2026 Medicare Advantage Plans in Madison County, NC
Last update: . Enrollment data updated: May 2, 2026
In Madison County, NC, there are 47 Medicare Advantage plans available for 2026. Of these, 34 offer a $0 monthly premium, and about 56% are rated 4 stars or higher based on CMS quality ratings.
Medicare Advantage Special Needs Plans (SNPs) are not included in the figures shown above. View Special Needs Plans in Madison County, NC. Or explore all Medicare Options available in Madison 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 26
- Average Monthly Premium $20.92/mo
- Total PPO Enrollment 558
- $0 Premium PPO Plans 19
- Average MOOP $7,519
- Top PPO by Enrollment Blue Medicare PPO Enhanced (PPO) — 97 enrollees
- PPO Plans Without Drug Coverage 8
What is the total number of PPO plans offered in Madison?
There are 26 PPO plans in 2026, covering 558 beneficiaries.
How much do PPO plans cost in Madison?
The average PPO premium in Madison is $20.92 per month, with 19 plans offering $0 premiums.
What is the most popular PPO plan in Madison?
Blue Medicare PPO Enhanced (PPO) is the top PPO in Madison, with 97 enrollees.
What is the number of PPO plans without Part D coverage in Madison?
There are 8 PPO plans in Madison 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
- 9
- Average Monthly Premium
- $4.80/mo
- Total HMO Enrollment
- 169
- $0 Premium HMO Plans
- 7
- Average MOOP
- $5,311
- Top HMO by Enrollment
- Alignment Health Platinum (HMO) — 67 enrollees
- HMO Plans Without Drug Coverage
- 1
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Alignment Health Platinum | $0 | $3,900 | $0 | H5296-003-0 | |
| Alignment Health Platinum Select | $0 | $5,900 | $225 | H5296-010-0 | |
| Alignment Health smartHMO | $0 | $3,400 | $615 | H5296-006-0 | |
| 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 | $3,500 | $295 | H9725-009-2 | |
| HealthSpring Preferred Plus | $11 | $3,200 | $200 | H9725-017-2 | |
| HealthSpring Preferred Savings | $0 | $6,400 | $0 | H9725-015-2 |
What is the average monthly premium for HMO plans?
HMO plans in Madison cost $4.80 per month on average.
Which HMO plan is most popular in Madison?
The most popular HMO plan in Madison is Alignment Health Platinum (HMO), with 67 enrollees.
How many HMO plans in Madison do not include drug coverage?
There are 1 HMO plans in Madison without prescription drug coverage.
Medicare Advantage HMO-POS Plans
HMO Point-of-Service (HMO-POS) plans combine HMO network rules with limited out-of-network access. Care outside the network typically costs more, but HMO-POS plans provide added flexibility compared with standard HMOs.
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Humana Gold Plus H1036-335 | $0 | $3,950 | $250 | H1036-335-2 | |
| AARP Medicare Advantage from UHC NC-0008 | $0 | $6,700 | $520 | H5253-079-0 | |
| AARP Medicare Advantage from UHC NC-0009 | $48 | $5,400 | $440 | H5253-080-0 | |
| AARP Medicare Advantage from UHC NC-24 | $0 | $5,400 | $520 | H5253-185-0 | |
| AARP Medicare Advantage Giveback from UHC NC-13 | $0 | $8,900 | $600 | H5253-105-0 | |
| 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 H6622-026 | $35 | $9,250 | $350 | H6622-026-0 | |
| Wellcare Simple | $0 | $4,200 | $615 | H4073-001-0 |
What is the leading HMO-POS plan in Madison?
Humana Gold Plus H1036-335 (HMO-POS) is the top HMO-POS in Madison, with 531 enrollees.
What is the number of HMO-POS plans without Part D coverage in Madison?
2 HMO-POS plans in Madison do not include prescription drug coverage.
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
- 1
- Average Monthly Premium
- $7.00/mo
- Total PFFS Enrollment
- 27
- $0 Premium PFFS Plans
- 0
- Average MOOP
- $7,550
- Top PFFS by Enrollment
- Humana Gold Choice H8145-004 (PFFS) — 27 enrollees
- PFFS Plans Without Drug Coverage
- 0
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-004 | $7 | $7,550 | $615 | H8145-004-0 |
What is the typical premium for PFFS plans in Madison?
PFFS plans in Madison cost $7.00 per month on average.
Which PFFS plan has the most enrollment in Madison?
The most popular PFFS plan in Madison is Humana Gold Choice H8145-004 (PFFS), with 27 enrollees.
How many PFFS options are available without prescription drug coverage in Madison?
There are 0 PFFS plans in Madison without prescription drug coverage.
The table below shows CMS star ratings for Medicare Advantage plans in Madison County, NC for 2026.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | 3 | 7% |
| 4 Stars (includes 5 Stars) | 24 | 56% |
| 3 Stars | 19 | 44% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 4 | 9% |
| Average Rating | 3.92 | |
* 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 .
- Medicare.gov, "Compare types of Medicare Advantage Plans" — 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.
This page follows data provenance practices aligned with the 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.