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Guide to Medicare Advantage Plans in Middlesex County, MA for 2025

There are 35 Medicare Advantage plans available in Middlesex County, MA for the 2025 plan year, including 17 plans with $0 premiums. Most plans include prescription drug coverage. These counts exclude Special Needs Plans.

Not in Middlesex County? Enter your ZIP code to see plans in your area.

Middlesex County, Massachusetts Medicare Advantage Plans

Plan Name Type Premium MOOP Rx Ded. Rating
Aetna Medicare Discover* PPO $0 $5,900 $250
☆☆☆☆☆
Aetna Medicare Eagle* PPO $0 $5,900 N/A
☆☆☆☆☆
Aetna Medicare Enhanced Select* PPO $157 $7,500 $450
☆☆☆☆☆
Aetna Medicare Explorer* PPO $0 $5,900 $450
☆☆☆☆☆
AARP Medicare Advantage from UHC MA-0003 HMO-POS $0 $5,900 $340
☆☆☆☆☆
Aetna Medicare Value HMO-POS $0 $6,750 $450
☆☆☆☆☆
Fallon Medicare Plus Blue HMO $164 $3,400 $0
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Fallon Medicare Plus Green HMO $68 $5,200 $175
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Fallon Medicare Plus Orange HMO $0 $7,550 $200
☆☆☆☆☆
Fallon Medicare Plus Saver No Rx HMO $35 $6,700 N/A
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Tufts Medicare Preferred HMO Basic Rx HMO $48 $3,650 $0
☆☆☆☆☆
Tufts Medicare Preferred HMO Prime No Rx HMO $143 $3,650 N/A
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Tufts Medicare Preferred HMO Prime Rx HMO $183 $3,650 $0
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Tufts Medicare Preferred HMO Prime Rx Plus HMO $217 $3,650 $0
☆☆☆☆☆
Tufts Medicare Preferred HMO Saver Rx HMO $0 $7,550 $0
☆☆☆☆☆
Tufts Medicare Preferred HMO Smart Saver Rx HMO $0 $5,200 $0
☆☆☆☆☆
Tufts Medicare Preferred HMO Value No Rx HMO $113 $3,650 N/A
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Tufts Medicare Preferred HMO Value Rx HMO $156 $3,650 $0
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Mass General Brigham Advantage PPO $0 $5,500 $0
☆☆☆☆☆
Mass General Brigham Advantage Premier PPO $140 $3,150 $0
☆☆☆☆☆
Mass General Brigham Advantage Signature PPO $299 $0 $0
☆☆☆☆☆
Medicare HMO Blue FlexRx HMO-POS $73 $4,100 $260
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Medicare HMO Blue PlusRx HMO $194 $3,800 $200
☆☆☆☆☆
Medicare HMO Blue SaverRx HMO-POS $0 $6,200 $0
☆☆☆☆☆
Medicare HMO Blue ValueRx HMO $23 $3,750 $320
☆☆☆☆☆
Medicare PPO Blue PlusRx PPO $250 $3,800 $200
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Medicare PPO Blue SaverRx PPO $0 $5,600 $0
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Medicare PPO Blue ValueRx PPO $87 $6,600 $0
☆☆☆☆☆
Tufts Medicare Preferred Access Rx PPO $0 $5,400 $0
☆☆☆☆☆
AARP Medicare Advantage from UHC MA-0006 PPO $0 $6,700 $420
☆☆☆☆☆
AARP Medicare Advantage Patriot No Rx MA-MA01 PPO $0 $6,700 N/A
☆☆☆☆☆
EternalHealth Forever HMO $0 $5,000 $185
☆☆☆☆☆
EternalHealth Freedom PPO $0 $6,000 $185
☆☆☆☆☆
EternalHealth Give Back PPO $0 $6,500 $300
☆☆☆☆☆
Mass General Brigham Advantage Secure HMO-POS $52 $3,350 $0
☆☆☆☆☆
**Certain PFFS, MSA, and HMO-POS plans have a combined in and out-of-network maximum. Limits are detailed on the plan pages.
📊 At a Glance: Medicare Advantage in Middlesex County
Average Monthly Premium
$68.63
Plans with $0 Premium
17
Average MOOP Limit
$5,071 ($9,350 max. in 2025)
Average Rx Deductible
$146.17
Plans Without Drug Coverage
4 (standalone Massachusetts Part D plans)
Plans with 5-Star Ratings
No 5-star plans available.
Stars  Ratings (Plan Mix)
4+ Stars: 58% · 3 Stars: 42% · Below 3: 0%
Plans Available
35 (excluding Middlesex County SNP plans)
Plan Type Breakdown
15 PPO · 5 HMO-POS · 15 HMO
Countywide Enrollments
74,219 (excluding SNP plans)
Top 3 Plans by Enrollment
1. Medicare PPO Blue SaverRx (PPO) — 8,118 enrollees
2. AARP Medicare Advantage from UHC MA-0006 (PPO) — 7,801 enrollees
3. Tufts Medicare Preferred HMO Smart Saver Rx (HMO) — 6,559 enrollees

Data Sources: CY2025 Landscape, PBP Benefits, Star Ratings Data, Monthly Enrollment by CPSC, and SimpleMaps U.S. Counties. Enrollment data last updated . County demographic data last updated .

Understanding Your Medicare Advantage Options

Medicare Advantage Plans, also known as Medicare Part C, are private health plans that provide all-in-one coverage, including Medicare Part A (hospital insurance) and Medicare Part B (medical insurance). On top of the core benefits, many of the plans in Middlesex County throw in some nice extras - think prescription drug coverage, dental, vision, and wellness programs - making them a solid choice for those in Middlesex County looking for something more than Original Medicare.

🏥 Health Maintenance Organization (HMO) Plans

HMO plan members must use the plan's network of doctors and hospitals in Middlesex County, and typically need a referral to see a specialist. Some Medicare Advantage HMO Plans may have lower costs but offer less flexibility in choosing healthcare providers. There are 30,222 residents enrolled in HMO plans in this county. The most popular plan is Tufts Medicare Preferred HMO Smart Saver Rx .

🔓 Preferred Provider Organization (PPO)

A PPO allows more flexibility in choosing healthcare providers, with the option to see specialists without referrals, though often at a higher cost. Medicare Advantage PPOs usually have higher premiums and out-of-pocket expenses. There are 35,850 Middlesex County residents enrolled in PPO plans. The most popular of these plans by enrollments is Medicare PPO Blue SaverRx .

🔀 Health Maintenance Organization Point of Sale (HMO-POS)

Medicare HMO-POS plans are a type of HMO that offers a little more flexibility. Like a regular HMO, you typically use the plan's network of doctors and hospitals for care, usually requiring a referral to see specialists. However, an HMO-POS plan lets you receive certain healthcare services outside of the network at a higher cost. There are 8,147 residents enrolled in HMO-POS plans in this Middlesex County. The most popular plan by enrollments is AARP Medicare Advantage from UHC MA-0003 .

Advantages of Enrolling in Medicare Advantage

Enrolling in a Medicare Advantage Plan can offer significant benefits compared to Original Medicare. These plans provide all-in-one coverage, including hospital and medical insurance, and often come with added perks like drug coverage, dental care, and wellness programs. With a Medicare Advantage Plan, you can access a wider range of services while potentially reducing your overall healthcare costs.

Below are some of the key benefits you can enjoy in Middlesex County with a Medicare Advantage Plan:

🧑‍⚕️Coordinated Care

Plans often include care coordination services, which help you manage your healthcare across different providers and services.

💸 Cost Savings

Many plans have low or $0 premiums and offer capped out-of-pocket costs, providing financial protection against high medical expenses.

🧾 Comprehensive Coverage

Includes Medicare Part A, Part B, and often Part D (prescription drug coverage), along with additional benefits like dental, vision, and hearing.

🧘 Wellness Programs

Many Yavapai County plans offer free gym memberships, wellness programs, and preventive care services. You need to stay healthy, right?

Tips for Selecting a Medicare Advantage Plan

Choosing the right Medicare Advantage Plan out of the 35 plans available in Middlesex County requires careful consideration of several key factors:

🏥1. Provider Network

Verify that your current doctors and preferred hospitals are included in the plan's network. Access to your healthcare providers can significantly impact your care experience.

💊 2. Prescription Drug Coverage

Make sure the plan covers your medications, particularly if you have specific prescriptions you rely on regularly.

💰 3. Costs

Examine the plan's premiums, copayments, and out-of-pocket limits. Compare these costs against your budget to avoid unexpected expenses.

🎁 4. Additional Benefits

Consider what extra services, such as dental, vision, or wellness programs, are important to you, and check if the plan offers them.

⭐ 5. Plan Ratings

Look into the plan's star ratings, which provide insight into the plan's overall quality and member satisfaction.

Learn more about the basics of comparing Medicare Advantage Plans.

Medicare Advantage Enrollment Periods

Making sense of Medicare Advantage enrollment periods can seem overwhelming, but it's worth the effort for better health coverage. Missing these key dates could delay your coverage or limit your plan choices for 2025 in Middlesex County.

📅 Initial Enrollment Period (IEP)

This is your first opportunity to enroll in a Medicare Advantage Plan when you first become eligible for Medicare. Your Initial Enrollment Period lasts for seven months, starting three months before your 65th birthday.

🗓️ Annual Enrollment Period (AEP)

Occurs every year from October 15 to December 7. During the Annual Enrollment Period, you can switch, drop, or join a Medicare Advantage Plan.

🔁 Open Enrollment Period (OEP)

From January 1 to March 31, you can switch Medicare Advantage plans or return to Original Medicare if you’re already enrolled in a Medicare Advantage Plan.

For more detailed information on the enrollment periods and how to enroll, visit our comprehensive guide on Medicare Advantage Plan Enrollment.

Frequently Asked Questions

What are the most popular Medicare Advantage plan types in Middlesex County?

Based on the 2025 plan data, PPO plans are the most common in Middlesex County. The full breakdown of plan types is: 15 PPO · 5 HMO-POS · 15 HMO.

How much can I expect to pay out of pocket for Medicare Advantage plans?

The average maximum out-of-pocket limit (MOOP) in Middlesex County is $5,071 for 2025.

Do any Medicare Advantage plans in Middlesex County have 5-star ratings?

No 5-star rated Medicare Advantage plans are available in Middlesex County for the 2025 plan year. However, 58% of plans have a rating of 4 stars or higher.

What is the average monthly premium for Medicare Advantage plans in Middlesex County?

The average monthly premium for Medicare Advantage plans in Middlesex County is $68.63. A total of 17 offer $0 premiums, though costs vary by plan type and benefits.

More About These Plans

Carrier Plans Offered

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross, Anthem Blue Cross and Blue Shield, Aspire Health Plan, Baylor Scott & White Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, Freedom Health, GlobalHealth, Health Care Service Corporation, Healthy Blue, HealthSun, Humana, Molina Healthcare, Mutual of Omaha, Medica Central Health Plan, Optimum HealthCare, Premera Blue Cross, SCAN Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.

Master Plan Pages by Plan ID

The plan pages listed in the table above have been modified for localization to help consumers identify plans available in their area. Most plans are available in multiple areas. The following list of plan IDs link to each plan's master page.

Plan Availability

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 Acton, Arlington, Ashby, Ashland, Auburndale, Ayer, Bedford, Belmont, Billerica, Boxborough, Burlington, Cambridge, Carlisle, Chelmsford, Chestnut Hill, Concord, Devens, Dracut, Dunstable, Everett, Framingham, Groton, Hanscom AFB, Holliston, Hopkinton, Hudson, Lexington, Lincoln, Littleton, Lowell, Malden, Marlborough, Maynard, Medford, Melrose, Natick, Newton, Newton Center, Newton Highlands, Newton Lower Falls, Newton Upper Falls, Newtonville, North Billerica, North Chelmsford, North Reading, Pepperell, Reading, Sherborn, Shirley, Somerville, Stoneham, Stow, Sudbury, Tewksbury, Townsend, Tyngsboro, Waban, Wakefield, Waltham, Watertown, Wayland, West Newton, West Townsend, Westford, Weston, Wilmington, Winchester, Woburn, and all other areas of Middlesex County, Massachusetts, including the following zip codes: 01431, 01432, 01434, 01450, 01460, 01463, 01464, 01469, 01472, 01474, 01701, 01702, 01703, 01704, 01705, 01718, 01719, 01720, 01721, 01730, 01731, 01741, 01742, 01746, 01748, 01749, 01752, 01754, 01760, 01770, 01773, 01775, 01776, 01778, 01784, 01801, 01803, 01805, 01813, 01815, 01821, 01822, 01824, 01825, 01826, 01827, 01850, 01851, 01852, 01853, 01854, 01862, 01863, 01864, 01865, 01866, 01867, 01876, 01879, 01880, 01886, 01887, 01888, 01889, 01890, 01940, 02129, 02134, 02138, 02139, 02140, 02141, 02142, 02143, 02144, 02145, 02148, 02149, 02150, 02153, 02155, 02156, 02176, 02180, 02238, 02420, 02421, 02451, 02452, 02453, 02454, 02455, 02456, 02458, 02459, 02460, 02461, 02462, 02464, 02465, 02466, 02467, 02468, 02471, 02472, 02474, 02475, 02476, 02477, 02478, 02479, 02493, 02495.

Citations & References