Medicare Advantage

HMO, PPO, PFFS, SNP: what the letters mean in Irving

Dallas County has 84 Medicare Advantage plans for 2027. Compared with 2026, 29 plans are not coming back, 20 are new, and 31 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 Irving, not which plan to pick.

Irving, Texas — If you live in Irving and are looking at Medicare Advantage for 2027, the first thing worth understanding isn't a specific plan — it's the shape of the market. Which companies sell here? What kinds of plans do they offer? And what do those letters after each plan name — HMO, PPO, PFFS, D-SNP — actually mean for you?

Irving sits in Dallas County, and Medicare uses the county to decide which plans are available to you. So the choices below reflect what CMS lists for Dallas County in 2027.

Which companies sell Medicare Advantage in Dallas County

Twelve carriers offer Medicare Advantage plans in Dallas County for 2027. In alphabetical order, they are:

• Aetna (CVS Health) — 8 plans (HMO, PPO; 4 Special Needs)
• American Health Advantage of Texas — 1 plan (HMO; 1 Special Needs)
• Baylor Scott & White Health Plan — 4 plans (HMO-POS, PPO)
• Blue Cross Blue Shield (HCSC) — 17 plans (HMO, PPO; 2 Special Needs)
• Centene (WellCare) — 6 plans (HMO; 3 Special Needs)
• Elevance Health (Anthem) — 6 plans (HMO, HMO-POS; 5 Special Needs)
• Humana — 26 plans (HMO, PFFS, PPO; 6 Special Needs)
• Molina Healthcare of Texas — 1 plan (HMO; 1 Special Needs)
• ProCare Advantage — 3 plans (HMO-POS; 3 Special Needs)
• Provider Partners Health Plans — 1 plan (HMO; 1 Special Needs)
• UnitedHealthcare — 18 plans (HMO-POS, PPO; 8 Special Needs)
• Verda Health Plan of Texas — 2 plans (HMO; 1 Special Needs)

The table below lists every plan by carrier. This piece is about how to read that list — not which plan is right for anyone.

HMO plans: a network-first approach

An HMO — Health Maintenance Organization — asks you to use doctors and hospitals inside the plan's network, except for emergencies. Most HMOs also ask you to pick a primary care doctor and get a referral before seeing a specialist.

Of Dallas County's 93 plans, 36 are straight HMOs. That includes offerings from carriers like Aetna, Blue Cross Blue Shield, Centene (WellCare), Humana, Molina, Provider Partners and Verda. HMOs tend to appeal to people who already have doctors they like inside a network and want a more coordinated experience.

HMO-POS: an HMO with a small door open

HMO-POS stands for "HMO with a Point-of-Service option." It works mostly like an HMO, but lets you go outside the network for certain services, usually at a higher cost.

If you want the structure of an HMO but a little flexibility for out-of-network care, HMO-POS plans exist for that reason. Carriers offering plans in Dallas County for 2027 include Baylor Scott & White, Elevance Health (Anthem), ProCare Advantage and UnitedHealthcare, among others.

PPO plans: more flexibility, usually more cost outside the network

A PPO — Preferred Provider Organization — lets you see any doctor who accepts Medicare, in or out of network, and generally doesn't require referrals. Staying in-network still costs less.

There are 35 PPO plans in the county, including plans from Aetna, Baylor Scott & White, Blue Cross Blue Shield, Humana and UnitedHealthcare. Some of the Humana and UnitedHealthcare PPOs are "Regional PPOs," which use a broader service area set by CMS. PPOs are often chosen by people who travel, spend time in more than one state, or want to keep options open.

PFFS plans: a less common option

PFFS stands for "Private Fee-for-Service." Instead of a network, a PFFS plan sets its own payment terms, and any Medicare-approved provider can choose whether to accept them, visit by visit. That makes it important to check with each provider first.

Humana offers PFFS plans in Dallas County for 2027.

Special Needs Plans: built for specific situations

Special Needs Plans (SNPs) are Medicare Advantage plans limited to people who fit specific criteria. There are 35 SNPs in the county. They come in three flavors:

• D-SNP (Dual Eligible): for people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition): for people with a qualifying long-term condition, such as diabetes, heart conditions or chronic kidney disease.
• I-SNP (Institutional): for people who live in a nursing home or need that level of care at home.

You'll see these categories reflected in plan names across the roster — for instance, D-SNP options from Aetna, Blue Cross Blue Shield, Centene, Elevance Health, Humana, Molina, UnitedHealthcare and others; C-SNPs from Aetna, Humana, ProCare Advantage, UnitedHealthcare, Verda and Elevance Health; and I-SNPs from American Health Advantage of Texas, Humana, ProCare Advantage, Provider Partners and UnitedHealthcare.

You have to qualify to enroll in an SNP, and if you lose eligibility, you'll need to move to a different plan.

What else is worth knowing for 2027

A few program-level facts apply to every Medicare Advantage plan that includes drug coverage — and in Dallas County, all 93 do:

• The Part D out-of-pocket cap is $2,100 in 2026. Once your drug spending hits that number, you pay $0 for covered drugs the rest of the year.
• The Part D maximum deductible is $615.
• The old "donut hole" coverage gap is gone as of 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly installments if that helps your budget.
• IRMAA (higher premiums for higher earners) kicks in above $109,000 in income for a single filer in 2026.

Key dates to keep in mind

• Annual Enrollment Period: Oct. 15 – Dec. 7, 2026. This is when most people compare and switch plans for 2027.
• Medicare Advantage Open Enrollment Period: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance in this window to switch to another MA plan or return to Original Medicare.