What is the difference between a Medicare HMO and a PPO?

A Medicare Advantage HMO (Health Maintenance Organization) usually asks you to use doctors and hospitals in the plan's network. You often pick a main doctor, and you may need a referral (that doctor's okay) to see a specialist. A Medicare Advantage PPO (Preferred Provider Organization) lets you see doctors in or out of the network, usually with no referral. Care out of network costs more. Both types must cap what you pay each year. In 2027, the cap for in-network care can be no more than $9,850, up from $9,250 in 2026. A PPO also has a cap for in-network and out-of-network care together of no more than $14,800, up from $13,900 in 2026. With either plan, you still pay the Part B premium ($202.90 a month in 2026). HMOs often cost less but have tighter rules. PPOs give more freedom at a higher price.