2026 Medicare Advantage Plans in Saint Lawrence County, NY
Last update: . Enrollment data updated: June 13, 2026
For 2026, Saint Lawrence County, NY includes 25 Medicare Advantage plans. Enrollment across these plans totals approximately 6,809, with 16 $0 premium options and 32% rated 4 stars or higher.
Totals on this page exclude Medicare Advantage Special Needs Plans (SNPs). SNP plans for Saint Lawrence County, NY are provided separately. Or you can discover all Medicare Options in Saint Lawrence County, NY.
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
- $33.65/mo
- Total PPO Enrollment
- 5,758
- $0 Premium PPO Plans
- 8
- Average MOOP
- $8,364
- Top PPO by Enrollment
- Medicare BlueVital (PPO) — 1,330 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 | $174 | $9,250 | $615 | H9615-022-0 | |
| 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 typical premium for PPO plans available in Saint Lawrence?
PPO plans in Saint Lawrence cost $33.65 per month on average.
Which PPO plan do most beneficiaries choose in Saint Lawrence?
The most popular PPO plan in Saint Lawrence is Medicare BlueVital (PPO), with 1,330 enrollees.
How many PPO options are offered without drug coverage in Saint Lawrence?
3 PPO plans in Saint Lawrence 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 691
- $0 Premium HMO Plans 3
- Average MOOP $6,900
- Top HMO by Enrollment Aetna Medicare Signature (HMO) — 513 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 total number of HMO plans offered in Saint Lawrence?
In 2026, Saint Lawrence County has 5 HMO plans with 691 enrollees.
How much do HMO plans cost in Saint Lawrence?
The typical HMO premium in Saint Lawrence is $47.00, and 3 plans have no monthly premium.
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
- 4
- Average Monthly Premium
- $8.13/mo
- Total HMO-POS Enrollment
- 334
- $0 Premium HMO-POS Plans
- 3
- Average MOOP
- $8,738
- Top HMO-POS by Enrollment
- Wellcare Fidelis Simple (HMO-POS) — 180 enrollees
- HMO-POS Plans Without Drug Coverage
- 2
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| MVP Medicare Preferred Gold without Part D | $0 | $7,200 | N/A | H3305-020-0 | |
| 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 Saint Lawrence cost $8.13 per month on average.
- Which HMO-POS plan is most popular in Saint Lawrence?
- The most popular HMO-POS plan in Saint Lawrence is Wellcare Fidelis Simple (HMO-POS), with 180 enrollees.
- How many HMO-POS plans in Saint Lawrence do not include drug coverage?
- There are 2 HMO-POS plans in Saint Lawrence 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 26
- $0 Premium PFFS Plans 2
- Average MOOP $5,500
- Top PFFS by Enrollment Wellcare Advantage Simple (PFFS) — 26 enrollees
- PFFS Plans Without Drug Coverage 2
| 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 Saint Lawrence?
There are 2 PFFS plans in 2026, covering 26 enrollees.
How much do PFFS plans cost in Saint Lawrence?
The average PFFS premium in Saint Lawrence is $0.00 per month, with 2 plans offering $0 premiums.
What is the top PFFS plan in Saint Lawrence?
Wellcare Advantage Simple (PFFS) is the top PFFS in Saint Lawrence, with 26 enrollees.
What is the number of PFFS plans without Part D coverage in Saint Lawrence?
2 PFFS plans in Saint Lawrence do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Saint Lawrence 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) | 8 | 32% |
| 3 Stars | 17 | 68% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.6 | |
* Star ratings are based on CMS quality measures and reflect plan performance for the 2026 rating period.
- 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, "Explore your Medicare coverage options" — 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.