2026 Medicare Advantage Plans in Hamilton County, NY
Last update: . Enrollment data updated: May 2, 2026
For 2026, Hamilton County, NY includes 23 Medicare Advantage plans. Enrollment across these plans totals approximately 444, with 15 $0 premium options and 35% rated 4 stars or higher.
Totals on this page exclude Medicare Advantage Special Needs Plans (SNPs). SNP plans for Hamilton County, NY are provided separately. Or you can discover all Medicare Options in Hamilton County, NY.
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
- 12
- Average Monthly Premium
- $37.90/mo
- Total PPO Enrollment
- 198
- $0 Premium PPO Plans
- 7
- Average MOOP
- $8,354
- Top PPO by Enrollment
- Aetna Medicare Signature (PPO) — 96 enrollees
- PPO Plans Without Drug Coverage
- 3
| PPO Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Aetna Medicare Eagle Giveback | $0 | $9,250 | N/A | H5521-323-0 | |
| Aetna Medicare Premier | $50 | $8,900 | $615 | H5521-340-0 | |
| Aetna Medicare Signature | $0 | $9,250 | $615 | H5521-077-0 | |
| 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 | |
| Humana USAA Honor Giveback | $0 | $4,950 | N/A | H5970-016-0 | |
| HumanaChoice Giveback H5970-030 | $0 | $9,250 | $615 | H5970-030-0 | |
| HumanaChoice H5970-029 | $32 | $9,250 | $615 | H5970-029-0 | |
| 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 typical premium for PPO plans available in Hamilton?
PPO plans in Hamilton cost $37.90 per month on average.
Which PPO plan do most beneficiaries choose in Hamilton?
The most popular PPO plan in Hamilton is Aetna Medicare Signature (PPO), with 96 enrollees.
How many PPO options are offered without drug coverage in Hamilton?
3 PPO plans in Hamilton 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 $47.00/mo
- Total HMO Enrollment 229
- $0 Premium HMO Plans 3
- Average MOOP $6,900
- Top HMO by Enrollment CDPHP $0 Medicare Rx (HMO) — 153 enrollees
- HMO Plans Without Drug Coverage 1
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | 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 | |
| Aetna Medicare Signature | $0 | $9,250 | $615 | H3312-048-0 |
What is the total number of HMO plans offered in Hamilton?
In 2026, Hamilton County has 5 HMO plans with 229 enrollees.
How much do HMO plans cost in Hamilton?
The typical HMO premium in Hamilton is $47.00, and 3 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
- 4
- Average Monthly Premium
- $8.13/mo
- Total HMO-POS Enrollment
- 17
- $0 Premium HMO-POS Plans
- 3
- Average MOOP
- $8,738
- Top HMO-POS by Enrollment
- Wellcare Fidelis Simple (HMO-POS) — 17 enrollees
- HMO-POS Plans Without Drug Coverage
- 2
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | 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 average monthly premium for HMO-POS plans?
- HMO-POS plans in Hamilton cost $8.13 per month on average.
- Which HMO-POS plan is most popular in Hamilton?
- The most popular HMO-POS plan in Hamilton is Wellcare Fidelis Simple (HMO-POS), with 17 enrollees.
- How many HMO-POS plans in Hamilton do not include drug coverage?
- There are 2 HMO-POS plans in Hamilton 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 $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
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | 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 total number of PFFS plans in Hamilton?
There are 2 PFFS plans in 2026, covering 0 enrollees.
How much do PFFS plans cost in Hamilton?
The average PFFS premium in Hamilton is $0.00 per month, with 2 plans offering $0 premiums.
What is the top PFFS plan in Hamilton?
is the top PFFS in Hamilton, with 0 enrollees.
What is the number of PFFS plans without Part D coverage in Hamilton?
2 PFFS plans in Hamilton do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Hamilton County, NY (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) | 8 | 35% |
| 3 Stars | 15 | 65% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.61 | |
* 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 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
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.