- Entity
- county:new-york-hamilton-36041
- Digest
- 2026-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/new-york/hamilton/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-county-plan-index
- Total Standard Medicare Advantage Plans
- 23
- PPO Plans
- 12
- HMO Plans
- 5
- HMO-POS Plans
- 4
- PFFS Plans
- 2
- Average Monthly Premium
- 31.4
- Average MOOP
- 7856.52
- Average Part D Deductible
- 536.33
- $0 Premium Plans
- 15
- Plans Without Part D Coverage
- 8
- Average CMS Star Rating
- 3.61
- $0 Premium Plan Share
- 65.22
- 5-Star Plan Share
- 0
- 4+ Star Plan Share
- 35
- 3-Star Plan Share
- 65
- Below 3-Star Plan Share
- 0
- Not-Rated Plan Share
- 0
- PPO Average Monthly Premium
- 37.9
- PPO Average MOOP
- 8354.17
- PPO Enrollment
- 201
- PPO $0 Premium Plans
- 7
- PPO Plans Without Part D Coverage
- 3
- HMO Average Monthly Premium
- 47
- HMO Average MOOP
- 6900
- HMO Enrollment
- 228
- HMO $0 Premium Plans
- 3
- HMO Plans Without Part D Coverage
- 1
- HMO-POS Average Monthly Premium
- 8.13
- HMO-POS Average MOOP
- 8737.5
- HMO-POS Enrollment
- 17
- HMO-POS $0 Premium Plans
- 3
- HMO-POS Plans Without Part D Coverage
- 2
- PFFS Average Monthly Premium
- 0
- PFFS Average MOOP
- 5500
- PFFS Enrollment
- 0
- PFFS $0 Premium Plans
- 2
- PFFS Plans Without Part D Coverage
- 2
- Entity
- county:new-york-hamilton-36041
- Digest
- 2026-county-ma-aggregate
- Population Scope
- Standard Medicare Advantage plans only; Special Needs Plans (SNPs) excluded
- Source URL
- https://www.medicareplans.com/medicare-advantage/new-york/hamilton/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-new-york-hamilton-36041-landscape-stats
- Plans Indexed
- 23
- Standard Medicare Advantage Plans
-
-
Aetna Medicare Eagle Giveback
H5521-323-0 -
Aetna Medicare Premier
H5521-340-0 -
Aetna Medicare Signature
H5521-077-0 -
CDPHP $0 Medicare Rx
H3388-014-0 -
CDPHP Choice Rx
H3388-002-0 -
CDPHP Clear Rx
H3388-020-0 -
CDPHP Core
H3388-001-0 -
MVP Medicare Preferred Gold without Part D
H3305-020-0 -
Medicare BluePlus
H3335-018-0 -
Medicare BlueSalute
H3335-044-0 -
MVP Medicare Complete Wellness with Part D
H9615-022-0 -
Wellcare Advantage Enhanced
H2816-037-0 -
Wellcare Advantage Simple
H2816-038-0 -
Aetna Medicare Signature
H3312-048-0 -
Humana USAA Honor Giveback
H5970-016-0 -
HumanaChoice Giveback H5970-030
H5970-030-0 -
HumanaChoice H5970-029
H5970-029-0 -
Wellcare Assist Open
H2775-113-0 -
Wellcare Fidelis Assist
H5599-002-0 -
Wellcare Fidelis Patriot Simple
H5599-010-0 -
Wellcare Fidelis Simple
H5599-004-0 -
Wellcare Giveback Open
H2775-111-0 -
Wellcare Simple Open
H2775-106-0
-
Aetna Medicare Eagle Giveback
- Total Standard Medicare Advantage Enrollment
- 446
2026 Medicare Advantage Plans in Hamilton County, NY
Last update: .
In Hamilton County, NY, there are 23 Medicare Advantage plans available for 2026. Of these, 15 offer a $0 monthly premium, and about 35% are rated 4 stars or higher based on CMS quality ratings.
Medicare Advantage Special Needs Plans (SNPs) are not included in the figures shown above. View Special Needs Plans in Hamilton County, NY. Or explore all Medicare Options available in Hamilton 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 12
- Average Monthly Premium $37.90/mo
- Total PPO Enrollment 201
- $0 Premium PPO Plans 7
- Average MOOP $8,354
- Top PPO by Enrollment Aetna Medicare Signature (PPO) — 99 enrollees
- PPO Plans Without Drug Coverage 3
| 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 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 total number of PPO plans offered in Hamilton?
There are 12 PPO plans in 2026, covering 201 beneficiaries.
How much do PPO plans cost in Hamilton?
The average PPO premium in Hamilton is $37.90 per month, with 7 plans offering $0 premiums.
What is the most popular PPO plan in Hamilton?
Aetna Medicare Signature (PPO) is the top PPO in Hamilton, with 99 enrollees.
What is the number of PPO plans without Part D coverage in Hamilton?
There are 3 PPO plans in Hamilton 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
- 5
- Average Monthly Premium
- $47.00/mo
- Total HMO Enrollment
- 228
- $0 Premium HMO Plans
- 3
- Average MOOP
- $6,900
- Top HMO by Enrollment
- CDPHP $0 Medicare Rx (HMO) — 151 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 | |
| Aetna Medicare Signature | $0 | $9,250 | $615 | H3312-048-0 |
What is the average monthly premium for HMO plans?
HMO plans in Hamilton cost $47.00 per month on average.
Which HMO plan is most popular in Hamilton?
The most popular HMO plan in Hamilton is CDPHP $0 Medicare Rx (HMO), with 151 enrollees.
How many HMO plans in Hamilton do not include drug coverage?
There are 1 HMO plans in Hamilton without prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO Point-of-Service (HMO-POS) plans combine HMO network rules with limited out-of-network access. Care outside the network typically costs more, but HMO-POS plans provide added flexibility compared with standard HMOs.
| 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 leading HMO-POS plan in Hamilton?
Wellcare Fidelis Simple (HMO-POS) is the top HMO-POS in Hamilton, with 17 enrollees.
What is the number of HMO-POS plans without Part D coverage in Hamilton?
2 HMO-POS plans in Hamilton do not include prescription drug coverage.
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 typical premium for PFFS plans in Hamilton?
PFFS plans in Hamilton cost $0.00 per month on average.
Which PFFS plan has the most enrollment in Hamilton?
The most popular PFFS plan in Hamilton is , with 0 enrollees.
How many PFFS options are available without prescription drug coverage in Hamilton?
There are 2 PFFS plans in Hamilton without prescription drug coverage.
The table below shows CMS star ratings for Medicare Advantage plans in Hamilton 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) | 8 | 35% |
| 3 Stars | 15 | 65% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.61 | |
* Medicare Advantage star ratings are determined by CMS each year using a standardized 5-star rating system.
- CMS.gov, Medicare Advantage & Special Needs Plan Landscape Source Files — Version: 202608
- CMS.gov, Medicare Part C & D Performance Data — Version: 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Version: 2026-07
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 .
- Medicare.gov, "Compare types of Medicare Advantage Plans" — 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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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.