2026 Medicare Advantage Plans in Monroe County, NY
Last update: . Enrollment data updated: May 2, 2026
Monroe County, NY has 19 Medicare Advantage plans available in 2026. These include 11 plans with no monthly premium, and roughly 47% are rated at least 4 stars based on CMS data.
Medicare Advantage Special Needs Plans (SNPs) are not included in the figures shown above. View Special Needs Plans in Monroe County, NY. Or explore all Medicare Options available in Monroe 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 7
- Average Monthly Premium $58.14/mo
- Total PPO Enrollment 11,822
- $0 Premium PPO Plans 3
- Average MOOP $8,636
- Top PPO by Enrollment HumanaChoice Giveback H5970-030 (PPO) — 6,033 enrollees
- PPO Plans Without Drug Coverage 2
| 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 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 most popular PPO plan in Monroe?
HumanaChoice Giveback H5970-030 (PPO) is the top PPO in Monroe, with 6,033 enrollees.
What is the number of PPO plans without Part D coverage in Monroe?
There are 2 PPO plans in Monroe 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
- 3
- Average Monthly Premium
- $26.67/mo
- Total HMO Enrollment
- 67,878
- $0 Premium HMO Plans
- 1
- Average MOOP
- $8,833
- Top HMO by Enrollment
- Medicare Blue Choice Core (HMO) — 56,054 enrollees
- HMO Plans Without Drug Coverage
- 0
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan 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 typical premium for HMO plans in Monroe?
HMO plans in Monroe cost $26.67 per month on average.
Which HMO plan do most beneficiaries choose in Monroe?
The most popular HMO plan in Monroe is Medicare Blue Choice Core (HMO), with 56,054 enrollees.
How many HMO options are offered without prescription drug coverage in Monroe?
There are 0 HMO plans in Monroe without prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO Point-of-Service (HMO-POS) plans combine HMO network requirements with limited out-of-network access. Care outside the network typically costs more, but HMO-POS plans provide added flexibility compared with standard HMOs.
- Total HMO-POS Plans 7
- Average Monthly Premium $64.83/mo
- Total HMO-POS Enrollment 8,896
- $0 Premium HMO-POS Plans 5
- Average MOOP $7,200
- Top HMO-POS by Enrollment Wellcare Simple (HMO-POS) — 3,193 enrollees
- HMO-POS Plans Without Drug Coverage 4
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan 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 total number of HMO-POS plans in Monroe?
In 2026, Monroe has 7 HMO-POS plans with 8,896 enrollees.
How much do HMO-POS plans cost in Monroe?
The typical HMO-POS premium in Monroe is $64.83, and 5 plans have no monthly premium.
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
- 36
- $0 Premium PFFS Plans
- 2
- Average MOOP
- $5,500
- Top PFFS by Enrollment
- Wellcare Advantage Simple (PFFS) — 20 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 average monthly premium for PFFS plans?
- PFFS plans in Monroe cost $0.00 per month on average.
- Which PFFS plan is most popular in Monroe?
- The most popular PFFS plan in Monroe is Wellcare Advantage Simple (PFFS), with 20 enrollees.
- How many PFFS plans in Monroe do not include drug coverage?
- There are 2 PFFS plans in Monroe without prescription drug coverage.
Below is a breakdown of CMS star ratings for Medicare Advantage plans available in Monroe 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) | 9 | 47% |
| 3 Stars | 10 | 53% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.66 | |
* Medicare Advantage star ratings are determined by CMS each year using a standardized 5-star rating system.
- 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
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 .
- CMS.gov, "Medicare Advantage Plan Fact Sheet" — 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
MedicarePlans.com is an independent, non-government informational resource and is not affiliated with or endorsed by the U.S. Government or the federal Medicare program.
Data provenance documentation is maintained in alignment 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.