Quick answer
Several large insurers are shrinking their Medicare Advantage footprint for 2027, and many are leaning toward HMOs. HCSC is cutting its individual plans from 948 counties to 450, UnitedHealthcare is leaving 140 counties and Aetna 123, and Humana says its exits affect about 600,000 members. If your PPO is ending, your choices are an HMO, another PPO, or Original Medicare with Medigap and a Part D plan. Compare doctors and total yearly cost before December 7.
2027 county footprint, individual Medicare Advantage plans
| Insurer | 2026 counties | 2027 counties |
|---|---|---|
| Health Care Service Corp. (HCSC) | 948 | 450 |
| UnitedHealthcare | 2,597 | 2,457 |
| Aetna (CVS Health) | 2,083 | 1,960 |
| Humana | 2,655 | 2,598 |
Last reviewed November 2, 2026 by Greg Wilson. Sources: Becker’s Payer county entries and exits for 2027, Becker’s Payer on Humana exits (Jul 2026). Partner links may earn SeniorAffair a commission.
If you picked a PPO for the freedom to see doctors out of network, a notice that it’s ending stings. Here is how the replacements compare.
What a PPO gave you
A PPO generally lets you see out-of-network providers at a higher cost and usually doesn’t require referrals. That flexibility is what you are trying to replace, so start by asking how much of it you used last year.
HMO vs. another PPO vs. Medigap
| HMO | Another PPO | Original Medicare + Medigap | |
|---|---|---|---|
| Network | Usually in-network only, with exceptions | In-network plus some out-of-network | No network; any provider that accepts Medicare |
| Referrals | Often needed for specialists | Usually not | Not needed |
| Premium | Often lower | Often moderate | Separate Medigap premium, typically higher |
| Cost protection | Yearly out-of-pocket cap | Yearly out-of-pocket cap | Medigap covers many gaps |
| Drug coverage | Often included | Often included | Separate Part D plan |
Compare PPO, HMO and Medigap options
A licensed agent from our partner can compare plans in your ZIP code at no cost to you.
Partner link: SeniorAffair may earn a commission. We do not offer every plan available in your area. Contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
Questions to settle your choice
- Do you travel or live in two places during the year?
- Are your specialists and hospital in the new plan’s network? Call their offices to confirm.
- Would you rather pay more each month for fewer surprises?
- Do you qualify for a Medigap policy without health questions (see below)?
Your Medigap rights when a plan ends
When your Medicare Advantage plan leaves your area, federal law generally gives you a guaranteed issue right to buy certain Medigap policies without health questions, if you apply within 63 days after your coverage ends. Some states add more protection. Outside that window, insurers in most states can ask health questions and turn you down, so confirm your rights with your State Health Insurance Assistance Program (SHIP) before you decide.
Decide by December 7
Open enrollment ends December 7. Because your plan is ending, you also get a special enrollment period that generally runs through the end of February, but choosing by December 7 avoids a gap in coverage on January 1. Our 7-day action plan walks through each step.
Free: Medicare Open Enrollment Checklist. A printable two-page list of what to check before December 7, with space for your drugs and doctors. Get the checklist
Common questions
Are all PPOs ending?
No. Cuts vary by insurer and county. Check the notice you received for your specific plan.
Is a PPO better than an HMO?
Neither is better for everyone. A PPO offers more flexibility, and an HMO often costs less. It depends on your doctors, travel and budget.
Does Medigap have a network?
No. Medigap works with Original Medicare, so you can see any provider who accepts Medicare. It does not include drug coverage, so you add a Part D plan.
Where can I get free help?
Your State Health Insurance Assistance Program (SHIP) offers free counseling, and 1-800-MEDICARE can answer general questions.
Part of our Medicare Guide. Costs, enrollment deadlines, Medicare Advantage vs. Medigap, Part D and what Medicare covers, all in one place. See the full guide →
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