Medicare Advantage

HMO or PPO? Virginia Medicare Advantage for 2027: 101 HMO Plans, 44 PPO

RICHMOND — Virginians weighing a Medicare Advantage plan for 2027 will find the choices sorted into a familiar set of letters: HMO, HMO-POS, PPO and PFFS. According to the CMS Medicare Advantage Landscape Source File for CY2027, 148 Medicare Advantage plans are listed statewide from 10 carriers. By plan type, 48 are HMO, 53 are HMO-POS, 44 are PPO and 3 are PFFS. Counting HMO and HMO-POS together, the HMO family totals 101 plans statewide, compared with 44 PPO plans.

HMO or PPO for 2027Virginia

Each plan is offered county by county, so a plan listed statewide may or may not appear on the menu in your ZIP code. The Annual Enrollment Period runs October 15 – December 7, 2026, and a choice made in that window takes effect January 1, 2027.

The statewide split by type

The CY2027 Landscape file shows the Medicare Advantage market in Virginia divided this way: 48 HMO plans, 53 HMO-POS plans, 44 PPO plans and 3 PFFS plans. The HMO family — standard HMO plus HMO-POS — adds up to 101 of the 148 plans. PPOs account for 44, and PFFS makes up the remaining 3.

These are statewide counts. The tables on this page show which plans and carriers appear in each category; which of them you can actually enroll in depends on your county.

What HMO, HMO-POS, PPO and PFFS mean

Plan type is shorthand for how a plan handles networks, referrals and care received outside the plan's provider list.

• HMO (Health Maintenance Organization). You generally use the plan's network of doctors and hospitals, and you may need to pick a primary care physician and get referrals to see specialists. Care outside the network is typically not covered except for emergencies and urgent care.
• HMO-POS (HMO with a Point-of-Service option). An HMO with a limited ability to go outside the network for certain services, under terms the plan defines. Rules on referrals and out-of-network use vary by plan.
• PPO (Preferred Provider Organization). You can usually see any Medicare-approved provider who agrees to treat you, with in-network and out-of-network cost shares. Referrals to specialists are generally not required.
• PFFS (Private Fee-for-Service). The plan sets the terms it pays providers, and providers decide, on a visit-by-visit basis, whether to accept those terms. Network rules vary by plan.

The specifics — including what each plan covers, what it charges and which providers participate — live in each plan's Evidence of Coverage and provider directory, not in the Landscape file.

Which carriers offer each type in 2027

Ten carriers appear in Virginia's 2027 Landscape, and they do not all offer every plan type. In alphabetical order by carrier:

• HMO plans are offered by Aetna (CVS Health), Devoted Health, Elevance Health (Anthem), HealthSpring, Humana, Johns Hopkins Advantage MD, Kaiser Permanente, Lifeworks Advantage and Sentara Medicare.
• HMO-POS plans are offered by Aetna (CVS Health), Elevance Health (Anthem), HealthSpring, Humana, Kaiser Permanente, Lifeworks Advantage and UnitedHealthcare.
• PPO plans are offered by Aetna (CVS Health), Elevance Health (Anthem), HealthSpring, Humana and UnitedHealthcare.
• PFFS plans are offered by Humana.

The tables on this page list the specific plan names under each carrier. Being listed statewide does not guarantee a plan is sold in your county.

How to decide which type fits your doctors and travel

Rather than starting with a brand name, start with how you actually use health care.

• Make a list of the doctors, hospitals and pharmacies you want to keep. Then check each candidate plan's directory to see whether those providers are in-network for 2027. Networks can change year to year.
• Think about referrals. If you prefer to self-refer to specialists, that is easier under PPO rules than HMO rules in most cases, though the specifics are set by each plan.
• Think about where you spend time. If you travel often, split time between states, or have family you visit for extended stretches, how a plan handles out-of-network and out-of-area care matters. HMOs generally limit routine care to the network; PPOs generally allow out-of-network care at a different cost share; PFFS rules depend on whether providers accept the plan's terms.
• Think about prescriptions. Many Medicare Advantage plans include Part D drug coverage, but formularies differ by plan. Confirm your medications on the plan's own drug list.

The Medicare Plan Finder at medicare.gov lets you enter your ZIP code, your providers and your prescriptions and see what is available for 2027 in your county.

What to do before December 7

A simple sequence for the weeks leading up to the deadline:

1. Read the Annual Notice of Change your current plan sent, if you are already in a Medicare Advantage or Part D plan, so you know what is changing for 2027. 2. Confirm your providers and prescriptions against each plan you are considering. 3. Compare plans in your county on medicare.gov. Enrollment choices made during Annual Enrollment take effect January 1, 2027.

December 7, 2026, is the last day of Annual Enrollment. Other enrollment periods exist for specific situations, and medicare.gov explains who qualifies.

Free help

You can compare 2027 plans in your county, review each plan's Summary of Benefits and Evidence of Coverage, and enroll at medicare.gov. For questions by phone, call 1-800-MEDICARE (1-800-633-4227), available 24 hours a day, 7 days a week; TTY users call 1-877-486-2048.