Medicare Advantage Plans in Jefferson County, NY:
Your Complete 2026 Guide
For 2026, residents of Jefferson County, NY can choose from 27 Medicare Advantage plan options. Of these, 17 cost nothing beyond the Part B premium. Enrollment in the County stands at approximately 7,058, with 33% of plans achieving 4 stars or better. The totals and data on this page do not cover Special Needs Plans. View SNPs available in Jefferson County, NY.
- Page Updated
- Enrollment Data
- May 2, 2026
- CMS Quality Ratings
- * CMS reviews Medicare Advantage plans annually with a 5-star rating program. Data sources
Medicare Advantage PPO Plans
Preferred Provider Organization (PPO) plans allow members to choose care from both in-network and out-of-network providers. While using out-of-network doctors or hospitals usually means higher costs, PPOs may appeal to people who want more flexibility in how they access their healthcare.
- Total PPO Plans
- 14
- Average Premium
- $22.29/mo
- Beneficiaries Enrolled
- 5,079
- $0 Premium PPOs
- 8
- Average MOOP
- $8,364
- Most Popular PPO
- Medicare BlueVital (PPO) with 1,595 enrollees
- PPOs Without Drug Coverage
- 3
| PPO Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Aetna Medicare Eagle Giveback | $0 | $9,250 | N/A | H5521 323 0 | |
| Aetna Medicare Premier | $50 | $8,900 | $615 | H5521 340 0 | |
| Aetna Medicare Signature | $0 | $9,250 | $615 | H5521 077 0 | |
| Medicare BlueBalanced | $55 | $8,000 | $615 | H3335 062 0 | |
| Medicare BlueEnhanced | $101 | $7,500 | $275 | H3335 015 0 | |
| Medicare BlueSalute | $0 | $4,500 | N/A | H3335 043 0 | |
| Medicare BlueVital | $0 | $9,250 | $615 | H3335 061 0 | |
| MVP Medicare Complete Wellness with Part D | $15 | $9,250 | $615 | H9615 024 0 | |
| Humana USAA Honor Giveback | $0 | $4,950 | N/A | H5970 016 0 | |
| HumanaChoice Giveback H5970-030 | $0 | $9,250 | $615 | H5970 030 0 | |
| HumanaChoice H5970-029 | $32 | $9,250 | $615 | H5970 029 0 | |
| Wellcare Assist Open | $59 | $9,250 | $530 | H2775 113 0 | |
| Wellcare Giveback Open | $0 | $9,250 | $615 | H2775 111 0 | |
| Wellcare Simple Open | $0 | $9,250 | $615 | H2775 106 0 |
What is the typical premium for PPO plans available in Jefferson?
On average, PPO plans in Jefferson cost $22.29 per month.
Which PPO plan do most beneficiaries choose in Jefferson?
The most popular PPO in Jefferson is Medicare BlueVital (PPO), covering 1,595 beneficiaries.
How many PPO options are offered without drug coverage in Jefferson?
3 PPO plans available in Jefferson do not include Part D benefits.
Medicare Advantage HMO Plans
Health Maintenance Organization (HMO) plans generally require members to use doctors, hospitals, and other providers within the plan’s network, except in emergencies. Because of this structure, HMOs often come with lower premiums and out-of-pocket costs compared with other plan types.
- Total HMO Plans 5
- Average Premium $47.00/mo
- Beneficiaries Enrolled 383
- $0 Premium HMOs 3
- Average MOOP $6,900
- Most Popular HMO Aetna Medicare Signature (HMO) with 315 enrollees
- HMOs Without Drug Coverage 1
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| CDPHP $0 Medicare Rx | $0 | $6,750 | $500 | H3388 014 0 | |
| CDPHP Choice Rx | $135 | $6,000 | $0 | H3388 002 0 | |
| CDPHP Clear Rx | $100 | $6,400 | $250 | H3388 020 0 | |
| CDPHP Core | $0 | $6,100 | N/A | H3388 001 0 | |
| Aetna Medicare Signature | $0 | $9,250 | $615 | H3312 048 0 |
What is the total number of HMO plans offered in Jefferson?
In 2026, Jefferson County has 5 HMO plans with 383 members.
How much do HMO plans cost on average in Jefferson?
The mean monthly HMO premium is $47.00, and 3 have no premium.
Medicare Advantage HMO-POS Plans
HMO-POS plans are structured like HMOs, requiring in-network care for the lowest costs, but they also permit some use of out-of-network doctors and hospitals. Those services are generally more expensive, but the added access can be valuable for people who don’t want to be fully limited to a single network.
- Total HMO-POS Plans
- 6
- Average Premium
- $25.00/mo
- Beneficiaries Enrolled
- 1,583
- $0 Premium HMO-POS
- 4
- Average MOOP
- $7,717
- Most Popular HMO-POS
- AARP Medicare Advantage from UHC NY-0006 (HMO-POS) with 1,349 enrollees
- HMO-POS Without Drug Coverage
- 3
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| MVP Medicare Preferred Gold without Part D | $0 | $7,200 | N/A | H3305 020 0 | |
| MVP Medicare Secure Plus with Part D | $116 | $6,000 | $400 | H3305 022 0 | |
| AARP Medicare Advantage from UHC NY-0006 | $34 | $7,900 | $520 | H3379 039 0 | |
| AARP Medicare Advantage Patriot No Rx NY-MA3 | $0 | $6,700 | N/A | H3379 060 0 | |
| Wellcare Fidelis Patriot Simple | $0 | $9,250 | N/A | H5599 010 0 | |
| Wellcare Simple | $0 | $9,250 | $615 | H4868 019 0 |
- What is the average monthly premium for HMO-POS plans?
- On average, HMO-POS plans in Jefferson cost $25.00 per month.
- Which HMO-POS plan is most popular in Jefferson?
- The leading HMO-POS in Jefferson is AARP Medicare Advantage from UHC NY-0006 (HMO-POS), with 1,349 members.
- How many HMO-POS plans in Jefferson do not include drug coverage?
- There are 3 HMO-POS plans in Jefferson without Part D benefits.
Medicare Advantage PFFS Plans
Private Fee-for-Service (PFFS) plans let members visit any Medicare-approved provider that accepts the plan’s payment rules and terms. This structure gives you more flexibility in selecting doctors and hospitals, but it’s important to check provider acceptance before receiving care.
- Total PFFS Plans 2
- Average Premium $0.00/mo
- Beneficiaries Enrolled 13
- $0 Premium PFFS 2
- Average MOOP $5,500
- Most Popular PFFS Wellcare Advantage Simple (PFFS) with 13 enrollees
- PFFS Without Drug Coverage 2
| Plan Name | Rating* | Premium | MOOP | Rx Ded. | Plan-ID |
|---|---|---|---|---|---|
| Wellcare Advantage Enhanced | $0 | $4,300 | N/A | H2816 037 0 | |
| Wellcare Advantage Simple | $0 | $6,700 | N/A | H2816 038 0 |
What is the total number of PFFS plans in Jefferson?
There are 2 PFFS plans in 2026, covering 13 beneficiaries.
How much do PFFS plans cost on average in Jefferson?
The average PFFS premium is $0.00, with 2 costing $0.
What is the top PFFS plan in Jefferson?
Wellcare Advantage Simple (PFFS) is the most popular PFFS plan in Jefferson, with 13 enrollees.
What is the number of PFFS plans without Part D coverage in Jefferson?
2 PFFS plans in Jefferson do not include prescription drug coverage.
The table below shows the quality ratings for Medicare Advantage plans offered in Jefferson County, NY for 2026.
| Rating Category | Number of Plans | Percent of Plans |
|---|---|---|
| 5 Stars | No 5-star plans available. | 0% |
| 4 Stars (includes 5 Stars) | 9 | 33% |
| 3 Stars | 18 | 67% |
| Below 3 Stars | 0 | 0% |
| Not Rated | 0 | 0% |
| Average Rating | 3.63 | |
Medicare Advantage comes with strict enrollment windows. By knowing when and how to sign up, you’ll avoid missed deadlines and keep your healthcare coverage aligned with your needs.
Understanding Enrollment Windows
- Initial Enrollment Period (IEP): Beginning three months before you turn 65 and lasting until three months after, this is the initial chance to join Medicare. You may also select a Medicare Advantage plan if it fits your needs. Learn more
- Medicare Advantage Open Enrollment Period (MA OEP): Running from January 1 to March 31 each year, this period allows one change to your current Medicare Advantage coverage or a move back to Original Medicare. Learn more
- Annual Enrollment Period (AEP): This yearly window, running October 15 to December 7, gives you the opportunity to join, switch, or drop Medicare Advantage and Part D plans. Learn more
- Special Enrollment Periods (SEPs): Certain qualifying events, such as a change in residence or loss of existing coverage, may allow you to enroll in or change Medicare Advantage plans outside of the usual enrollment windows. Learn more
Enrollment Options Explained
- Talk with a Licensed Agent: Licensed agents at HealthCompare can explain your Medicare Advantage choices. Reach them at 1-833-748-3201 (TTY 711), Monday–Friday 5am–6pm and Saturday 6am–5pm PST.
- Contact the Plan Provider Directly: Enrollment can also be completed by calling the plan provider’s customer service line or visiting their official website.
- Use Medicare.gov: The official Medicare website, Medicare.gov, lets you review available plans and complete enrollment 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 Watertown, Fort Drum, Adams, Adams Center, Alexandria Bay, Antwerp, Black River, Brownville, Calcium, Cape Vincent, Carthage, Chaumont, Clayton, Dexter, Evans Mills, Henderson, La Fargeville, Mannsville, Philadelphia, Redwood, Sackets Harbor, Theresa, and all other areas of Jefferson County, New York.
Plans Offered for Enrollment through Medicare.org
Medicare Advantage and Part D plans and benefits offered by the following carriers: 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, Capital Blue Cross, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, 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(R), Wellcare, WellPoint
- CMS.gov, Landscape Source Files — Last accessed September 26, 2025
- CMS.gov, Medicare Part C & D Performance — Last accessed October 10, 2025
- CMS.gov, Plan Benefits Package — Last accessed October 13, 2025
- CMS.gov, Medicare Advantage/Part D Contract and Enrollment Data — Last accessed May 2, 2026
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, "Understanding Medicare Advantage Plans" — Last accessed 25 May, 2025
- Medicare.gov, "Explore your Medicare coverage options" — Last accessed 25 May, 2025
- NCOA.org, "5 Steps to Choosing the Right Medicare Plan for You" — 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 2026 Medicare Advantage plans available in Jefferson 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, Medicare Technical Operator, using a standardized, data-driven methodology designed for accurate, non-commercial Medicare plan interpretation and resolution.