2026 Medicare Advantage Plans in Essex County, NY
Last update: . Enrollment data updated: May 2, 2026
Essex County, NY has 18 Medicare Advantage plans available in 2026. These include 11 plans with no monthly premium, and roughly 39% are rated at least 4 stars based on CMS data.
Medicare Advantage Special Needs Plans (SNPs) are not included in the figures shown above. View Special Needs Plans in Essex County, NY. Or explore all Medicare Options available in Essex County, NY.
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow access to both in-network and out-of-network providers. Out-of-network care usually costs more, but PPOs offer greater flexibility in choosing doctors and hospitals.
- Total PPO Plans 8
- Average Monthly Premium $53.60/mo
- Total PPO Enrollment 1,474
- $0 Premium PPO Plans 4
- Average MOOP $8,488
- Top PPO by Enrollment Aetna Medicare Enhanced (PPO) — 1,073 enrollees
- PPO Plans Without Drug Coverage 2
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Aetna Medicare Eagle Giveback | $0 | $9,250 | N/A | H5521-323-0 | |
| Aetna Medicare Enhanced | $56 | $9,250 | $615 | H5521-520-0 | |
| Medicare BluePlus | $140 | $7,900 | $615 | H3335-018-0 | |
| Medicare BlueSalute | $0 | $4,500 | N/A | H3335-044-0 | |
| MVP Medicare Complete Wellness with Part D | $174 | $9,250 | $615 | H9615-022-0 | |
| Wellcare Assist Open | $59 | $9,250 | $530 | H2775-113-0 | |
| Wellcare Giveback Open | $0 | $9,250 | $615 | H2775-111-0 | |
| Wellcare Simple Open | $0 | $9,250 | $615 | H2775-106-0 |
What is the most popular PPO plan in Essex?
Aetna Medicare Enhanced (PPO) is the top PPO in Essex, with 1,073 enrollees.
What is the number of PPO plans without Part D coverage in Essex?
There are 2 PPO plans in Essex without prescription drug coverage.
Medicare Advantage HMO Plans
HMO plans typically require members to use in-network providers and facilities, except in emergencies. In return, HMOs often offer lower monthly premiums and reduced cost-sharing.
- Total HMO Plans
- 4
- Average Monthly Premium
- $58.75/mo
- Total HMO Enrollment
- 1,094
- $0 Premium HMO Plans
- 2
- Average MOOP
- $6,313
- Top HMO by Enrollment
- CDPHP $0 Medicare Rx (HMO) — 860 enrollees
- HMO Plans Without Drug Coverage
- 1
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| CDPHP $0 Medicare Rx | $0 | $6,750 | $500 | H3388-014-0 | |
| CDPHP Choice Rx | $135 | $6,000 | $0 | H3388-002-0 | |
| CDPHP Clear Rx | $100 | $6,400 | $250 | H3388-020-0 | |
| CDPHP Core | $0 | $6,100 | N/A | H3388-001-0 |
What is the typical premium for HMO plans in Essex?
HMO plans in Essex cost $58.75 per month on average.
Which HMO plan do most beneficiaries choose in Essex?
The most popular HMO plan in Essex is CDPHP $0 Medicare Rx (HMO), with 860 enrollees.
How many HMO options are offered without prescription drug coverage in Essex?
There are 1 HMO plans in Essex without prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO Point-of-Service (HMO-POS) plans combine HMO network requirements with limited out-of-network access. Care outside the network typically costs more, but HMO-POS plans provide added flexibility compared with standard HMOs.
- Total HMO-POS Plans 4
- Average Monthly Premium $8.13/mo
- Total HMO-POS Enrollment 246
- $0 Premium HMO-POS Plans 3
- Average MOOP $8,738
- Top HMO-POS by Enrollment Wellcare Fidelis Simple (HMO-POS) — 193 enrollees
- HMO-POS Plans Without Drug Coverage 2
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| MVP Medicare Preferred Gold without Part D | $0 | $7,200 | N/A | H3305-020-0 | |
| Wellcare Fidelis Assist | $33 | $9,250 | $615 | H5599-002-0 | |
| Wellcare Fidelis Patriot Simple | $0 | $9,250 | N/A | H5599-010-0 | |
| Wellcare Fidelis Simple | $0 | $9,250 | $615 | H5599-004-0 |
What is the total number of HMO-POS plans in Essex?
In 2026, Essex has 4 HMO-POS plans with 246 enrollees.
How much do HMO-POS plans cost in Essex?
The typical HMO-POS premium in Essex is $8.13, and 3 plans have no monthly premium.
Medicare Advantage PFFS Plans
PFFS plans allow members to visit any Medicare-approved provider who accepts the plan’s payment terms. This offers broader choice than network-based plans, but coverage depends on provider participation, so acceptance should be confirmed in advance.
- Total PFFS Plans
- 2
- Average Monthly Premium
- $0.00/mo
- Total PFFS Enrollment
- 0
- $0 Premium PFFS Plans
- 2
- Average MOOP
- $5,500
- Top PFFS by Enrollment
- — 0 enrollees
- PFFS Plans Without Drug Coverage
- 2
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Wellcare Advantage Enhanced | $0 | $4,300 | N/A | H2816-037-0 | |
| Wellcare Advantage Simple | $0 | $6,700 | N/A | H2816-038-0 |
- What is the average monthly premium for PFFS plans?
- PFFS plans in Essex cost $0.00 per month on average.
- Which PFFS plan is most popular in Essex?
- The most popular PFFS plan in Essex is , with 0 enrollees.
- How many PFFS plans in Essex do not include drug coverage?
- There are 2 PFFS plans in Essex without prescription drug coverage.
Below is a breakdown of CMS star ratings for Medicare Advantage plans available in Essex County, NY for 2026.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 7 | 39% |
| 3 Stars | 11 | 61% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.69 | |
* Medicare Advantage star ratings are determined by CMS each year using a standardized 5-star rating system.
- CMS.gov, Medicare Advantage Landscape Source Files — Last accessed May 2, 2026
- CMS.gov, Medicare Part C & D Performance Data — Last accessed May 2, 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Last accessed May 2, 2026
County-level figures shown on this page, including plan counts, enrollment totals, averages, and percentage distributions, reflect standard Medicare Advantage (MA/MAPD) plans only and are derived from CMS datasets using a standardized aggregation methodology.
Data sources and methodology documentation .
- CMS.gov, "Medicare Advantage Plan Fact Sheet" — Last accessed 25 May, 2025
- Medicare.gov, "Your coverage options" — Last accessed 25 May, 2025
- Medicare.gov, "Joining a plan" — Last accessed 25 May, 2025
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