2026 Medicare Advantage Plans in Madison County, IL
Last update: . Enrollment data updated: August 15, 2026
For 2026, Madison County, IL includes 49 Medicare Advantage plans. Enrollment across these plans totals approximately 21,537, with 39 $0 premium options and 33% rated 4 stars or higher.
Totals on this page exclude Medicare Advantage Special Needs Plans (SNPs). SNP plans for Madison County, IL are provided separately. Or you can discover all Medicare Options in Madison County, IL.
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow members to choose care from both in-network and out-of-network providers. Out-of-network care usually costs more, but PPOs offer greater flexibility in how members access care.
- Total PPO Plans
- 27
- Average Monthly Premium
- $21.78/mo
- Total PPO Enrollment
- 6,206
- $0 Premium PPO Plans
- 20
- Average MOOP
- $5,657
- Top PPO by Enrollment
- Humana Value Choice H7617-023 (PPO) — 1,083 enrollees
- PPO Plans Without Drug Coverage
- 4
What is the typical premium for PPO plans available in Madison?
PPO plans in Madison cost $21.78 per month on average.
Which PPO plan do most beneficiaries choose in Madison?
The most popular PPO plan in Madison is Humana Value Choice H7617-023 (PPO), with 1,083 enrollees.
How many PPO options are offered without drug coverage in Madison?
4 PPO plans in Madison do not include prescription drug coverage.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans generally require members to use in-network doctors, hospitals, and other providers, except in emergencies. Because of this structure, HMOs often have lower premiums and out-of-pocket costs than other plan types.
- Total HMO Plans 12
- Average Monthly Premium $4.92/mo
- Total HMO Enrollment 5,181
- $0 Premium HMO Plans 11
- Average MOOP $4,638
- Top HMO by Enrollment Essence Advantage Select (HMO) — 1,862 enrollees
- HMO Plans Without Drug Coverage 1
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Essence Advantage | $0 | $3,400 | $0 | H2610-005-0 | |
| Essence Advantage Plus | $59 | $2,900 | $0 | H2610-006-0 | |
| Essence Advantage Select | $0 | $3,900 | $340 | H2610-016-0 | |
| Humana Gold Plus Giveback H0028-065 | $0 | $4,200 | $615 | H0028-065-0 | |
| Humana Gold Plus H0028-014 | $0 | $2,700 | $615 | H0028-014-0 | |
| Blue Cross Medicare Advantage Value | $0 | $4,000 | $450 | H3822-014-0 | |
| Wellcare Giveback | $0 | $7,500 | $615 | H5779-010-0 | |
| Wellcare Patriot Giveback | $0 | $5,500 | N/A | H5779-011-0 | |
| Wellcare Simple Essential | $0 | $4,200 | $615 | H5779-002-0 | |
| Wellcare Simple Essential Value | $0 | $3,900 | $615 | H5779-009-0 | |
| Clear Spring Health BrightPath Advantage | $0 | $4,200 | $200 | H5454-001-0 | |
| Molina Medicare Choice Care | $0 | $9,250 | $0 | H2715-003-0 |
What is the total number of HMO plans offered in Madison?
In 2026, Madison County has 12 HMO plans with 5,181 enrollees.
How much do HMO plans cost in Madison?
The typical HMO premium in Madison is $4.92, and 11 plans have no monthly premium.
Medicare Advantage HMO-POS Plans
HMO-POS plans are structured like HMOs, requiring in-network care for the lowest costs, while allowing limited out-of-network access at higher cost. This provides added flexibility compared with standard HMO plans.
- Total HMO-POS Plans
- 8
- Average Monthly Premium
- $5.00/mo
- Total HMO-POS Enrollment
- 10,150
- $0 Premium HMO-POS Plans
- 7
- Average MOOP
- $4,575
- Top HMO-POS by Enrollment
- AARP Medicare Advantage Essentials from UHC ST-3 (HMO-POS) — 4,030 enrollees
- HMO-POS Plans Without Drug Coverage
- 1
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| AARP Medicare Advantage CareFlex from UHC ST-6 | $0 | $6,700 | $600 | H2802-073-0 | |
| AARP Medicare Advantage Essentials from UHC ST-3 | $0 | $3,200 | $440 | H2802-028-0 | |
| AARP Medicare Advantage Extras from UHC ST-4 | $0 | $3,900 | $520 | H2802-052-0 | |
| AARP Medicare Advantage Patriot No Rx MO-MA01 | $0 | $4,900 | N/A | H2802-050-0 | |
| Aetna Medicare Enhanced Extra | $40 | $5,900 | $615 | H2663-006-0 | |
| Aetna Medicare Signature | $0 | $4,200 | $615 | H2663-103-0 | |
| Wellcare Simple | $0 | $3,900 | $615 | H1416-009-0 | |
| Wellcare Simple Value | $0 | $3,900 | $615 | H1416-082-0 |
- What is the average monthly premium for HMO-POS plans?
- HMO-POS plans in Madison cost $5.00 per month on average.
- Which HMO-POS plan is most popular in Madison?
- The most popular HMO-POS plan in Madison is AARP Medicare Advantage Essentials from UHC ST-3 (HMO-POS), with 4,030 enrollees.
- How many HMO-POS plans in Madison do not include drug coverage?
- There are 1 HMO-POS plans in Madison without prescription drug coverage.
Medicare Advantage PFFS Plans
Private Fee-for-Service (PFFS) plans allow members to visit any Medicare-approved provider that accepts the plan’s payment terms. This provides flexibility in choosing doctors and hospitals, but provider acceptance should be confirmed before receiving care.
- Total PFFS Plans 2
- Average Monthly Premium $18.50/mo
- Total PFFS Enrollment 0
- $0 Premium PFFS Plans 1
- Average MOOP $6,750
- Top PFFS by Enrollment — 0 enrollees
- PFFS Plans Without Drug Coverage 1
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-006 | $37 | $6,800 | $615 | H8145-006-0 | |
| Humana Gold Choice H8145-126 | $0 | $6,700 | N/A | H8145-126-0 |
What is the total number of PFFS plans in Madison?
There are 2 PFFS plans in 2026, covering 0 enrollees.
How much do PFFS plans cost in Madison?
The average PFFS premium in Madison is $18.50 per month, with 1 plans offering $0 premiums.
What is the top PFFS plan in Madison?
is the top PFFS in Madison, with 0 enrollees.
What is the number of PFFS plans without Part D coverage in Madison?
1 PFFS plans in Madison do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Madison County, IL (2026) are summarized below.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 15 | 33% |
| 3 Stars | 30 | 67% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 4 | 8% |
| Average Rating | 3.57 | |
* Star ratings are based on CMS quality measures and reflect plan performance for the 2026 rating period.
- CMS.gov, Medicare Advantage Landscape Source Files — Last accessed August 15, 2026
- CMS.gov, Medicare Part C & D Performance Data — Last accessed August 15, 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Last accessed August 15, 2026
All plan counts, enrollment totals, averages, and percentage distributions are calculated at the county level using CMS data and include standard Medicare Advantage (MA/MAPD) plans only, based on a consistent aggregation methodology.
Data sources and methodology documentation .
- Medicare.gov, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Explore your Medicare coverage options" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
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Data provenance is documented in accordance with the U.S. Core Data for Interoperability (USCDI) Provenance standard .
Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.