2026 Medicare Advantage Plans in Monroe County, PA
Last update: . Enrollment data updated: June 13, 2026
For 2026, Monroe County, PA includes 55 Medicare Advantage plans. Enrollment across these plans totals approximately 11,926, with 34 $0 premium options and 60% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Monroe County, PA are summarized separately. Visit Medicare Options in Monroe County, PA 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
- 33
- Average Monthly Premium
- $36.66/mo
- Total PPO Enrollment
- 7,593
- $0 Premium PPO Plans
- 18
- Average MOOP
- $6,632
- Top PPO by Enrollment
- Aetna Medicare Signature Giveback (PPO) — 1,689 enrollees
- PPO Plans Without Drug Coverage
- 6
What is the average monthly premium for PPO plans in Monroe?
PPO plans in Monroe cost $36.66 per month on average.
Which PPO plan has the highest enrollment in Monroe?
The most popular PPO plan in Monroe is Aetna Medicare Signature Giveback (PPO), with 1,689 enrollees.
How many PPO plans in Monroe do not include prescription drug coverage?
6 PPO plans in Monroe 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 15
- Average Monthly Premium $18.17/mo
- Total HMO Enrollment 3,753
- $0 Premium HMO Plans 10
- Average MOOP $6,760
- Top HMO by Enrollment Geisinger Gold Classic 360 Rx (HMO) — 1,016 enrollees
- HMO Plans Without Drug Coverage 2
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Community Blue Medicare HMO Distinct | $55 | $6,250 | $615 | H3957-049-7 | |
| Community Blue Medicare HMO Signature | $0 | $6,500 | $615 | H3957-042-6 | |
| Geisinger Gold Classic 360 Rx | $0 | $7,100 | $0 | H3954-160-0 | |
| Geisinger Gold Classic Advantage Rx | $114 | $3,450 | $0 | H3954-157-22 | |
| Geisinger Gold Classic Complete Rx | $48 | $5,700 | $0 | H3954-158-13 | |
| Geisinger Gold Classic Essential Rx | $0 | $6,750 | $0 | H3954-161-0 | |
| Geisinger Gold Heritage | $0 | $6,700 | N/A | H3954-162-0 | |
| Geisinger Gold Value Rx | $23 | $9,250 | $0 | H3954-163-0 | |
| UPMC for Life HMO No Rx | $0 | $6,000 | N/A | H3907-002-0 | |
| Humana Gold Plus H6622-036 | $0 | $8,250 | $615 | H6622-036-0 | |
| Jefferson Health Plans Complete | $0 | $6,500 | $0 | H9207-012-0 | |
| Jefferson Health Plans Giveback | $0 | $9,250 | $300 | H9207-015-0 | |
| Jefferson Health Plans Prime | $33 | $6,000 | $0 | H9207-002-0 | |
| DEVOTED CORE 008 PA | $0 | $6,700 | $375 | H6852-008-0 | |
| DEVOTED GIVEBACK 009 PA | $0 | $7,000 | $605 | H6852-009-0 |
What is the top HMO by enrollment in Monroe?
Geisinger Gold Classic 360 Rx (HMO) is the top HMO in Monroe, with 1,016 enrollees.
What is the number of HMO plans without Part D coverage in Monroe?
2 HMO plans in Monroe 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
- 6
- Average Monthly Premium
- $5.45/mo
- Total HMO-POS Enrollment
- 580
- $0 Premium HMO-POS Plans
- 5
- Average MOOP
- $6,358
- Top HMO-POS by Enrollment
- AARP Medicare Advantage from UHC PA-0002 (HMO-POS) — 264 enrollees
- HMO-POS Plans Without Drug Coverage
- 3
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | 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 | |
| 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 typical premium for HMO-POS plans in Monroe?
HMO-POS plans in Monroe cost $5.45 per month on average.
Which HMO-POS plan has the most members in Monroe?
The most popular HMO-POS plan in Monroe is AARP Medicare Advantage from UHC PA-0002 (HMO-POS), with 264 enrollees.
How many HMO-POS options are offered without prescription drug coverage in Monroe?
There are 3 HMO-POS plans in Monroe 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 |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-163 | $0 | $1,500 | N/A | H8145-163-0 |
What is the total number of PFFS plans in Monroe?
In 2026, Monroe has 1 PFFS plans with 0 enrollees.
How much do PFFS plans cost in Monroe?
The typical PFFS premium in Monroe is $0.00, and 1 plans have no monthly premium.
CMS quality ratings for Medicare Advantage plans in Monroe County, PA (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) | 30 | 60% |
| 3 Stars | 20 | 40% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 5 | 9% |
| Average Rating | 4.03 | |
* 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.