Medicare Advantage

Oct. 15 opens Richmond's 60-plan Advantage lineup

People in Richmond can choose from 74 Medicare Advantage plans for 2027, against 72 this year. Eight of this year’s plans are gone, 10 are new to Richmond city, and 42 that continue have changed their premium, deductible, plan type or name, 14 of them under a new name.

RICHMOND, Va. — If you are shopping for Medicare Advantage coverage here, the first fork in the road is not really about which insurer to pick. It is about which kind of plan fits how you like to get care. Richmond is in Richmond city, where the CMS 2027 Medicare Advantage Landscape shows eight carriers offering 60 Medicare Advantage plans, and those plans come in four flavors: HMO, HMO-POS, PPO, and PFFS — plus a set of Special Needs Plans built for specific situations.

Knowing what those letters mean, and which carriers offer which types locally, makes the rest of the search a lot less overwhelming.

What the plan types actually mean

Every Medicare Advantage plan is offered by a private insurer under contract with Medicare, but the "type" tells you how the network and referrals work.

• HMO (Health Maintenance Organization). You generally use in-network doctors and hospitals, and you may need a referral from a primary care doctor to see a specialist. Out-of-network care is usually not covered except in emergencies.
• HMO-POS (Point of Service). Works like an HMO, but with a limited "point of service" option to go out of network for certain services, usually at a higher cost.
• PPO (Preferred Provider Organization). You can see any Medicare-approved provider, in or out of network. In-network costs are lower; out-of-network costs are higher. Referrals are usually not required.
• PFFS (Private Fee-for-Service). The plan — not Medicare — decides how much it will pay providers and how much you pay. You can see any Medicare-approved provider who agrees to the plan's payment terms, so it is worth confirming acceptance before each visit.

In Richmond city, the 72 plans break down as 24 HMO, 18 HMO-POS, 28 PPO, and 2 PFFS. All 72 include Part D prescription drug coverage.

Where Special Needs Plans fit

Special Needs Plans (SNPs) are Medicare Advantage plans with a smaller, defined group of members. There are three kinds:

• D-SNP (Dual-Eligible) — for people who have both Medicare and Medicaid.
• C-SNP (Chronic Condition) — for people with a qualifying chronic condition, such as diabetes, chronic heart failure, or end-stage renal disease.
• I-SNP (Institutional) — for people living in a nursing home or who need that level of care at home.

You cannot simply choose an SNP the way you would a general plan; you have to meet the eligibility rules. Of the 72 plans available locally, 29 are SNPs. If you do not qualify for one, the HMO, HMO-POS, PPO and PFFS options are where to focus.

Which carriers offer plans in Richmond

Eight carriers file Medicare Advantage plans in Richmond city for 2027. In alphabetical order, they are:

• Aetna (CVS Health) — 6 plans (HMO, PPO; 1 SNP)
• Blue Cross Blue Shield (HCSC) — 4 plans (HMO, HMO-POS, PPO)
• Devoted Health — 4 plans (HMO; 2 SNP)
• Elevance Health (Anthem) — 12 plans (HMO, HMO-POS, PPO; 7 SNP)
• Humana — 28 plans (HMO, HMO-POS, PFFS, PPO; 7 SNP)
• Lifeworks Advantage — 2 plans (HMO, HMO-POS; 2 SNP)
• Sentara Medicare — 2 plans (HMO; 2 SNP)
• UnitedHealthcare — 14 plans (HMO-POS, PPO; 8 SNP)

The table below lists every plan by carrier. Not every carrier offers every plan type — for example, PFFS plans in the local market come from a single carrier's lineup, while PPOs and HMOs are offered by several. That matters because your plan type shapes how you get care, not just what it costs.

How to narrow it down

A useful order of questions when you sit down with the table:

1. Do I qualify for an SNP? If you have Medicaid too, or a qualifying chronic condition, an SNP may be designed around your situation. If not, skip these and look at the general plans. 2. How do I feel about networks? If you want the freedom to see providers without referrals, or you split time between Virginia and another state, PPO rules may feel more comfortable. If you are fine sticking with a set of local providers, HMO or HMO-POS may be a fit. 3. Do my doctors take the plan? Before you sign up for anything, call the plan and your providers to confirm. This is especially important with PFFS plans, where providers can decide visit by visit whether to accept the plan's terms. 4. What about drug coverage? All 60 Advantage plans in Richmond city include Part D. The Part D annual out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. The Part D maximum deductible is $615 in 2026 and $700 in 2027. The coverage gap ("donut hole") was eliminated in 2025, so there are now three payment phases instead of four. The optional Medicare Prescription Payment Plan lets you smooth your drug costs into monthly payments through the plan year.

Dates to keep in mind

• Annual Enrollment Period: Oct. 15 – Dec. 7. This is when most people compare and switch plans for the coming year.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you are already in a Medicare Advantage plan, you can make one change during this window.
• IRMAA note: Higher-income beneficiaries pay an income-related surcharge on Part B and Part D. For 2026, that starts above $109,000 in income for a single filer.