2026 Medicare Advantage Plans in Durham County, NC
Last update: . Enrollment data updated: August 15, 2026
Durham County, NC has 46 Medicare Advantage plans available in 2026. These include 34 plans with no monthly premium, and roughly 59% 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 Durham County, NC. Or explore all Medicare Options available in Durham County, NC.
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 24
- Average Monthly Premium $25.67/mo
- Total PPO Enrollment 3,209
- $0 Premium PPO Plans 16
- Average MOOP $7,188
- Top PPO by Enrollment Aetna Medicare Signature (PPO) — 779 enrollees
- PPO Plans Without Drug Coverage 7
What is the most popular PPO plan in Durham?
Aetna Medicare Signature (PPO) is the top PPO in Durham, with 779 enrollees.
What is the number of PPO plans without Part D coverage in Durham?
There are 7 PPO plans in Durham 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
- 11
- Average Monthly Premium
- $4.83/mo
- Total HMO Enrollment
- 3,031
- $0 Premium HMO Plans
- 8
- Average MOOP
- $5,618
- Top HMO by Enrollment
- Aetna Medicare Signature (HMO) — 991 enrollees
- HMO Plans Without Drug Coverage
- 1
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Aetna Medicare Signature | $0 | $6,750 | $615 | H3146-004-0 | |
| Aetna Medicare Signature Care | $0 | $6,350 | $615 | H3146-021-0 | |
| Aetna Medicare Value Plus | $32 | $5,500 | $615 | H3146-006-0 | |
| Blue Medicare Essential | $0 | $9,250 | $615 | H3449-027-2 | |
| HealthSpring Courage | $0 | $6,750 | N/A | H9725-005-0 | |
| HealthSpring Preferred | $0 | $3,550 | $295 | H9725-009-4 | |
| HealthSpring Preferred Plus | $14 | $3,300 | $200 | H9725-017-4 | |
| HealthSpring Preferred Savings | $0 | $6,700 | $0 | H9725-015-4 | |
| HealthSpring Preferred Select | $0 | $3,200 | $295 | H9725-014-0 | |
| Experience Health Medicare Advantage | $7 | $6,500 | $615 | H3777-002-0 | |
| Troy Medicare | $0 | $3,950 | $0 | H4676-001-0 |
What is the typical premium for HMO plans in Durham?
HMO plans in Durham cost $4.83 per month on average.
Which HMO plan do most beneficiaries choose in Durham?
The most popular HMO plan in Durham is Aetna Medicare Signature (HMO), with 991 enrollees.
How many HMO options are offered without prescription drug coverage in Durham?
There are 1 HMO plans in Durham 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 11
- Average Monthly Premium $3.64/mo
- Total HMO-POS Enrollment 9,685
- $0 Premium HMO-POS Plans 10
- Average MOOP $6,155
- Top HMO-POS by Enrollment Blue Medicare Essential Plus (HMO-POS) — 2,497 enrollees
- HMO-POS Plans Without Drug Coverage 2
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Humana Gold Plus Giveback H1036-318 | $0 | $9,250 | $450 | H1036-318-0 | |
| Humana Gold Plus H1036-335 | $0 | $3,950 | $250 | H1036-335-2 | |
| AARP Medicare Advantage from UHC NC-0007 | $0 | $6,200 | $520 | H5253-039-0 | |
| AARP Medicare Advantage from UHC NC-0015 | $0 | $4,200 | $440 | H5253-117-0 | |
| AARP Medicare Advantage Giveback from UHC NC-14 | $0 | $9,250 | $600 | H5253-110-0 | |
| AARP Medicare Advantage Patriot No Rx NC-MA02 | $0 | $7,900 | N/A | H5253-040-0 | |
| Blue Medicare Enhanced | $40 | $4,200 | $100 | H3449-024-2 | |
| Blue Medicare Essential Plus | $0 | $5,400 | $615 | H3449-023-2 | |
| Blue Medicare Medical Only | $0 | $3,900 | N/A | H3449-012-0 | |
| Humana Gold Plus H6622-060 | $0 | $9,250 | $350 | H6622-060-0 | |
| Wellcare Simple | $0 | $4,200 | $615 | H4073-001-0 |
What is the total number of HMO-POS plans in Durham?
In 2026, Durham has 11 HMO-POS plans with 9,685 enrollees.
How much do HMO-POS plans cost in Durham?
The typical HMO-POS premium in Durham is $3.64, and 10 plans have no monthly premium.
Below is a breakdown of CMS star ratings for Medicare Advantage plans available in Durham County, NC for 2026.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 27 | 59% |
| 3 Stars | 19 | 41% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.85 | |
* 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 August 15, 2026
- CMS.gov, Medicare Part C & D Performance Data — Last accessed August 15, 2026
- CMS.gov, Medicare Advantage & Part D Contract and Enrollment Data — Last accessed August 15, 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
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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.