2026 Medicare Advantage Plans in Jefferson County, NY
Last update: . Enrollment data updated: June 13, 2026
For 2026, Jefferson County, NY includes 27 Medicare Advantage plans. Enrollment across these plans totals approximately 7,073, with 17 $0 premium options and 33% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Jefferson County, NY are summarized separately. Visit Medicare Options in Jefferson 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
- 14
- Average Monthly Premium
- $22.29/mo
- Total PPO Enrollment
- 5,100
- $0 Premium PPO Plans
- 8
- Average MOOP
- $8,364
- Top PPO by Enrollment
- Medicare BlueVital (PPO) — 1,591 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 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 Jefferson?
PPO plans in Jefferson cost $22.29 per month on average.
Which PPO plan has the highest enrollment in Jefferson?
The most popular PPO plan in Jefferson is Medicare BlueVital (PPO), with 1,591 enrollees.
How many PPO plans in Jefferson do not include prescription drug coverage?
3 PPO plans in Jefferson 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 382
- $0 Premium HMO Plans 3
- Average MOOP $6,900
- Top HMO by Enrollment Aetna Medicare Signature (HMO) — 314 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 top HMO by enrollment in Jefferson?
Aetna Medicare Signature (HMO) is the top HMO in Jefferson, with 314 enrollees.
What is the number of HMO plans without Part D coverage in Jefferson?
1 HMO plans in Jefferson 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
- 6
- Average Monthly Premium
- $25.00/mo
- Total HMO-POS Enrollment
- 1,580
- $0 Premium HMO-POS Plans
- 4
- Average MOOP
- $7,717
- Top HMO-POS by Enrollment
- AARP Medicare Advantage from UHC NY-0006 (HMO-POS) — 1,342 enrollees
- HMO-POS Plans Without Drug Coverage
- 3
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-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 | |
| AARP Medicare Advantage from UHC NY-0006 | $34 | $7,900 | $520 | H3379-039-0 | |
| AARP Medicare Advantage Patriot No Rx NY-MA3 | $0 | $6,700 | N/A | H3379-060-0 | |
| Wellcare Fidelis Patriot Simple | $0 | $9,250 | N/A | H5599-010-0 | |
| Wellcare Simple | $0 | $9,250 | $615 | H4868-019-0 |
What is the typical premium for HMO-POS plans in Jefferson?
HMO-POS plans in Jefferson cost $25.00 per month on average.
Which HMO-POS plan has the most members in Jefferson?
The most popular HMO-POS plan in Jefferson is AARP Medicare Advantage from UHC NY-0006 (HMO-POS), with 1,342 enrollees.
How many HMO-POS options are offered without prescription drug coverage in Jefferson?
There are 3 HMO-POS plans in Jefferson without prescription drug coverage.
Medicare Advantage PFFS Plans
PFFS, or Private Fee-for-Service plans, allow access to any Medicare-approved doctor or hospital that accepts the plan’s terms. They provide wide flexibility in choosing providers, but it’s essential to verify that your preferred healthcare professionals agree to the plan’s payment rules before scheduling care.
| 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 Jefferson?
In 2026, Jefferson has 2 PFFS plans with 11 enrollees.
How much do PFFS plans cost in Jefferson?
The typical PFFS premium in Jefferson is $0.00, and 2 plans have no monthly premium.
CMS quality ratings for Medicare Advantage plans in Jefferson 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) | 9 | 33% |
| 3 Stars | 18 | 67% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.63 | |
* CMS assigns Medicare Advantage star ratings annually based on plan quality and performance measures.
- CMS.gov, Medicare Advantage Landscape Source Files — Last accessed June 13, 2026
- CMS.gov, Medicare Part C & D Performance Data — Last accessed June 13, 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Last accessed June 13, 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, "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
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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.