2026 Medicare Advantage Plans in Berks County, PA
Last update: . Enrollment data updated: May 2, 2026
In Berks County, PA, there are 77 Medicare Advantage plans available for 2026. Of these, 44 offer a $0 monthly premium, and about 65% 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 Berks County, PA. Or explore all Medicare Options available in Berks County, PA.
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow members to use both in-network and out-of-network providers. Out-of-network care typically costs more, but PPOs offer greater flexibility in how care is accessed.
What is the total number of PPO plans offered in Berks?
Berks County has 48 PPO plans for 2026, with 23,023 enrolled.
How much do PPO plans cost in Berks?
The typical PPO premium in Berks is $34.74, and 25 plans have no monthly premium.
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
- 19
- Average Monthly Premium
- $36.72/mo
- Total HMO Enrollment
- 4,155
- $0 Premium HMO Plans
- 11
- Average MOOP
- $6,645
- Top HMO by Enrollment
- Humana Gold Plus H6622-035 (HMO) — 1,234 enrollees
- HMO Plans Without Drug Coverage
- 2
- What is the average monthly premium for HMO plans?
- HMO plans in Berks cost $36.72 per month on average.
- Which HMO plan is most popular in Berks?
- The most popular HMO plan in Berks is Humana Gold Plus H6622-035 (HMO), with 1,234 enrollees.
- How many HMO plans in Berks do not include drug coverage?
- There are 2 HMO plans in Berks 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 $11.53/mo
- Total HMO-POS Enrollment 1,305
- $0 Premium HMO-POS Plans 5
- Average MOOP $6,521
- Top HMO-POS by Enrollment AARP Medicare Advantage from UHC PA-0002 (HMO-POS) — 559 enrollees
- HMO-POS Plans Without Drug Coverage 3
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| AARP Medicare Advantage from UHC PA-0002 | $0 | $6,700 | $440 | H5253-146-0 | |
| AARP Medicare Advantage Patriot No Rx PA-MA01 | $0 | $6,700 | N/A | H5253-152-0 | |
| Aetna Medicare Advantra Eagle Plus | $0 | $5,500 | N/A | H3959-041-0 | |
| Aetna Medicare Advantra Enhanced | $48 | $7,500 | $615 | H3959-039-0 | |
| Wellcare Assist | $33 | $5,500 | $475 | H2915-011-0 | |
| Wellcare Patriot Giveback | $0 | $7,550 | N/A | H2915-013-0 | |
| Wellcare Simple | $0 | $6,200 | $615 | H2915-003-0 |
What is the total number of HMO-POS plans in Berks?
There are 7 HMO-POS plans in 2026, covering 1,305 enrollees.
How much do HMO-POS plans cost in Berks?
The average HMO-POS premium in Berks is $11.53 per month, with 5 plans offering $0 premiums.
What is the leading HMO-POS plan in Berks?
AARP Medicare Advantage from UHC PA-0002 (HMO-POS) is the top HMO-POS in Berks, with 559 enrollees.
What is the number of HMO-POS plans without Part D coverage in Berks?
3 HMO-POS plans in Berks 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
- 3
- Average Monthly Premium
- $0.00/mo
- Total PFFS Enrollment
- 263
- $0 Premium PFFS Plans
- 3
- Average MOOP
- $5,100
- Top PFFS by Enrollment
- Humana Gold Choice H8145-052 (PFFS) — 220 enrollees
- PFFS Plans Without Drug Coverage
- 2
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-052 | $0 | $7,100 | $615 | H8145-052-0 | |
| Humana Gold Choice H8145-055 | $0 | $6,700 | N/A | H8145-055-0 | |
| Humana Gold Choice H8145-163 | $0 | $1,500 | N/A | H8145-163-0 |
What is the average monthly premium for PFFS plans?
PFFS plans in Berks cost $0.00 per month on average.
Which PFFS plan is most popular in Berks?
The most popular PFFS plan in Berks is Humana Gold Choice H8145-052 (PFFS), with 220 enrollees.
How many PFFS plans in Berks do not include drug coverage?
There are 2 PFFS plans in Berks without prescription drug coverage.
The table below shows CMS star ratings for Medicare Advantage plans in Berks County, PA for 2026.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 47 | 65% |
| 3 Stars | 25 | 35% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 5 | 6% |
| Average Rating | 4.08 | |
* 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
This page presents county-level Medicare Advantage (MA/MAPD) data, including plan counts, enrollment totals, averages, and percentage distributions, derived from CMS datasets using a standardized aggregation approach.
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
- AARP.org, "The Big Choice: Original Medicare vs. Medicare Advantage" — 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.