2026 Medicare Advantage Plans in Ontario County, NY
Last update: . Enrollment data updated: June 13, 2026
For 2026, Ontario County, NY includes 20 Medicare Advantage plans. Enrollment across these plans totals approximately 15,595, with 10 $0 premium options and 45% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Ontario County, NY are summarized separately. Visit Medicare Options in Ontario 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
- $61.97/mo
- Total PPO Enrollment
- 1,935
- $0 Premium PPO Plans
- 3
- Average MOOP
- $9,250
- Top PPO by Enrollment
- Aetna Medicare Elite (PPO) — 642 enrollees
- PPO Plans Without Drug Coverage
- 1
| PPO Plan Name | Rating* | Premium | MOOP | Rx Ded. | 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 | |
| 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 Ontario?
PPO plans in Ontario cost $61.97 per month on average.
Which PPO plan has the highest enrollment in Ontario?
The most popular PPO plan in Ontario is Aetna Medicare Elite (PPO), with 642 enrollees.
How many PPO plans in Ontario do not include prescription drug coverage?
1 PPO plans in Ontario 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 2
- Average Monthly Premium $27.50/mo
- Total HMO Enrollment 12,568
- $0 Premium HMO Plans 1
- Average MOOP $8,625
- Top HMO by Enrollment Medicare Blue Choice Core (HMO) — 10,064 enrollees
- HMO Plans Without Drug Coverage 0
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Medicare Blue Choice Core | $0 | $9,250 | $615 | H3351-022-0 | |
| Medicare Blue Choice Prime | $55 | $8,000 | $615 | H3351-023-0 |
What is the top HMO by enrollment in Ontario?
Medicare Blue Choice Core (HMO) is the top HMO in Ontario, with 10,064 enrollees.
What is the number of HMO plans without Part D coverage in Ontario?
0 HMO plans in Ontario 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
- $69.47/mo
- Total HMO-POS Enrollment
- 1,064
- $0 Premium HMO-POS Plans
- 4
- Average MOOP
- $7,564
- Top HMO-POS by Enrollment
- MVP Medicare Preferred Gold with Part D (HMO-POS) — 356 enrollees
- HMO-POS Plans Without Drug Coverage
- 3
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | 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 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 typical premium for HMO-POS plans in Ontario?
HMO-POS plans in Ontario cost $69.47 per month on average.
Which HMO-POS plan has the most members in Ontario?
The most popular HMO-POS plan in Ontario is MVP Medicare Preferred Gold with Part D (HMO-POS), with 356 enrollees.
How many HMO-POS options are offered without prescription drug coverage in Ontario?
There are 3 HMO-POS plans in Ontario 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 | |
| Wellcare Premium Enhanced | $50 | $3,400 | $615 | H2816-019-0 | |
| Wellcare Premium Ultra | $127 | $3,400 | $615 | H2816-013-0 |
What is the total number of PFFS plans in Ontario?
In 2026, Ontario has 4 PFFS plans with 28 enrollees.
How much do PFFS plans cost in Ontario?
The typical PFFS premium in Ontario is $44.25, and 2 plans have no monthly premium.
CMS quality ratings for Medicare Advantage plans in Ontario 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 | 45% |
| 3 Stars | 11 | 55% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.65 | |
* 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.