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The 2023 Medicare Advantage Plans in Madison County NY.



2022 Madison County New York
Medicare Advantage Plans

There are 48 Medicare Advantage Plans available in Madison County NY from 8 different health insurance providers. 15 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3400 and the highest out of pocket is $7550. Madison County New York residents can also pick from 8 Medicare Special Needs Plans. The best Medicare Advantage plan in Madison County New York received a 5 overall star rating from CMS and the lowest rated plan is 3.5 stars.



(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)

Name ⇅ Premium Deductible MOOP Gap Plan
Rating
Click
for
Formulary
AARP Medicare Advantage (HMO)
(H3379-039)

$0$195.00$7,550YesBrowse
Formulary
Aetna Medicare Credit Plan (PPO)
(H5521-313)

$0$350.00$7,550YesBrowse
Formulary
Aetna Medicare Discover Value Plan (PPO)
(H5521-340)

$25.00$300.00$7,550YesBrowse
Formulary
Aetna Medicare Premier Plan (PPO)
(H5521-077)

$0$250.00$7,550YesBrowse
Formulary
Aetna Medicare Value Plan (HMO)
(H3312-048)

$0$0$7,550YesBrowse
Formulary
CDPHP $0 Medicare Rx (HMO)
(H3388-014)

$0$300.00$7,500NoBrowse
Formulary
CDPHP Basic RX (HMO)
(H3388-013)

$31.00$0$6,700NoBrowse
Formulary
CDPHP Choice Rx (HMO)
(H3388-002)

$131.00$0$5,000NoBrowse
Formulary
CDPHP Flex Rx (PPO)
(H5042-011)

$42.00$0$5,500NoBrowse
Formulary
CDPHP Value Rx (HMO)
(H3388-004)

$60.80$0$5,800NoBrowse
Formulary
CDPHP Vital Rx (PPO)
(H5042-009)

$0$350.00$7,500NoBrowse
Formulary
Humana Gold Plus H3533-006 (HMO)
(H3533-006)

$0$300.00$7,200NoBrowse
Formulary
Humana Gold Plus H3533-013 (HMO)
(H3533-013)

$26.00$275.00$6,700NoBrowse
Formulary
HumanaChoice H5970-015 (PPO)
(H5970-015)

$0$250.00$4,900NoBrowse
Formulary
HumanaChoice H5970-018 (PPO)
(H5970-018)

$0$310.00$4,800NoBrowse
Formulary
HumanaChoice H5970-019 (PPO)
(H5970-019)

$24.00$0$4,500NoBrowse
Formulary
Medicare BlueActive (PPO)
(H3335-055)

$0$350.00$7,550NoBrowse
Formulary
Medicare BlueClassic (PPO)
(H3335-038)

$38.00$0$7,200NoBrowse
Formulary
Medicare BlueEnhanced (PPO)
(H3335-015)

$124.00$0$5,000NoBrowse
Formulary
Medicare BlueEssential (PPO)
(H3335-053)

$0$150.00$7,550NoBrowse
Formulary
Medicare BlueSecure (PPO)
(H3335-014)

$92.00$0$6,700NoBrowse
Formulary
MediGold Essential Care (HMO)
(H9827-001)

$0$0$6,200YesToo NewBrowse
Formulary
MediGold True Advantage (HMO)
(H9827-002)

$29.00$0$5,500YesToo NewBrowse
Formulary
MVP Medicare Preferred Gold with Part D (HMO-POS)
(H3305-021)

$140.00$0$5,800YesBrowse
Formulary
MVP Medicare Secure Plus with Part D (HMO-POS)
(H3305-022)

$90.00$0$7,550YesBrowse
Formulary
MVP Medicare Secure with Part D (HMO-POS)
(H3305-032)

$40.00$150.00$7,550NoBrowse
Formulary
MVP Medicare WellSelect Plus with Part D (PPO)
(H9615-007)

$125.00$0$6,500YesBrowse
Formulary
MVP Medicare WellSelect with Part D (PPO)
(H9615-008)

$0$300.00$7,550NoBrowse
Formulary
UnitedHealthcare Medicare Advantage Choice Plan 1 (Region
(R5342-001)

$16.00$300.00$7,200YesBrowse
Formulary
UnitedHealthcare Medicare Advantage Choice Plan 3 (Region
(R5342-005)

$46.00$250.00$6,900YesBrowse
Formulary
UnitedHealthcare Medicare Advantage Choice Plan 4 (Region
(R5342-006)

$84.00$150.00$6,700YesBrowse
Formulary
Wellcare Assist Open (PPO)
(H2775-113)

$30.70$480.00$6,700NoBrowse
Formulary
Wellcare Giveback Open (PPO)
(H2775-111)

$0$325.00$7,550YesBrowse
Formulary
Wellcare No Premium Open (PPO)
(H2775-106)

$0$0$6,700YesBrowse
Formulary
Wellcare Premium Enhanced (PFFS)
(H2816-019)

$55.00$0$-NoBrowse
Formulary
Wellcare Premium Ultra (PFFS)
(H2816-013)

$156.00$0$-NoBrowse
Formulary
Wellcare Premium Ultra Open (PPO)
(H2775-105)

$121.00$0$3,400NoBrowse
Formulary


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Medicare Advantage Health Plans Without Drug Coverage





2022 Medicare Special Needs Plans in Madison county New York

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Aetna Medicare Assure Plan (HMO D-SNP) $23.80$425.0No Gap CoverageDual-Eligible
Humana Gold Plus SNP-DE H3533-002 (HMO D-SNP) $30.10$460.0No Gap CoverageDual-Eligible
HumanaChoice SNP-DE H5970-020 (PPO D-SNP) $19.40$480.0No Gap CoverageDual-Eligible
UnitedHealthcare Dual Complete Plan 1 (HMO D-SNP) $42.40$480.0No Gap CoverageDual-Eligible
UnitedHealthcare Dual Complete Plan 2 (HMO D-SNP) $37.40$480.0No Gap CoverageDual-Eligible
UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) $42.40$480.0No Gap CoverageInstitutional
UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) $42.40$480.0No Gap CoverageInstitutional
Wellcare Dual Access Open (PPO D-SNP) $37.30$480.0No Gap CoverageDual-Eligible



Plan Type Is the type of organization offering the Medicare Plan.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescription Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your provider for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type
  • (EA) Enhanced Alternative may offer additional gap coverage which is calculated as the percentage of generic formulary products with coverage above standard generic coverage gap cost-sharing benefit and/or the percentage of brand formulary products covered in addition to the coverage gap discount for applicable drugs.
  • (DS) Defined Standard Benefit
  • (BA) Basic Alternative
  • (AE) Actuarially Equivalent Standard

GAP
  • Many - Many Generics and Some Brands
  • Some - Some Generics and Few Brands

Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable



Source: CMS. Data as of September 1, 2021.
Plans are subject to change as contracts are finalized.
Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.


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MedicareHelp.org is a privately-owned Non-governmental agency. The government website can be found at HealthCare.gov.

Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.