Medicare Advantage

Before you pick a Medicare Advantage plan in Virginia Beach: how HMO, PPO, PFFS and SNPs differ

Virginia Beach city has 70 Medicare Advantage plans for 2027. Compared with 2026, 3 plans are not coming back, 6 are new, and 45 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 Virginia Beach, not which plan to pick.

VIRGINIA BEACH — If you're shopping for a Medicare Advantage plan here, the first choice isn't really which company to pick. It's which type of plan fits how you like to get care. Virginia Beach shoppers can choose from HMOs, HMO-POS plans, PPOs, a couple of PFFS plans and a large group of Special Needs Plans built for people with specific situations. Knowing what those letters mean makes the rest of the decision a lot easier.

Virginia Beach is in Virginia Beach city, where the Centers for Medicare & Medicaid Services (CMS) counts 54 Medicare Advantage plans offered by 6 carriers for 2027. Every one of those plans includes drug coverage. The full roster is in the table below on this page.

Who sells Medicare Advantage in Virginia Beach

Six carriers offer MA-PD plans in the area for 2027, listed here in alphabetical order:

• Aetna (CVS Health): 6 plans (HMO, HMO-POS, PPO; 1 Special Needs)
• Elevance Health (Anthem): 13 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)

Each carrier offers a different mix of plan types. Some lean toward PPOs, some concentrate on HMO-POS or SNP designs. The table below on this page lists every plan by name and type.

HMO plans: in-network care, usually with a primary doctor

An HMO — Health Maintenance Organization — asks you to use doctors, hospitals and other providers in the plan's network. You typically pick a primary care physician, and you usually need a referral to see a specialist. If you go outside the network for non-emergency care, the plan generally won't pay.

HMOs can be a good fit if your doctors are already in a plan's network and you don't mind coordinating care through one main office. In Virginia Beach, 19 of the 67 plans are HMOs.

HMO-POS: an HMO with a small door to the outside

HMO-POS stands for "point of service." It works like an HMO most of the time, but adds limited coverage for certain services from out-of-network providers, usually at higher cost-sharing. The details vary by plan, so read the Evidence of Coverage before you assume a specific service is covered outside the network.

Nineteen Virginia Beach plans are HMO-POS.

PPO: more flexibility, at a price

A PPO — Preferred Provider Organization — lets you see any doctor who accepts Medicare and the plan's terms, in or out of network. You pay less when you stay in network. You generally don't need a referral for a specialist.

PPOs tend to appeal to people who travel, split time between two homes, or want to keep options open. Twenty-seven of the Virginia Beach plans are PPOs, and that includes some regional PPOs that operate across a wider geography.

PFFS: pay-for-service, at Medicare-based terms

PFFS — Private Fee-for-Service — is less common today. The plan sets the terms for what it pays providers and what you pay. Any Medicare provider can accept the plan on a visit-by-visit basis, but they aren't required to, so it's smart to confirm before every appointment. Compared with last year, 3 plans are not returning, 6 are new, and 16 have been renamed for 2027.

Special Needs Plans: built for a specific situation

Special Needs Plans (SNPs) are Medicare Advantage plans designed for people who fit certain categories. There are three kinds:

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

SNPs cover the same Medicare benefits as any other MA plan but tailor the network, drug list and extra benefits to the group they serve. You can only enroll if you meet the eligibility rules. Of the 48 plans continuing into 2027, 29 change something in their terms — the ANOC mailed by the plan spells those out. The table shows which SNPs are D-SNP, C-SNP or I-SNP.

What to line up before you compare

A few program-level facts that apply everywhere in 2027:

• The Part D out-of-pocket cap is $2,100. Once your spending on covered drugs hits that, you pay $0 for covered prescriptions for the rest of the year.
• The Part D maximum deductible is $615, but many plans set theirs lower.
• The coverage gap ("donut hole") is gone as of 2025. Part D now has three phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the year in monthly bills, at no extra charge, if you opt in.
• IRMAA surcharges on Part B and Part D begin above $109,000 in income for a single filer in 2026.

Also worth knowing: CMS lists 0 stand-alone Part D plans in Virginia Beach city for the current file. That's because every Medicare Advantage plan available here already includes drug coverage. If you want Original Medicare with a separate Part D plan, availability may be different — the SHIP counselors below can walk you through it.

Dates to keep on your calendar

• Annual Enrollment Period: Oct. 15 – Dec. 7. This is when most people join, switch or drop Medicare Advantage and Part D plans.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you can make one change during this window.
• Special Enrollment Periods may apply if you move, lose other coverage, or qualify for a SNP.