- Entity
- county:new-york-herkimer-36043
- 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/herkimer/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-county-plan-index
- Total Standard Medicare Advantage Plans
- 22
- PPO Plans
- 12
- HMO Plans
- 1
- HMO-POS Plans
- 5
- PFFS Plans
- 4
- Average Monthly Premium
- 26.71
- Average MOOP
- 7588.64
- Average Part D Deductible
- 572.33
- $0 Premium Plans
- 13
- Plans Without Part D Coverage
- 7
- Average CMS Star Rating
- 3.36
- $0 Premium Plan Share
- 59.09
- 5-Star Plan Share
- 0
- 4+ Star Plan Share
- 14
- 3-Star Plan Share
- 86
- Below 3-Star Plan Share
- 0
- Not-Rated Plan Share
- 0
- PPO Average Monthly Premium
- 21.84
- PPO Average MOOP
- 8245.83
- PPO Enrollment
- 4987
- PPO $0 Premium Plans
- 7
- PPO Plans Without Part D Coverage
- 3
- HMO Average Monthly Premium
- 0
- HMO Average MOOP
- 9250
- HMO Enrollment
- 835
- HMO $0 Premium Plans
- 1
- HMO Plans Without Part D Coverage
- 0
- HMO-POS Average Monthly Premium
- 29.7
- HMO-POS Average MOOP
- 8190
- HMO-POS Enrollment
- 502
- HMO-POS $0 Premium Plans
- 3
- HMO-POS Plans Without Part D Coverage
- 2
- PFFS Average Monthly Premium
- 44.25
- PFFS Average MOOP
- 4450
- PFFS Enrollment
- 83
- PFFS $0 Premium Plans
- 2
- PFFS Plans Without Part D Coverage
- 2
- Entity
- county:new-york-herkimer-36043
- 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/herkimer/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-new-york-herkimer-36043-landscape-stats
- Plans Indexed
- 22
- Standard Medicare Advantage Plans
-
-
Aetna Medicare Eagle Giveback
H5521-323-0 -
MVP Medicare Preferred Gold without Part D
H3305-020-0 -
MVP Medicare Secure Plus with Part D
H3305-022-0 -
Medicare BlueBalanced
H3335-062-0 -
Medicare BlueEnhanced
H3335-015-0 -
Medicare BlueSalute
H3335-043-0 -
Medicare BlueVital
H3335-061-0 -
MVP Medicare Complete Wellness with Part D
H9615-024-0 -
Wellcare Advantage Enhanced
H2816-037-0 -
Wellcare Advantage Simple
H2816-038-0 -
Wellcare Premium Enhanced
H2816-019-0 -
Wellcare Premium Ultra
H2816-013-0 -
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
- 6407
2026 Medicare Advantage Plans in Herkimer County, NY
Last update: .
For 2026, Herkimer County, NY includes 22 Medicare Advantage plans. Enrollment across these plans totals approximately 6,407, with 13 $0 premium options and 14% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Herkimer County, NY are summarized separately. Visit Medicare Options in Herkimer County, NY to see more options.
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
- $21.84/mo
- Total PPO Enrollment
- 4,987
- $0 Premium PPO Plans
- 7
- Average MOOP
- $8,246
- Top PPO by Enrollment
- Medicare BlueVital (PPO) — 1,715 enrollees
- PPO Plans Without Drug Coverage
- 3
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Aetna Medicare Eagle Giveback | $0 | $9,250 | N/A | H5521-323-0 | |
| Medicare BlueBalanced | $55 | $8,000 | $615 | H3335-062-0 | |
| Medicare BlueEnhanced | $101 | $7,500 | $275 | H3335-015-0 | |
| Medicare BlueSalute | $0 | $4,500 | N/A | H3335-043-0 | |
| Medicare BlueVital | $0 | $9,250 | $615 | H3335-061-0 | |
| MVP Medicare Complete Wellness with Part D | $15 | $9,250 | $615 | H9615-024-0 | |
| 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 average monthly premium for PPO plans in Herkimer?
- PPO plans in Herkimer cost $21.84 per month on average.
- Which PPO plan has the highest enrollment in Herkimer?
- The most popular PPO plan in Herkimer is Medicare BlueVital (PPO), with 1,715 enrollees.
- How many PPO plans in Herkimer do not include prescription drug coverage?
- 3 PPO plans in Herkimer do not include prescription drug coverage.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans are built around a defined network of doctors and hospitals. Care is generally covered only within the network, except in emergencies, but this structure often results in lower premiums and out-of-pocket costs.
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Aetna Medicare Signature | $0 | $9,250 | $615 | H3312-048-0 |
What is the total number of HMO plans offered in Herkimer?
There are 1 HMO plans in 2026, covering 835 enrollees.
How much do HMO plans cost in Herkimer?
The average HMO premium in Herkimer is $0.00 per month, with 1 plans offering $0 premiums.
What is the top HMO by enrollment in Herkimer?
Aetna Medicare Signature (HMO) is the top HMO in Herkimer, with 835 enrollees.
What is the number of HMO plans without Part D coverage in Herkimer?
0 HMO plans in Herkimer do not include prescription drug coverage.
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
- 5
- Average Monthly Premium
- $29.70/mo
- Total HMO-POS Enrollment
- 502
- $0 Premium HMO-POS Plans
- 3
- Average MOOP
- $8,190
- Top HMO-POS by Enrollment
- Wellcare Fidelis Simple (HMO-POS) — 251 enrollees
- HMO-POS Plans Without Drug Coverage
- 2
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| MVP Medicare Preferred Gold without Part D | $0 | $7,200 | N/A | H3305-020-0 | |
| MVP Medicare Secure Plus with Part D | $116 | $6,000 | $400 | H3305-022-0 | |
| 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 Herkimer cost $29.70 per month on average.
Which HMO-POS plan is most popular in Herkimer?
The most popular HMO-POS plan in Herkimer is Wellcare Fidelis Simple (HMO-POS), with 251 enrollees.
How many HMO-POS plans in Herkimer do not include drug coverage?
There are 2 HMO-POS plans in Herkimer 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 4
- Average Monthly Premium $44.25/mo
- Total PFFS Enrollment 83
- $0 Premium PFFS Plans 2
- Average MOOP $4,450
- Top PFFS by Enrollment Wellcare Advantage Simple (PFFS) — 46 enrollees
- PFFS Plans Without Drug Coverage 2
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Wellcare Advantage Enhanced | $0 | $4,300 | N/A | H2816-037-0 | |
| Wellcare Advantage Simple | $0 | $6,700 | N/A | H2816-038-0 | |
| Wellcare Premium Enhanced | $50 | $3,400 | $615 | H2816-019-0 | |
| Wellcare Premium Ultra | $127 | $3,400 | $615 | H2816-013-0 |
What is the top PFFS plan in Herkimer?
Wellcare Advantage Simple (PFFS) is the top PFFS in Herkimer, with 46 enrollees.
What is the number of PFFS plans without Part D coverage in Herkimer?
2 PFFS plans in Herkimer do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Herkimer 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) | 3 | 14% |
| 3 Stars | 19 | 86% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.36 | |
* CMS assigns Medicare Advantage star ratings annually based on plan quality and performance measures.
- 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: 2026-08
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, "Compare Original Medicare & Medicare Advantage" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — Last accessed 25 May, 2025
MedicarePlans.com is an independent informational resource and has no affiliation with, or endorsement from, the U.S. Government or the federal Medicare program.
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.