2026 Medicare Advantage Plans in Middlesex County, VA
Last update: . Enrollment data updated: May 2, 2026
For 2026, Middlesex County, VA includes 31 Medicare Advantage plans. Enrollment across these plans totals approximately 1,013, with 24 $0 premium options and 35% rated 4 stars or higher.
This page and its statistics exclude Medicare Advantage Special Needs Plans (SNPs). Special Needs Plans in Middlesex County, VA are summarized separately. Visit Medicare Options in Middlesex County, VA 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
- 20
- Average Monthly Premium
- $13.83/mo
- Total PPO Enrollment
- 525
- $0 Premium PPO Plans
- 15
- Average MOOP
- $8,023
- Top PPO by Enrollment
- Humana Value Choice H5216-266 (PPO) — 118 enrollees
- PPO Plans Without Drug Coverage
- 7
- What is the average monthly premium for PPO plans in Middlesex?
- PPO plans in Middlesex cost $13.83 per month on average.
- Which PPO plan has the highest enrollment in Middlesex?
- The most popular PPO plan in Middlesex is Humana Value Choice H5216-266 (PPO), with 118 enrollees.
- How many PPO plans in Middlesex do not include prescription drug coverage?
- 7 PPO plans in Middlesex do not include prescription drug coverage.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans are built around a defined network of doctors and hospitals. Care is generally covered only within the network, except in emergencies, but this structure often results in lower premiums and out-of-pocket costs.
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Humana Gold Plus Giveback H1036-334 | $0 | $9,250 | $450 | H1036-334-0 | |
| Humana Gold Plus Giveback H6622-090 | $0 | $9,250 | $450 | H6622-090-0 | |
| Humana Gold Plus H6622-083 | $0 | $8,950 | $350 | H6622-083-0 | |
| Humana Gold Plus H6622-085 | $16 | $9,250 | $615 | H6622-085-0 | |
| Humana Total Complete H6622-091 | $0 | $7,900 | $450 | H6622-091-0 | |
| Humana Gold Plus H5619-157 | $0 | $9,250 | $350 | H5619-157-0 |
What is the total number of HMO plans offered in Middlesex?
There are 6 HMO plans in 2026, covering 92 enrollees.
How much do HMO plans cost in Middlesex?
The average HMO premium in Middlesex is $2.60 per month, with 5 plans offering $0 premiums.
What is the top HMO by enrollment in Middlesex?
Humana Gold Plus Giveback H1036-334 (HMO) is the top HMO in Middlesex, with 31 enrollees.
What is the number of HMO plans without Part D coverage in Middlesex?
0 HMO plans in Middlesex 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
- 3
- Average Monthly Premium
- $0.00/mo
- Total HMO-POS Enrollment
- 378
- $0 Premium HMO-POS Plans
- 3
- Average MOOP
- $6,517
- Top HMO-POS by Enrollment
- Anthem Medicare Advantage (HMO-POS) — 160 enrollees
- HMO-POS Plans Without Drug Coverage
- 0
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Anthem Medicare Advantage | $0 | $8,550 | $250 | H3447-013-0 | |
| Anthem Medicare Advantage 3 | $0 | $4,250 | $295 | H3447-049-0 | |
| Aetna Medicare Signature Care | $0 | $6,750 | $615 | H3931-100-0 |
What is the average monthly premium for HMO-POS plans?
HMO-POS plans in Middlesex cost $0.00 per month on average.
Which HMO-POS plan is most popular in Middlesex?
The most popular HMO-POS plan in Middlesex is Anthem Medicare Advantage (HMO-POS), with 160 enrollees.
How many HMO-POS plans in Middlesex do not include drug coverage?
There are 0 HMO-POS plans in Middlesex 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 $3.50/mo
- Total PFFS Enrollment 18
- $0 Premium PFFS Plans 1
- Average MOOP $6,725
- Top PFFS by Enrollment Humana Gold Choice H8145-004 (PFFS) — 18 enrollees
- PFFS Plans Without Drug Coverage 1
| Plan Name | CMS Stars* | Premium/Mo | MOOP | Rx Ded. | CMS ID |
|---|---|---|---|---|---|
| Humana Gold Choice H8145-004 | $7 | $7,550 | $615 | H8145-004-0 | |
| Humana Gold Choice H8145-042 | $0 | $5,900 | N/A | H8145-042-0 |
What is the top PFFS plan in Middlesex?
Humana Gold Choice H8145-004 (PFFS) is the top PFFS in Middlesex, with 18 enrollees.
What is the number of PFFS plans without Part D coverage in Middlesex?
1 PFFS plans in Middlesex do not include prescription drug coverage.
CMS quality ratings for Medicare Advantage plans in Middlesex County, VA (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) | 11 | 35% |
| 3 Stars | 20 | 65% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.81 | |
* CMS assigns Medicare Advantage star ratings annually based on plan quality and performance measures.
- 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
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
MedicarePlans.com is an independent informational resource and has no affiliation with, or endorsement from, the U.S. Government or the federal Medicare program.
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.