Medicare Advantage

Before you pick a Medicare Advantage plan in Nashville: how HMO, PPO and SNP choices differ

Davidson County has 69 Medicare Advantage plans for 2027. Compared with 2026, 14 plans are not coming back, 9 are new, and 30 continuing plans changed in some way you should check before December 7, 9 of them under a new name. This guide covers what those numbers mean for Nashville, not which plan to pick.

Nashville shoppers opening the 2027 Medicare Advantage lineup will see a lot of letters after the plan names — HMO, HMO-POS, PPO, D-SNP, C-SNP, I-SNP. Those letters matter more than the marketing on the brochure, because they tell you how the plan actually works: which doctors you can see, whether you need a referral, and whether the plan is built for a specific health or income situation.

Nashville is in Davidson County, where Medicare beneficiaries have 74 Medicare Advantage plans to sort through, offered by 13 carriers. Here is what the plan types mean and how the local market breaks down across them.

What "HMO," "PPO" and "PFFS" actually mean

These are plan-type labels set by Medicare, and they describe the network rules, not the benefits.

• HMO (Health Maintenance Organization). You pick a primary care doctor and generally stay inside the plan's network. Out-of-network care usually isn't covered except in emergencies. Referrals are often required to see specialists.
• HMO-POS (Point of Service). Same core idea as an HMO, but with a limited "point of service" option to go out of network for certain services, usually at a higher cost.
• PPO (Preferred Provider Organization). More flexibility. You can see out-of-network providers who accept Medicare, though you'll typically pay more than you would in-network. Referrals are usually not required.
• PFFS (Private Fee-for-Service). These plans let you see any Medicare provider who agrees to the plan's payment terms. PFFS plans are not part of the Davidson County 2027 lineup, so Nashville shoppers will be choosing among HMO, HMO-POS and PPO structures.

What Special Needs Plans are — and who they're for

Special Needs Plans (SNPs) are a category of Medicare Advantage designed for people who fit specific criteria. You must qualify to enroll. There are three flavors, and all three show up in the Davidson County lineup:

• D-SNP (Dual Eligible). For people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition). For people with certain qualifying chronic conditions, such as diabetes or heart conditions.
• I-SNP (Institutional). For people who live in a nursing facility or need a nursing-facility level of care.

Of the 74 plans in the county, 30 are SNPs. If you don't meet the eligibility rules for a given SNP, that plan isn't an option for you — even if the name looks appealing.

How the Nashville-area carrier lineup breaks down

Twelve carriers offer Medicare Advantage plans in Davidson County for 2027. In alphabetical order:

• Abilis Health — 2 plans (HMO; 2 SNPs)
• Aetna (CVS Health) — 4 plans (HMO, PPO)
• American Health Advantage of Tennessee — 1 plan (HMO; 1 SNP)
• Blue Cross Blue Shield (HCSC) — 9 plans (HMO, HMO-POS, PPO; 2 SNPs)
• BlueCare Plus Tennessee — 3 plans (HMO; 3 SNPs)
• BlueCross BlueShield of Tennessee — 7 plans (PPO; 2 SNPs)
• Centene (WellCare) — 6 plans (HMO-POS; 1 SNP)
• Devoted Health — 6 plans (HMO, PPO; 2 SNPs)
• Elevance Health (Anthem) — 6 plans (HMO, HMO-POS; 3 SNPs)
• Humana — 15 plans (HMO, PPO; 4 SNPs)
• NHC Advantage — 2 plans (HMO; 2 SNPs)
• UnitedHealthcare — 8 plans (HMO-POS; 5 SNPs)
• Zing Health — 5 plans (HMO, PPO; 3 SNPs)

The full plan-by-plan list — every plan name, its type, and whether it includes drug coverage — is in the table below on this page.

Drug coverage and the 2027 rules that apply

All 60 Medicare Advantage plans in Davidson County include prescription drug coverage. There are no stand-alone Part D plans listed in the county's 2027 landscape, so most people getting drug coverage locally will get it built into their MA plan.

A few program-level rules apply everywhere in 2027, regardless of which plan you pick:

• The Part D out-of-pocket cap is $2,100 for the year.
• The Part D maximum deductible is $615.
• The old "donut hole" is gone — Part D now has three phases (deductible, initial coverage, catastrophic).
• The Medicare Prescription Payment Plan lets you spread your drug costs out over the calendar year in monthly installments, at no extra cost, if you opt in.
• Income-related surcharges (IRMAA) start above $109,000 for a single filer in 2026.

How to narrow the list for yourself

With 74 plans on the table, most Nashville shoppers find it easier to filter first, compare second:

1. Rule in or out the SNPs based on whether you qualify (dual-eligible, chronic condition, institutional). 2. Decide on network flexibility — HMO/HMO-POS if you're comfortable with a set network and referrals; PPO if you want the option to go out of network. 3. Check that your doctors, hospitals and pharmacies are in the plan's network, and that your medications are on the plan's formulary. This is where the medicare.gov Plan Finder is most useful. 4. Note the enrollment windows. The Annual Enrollment Period is Oct. 15 – Dec. 7. If you're already in a Medicare Advantage plan and want to switch or drop it, the MA Open Enrollment Period runs Jan. 1 – March 31.