2026 Medicare Advantage Plans in Sangamon County, IL
Last update: . Enrollment data updated: August 15, 2026
For 2026, Sangamon County, IL includes 26 Medicare Advantage plans. Enrollment across these plans totals approximately 9,316, with 18 $0 premium options and 13% rated 4 stars or higher.
Totals on this page exclude Medicare Advantage Special Needs Plans (SNPs). SNP plans for Sangamon County, IL are provided separately. Or you can discover all Medicare Options in Sangamon 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
- 18
- Average Monthly Premium
- $24.72/mo
- Total PPO Enrollment
- 8,346
- $0 Premium PPO Plans
- 12
- Average MOOP
- $5,831
- Top PPO by Enrollment
- Aetna Medicare Enhanced (PPO) — 3,072 enrollees
- PPO Plans Without Drug Coverage
- 6
What is the typical premium for PPO plans available in Sangamon?
PPO plans in Sangamon cost $24.72 per month on average.
Which PPO plan do most beneficiaries choose in Sangamon?
The most popular PPO plan in Sangamon is Aetna Medicare Enhanced (PPO), with 3,072 enrollees.
How many PPO options are offered without drug coverage in Sangamon?
6 PPO plans in Sangamon 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 5
- Average Monthly Premium $0.00/mo
- Total HMO Enrollment 675
- $0 Premium HMO Plans 5
- Average MOOP $5,320
- Top HMO by Enrollment Wellcare Simple Essential (HMO) — 248 enrollees
- HMO Plans Without Drug Coverage 1
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Blue Cross Medicare Advantage Basic | $0 | $5,500 | $450 | H3822-012-0 | |
| 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 |
What is the total number of HMO plans offered in Sangamon?
In 2026, Sangamon County has 5 HMO plans with 675 enrollees.
How much do HMO plans cost in Sangamon?
The typical HMO premium in Sangamon is $0.00, and 5 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
- 1
- Average Monthly Premium
- $45.00/mo
- Total HMO-POS Enrollment
- 196
- $0 Premium HMO-POS Plans
- 0
- Average MOOP
- $4,900
- Top HMO-POS by Enrollment
- AARP Medicare Advantage from UHC IA-0002 (HMO-POS) — 196 enrollees
- HMO-POS Plans Without Drug Coverage
- 0
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| AARP Medicare Advantage from UHC IA-0002 | $45 | $4,900 | $520 | H5253-108-1 |
- What is the average monthly premium for HMO-POS plans?
- HMO-POS plans in Sangamon cost $45.00 per month on average.
- Which HMO-POS plan is most popular in Sangamon?
- The most popular HMO-POS plan in Sangamon is AARP Medicare Advantage from UHC IA-0002 (HMO-POS), with 196 enrollees.
- How many HMO-POS plans in Sangamon do not include drug coverage?
- There are 0 HMO-POS plans in Sangamon 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 99
- $0 Premium PFFS Plans 1
- Average MOOP $6,750
- Top PFFS by Enrollment Humana Gold Choice H8145-006 (PFFS) — 80 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 Sangamon?
There are 2 PFFS plans in 2026, covering 99 enrollees.
How much do PFFS plans cost in Sangamon?
The average PFFS premium in Sangamon is $18.50 per month, with 1 plans offering $0 premiums.
What is the top PFFS plan in Sangamon?
Humana Gold Choice H8145-006 (PFFS) is the top PFFS in Sangamon, with 80 enrollees.
What is the number of PFFS plans without Part D coverage in Sangamon?
1 PFFS plans in Sangamon do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Sangamon 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) | 3 | 13% |
| 3 Stars | 21 | 88% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 2 | 8% |
| Average Rating | 3.42 | |
* 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.