Medicare Advantage

HMO, PPO or PFFS in Virginia Beach: how 2027 Medicare Advantage plans split by type

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, Va. — Fall 2026. As the Annual Enrollment Period for 2027 coverage opens Oct. 15 and runs through Dec. 7, 2026, shoppers in Virginia Beach will see 70 Medicare Advantage plans from six carriers next year — and the mix leans heavily toward PPOs. Before you compare premiums or extra benefits, it helps to know what the letters after each plan name actually mean, because plan type decides how you use your coverage every time you see a doctor.

Virginia Beach is in Virginia Beach city, which is the county CMS uses to set plan availability. For 2027 in that area, the 70 plans break down this way: 18 HMO, 20 HMO-POS, 30 PPO, and 2 PFFS. The table below lists every plan by carrier.

What each plan type actually means

HMO (Health Maintenance Organization). You pick a primary care doctor and use the plan's network. Many HMOs require a referral to see a specialist. Out-of-network care is generally not covered except in emergencies or urgent care.

HMO-POS (HMO with a Point-of-Service option). It works like an HMO, but with a narrow door to go outside the network for certain services, usually at a higher cost share. The specifics vary plan by plan.

PPO (Preferred Provider Organization). You can see any Medicare-approved provider. Staying in-network costs less; going out-of-network is covered but costs more. Referrals are typically not required.

PFFS (Private Fee-for-Service). The plan sets the payment terms, and any provider who agrees to those terms and accepts the plan can treat you. There is no traditional network in the HMO/PPO sense, but providers can decide visit by visit whether to accept the plan.

None of these is universally cheaper or better. The question is whether the doctors and hospitals you want to use work with the plan, and how much flexibility you need when you travel or need a specialist.

How Virginia Beach's 2027 lineup splits

Of the 70 Medicare Advantage plans available in Virginia Beach city for 2027:

• HMO: 18 plans. Offered by Aetna (CVS Health), Elevance Health (Anthem), Humana, Lifeworks Advantage, and Sentara Medicare.
• HMO-POS: 20 plans. Offered by Aetna (CVS Health), Elevance Health (Anthem), Humana, Lifeworks Advantage, and UnitedHealthcare.
• PPO: 30 plans. Offered by Aetna (CVS Health), Elevance Health (Anthem), Humana, and UnitedHealthcare.
• PFFS: 2 plans. Offered by Humana.

Taken together, HMO-style plans (HMO plus HMO-POS) add up to 38 for 2027, and PPOs make up the single largest group at 30. Special Needs Plans — for people who are dually eligible for Medicare and Medicaid, live in an institution, or have certain chronic conditions — appear across several of these types and have their own eligibility rules.

Networks, referrals and out-of-network care

The practical difference between types shows up in three places:

1. Networks. HMO and HMO-POS plans build care around a defined network. PPOs have networks too, but cover out-of-network care at a higher cost. PFFS depends on whether a provider accepts the plan's terms. 2. Referrals. HMOs are the most likely to require a referral to see a specialist. PPOs usually do not. HMO-POS and PFFS rules vary — check the plan's Evidence of Coverage. 3. Travel. If you spend part of the year outside the Hampton Roads area, a PPO or PFFS often gives you more room to get non-emergency care while you're away. HMO plans generally only cover emergency and urgent care outside the service area.

For the exact network, referral and out-of-network rules of any specific plan, the Medicare Plan Finder at medicare.gov and the plan's own directory and Evidence of Coverage are the sources that count.

What's changing for 2027 — and what you need to do

For 2027, three plans are not returning in the area, six are new, and 16 have been renamed. If your current plan is affected, your Annual Notice of Change (ANOC) spells out exactly what is different for next year — including any shift in network, referral rules, or cost sharing.

A few program-wide numbers worth knowing as you compare:

• The Part D out-of-pocket cap is $2,400 in 2027, up from $2,100 in 2026.
• The Part D maximum deductible is $700 in 2027, up from $615 in 2026.
• The 2027 Part B standard premium and deductible, and the 2027 IRMAA income brackets, are set by CMS later in the fall.

If you do nothing during AEP, your current plan renews for 2027 with the changes in its ANOC. If you want to switch types — say, from an HMO to a PPO, or vice versa — Oct. 15 through Dec. 7, 2026 is the window, with coverage starting Jan. 1, 2027.