Medicare Advantage

HMO or PPO? Utah Medicare Advantage for 2027: 16 HMO Plans, 35 PPO

SALT LAKE CITY — For the 2027 plan year, Utah Medicare Advantage shoppers will see a lineup that leans toward PPO designs, according to the CMS Medicare Advantage Landscape Source Files. Statewide, 51 plans from 8 carriers are listed, and the split by type matters because it shapes how you see doctors, whether you need referrals, and what happens when you travel.

How many Medicare Advantage plans are offered in Utah for 2027, and how do they split between HMO and PPO?

Utah has 51 Medicare Advantage plans from 8 carriers listed for 2027, split into 9 HMO, 7 HMO-POS and 35 PPO plans. Counting HMO together with HMO-POS, there are 16 HMO-style plans and 35 PPO plans statewide.

These counts come from the CMS MA Landscape Source File for 2027 and reflect statewide availability. A plan listed in the file is offered county by county, so the menu in Salt Lake County may look different from the menu in Washington, Cache or San Juan County. The tables elsewhere on this page show the full plan list; the point of this article is the shape of the market, not a ranking.

What do HMO, HMO-POS, PPO and PFFS mean for networks, referrals and out-of-network care in Utah for 2027?

In plain terms: HMO plans typically ask you to use an in-network doctor and often require a referral to see a specialist; HMO-POS plans add a limited "point of service" option to go outside the network for certain services; PPO plans let you see out-of-network providers (usually at a higher cost share) and generally do not require referrals; PFFS plans pay providers on a fee schedule and let you see any Medicare provider who agrees to the plan's terms. No PFFS plans are listed in the 2027 Utah block.

Each plan sets its own network and rules, so two PPOs from different carriers can feel quite different in day-to-day use. The Evidence of Coverage and provider directory for a specific plan are where you confirm how its network, referrals and out-of-network coverage actually work.

Which carriers offer HMO, HMO-POS and PPO Medicare Advantage plans in Utah for 2027?

For 2027 in Utah, HMO plans are offered by Aetna (CVS Health), American Health Advantage of Utah, Humana, Molina Healthcare of Utah & Idaho, and Select Health. HMO-POS plans are offered by UnitedHealthcare. PPO plans are offered by Aetna (CVS Health), Devoted Health, Humana, Regence BlueCross BlueShield of Utah, and UnitedHealthcare.

A few carriers appear on more than one list — Aetna (CVS Health), Humana and UnitedHealthcare each offer more than one plan type statewide — so if you like a brand, you may still need to decide between its HMO and PPO offerings. The carrier lineup in your county may be a subset of the statewide lineup; the Plan Finder shows what is actually sold at your ZIP code.

How should Utah shoppers decide which plan type fits their doctors and travel for 2027?

Start with your doctors. If the clinicians you want to keep are all in one local network, an HMO or HMO-POS can be a natural fit; if you split time between, say, Utah and Arizona, or your specialists sit in different systems, a PPO's out-of-network flexibility may matter more. Then layer in referrals: HMO rules often route you through a primary care doctor, while PPOs typically let you self-refer.

Travel is the other big filter. Snowbirds, frequent visitors to adult children out of state, and people who spend summers in a cabin outside their home county should ask specifically how a plan covers routine care away from home — not just emergencies, which Medicare Advantage plans must cover nationwide. Call the plan, or check its Evidence of Coverage, before you enroll.

For any individual plan, premiums, deductibles, copays, drug lists and star ratings live on the Medicare Plan Finder at medicare.gov and in each plan's own documents — not in a news article.

What should Utah Medicare shoppers do before December 7, 2026?

Before December 7, 2026, confirm three things: that your current plan (if you have one) is still offered in your county for 2027, that your doctors and prescriptions are covered under the plan you are considering, and that the plan type — HMO, HMO-POS or PPO — matches how you actually get care. The Annual Enrollment Period runs October 15 – December 7, 2026, and the plan you choose takes effect January 1, 2027.

Your Annual Notice of Change, mailed in September 2026, is where current members see what is changing. New-to-Medicare shoppers can start fresh on the Plan Finder. If nothing in your life or your plan has changed, you are allowed to do nothing and stay put.

Where can Utah residents get free help comparing Medicare Advantage plans for 2027?

Two free, official resources cover the whole state: the Medicare Plan Finder at medicare.gov, where you can enter your ZIP code and medications to see every plan available in your county, and 1-800-MEDICARE (TTY 1-877-486-2048), staffed around the clock. Both can show you the HMO, HMO-POS and PPO plans sold where you live and let you compare them side by side.

You can also contact a plan directly for its Evidence of Coverage, Summary of Benefits and provider directory. Those documents, not any third-party summary, are the authoritative source for what a plan does and does not cover.