Medicare Advantage

Before you pick an HMO in Norfolk: how Medicare Advantage plan types compare

Norfolk city has 68 Medicare Advantage plans for 2027. Compared with 2026, 3 plans are not coming back, 6 are new, and 44 continuing plans changed in some way you should check before December 7, 16 of them under a new name. This guide covers what those numbers mean for Norfolk, not which plan to pick.

If you live in Norfolk and you are shopping Medicare Advantage for 2027, the first fork in the road isn't a carrier — it's the plan type. HMO, HMO-POS, PPO, PFFS and Special Needs Plans all count as Medicare Advantage, but they handle networks, referrals and eligibility very differently. Picking the right type first makes the rest of the choice much smaller.

Start with the plan type, not the plan name

Norfolk is in Norfolk city, where CMS lists 52 Medicare Advantage plans for 2027 from 6 carriers. Of those, 46 continue from 2026, 6 are new, 3 did not return, and 16 were renamed; 28 continuing plans change something in their terms, which the plan's Annual Notice of Change spells out.

What each plan type actually means

HMO (Health Maintenance Organization). You pick a primary care doctor and generally use the plan's network. Care outside the network usually isn't covered except in emergencies. Referrals may be required to see a specialist.

HMO-POS (Point of Service). An HMO with a limited "point of service" option that lets you go out of network for certain services, usually at a higher cost.

PPO (Preferred Provider Organization). You can see providers in or out of network without a referral in most cases. Out-of-network care is typically covered but costs more. Some PPOs are "regional," covering a larger multi-county or multi-state area.

PFFS (Private Fee-for-Service). The plan — not Medicare — sets what it pays providers and what you pay. Any provider who accepts the plan's payment terms can treat you, visit by visit. Networks vary.

SNPs (Special Needs Plans). These are built for a specific group and come in three flavors:

• D-SNP for people who have both Medicare and Medicaid ("dual eligible").
• C-SNP for people with certain chronic conditions, such as diabetes, heart conditions or kidney disease.
• I-SNP for people who live in a nursing home or need a nursing-home level of care at home.

You can only enroll in an SNP if you meet its eligibility rules.

Who offers plans in Norfolk city

Six carriers offer Medicare Advantage in the area. Listed alphabetically, with the plan types each one fields locally:

• Aetna (CVS Health) — 6 plans (HMO, HMO-POS, PPO; 1 Special Needs)
• Elevance Health (Anthem) — 11 plans (HMO, HMO-POS, PPO; 7 Special Needs)
• Humana — 30 plans (HMO, HMO-POS, PFFS, PPO; 7 Special Needs)
• Lifeworks Advantage — 2 plans (HMO, HMO-POS; 2 Special Needs)
• Sentara Medicare — 2 plans (HMO; 2 Special Needs)
• UnitedHealthcare — 14 plans (HMO-POS, PPO; 8 Special Needs)

The table below lists every plan by carrier so you can see exactly which type each one is. For example, the two PFFS plans in the area are Humana Gold Choice H8145-004 and Humana Gold Choice H8145-042; Sentara Community Complete and Sentara Community Complete Select are D-SNPs; and the AARP Medicare Advantage and UHC Dual Complete plans from UnitedHealthcare show the split between general PPO/HMO-POS and D-SNP designs.

How to narrow it down

A few questions do most of the work:

1. Do you already have doctors you want to keep? Check whether they're in a plan's network before anything else. HMO and HMO-POS plans lean on the network more than PPOs do. 2. Do you travel or spend part of the year outside Virginia? PPO and PFFS designs generally give more flexibility away from home, though rules vary by plan. 3. Do you have Medicaid, a qualifying chronic condition, or live in a nursing facility? A D-SNP, C-SNP or I-SNP may fit — and non-SNP shoppers won't be eligible for those plans at all. 4. Do you take prescriptions? Check each plan's 2027 drug list. People enrolled in an MA-PD plan get their drug coverage through the plan itself.

2027 rules worth knowing before you sign

Whichever plan type you pick, a few program-wide numbers apply:

• Part D has a new $2,100 out-of-pocket cap on covered drugs for 2026.
• The Part D deductible can be up to $615.
• The old coverage gap ("donut hole") 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 payments if you choose.
• IRMAA income surcharges start above $109,000 for a single filer in 2026.
• AEP runs Oct. 15 – Dec. 7. MA Open Enrollment runs Jan. 1 – March 31, when you can switch MA plans or drop back to Original Medicare once.