Medicare Advantage

HMO or PPO? Texas Medicare Advantage for 2027: 342 HMO Plans, 78 PPO

AUSTIN — When Texans open the Medicare Plan Finder this fall, the choice between an HMO and a PPO will shape almost every Medicare Advantage decision they make. According to the CMS Medicare Advantage Landscape Source File for CY2027, Texas will have 421 Medicare Advantage plans available statewide from 21 carriers. Of those, 247 are HMO plans, 95 are HMO-POS, 78 are PPO, and 1 is a PFFS plan. Counting HMO and HMO-POS together, 342 of the 421 Texas plans are built on the HMO chassis.

That statewide math matters, but it comes with a caveat: Medicare Advantage plans are offered county by county. A plan counted in the statewide total may or may not be sold where you live. The Plan Finder at medicare.gov is the tool that filters by ZIP code.

The statewide split by type

The 2027 Texas landscape leans heavily toward HMO-style coverage. Of 421 total Medicare Advantage plans:

• HMO: 247
• HMO-POS: 95
• PPO: 78
• PFFS: 1

Added together, HMO and HMO-POS plans represent 342 of the 421. PPOs account for 78. One PFFS plan rounds out the statewide picture. These are statewide plan counts from the CMS MA Landscape Source Files for CY2026 and CY2027; the tables elsewhere on this page show the full carrier-by-carrier breakdown.

What HMO, HMO-POS, PPO and PFFS mean

These four letters describe how a plan handles its network and your access to care outside it. In general terms:

• HMO (Health Maintenance Organization). You pick an in-network primary care doctor and generally use in-network providers. Referrals to specialists are often required. Out-of-network care is usually not covered except in emergencies.
• HMO-POS (Point of Service). Like an HMO, but with a limited "point of service" option to see certain providers outside the network under rules the plan spells out.
• PPO (Preferred Provider Organization). You can see in-network or out-of-network providers, usually without a referral, though out-of-network care typically costs more.
• PFFS (Private Fee-for-Service). You can see any Medicare-approved provider who agrees to the plan's terms of payment at the time of service.

The specifics — which providers are in network, what rules apply, and what any out-of-network care costs — live in each plan's Evidence of Coverage and provider directory, not in the plan-type label.

Which Texas carriers offer each type for 2027

The CMS file lists the carriers offering each plan type in Texas for 2027. The full lists appear in the tables on this page; the names below are reproduced to show how the market is organized, not to rank anyone.

• HMO carriers (17): Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Centene (WellCare), Community First, Community Health Choice, Devoted Health, El Paso Health Medicare Advantage, Elevance Health (Anthem), Humana, MedCare Partners Health Plan of Texas, Molina Healthcare of Texas, Inc., Prominence Health Plan, Provider Partners Health Plans, SCAN Health Plan, Texas Independence Health Plan, UnitedHealthcare, and Verda Health Plan of Texas.
• HMO-POS carriers (7): Alignment Health Plan, Baylor Scott & White Health Plan, Centene (WellCare), Elevance Health (Anthem), ProCare Advantage, Prominence Health Plan, and UnitedHealthcare.
• PPO carriers (7): Aetna (CVS Health), Baylor Scott & White Health Plan, Blue Cross Blue Shield (HCSC), Clover Health, Devoted Health, Humana, and UnitedHealthcare.
• PFFS carriers (1): Humana.

A few carriers appear across more than one plan type — for example, Aetna (CVS Health), Blue Cross Blue Shield (HCSC), Devoted Health, Humana and UnitedHealthcare show up in both HMO and PPO lists; Centene (WellCare), Elevance Health (Anthem), Prominence Health Plan and UnitedHealthcare show up in both HMO and HMO-POS. Whether any of them actually sells a plan in your county is a separate question, answered by the Plan Finder.

How to decide which type fits your doctors and travel

Rather than start with the plan name, start with your own list.

• Your doctors and hospitals. Write down everyone you want to keep seeing. For HMOs and HMO-POS plans, confirm they are in that plan's network. For PPOs, check network status too, because in-network and out-of-network cost-sharing is usually different.
• How you prefer to see specialists. If you want to self-refer, that leans toward a PPO. If you don't mind getting a referral through a primary care doctor, an HMO or HMO-POS may be a comfortable fit.
• Travel inside and outside Texas. If you spend part of the year away or travel frequently, ask how each plan handles care outside its service area. PPOs and PFFS plans generally give more flexibility; HMOs are typically tightest.
• Prescriptions and ongoing conditions. The plan type doesn't tell you what drugs are covered or at what cost. That has to be checked plan by plan on medicare.gov.

Nothing in the CMS Landscape file ranks these plan types. It only counts them.

What to do before December 7

The Annual Enrollment Period runs October 15 through December 7, 2026, and any Medicare Advantage choice made during that window takes effect January 1, 2027. A reasonable sequence:

1. Make your list of doctors, hospitals, pharmacies and prescriptions. 2. Go to medicare.gov, enter your ZIP code, and see which plans are offered in your county. 3. Narrow by plan type based on how you want networks and referrals to work. 4. On any plan you're seriously considering, read the Evidence of Coverage and check the provider and drug directories. 5. If you want to switch, enroll before December 7, 2026.

If you do nothing, your current coverage generally continues under its 2027 terms, which your plan will describe in its Annual Notice of Change.

Free help

• medicare.gov — the official Medicare Plan Finder, which filters plans by ZIP code and lets you compare details side by side.
• 1-800-MEDICARE (1-800-633-4227) — available 24 hours a day, 7 days a week.