needs Plans (SNPs). SNPs are Medicare Advantage plans limited to people who meet specific criteria. 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 conditions, such as diabetes or chronic heart failure. Several plans in the local table target diabetes and heart conditions specifically.
• I-SNP (Institutional) — for people who live in a nursing home or need that level of care at home.

If you do not meet the eligibility rule, you cannot enroll in that SNP, even if the benefits look appealing. If you do qualify, an SNP can be worth a close look because the plan is designed around your situation.

A few program-level facts to keep in mind

Whichever type you choose, some rules apply the same way across all Medicare Advantage plans with drug coverage:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027.
• The Part D deductible cannot exceed $615.
• The coverage gap ("donut hole") was eliminated in 2025; there are now three drug payment phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly amounts, if you choose to opt in.
• IRMAA income-related surcharges begin above $109,000 for single filers in 2026.

Note that Shelby County has zero stand-alone Part D plans listed in the current file, which is one reason drug coverage is bundled into every Medicare Advantage plan available in the area.