- Entity
- county:new-york-monroe-36055
- 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/monroe/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-county-plan-index
- Total Standard Medicare Advantage Plans
- 19
- PPO Plans
- 7
- HMO Plans
- 3
- HMO-POS Plans
- 7
- PFFS Plans
- 2
- Average Monthly Premium
- 49.52
- Average MOOP
- 7807.89
- Average Part D Deductible
- 529.09
- $0 Premium Plans
- 11
- Plans Without Part D Coverage
- 8
- Average CMS Star Rating
- 3.66
- $0 Premium Plan Share
- 57.89
- 5-Star Plan Share
- 0
- 4+ Star Plan Share
- 47
- 3-Star Plan Share
- 53
- Below 3-Star Plan Share
- 0
- Not-Rated Plan Share
- 0
- PPO Average Monthly Premium
- 58.14
- PPO Average MOOP
- 8635.71
- PPO Enrollment
- 11953
- PPO $0 Premium Plans
- 3
- PPO Plans Without Part D Coverage
- 2
- HMO Average Monthly Premium
- 26.67
- HMO Average MOOP
- 8833.33
- HMO Enrollment
- 68812
- HMO $0 Premium Plans
- 1
- HMO Plans Without Part D Coverage
- 0
- HMO-POS Average Monthly Premium
- 64.83
- HMO-POS Average MOOP
- 7200
- HMO-POS Enrollment
- 8810
- HMO-POS $0 Premium Plans
- 5
- HMO-POS Plans Without Part D Coverage
- 4
- PFFS Average Monthly Premium
- 0
- PFFS Average MOOP
- 5500
- PFFS Enrollment
- 34
- PFFS $0 Premium Plans
- 2
- PFFS Plans Without Part D Coverage
- 2
- Entity
- county:new-york-monroe-36055
- 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/monroe/
- Glossary Scope
- cms_landscape
- Fragment Scope
- semantic-digest
- Method
- https://webmem.com/protocol/serialization/html/
- fragment-new-york-monroe-36055-landscape-stats
- Plans Indexed
- 19
- Standard Medicare Advantage Plans
-
-
Aetna Medicare Eagle Giveback
H5521-323-0 -
Aetna Medicare Elite
H5521-521-0 -
Aetna Medicare Enhanced
H5521-522-0 -
Medicare Blue Choice Core
H3351-022-0 -
Medicare Blue Choice Freedom
H3351-007-0 -
Medicare Blue Choice Optimum
H3351-006-0 -
Medicare Blue Choice Prime
H3351-023-0 -
MVP Medicare Preferred Gold with Part D
H3305-015-0 -
MVP Medicare Preferred Gold without Part D
H3305-007-0 -
MVP Medicare WellSelect with Part D
H9615-021-0 -
VNS Health EasyCare
H5549-012-0 -
Wellcare Advantage Enhanced
H2816-037-0 -
Wellcare Advantage Simple
H2816-038-0 -
Humana USAA Honor Giveback
H5970-016-0 -
HumanaChoice Giveback H5970-030
H5970-030-0 -
HumanaChoice H5970-029
H5970-029-0 -
Wellcare Fidelis Patriot Simple
H5599-010-0 -
Wellcare Patriot Simple
H4868-003-0 -
Wellcare Simple
H4868-019-0
-
Aetna Medicare Eagle Giveback
- Total Standard Medicare Advantage Enrollment
- 89609
2026 Medicare Advantage Plans in Monroe County, NY
Last update: .
For 2026, Monroe County, NY includes 19 Medicare Advantage plans. Enrollment across these plans totals approximately 89,609, with 11 $0 premium options and 47% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Monroe County, NY are summarized separately. Visit Medicare Options in Monroe 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
- 7
- Average Monthly Premium
- $58.14/mo
- Total PPO Enrollment
- 11,953
- $0 Premium PPO Plans
- 3
- Average MOOP
- $8,636
- Top PPO by Enrollment
- HumanaChoice Giveback H5970-030 (PPO) — 6,112 enrollees
- PPO Plans Without Drug Coverage
- 2
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Aetna Medicare Eagle Giveback | $0 | $9,250 | N/A | H5521-323-0 | |
| Aetna Medicare Elite | $84 | $9,250 | $615 | H5521-521-0 | |
| Aetna Medicare Enhanced | $131 | $9,250 | $615 | H5521-522-0 | |
| MVP Medicare WellSelect with Part D | $160 | $9,250 | $615 | H9615-021-0 | |
| 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 |
- What is the average monthly premium for PPO plans in Monroe?
- PPO plans in Monroe cost $58.14 per month on average.
- Which PPO plan has the highest enrollment in Monroe?
- The most popular PPO plan in Monroe is HumanaChoice Giveback H5970-030 (PPO), with 6,112 enrollees.
- How many PPO plans in Monroe do not include prescription drug coverage?
- 2 PPO plans in Monroe 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 |
|---|---|---|---|---|---|
| Medicare Blue Choice Core | $0 | $9,250 | $615 | H3351-022-0 | |
| Medicare Blue Choice Prime | $55 | $8,000 | $615 | H3351-023-0 | |
| VNS Health EasyCare | $25 | $9,250 | $500 | H5549-012-0 |
What is the total number of HMO plans offered in Monroe?
There are 3 HMO plans in 2026, covering 68,812 enrollees.
How much do HMO plans cost in Monroe?
The average HMO premium in Monroe is $26.67 per month, with 1 plans offering $0 premiums.
What is the top HMO by enrollment in Monroe?
Medicare Blue Choice Core (HMO) is the top HMO in Monroe, with 57,006 enrollees.
What is the number of HMO plans without Part D coverage in Monroe?
0 HMO plans in Monroe 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
- 7
- Average Monthly Premium
- $64.83/mo
- Total HMO-POS Enrollment
- 8,810
- $0 Premium HMO-POS Plans
- 5
- Average MOOP
- $7,200
- Top HMO-POS by Enrollment
- Wellcare Simple (HMO-POS) — 3,224 enrollees
- HMO-POS Plans Without Drug Coverage
- 4
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Medicare Blue Choice Freedom | $0 | $4,500 | N/A | H3351-007-0 | |
| Medicare Blue Choice Optimum | $225 | $6,700 | $100 | H3351-006-0 | |
| MVP Medicare Preferred Gold with Part D | $229 | $6,800 | $300 | H3305-015-0 | |
| MVP Medicare Preferred Gold without Part D | $0 | $7,200 | N/A | H3305-007-0 | |
| Wellcare Fidelis Patriot Simple | $0 | $9,250 | N/A | H5599-010-0 | |
| Wellcare Patriot Simple | $0 | $6,700 | N/A | H4868-003-0 | |
| Wellcare Simple | $0 | $9,250 | $615 | H4868-019-0 |
What is the average monthly premium for HMO-POS plans?
HMO-POS plans in Monroe cost $64.83 per month on average.
Which HMO-POS plan is most popular in Monroe?
The most popular HMO-POS plan in Monroe is Wellcare Simple (HMO-POS), with 3,224 enrollees.
How many HMO-POS plans in Monroe do not include drug coverage?
There are 4 HMO-POS plans in Monroe 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 34
- $0 Premium PFFS Plans 2
- Average MOOP $5,500
- Top PFFS by Enrollment Wellcare Advantage Simple (PFFS) — 18 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 |
What is the top PFFS plan in Monroe?
Wellcare Advantage Simple (PFFS) is the top PFFS in Monroe, with 18 enrollees.
What is the number of PFFS plans without Part D coverage in Monroe?
2 PFFS plans in Monroe do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Monroe 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 | 47% |
| 3 Stars | 10 | 53% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.66 | |
* 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.