Medicare Blue Choice 033 (HMO-POS) Medicare Advantage Plan H3351-033 • 2027 • Essex County, NY
- Monthly Premium
- $0.00Plus Part B premium.
- Medical Deductible
- $0.00
- Maximum Out-of-Pocket
- $6500.00In-network
- Part B Giveback
- Not offered
- Prescription Coverage
- Not Included
- Additional Benefits
- Dental, Vision, Hearing
- Service Area
- Essex County, NY
- Local Enrollment
- 0 beneficiaries in Essex County
Medicare Blue Choice 033 (HMO-POS) Introduction
CMS Plan ID H3351-033 identifies Medicare Blue Choice 033, a Medicare Advantage HMO-POS plan offered by Excellus Health Plan, Inc. The plan uses a Health Maintenance Organization with a Point of Service (HMO-POS) provider network and comes without prescription drug coverage. Its costs for the 2027 plan year include a $0.00 monthly premium, $0.00 medical deductible, and $6500.00 in-network maximum out-of-pocket.
This plan is available to eligible beneficiaries who live in Essex County, New York. CMS reports local enrollment of 0 beneficiaries for this plan in Essex County. New members can contact the plan at (800)659-1986 (TTY 711) for help and additional plan information.
Compare Similar Plans in Essex County
Compare this plan with the two most-enrolled HMO-POS plans available in Essex County, New York. Enrollment is based on CMS local enrollment data.
| Plan Detail | Medicare Blue Choice 033 | Wellcare Fidelis Simple | Wellcare Fidelis Assist |
|---|---|---|---|
| CMS Plan ID | H3351-033-0 |
H5599-004-0 |
H5599-002-0 |
| Local Enrollment | 0 | 208 | 62 |
| Monthly Premium | $0.00 | $0.00 | $0.00 |
| Medical Deductible | $0.00 | $430 | $0.00 |
| Maximum Out-of-Pocket | $6,500.00 | $9,850.00 | $9,850.00 |
| Part B Giveback | Not offered | Not offered | Not offered |
| Primary Care | $5 copay | $0 copay | $0 copay |
| Specialist | $35 copay | $50 copay | $35 copay |
| Part D Deductible | Not Applicable | $700.00 | $700.00 |
| CMS Star Rating | 4.0 | 3.0 | 3.0 |
| Dental | $0 copay | $0 copay | $0 copay |
| Vision | $0 copay | $0 copay | $0 copay |
| Hearing | $0 copay | $0 copay | $0 copay |
Want to explore more options? Browse all Medicare Advantage plans in Essex County, or compare Medicare Advantage plans across New York, including premiums, out-of-pocket costs, CMS ratings, and enrollment.
Plan Benefits
Medicare Blue Choice 033 includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H3351-033.
You can also compare 2027 costs and coverage with last year, side-by-side: Plan H3351-033-0 Cost Compare.
Office Visits
- Primary care
- In-network: $5 copay
Out-of-network: 30% coinsurance - Specialist
- In-network: $35 copay
Out-of-network: 30% coinsurance
Preventive and Wellness Services
- Annual wellness exam
- In-network: $0 copay
- Telehealth benefit
- In-network: $0-$35 copay, 20% coinsurance
- Routine chiropractic
- Not covered
- Fitness benefits
- Coming soon
- Health education
- Not covered
- Counseling services
- Not covered
- Over-the-counter drug benefits
- Not covered
- Health transportation (non-emergency)
- Coming soon
Diagnostic, Lab, and Imaging Services
- Diagnostic radiology services
- In-network: $150 copay
Out-of-network: 30% coinsurance - Lab services
- In-network: $15 copay
Out-of-network: 30% coinsurance - Outpatient x-rays
- In-network: $40 copay
Out-of-network: 30% coinsurance - Diagnostic tests and procedures
- In-network: $15 copay
Out-of-network: 30% coinsurance
Emergency and Urgent Care Services
- Emergency room care
- $115 copay
- Worldwide emergency care
- Coming soon
- Urgent care
- $40 copay
- Inpatient hospital care
- In-network:
Tier 1
$325 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
30% per stay - Skilled Nursing Facility
- In-network:
Tier 1
$0 per day for days 1-20
$221 per day for days 21-100
Out-of-network:
30% per stay - Ground ambulance
- In-network: $200 copay
Out-of-network: $200 copay
Mental Health Services
- Outpatient individual therapy
- In-network: $0 copay
Out-of-network: 30% coinsurance - Outpatient group therapy
- In-network: $0 copay
Out-of-network: 30% coinsurance - Inpatient psychiatric hospital care
- In-network:
Tier 1
$325 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
30% per stay
Rehabilitation Services
- Physical therapy and speech and language therapy
- In-network: $35 copay
Out-of-network: 30% coinsurance - Occupational therapy
- In-network: $35 copay
Out-of-network: 30% coinsurance
Medical Equipment and Supplies
- Diabetes supplies
- In-network: $5 copay, 20% coinsurance
Out-of-network: 30% coinsurance - Durable medical equipment
- In-network: 20% coinsurance
Out-of-network: 30% coinsurance - Prosthetics
- In-network: 20% coinsurance
Out-of-network: 30% coinsurance
Medicare Part B Drugs
- Chemotherapy
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance - Other Part B drugs (Medicare-covered)
- In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
Dental Services
- Oral exam
- In-network: $0 copay
- Dental x-rays
- In-network: $0 copay
- Cleaning
- In-network: $0 copay
- Periodontics
- Not covered
- Endodontics
- Not covered
- Restorative services
- Not covered
- Implant services
- Not covered
- Orthodontics
- Not covered
- Oral/Maxillofacial surgery
- Not covered
Vision Services
- Routine eye exam
- In-network: $0 copay
- Contact lenses
- In-network: $0 copay
- Eyeglass frames only
- Not covered
- Eyeglass lenses only
- Not covered
- Eyeglasses (frames & lenses)
- In-network: $0 copay
- Upgrades
- Not covered
Hearing Services
- Hearing exam
- In-network: $0 copay
- Fitting/evaluation
- In-network: $0 copay
- Prescription hearing aids
- In-network: $299-$799 copay
- OTC hearing aids
- Not covered
Additional and Special Needs Services
- Adult day health services
- Not covered
- Home-based palliative care
- Not covered
- Personal emergency response system
- Coming soon
- Weight management programs
- Not covered
- Wigs for chemotherapy-related hair loss
- Coming soon
- Alternative therapies
- Not covered
- Massage therapy
- Not covered
- Home/bathroom safety devices
- Not covered
Certain preventive services are covered 100% by Medicare Blue Choice 033 as a Part B benefit.
Prescription Drug Coverage
This plan does not include a Medicare Part D plan for prescriptions.
CMS 5-Star Performance Ratings (Contract ID: H3351)
CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.
| CMS Measure | Star Rating |
|---|---|
| 2027 Overall Rating | |
| Staying Healthy: Screenings, Tests, Vaccines | |
| Managing Chronic (Long Term) Conditions | |
| Member Experience with Health Plan | |
| Complaints and Changes in Plans Performance | |
| Health Plan Customer Service | |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
Contact Information for Excellus Health Plan, Inc
- Website
- Excellus Health Plan, Inc Plan Page
- Providers
- Excellus Health Plan, Inc Providers Page
- Formulary
- Excellus Health Plan, Inc Formulary Page
- Pharmacy
- Excellus Health Plan, Inc Pharmacy Page
- New Member Health Plan Help
- (800)659-1986
- New Member Health Plan TTY
- 711
Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.
Medicare Advantage Plan Availability
Medicare Blue Choice 033 is available to eligible Medicare beneficiaries residing in Essex County, New York, including communities such as Schroon Lake, Ticonderoga, Crown Point, Lake Placid, Port Henry, Ray Brook, Westport, Willsboro, and other areas throughout the county. Enrollment eligibility is based on county of residence, not city.
Medicare Plan Data Sources and Methodology
| Data Source | Publisher | Last Accessed |
|---|---|---|
| Landscape Source Files | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Medicare Part C & D Performance | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Plan Benefits Package | Centers for Medicare & Medicaid Services | October 5, 2026 |
| Monthly Enrollment by Contract/Plan/State/County | Centers for Medicare & Medicaid Services | October 5, 2026 |
Data sources and methodology documentation.
| Publisher | Reference | Last Accessed |
|---|---|---|
| Excellus Health Plan, Inc (official source) | http://www.UniveraMedicare.com | October 4, 2026 |
| Medicare.gov | Compare types of Medicare Advantage Plans | 25 May, 2025 |
| Medicare.gov | Joining a plan | 25 May, 2025 |
| Medicare.gov | Your coverage options | 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.