Medicare Advantage

Milwaukee's 2027 Medicare Advantage menu: how networks, referrals and travel coverage compare

People in Milwaukee can choose from 52 Medicare Advantage plans for 2027, against 52 this year. Six of this year’s plans are gone, 6 are new to Milwaukee County, and 31 that continue have changed their premium, deductible, plan type or name, 12 of them under a new name.

MILWAUKEE — As the Annual Enrollment Period opens Oct. 15, 2026, shoppers in Milwaukee County will again see a Medicare Advantage lineup that leans heavily toward PPOs, with a smaller group of HMO and HMO-POS plans and a single PFFS option. The letters after a plan's name — HMO, HMO-POS, PPO, PFFS — are not branding. They decide whether you need a primary care doctor to refer you, whether an out-of-network provider will be covered, and how your plan treats care when you're traveling.

Here is how the 2027 slate breaks down for Milwaukee, and what each plan type actually means before you sign anything.

How the 2027 Milwaukee lineup splits by type

Milwaukee is in Milwaukee County, which is where Medicare sets plan availability. For 2027, the county has 52 Medicare Advantage plans from 7 carriers. By type, that is 6 HMO plans, 16 HMO-POS plans, 28 PPO plans, 1 PFFS plan and 1 MSA plan. Counting HMO and HMO-POS together, 22 of the 52 plans are HMO-family; PPOs are the single largest group.

Which carriers offer which type in Milwaukee County for 2027:

• HMO: Elevance Health (Anthem), Humana, Molina Healthcare of Wisconsin
• HMO-POS: Aetna (CVS Health), Centene (WellCare), Elevance Health (Anthem), UnitedHealthcare
• PPO: Aetna (CVS Health), Elevance Health (Anthem), Humana, Network Health Medicare Advantage Plans, UnitedHealthcare
• PFFS: Humana

The table below lists every plan by carrier and type.

What HMO means

A Health Maintenance Organization plan asks you to get your care from doctors, hospitals and other providers in the plan's network. You usually pick a primary care physician, and that doctor coordinates referrals to specialists. If you go outside the network for non-emergency care, the plan generally will not pay — you are responsible for the full bill.

HMOs can be a good fit for people whose doctors are already in one system and who do not travel for months at a time. Emergency and urgent care are covered anywhere in the United States under Medicare Advantage rules, regardless of plan type.

What HMO-POS means

HMO-POS is a Health Maintenance Organization with a Point-of-Service option. It works like an HMO — network first, usually with a primary care doctor — but it adds a limited ability to see certain out-of-network providers, often for specific services, usually at a higher cost share. The exact "POS" rules vary a lot from plan to plan, so the Evidence of Coverage is where you confirm what the out-of-network door actually opens.

What PPO means

A Preferred Provider Organization plan has a network, but it also covers out-of-network care, typically at a higher cost share than in-network care. You generally do not need referrals to see specialists. PPOs tend to appeal to people who want flexibility — a snowbird who spends winters out of state, a patient who wants to see a specialist out of area, or someone who simply doesn't want to deal with referral paperwork.

Flexibility is a feature, not a price. A PPO is not automatically cheaper or more expensive than an HMO; that depends on the specific plan, your providers and the care you use.

What PFFS means

A Private Fee-for-Service plan sets the terms it pays providers under, and any Medicare-approved provider can choose to accept those terms on a visit-by-visit basis. There is often no formal network in the HMO/PPO sense, but acceptance is not guaranteed — a provider who treated you last year does not have to agree to the plan's terms this year. Before each visit, confirm the provider will accept the plan.

Only one PFFS plan is offered in Milwaukee County for 2027, from Humana.

What's changing for 2027

For Milwaukee County, 6 plans are not returning for 2027, 6 are new, and 12 have been renamed. If your plan is renewing, your Annual Notice of Change (ANOC), mailed in September, lays out exactly what is different — including any shifts in network, drug list or cost sharing. If you do nothing during the Oct. 15 – Dec. 7, 2026 window, your current plan simply renews with those changes on Jan. 1, 2027.

A few program-level numbers worth knowing while you shop: the Part D out-of-pocket cap rises to $2,400 for 2027 (up from $2,100 in 2026), and the Part D maximum deductible is $700 for 2027 (up from $615 in 2026). CMS typically publishes the 2027 Part B standard premium, deductible and IRMAA income brackets later in the fall.

How to decide which type fits

Start with your doctors and hospitals, not the plan type. Make a short list of the providers and prescriptions you actually use, then check each plan on the Medicare Plan Finder at medicare.gov to see whether those providers are in-network and whether your drugs are on the formulary. From there, the plan type tells you what happens when you need care that isn't on your list — a specialist you've never seen, a hospital in another state, a doctor your friend recommended.

• If almost all your care is local and in one system, an HMO or HMO-POS may work well.
• If you want to see specialists without referrals, or you spend significant time outside Wisconsin, a PPO's out-of-network coverage may matter more to you.
• If you are drawn to a PFFS plan, confirm with each of your providers that they will accept the plan's terms.

No plan type is "better" — the right answer is the one that covers the care you actually use.