Medicare Advantage Plans in Herkimer County, NY:
Your Complete 2027 Guide
In Herkimer County, NY, Medicare beneficiaries have 19 Medicare Advantage plans to consider for 2027. Among them, 11 are offered at a $0 premium. About 2,141 people in the County are currently enrolled, and 32% of plans are rated 4 stars or higher. Special Needs Plans are not included in the figures shown above. Explore SNP options for Herkimer County, NY here. For a broader view beyond Medicare Advantage, see all Medicare coverage options in Herkimer County.
Page last revised:
Enrollment data refreshed: October 5, 2026
* Each year CMS evaluates Medicare Advantage plans on a 5-star scale. Data sources
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans offer flexibility by allowing you to see both in-network and out-of-network providers. Out-of-network care usually costs more, but PPOs may appeal to people who want more choice in doctors and hospitals.
- Total PPO Plans 8
- Average Premium $46.88/mo
- Beneficiaries Enrolled 795
- $0 Premium PPOs 5
- Average MOOP $8,869
- Most Popular PPO Wellcare Simple Open (PPO) with 318 enrollees
- PPOs Without Drug Coverage 2
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Aetna Medicare Eagle Giveback | $0 | $9,850 | N/A | H5521 323 0 | |
| Aetna Medicare Elite | $54 | $9,850 | $700 | H5521 740 0 | |
| MVP Medicare Secure Plus Choice with Part D | $256 | $7,500 | $500 | H9615 025 0 | |
| Humana USAA Honor Giveback | $0 | $4,950 | N/A | H5970 016 0 | |
| HumanaChoice H5970-029 | $65 | $9,250 | $700 | H5970 029 0 | |
| Wellcare Assist Open | $0 | $9,850 | $700 | H2775 113 0 | |
| Wellcare Giveback Open | $0 | $9,850 | $700 | H2775 111 0 | |
| Wellcare Simple Open | $0 | $9,850 | $700 | H2775 106 0 |
What is the total number of PPO plans offered in Herkimer?
There are 8 PPO plans in 2027, covering 795 beneficiaries.
How much do PPO plans cost on average in Herkimer?
The average PPO premium is $46.88, with 5 costing $0.
What is the most popular PPO plan in Herkimer?
Wellcare Simple Open (PPO) is the top PPO in Herkimer, with 318 enrollees.
What is the number of PPO plans without Part D coverage in Herkimer?
There are 2 PPO plans in Herkimer without prescription drug coverage.
Medicare Advantage HMO Plans
With an HMO, you’ll typically get care from providers and facilities in the plan’s network. In exchange for this limitation, HMO plans usually feature lower monthly premiums and reduced cost-sharing, which can help enrollees better manage their healthcare expenses.
- Total HMO Plans
- 2
- Average Premium
- $7.00/mo
- Beneficiaries Enrolled
- 842
- $0 Premium HMOs
- 1
- Average MOOP
- $9,850
- Most Popular HMO
- Aetna Medicare Signature (HMO) with 842 enrollees
- HMOs Without Drug Coverage
- 0
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Medicare Blue Choice 028 | $14 | $9,850 | $700 | H3351 028 0 | |
| Aetna Medicare Signature | $0 | $9,850 | $700 | H3312 048 0 |
What is the average monthly premium for HMO plans?
On average, HMO plans in Herkimer cost $7.00 per month.
Which HMO plan is most popular in Herkimer?
The leading HMO in Herkimer is Aetna Medicare Signature (HMO), with 842 members.
How many HMO plans in Herkimer do not include drug coverage?
There are 0 HMO plans available in Herkimer without Part D benefits.
Medicare Advantage HMO-POS Plans
With HMO Point-of-Service (HMO-POS) plans, you can enjoy the cost savings of an HMO while still having the flexibility to see out-of-network providers when necessary. Though out-of-network care typically costs more, this type of plan offers a good middle ground for those who want some freedom in their provider choices.
| Health Plan Name | CMS Rating* | Premium Per Mo | MOOP | PDP Ded. | CMS Plan ID |
|---|---|---|---|---|---|
| Medicare Blue Choice 029 | $85 | $8,500 | $700 | H3351 029 0 | |
| Medicare Blue Choice 030 | $125 | $7,500 | $325 | H3351 030 0 | |
| Medicare Blue Choice 031 | $0 | $6,500 | N/A | H3351 031 0 | |
| MVP Medicare Preferred Gold without Part D | $0 | $7,200 | N/A | H3305 020 0 | |
| MVP Medicare Secure Plus with Part D | $165 | $6,000 | $500 | H3305 022 0 | |
| MVP Medicare WellValue with Part D | $71 | $9,850 | $700 | H3305 038 0 | |
| Wellcare Fidelis Assist | $0 | $9,850 | $700 | H5599 002 0 | |
| Wellcare Fidelis Patriot Simple | $0 | $9,850 | N/A | H5599 010 0 | |
| Wellcare Fidelis Simple | $0 | $9,850 | $700 | H5599 004 0 |
What is the leading HMO-POS plan in Herkimer?
Wellcare Fidelis Simple (HMO-POS) is the most popular HMO-POS plan in Herkimer, with 252 enrollees.
What is the number of HMO-POS plans without Part D coverage in Herkimer?
3 HMO-POS plans in Herkimer do not include drug coverage.
The table below shows the quality ratings for Medicare Advantage plans offered in Herkimer County, NY for 2027.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 6 | 32% |
| 3 Stars | 13 | 68% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.42 | |
In Herkimer County, Medicare Advantage enrollment follows specific timelines. Understanding these options—whether it’s your first time enrolling or switching plans—helps you choose coverage that matches your health and budget.
When You Can Sign Up
- Initial Enrollment Period (IEP): Lasting seven months around your 65th birthday, this period lets you enroll in Medicare for the first time. You may also choose a Medicare Advantage plan during this time. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): Between January 1 and March 31, people already enrolled in Medicare Advantage can make a one-time change—switch to another plan or return to Original Medicare. Learn more
- Annual Enrollment Period (AEP): From October 15 through December 7 each year, you can make changes to your Medicare coverage for the following year. Learn more
- Special Enrollment Periods (SEPs): Life events like moving to a new service area, losing other health coverage, or becoming eligible for assistance may open a Special Enrollment Period to adjust your Medicare coverage. Learn more
How to Sign Up for a Medicare Advantage Plan
- Licensed Agent Assistance: For one-on-one guidance, contact HealthCompare at 1-833-748-3201 (TTY 711). Agents are available Mon-Fri 8AM-10PM, Sat 9AM-8PM EST.
- Contact the Plan Provider Directly: Start enrollment by reaching out to the plan provider through their website or by phone with their member services team.
- Use Medicare.gov: At Medicare.gov, you can compare Medicare Advantage plans side by side and enroll securely online.
The MA and MAPD plans on this page are available to people on Medicare enrolled in both Medicare Part A and Part B living in Cold Brook, Dolgeville, Frankfort, Herkimer, Ilion, Little Falls, Mohawk, Newport, Old Forge, Poland, West Winfield, and all other areas of Herkimer County, New York. For a broader view of coverage choices across the state, see Medicare plan options in New York.
Plans Offered through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, Health Care Service Corporation, HealthSpring℠, HealthSun, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare®, Wellcare, WellPoint
- CMS.gov, Landscape Source Files — Version: CY2027 Landscape (202609.1)
- CMS.gov, Medicare Part C & D Performance — Version: 2027 Star Ratings Data Tables
- CMS.gov, Plan Benefits Package — Version: PBP Benefits-2027
- CMS.gov, Medicare Advantage/Part D Contract and Enrollment Data — Version: 2026-09
Some facts and percentages shown on this page (such as average premiums, distribution of plan types, and percentage of $0 premium plans) are calculated by Medicare.org using data from the CMS Landscape file, Plan Benefits Package (PBP) files and Part C & D Performance files. All underlying values originate from CMS, and calculations are refreshed whenever CMS issues updated data. Enrollment counts and rankings (such as Top 3 plans by enrollment) are derived from CMS monthly enrollment files and aggregated at the county level.
Medicare.org separates Medicare Advantage (MA/MAPD) plans and Special Needs Plans (SNPs) into different pages for clarity. As a result, plan counts, percentages, and other calculations shown here may differ from the aggregate totals published in the CMS Landscape files. All plan availability and benefit details originate from CMS.
Learn more about how we use CMS data.
- 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
Some facts and percentages shown on this page (such as average premiums, distribution of plan types, and percentage of $0 premium plans) are calculated by Medicare.org using data from the CMS Plan Benefits Package (PBP) files and Part C & D Performance files. All underlying values originate from CMS, and calculations are refreshed whenever CMS issues updated data.
To explore how 2027 Medicare Advantage plans available in Herkimer County compare with plans offered elsewhere, you can search the Medicare Advantage plan directory to review options nationwide using the same authoritative data sources.
Medicare.org is owned and operated by Health Network Group, LLC, an Allstate company. Medicare.org provides information only and is not connected with or endorsed by the U.S. Government or the federal Medicare program.
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 Medicare coverage interpretation and resolution.