- Entity
- county:illinois-madison-17119
- Digest
- 2027-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/illinois/madison/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-county-plan-index
- Total Standard Medicare Advantage Plans
- 38
- PPO Plans
- 20
- HMO Plans
- 10
- HMO-POS Plans
- 6
- PFFS Plans
- 2
- Average Monthly Premium
- 21.29
- Average MOOP
- 5659.21
- Average Part D Deductible
- 640.94
- $0 Premium Plans
- 27
- Plans Without Part D Coverage
- 5
- Average CMS Star Rating
- 3.94
- $0 Premium Plan Share
- 71.05
- 5-Star Plan Share
- 0
- 4+ Star Plan Share
- 69
- 3-Star Plan Share
- 31
- Below 3-Star Plan Share
- 0
- Not-Rated Plan Share
- 8
- PPO Average Monthly Premium
- 30.8
- PPO Average MOOP
- 6157.5
- PPO Enrollment
- 5348
- PPO $0 Premium Plans
- 13
- PPO Plans Without Part D Coverage
- 3
- HMO Average Monthly Premium
- 11.4
- HMO Average MOOP
- 4235
- HMO Enrollment
- 5079
- HMO $0 Premium Plans
- 8
- HMO Plans Without Part D Coverage
- 0
- HMO-POS Average Monthly Premium
- 3.17
- HMO-POS Average MOOP
- 5316.67
- HMO-POS Enrollment
- 8823
- HMO-POS $0 Premium Plans
- 5
- HMO-POS Plans Without Part D Coverage
- 1
- PFFS Average Monthly Premium
- 30
- PFFS Average MOOP
- 8825
- PFFS Enrollment
- 0
- PFFS $0 Premium Plans
- 1
- PFFS Plans Without Part D Coverage
- 1
- Entity
- county:illinois-madison-17119
- Digest
- 2027-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/illinois/madison/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-illinois-madison-17119-landscape-stats
- Plans Indexed
- 38
- Standard Medicare Advantage Plans
-
-
Humana Essentials Plus Giveback
H4461-045-0 -
Humana Essentials Plus Giveback
H0028-065-0 -
Humana Full Access
H7617-008-0 -
Humana Total Complete
H4461-046-0 -
Humana Total Complete
H0028-014-0 -
Humana USAA Honor Giveback
H7617-012-0 -
Humana Value Choice
H7617-023-0 -
HumanaChoice Giveback H7617-013
H7617-013-0 -
AARP Medicare Advantage from UHC ST-0001
H2406-043-0 -
Aetna Medicare Enhanced
H7301-009-0 -
Aetna Medicare Signature
H7301-007-0 -
Essence Advantage
H2610-005-0 -
Essence Advantage Choice
H6200-001-0 -
Essence Advantage Plus
H2610-006-0 -
Essence Advantage Premier Plus
H6200-008-0 -
Essence Advantage Select
H2610-016-0 -
Humana Full Access
H5216-407-0 -
Humana Gold Choice H8145-006
H8145-006-0 -
Humana Gold Choice H8145-126
H8145-126-0 -
Humana USAA Honor Giveback
H5216-278-1 -
Humana Value Choice
H5216-318-1 -
HumanaChoice Giveback H5216-403
H5216-403-0 -
HumanaChoice H5216-032
H5216-032-0 -
HumanaChoice H5216-399
H5216-399-0 -
AARP Medicare Advantage CareFlex from UHC ST-6
H2802-073-0 -
AARP Medicare Advantage Essentials from UHC ST-3
H2802-028-0 -
AARP Medicare Advantage Extras from UHC ST-4
H2802-052-0 -
AARP Medicare Advantage Patriot No Rx MO-MA01
H2802-050-0 -
Aetna Medicare Enhanced
H1206-011-0 -
Aetna Medicare Signature
H2663-103-0 -
Humana USAA Honor Giveback
R5361-001-0 -
HumanaChoice R5361-002
R5361-002-0 -
Wellcare Giveback
H5779-010-0 -
Wellcare Simple Essential
H5779-009-0 -
Wellcare Simple Value
H1416-084-0 -
DEVOTED CHOICE 005 IL
H8320-005-0 -
DEVOTED CHOICE GIVEBACK 006 IL
H8320-006-0 -
DEVOTED CHOICE GIVEBACK EXTRAS 020 IL
H8320-020-0
-
Humana Essentials Plus Giveback
- Total Standard Medicare Advantage Enrollment
- 19250
2027 Medicare Advantage Plans in Madison County, IL
Last update: .
For 2027, Madison County, IL includes 38 Medicare Advantage plans. Enrollment across these plans totals approximately 19,250, with 27 $0 premium options and 69% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Madison County, IL are summarized separately. Visit Medicare Options in Madison County, IL to see more options.
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
- 20
- Average Monthly Premium
- $30.80/mo
- Total PPO Enrollment
- 5,348
- $0 Premium PPO Plans
- 13
- Average MOOP
- $6,158
- Top PPO by Enrollment
- Humana Value Choice (PPO) — 1,111 enrollees
- PPO Plans Without Drug Coverage
- 3
- What is the average monthly premium for PPO plans in Madison?
- PPO plans in Madison cost $30.80 per month on average.
- Which PPO plan has the highest enrollment in Madison?
- The most popular PPO plan in Madison is Humana Value Choice (PPO), with 1,111 enrollees.
- How many PPO plans in Madison do not include prescription drug coverage?
- 3 PPO plans in Madison do not include prescription drug coverage.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans are built around a defined network of doctors and hospitals. Care is generally covered only within the network, except in emergencies, but this structure often results in lower premiums and out-of-pocket costs.
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Humana Essentials Plus Giveback | $0 | $4,200 | $700 | H4461-045-0 | |
| Humana Essentials Plus Giveback | $0 | $4,200 | $700 | H0028-065-0 | |
| Humana Total Complete | $0 | $2,850 | $700 | H4461-046-0 | |
| Humana Total Complete | $0 | $2,850 | $700 | H0028-014-0 | |
| Essence Advantage | $0 | $3,400 | $0 | H2610-005-0 | |
| Essence Advantage Plus | $59 | $2,900 | $450 | H2610-006-0 | |
| Essence Advantage Select | $0 | $4,450 | $450 | H2610-016-0 | |
| Aetna Medicare Enhanced | $55 | $4,200 | $700 | H1206-011-0 | |
| Wellcare Giveback | $0 | $7,800 | $700 | H5779-010-0 | |
| Wellcare Simple Essential | $0 | $5,500 | $700 | H5779-009-0 |
What is the total number of HMO plans offered in Madison?
There are 10 HMO plans in 2027, covering 5,079 enrollees.
How much do HMO plans cost in Madison?
The average HMO premium in Madison is $11.40 per month, with 8 plans offering $0 premiums.
What is the top HMO by enrollment in Madison?
Essence Advantage Select (HMO) is the top HMO in Madison, with 1,871 enrollees.
What is the number of HMO plans without Part D coverage in Madison?
0 HMO plans in Madison do not include prescription drug coverage.
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
- 6
- Average Monthly Premium
- $3.17/mo
- Total HMO-POS Enrollment
- 8,823
- $0 Premium HMO-POS Plans
- 5
- Average MOOP
- $5,317
- Top HMO-POS by Enrollment
- AARP Medicare Advantage Essentials from UHC ST-3 (HMO-POS) — 4,005 enrollees
- HMO-POS Plans Without Drug Coverage
- 1
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| AARP Medicare Advantage CareFlex from UHC ST-6 | $0 | $7,150 | $685 | H2802-073-0 | |
| AARP Medicare Advantage Essentials from UHC ST-3 | $0 | $4,450 | $685 | H2802-028-0 | |
| AARP Medicare Advantage Extras from UHC ST-4 | $19 | $4,450 | $685 | H2802-052-0 | |
| AARP Medicare Advantage Patriot No Rx MO-MA01 | $0 | $5,900 | N/A | H2802-050-0 | |
| Aetna Medicare Signature | $0 | $4,450 | $700 | H2663-103-0 | |
| Wellcare Simple Value | $0 | $5,500 | $700 | H1416-084-0 |
What is the average monthly premium for HMO-POS plans?
HMO-POS plans in Madison cost $3.17 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 4,005 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 $30.00/mo
- Total PFFS Enrollment 0
- $0 Premium PFFS Plans 1
- Average MOOP $8,825
- Top PFFS by Enrollment — 0 enrollees
- PFFS Plans Without Drug Coverage 1
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-006 | $60 | $7,800 | $700 | H8145-006-0 | |
| Humana Gold Choice H8145-126 | $0 | $9,850 | N/A | H8145-126-0 |
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 (2027) are summarized below.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 24 | 69% |
| 3 Stars | 11 | 31% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 3 | 8% |
| Average Rating | 3.94 | |
* CMS assigns Medicare Advantage star ratings annually based on plan quality and performance measures.
| Data Source | Publisher | CMS Version |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | CY2027 Landscape (202609.1) |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | 2027 Star Ratings Data Tables |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | PBP Benefits-2027 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | 2026-09 |
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.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Medicare.gov | Understanding Medicare Advantage Plans | 25 May, 2025 |
| Medicare.gov | Compare Original Medicare & Medicare Advantage | 25 May, 2025 |
| NCOA.org | 5 Steps to Choosing the Right Medicare Plan for You | 25 May, 2025 |
MedicarePlans.com is an independent informational resource and has no affiliation with, or endorsement from, the U.S. Government or the federal Medicare program.
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.