Medicare Advantage

What HMO, PPO and SNP Mean for Spokane Shoppers

People in Spokane can choose from 47 Medicare Advantage plans for 2027, against 59 this year. 21 of this year’s plans are gone, 9 are new to Spokane County, and 28 that continue have changed their premium, deductible, plan type or name, 10 of them under a new name.

SPOKANE, Wash. — If you're weighing Medicare Advantage coverage here for 2027, the first thing worth knowing isn't a price tag or a star — it's the shape of the shelf. Spokane sits in Spokane County, where 11 insurance carriers are offering Medicare Advantage plans, and those plans come in a few different structures with real differences in how you use them.

This piece walks through who the carriers are, how many plans each one is offering, and what the letters after each plan name — HMO, HMO-POS, PPO, PFFS, D-SNP, C-SNP, I-SNP — actually mean for you.

Who's selling Medicare Advantage in Spokane County

Eleven carriers are on the 2027 shelf in Spokane County. Providence Medicare Advantage Plans is not offering plans in the county next year, and MultiCare Health Plan Medicare Advantage Evergreen Plans is new to the county. The full lineup by carrier and plan type is in the table below.

The full lineup — every plan by carrier and plan type — is in the table below on this page. Counts here come from the CMS Medicare Advantage Landscape Source File for plan year 2027.

HMO, HMO-POS, PPO and PFFS — what the letters mean

Most of the choice in Spokane comes down to plan type. Here is what each one is, at the program level:

HMO (Health Maintenance Organization). You use doctors and hospitals in the plan's network, and you usually pick a primary care doctor who coordinates referrals to specialists. Out-of-network care generally isn't covered except in emergencies. In Spokane County, 23 of the 59 plans are HMOs.

HMO-POS (HMO with a Point-of-Service option). Same idea as an HMO, but with a limited ability to see certain out-of-network providers, often at a higher cost share. 14 plans in the county are HMO-POS.

PPO (Preferred Provider Organization). More flexibility to see out-of-network providers without a referral, though staying in network costs less. 22 plans in the county are PPOs.

PFFS (Private Fee-for-Service). These plans set their own payment terms, and providers can decide visit by visit whether to accept them. No PFFS plans are being offered in Spokane County for 2027.

None of this tells you which plan is right for you — that depends on your doctors, prescriptions and travel patterns. But the plan type sets the ground rules for how you'll use the card.

Special Needs Plans (SNPs) — for specific situations

Of the 59 plans in Spokane County, 27 are Special Needs Plans. SNPs are Medicare Advantage plans limited to people who meet specific eligibility criteria, and they come in three flavors:

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

You can only enroll in an SNP if you meet its criteria, and the plan typically tailors its drug list and extra benefits to that population. If none of those categories apply to you, an SNP isn't a choice on your menu.

Drug coverage and the Part D rules for 2027

Every one of the 37 Medicare Advantage plans in Spokane County includes Part D drug coverage. There are no stand-alone Part D plans listed for the county in the 2027 landscape file — which matters mostly for people considering Original Medicare and looking for separate drug coverage.

A few program-wide Part D rules to keep in mind for 2027:

• The out-of-pocket cap for covered Part D drugs is $2,100.
• The maximum Part D deductible any plan can set is $615.
• The old "donut hole" coverage gap is gone as of 2025; there are now three payment phases.
• The Medicare Prescription Payment Plan lets you spread your drug costs over the calendar year in level monthly payments — it's optional, and it doesn't change what you owe overall.
• IRMAA income-based surcharges on Part B and Part D begin above $109,000 for a single filer (2026).

Enrollment dates to circle

• Annual Enrollment Period: Oct. 15 – Dec. 7. You can join, switch or drop a Medicare Advantage or Part D plan; changes take effect Jan. 1.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you get one chance to switch to another MA plan or return to Original Medicare (and pick up a Part D plan).

People who qualify for a Special Enrollment Period — moving, losing other coverage, becoming eligible for Medicaid, and other life events — may be able to make changes outside those windows.

How to compare without getting overwhelmed

A workable approach:

1. Make a short list of your doctors, hospitals and regular prescriptions. 2. On medicare.gov's Plan Finder, enter your ZIP code and drugs to see how each plan handles them. 3. Check whether your providers are in a plan's network before you enroll — network rules vary by plan type. 4. If you qualify for a D-SNP, C-SNP or I-SNP, ask specifically about those.

For free one-on-one help, Washington's State Health Insurance Benefits Advisors (SHIBA) program is the local SHIP; counselors don't sell plans.