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Written by David Bynon [3], Medicare Analyst since 2012.  Last updated May 22, 2025

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Medicare Advantage
 » 
Massachusetts
 » 
Worcester County

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

List of Plans | Plan Overview | Benefits | How to Choose | Enrollment | FAQ

There are 45 Medicare Advantage plans available in Worcester County, MA for the 2025 plan year, including 25 plans with $0 premiums. Most plans include prescription drug coverage. These counts exclude Special Needs Plans.

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

  • Top 3 Plans by Enrollment:
    1. Medicare PPO Blue SaverRx (PPO) — 7,165 enrollees
    2. Medicare PPO Blue ValueRx (PPO) — 5,432 enrollees
    3. Aetna Medicare Explorer (PPO) — 5,063 enrollees
  • Average Monthly Premium: $54.48
  • Average Maximum Out-of-Pocket Limit: $5,111
  • Average Prescription Drug Deductible: $162.11
  • Ratings (Plan Mix): 4+ Stars: 46% · 3 Stars: 54% · Below 3: 0%
  • Plan Type Breakdown 22 PPO · 6 HMO-POS · 17 HMO

Worcester County, Massachusetts Medicare Advantage Plans

Medicare Advantage Plans in Worcester County, MA for 2024
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 $0
☆☆☆☆☆
AARP Medicare Advantage CareFlex from UHC MA-9 HMO-POS $0 $6,700 $495
☆☆☆☆☆
AARP Medicare Advantage from UHC MA-0003 HMO-POS $0 $5,200 $340
☆☆☆☆☆
Aetna Medicare Value HMO-POS $0 $6,750 $590
☆☆☆☆☆
Fallon Medicare Plus Blue HMO $197 $3,400 $0
☆☆☆☆☆
Fallon Medicare Plus Green HMO $90 $5,200 $175
☆☆☆☆☆
Fallon Medicare Plus Orange HMO $0 $7,550 $200
☆☆☆☆☆
Fallon Medicare Plus Saver No Rx HMO $35 $6,700 N/A
☆☆☆☆☆
Tufts Medicare Preferred HMO Basic No Rx HMO $30 $3,650 N/A
☆☆☆☆☆
Tufts Medicare Preferred HMO Basic Rx HMO $45 $3,650 $0
☆☆☆☆☆
Tufts Medicare Preferred HMO Prime No Rx HMO $162 $3,650 N/A
☆☆☆☆☆
Tufts Medicare Preferred HMO Prime Rx HMO $193 $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 $122 $3,650 N/A
☆☆☆☆☆
Tufts Medicare Preferred HMO Value Rx HMO $163 $3,650 $0
☆☆☆☆☆
Humana USAA Honor Giveback PPO $0 $4,950 N/A
☆☆☆☆☆
HumanaChoice Giveback H5216-138 PPO $0 $5,200 $395
☆☆☆☆☆
HumanaChoice Giveback H5216-424 PPO $0 $5,200 $395
☆☆☆☆☆
HumanaChoice H5216-249 PPO $0 $6,750 $350
☆☆☆☆☆
HumanaChoice H5216-250 PPO $6 $6,400 $450
☆☆☆☆☆
Mass Advantage Basic HMO $0 $5,000 $0
☆☆☆☆☆
Mass Advantage Plus HMO $95 $3,000 $0
☆☆☆☆☆
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 $93 $4,100 $260
☆☆☆☆☆
Medicare HMO Blue PlusRx HMO $194 $3,800 $200
☆☆☆☆☆
Medicare HMO Blue SaverRx HMO-POS $0 $6,200 $0
☆☆☆☆☆
Medicare HMO Blue ValueRx HMO $42 $3,750 $320
☆☆☆☆☆
Medicare PPO Blue PlusRx PPO $250 $3,800 $200
☆☆☆☆☆
Medicare PPO Blue SaverRx PPO $0 $5,600 $0
☆☆☆☆☆
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
☆☆☆☆☆
Mass Advantage Extra PPO $0 $5,000 $0
☆☆☆☆☆
Mass Advantage Premiere PPO $0 $5,000 $0
☆☆☆☆☆
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 Worcester County
Average Monthly Premium
$54.48
Plans with $0 Premium
25
Average MOOP Limit
$5,111 ($9,350 max. in 2025)
Average Rx Deductible
$162.11
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: 46% · 3 Stars: 54% · Below 3: 0%
Plans Available
45 (excluding Worcester County SNP plans)
Plan Type Breakdown
22 PPO · 6 HMO-POS · 17 HMO
Countywide Enrollments
56,924 (excluding SNP plans)
Top 3 Plans by Enrollment
1. Medicare PPO Blue SaverRx (PPO) — 7,165 enrollees
2. Medicare PPO Blue ValueRx (PPO) — 5,432 enrollees
3. Aetna Medicare Explorer (PPO) — 5,063 enrollees

Data Sources: CY2025 Landscape, PBP Benefits, Star Ratings Data, Monthly Enrollment by CPSC, and SimpleMaps U.S. Counties. Enrollment data last updated April 7, 2025. County demographic data last updated April 5, 2025.

Understanding Your Medicare Advantage Options

Medicare Advantage Plans, or Part C, are health plans provided by private insurers that offer all-in-one coverage, combining Medicare Part A (hospital coverage) and Part B (medical coverage). Many of the 45 plans available to you in Worcester County also include additional benefits like prescription drug coverage, as well as dental, vision, and wellness services, offering a more comprehensive package than Original Medicare.

🏥 Health Maintenance Organization (HMO) Plans

HMO plan members must use the plan's network of doctors and hospitals in Worcester 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 20,292 residents enrolled in HMO plans in this county. The most popular plan is Fallon Medicare Plus Orange .

🔓 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 31,744 Worcester 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 4,888 residents enrolled in HMO-POS plans in this Worcester County. The most popular plan by enrollments is AARP Medicare Advantage from UHC MA-0003 .

If you qualify for Original Medicare or Medicare Advantage in Worcester County but don't know where to begin, we have licensed insurance agents[1] at 1-855-728-0510 (TTY 711) who can answer your questions (Mon-Fri 5am-6pm, Sat 6am-5pm PST) and help you get enrolled. There's no obligation.

Advantages of Enrolling in Medicare Advantage

Medicare Advantage Plans, also known as Part C, provide several key advantages over Original Medicare. Bundle up your healthcare with plans that cover Medicare Parts A and B, plus some extras like prescription meds, dental care, and vision services - it's a package deal! Medicare Advantage can be a smart choice if you want to maximize your healthcare dollars and enjoy extras like additional services and lower out-of-pocket costs.

Here are some of the top advantages these plans offer Worcester County residents:

🧑‍⚕️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

Selecting the ideal Medicare Advantage Plan from the 45 plans available in Worcester County involves evaluating several crucial aspects:

🏥1. Provider Network

Ensure your healthcare providers are within the plan's network to maintain continuity of care.

💊 2. Prescription Drug Coverage

Confirm that your current medications are included in the plan's formulary to avoid higher out-of-pocket costs.

💰 3. Costs

Assess the plan’s premium, deductible, and out-of-pocket expenses. The ideal plan aligns with both your financial situation and your healthcare needs.

🎁 4. Additional Benefits

Identify any additional benefits that are important to you, such as fitness programs, routine dental, or over-the-counter medication benefits, and ensure the plan includes them.

⭐ 5. Plan Ratings

If a plan offers the benefits you need at a price you can afford, be sure to check its CMS star ratings. This will help you avoid plans with known problems, like poor customer service.

Discover the key factors to consider when comparing Medicare Advantage Plans.

Medicare Advantage Enrollment Periods

Enrolling in a Medicare Advantage Plan is a straightforward process, but timing is crucial to ensure you don't miss out on the benefits. Understanding when you can enroll will help you take full advantage of the options available in Worcester County.

📅 Initial Enrollment Period (IEP)

The IEP is a seven-month window surrounding your 65th birthday, allowing you to sign up for a Medicare Advantage Plan as soon as you become eligible for Medicare.

🗓️ Annual Enrollment Period (AEP)

The AEP runs from October 15 to December 7 each year, giving you the opportunity to change, drop, or enroll in a Medicare Advantage Plan.

🔁 Open Enrollment Period (OEP)

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

To learn more about the enrollment periods and steps to take, check out our comprehensive Medicare Enrollment guide.

Are you ready to enroll? Do you still have questions? Our licensed insurance agents are ready to help with no obligation. Call 1-855-728-0510 (TTY 711) for assistance, Mon-Fri 5am-6pm, Sat 6am-5pm PST.

Frequently Asked Questions

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

Based on the 2025 plan data, PPO plans are the most common in Worcester County. The full breakdown of plan types is: 22 PPO · 6 HMO-POS · 17 HMO.

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

The average maximum out-of-pocket limit (MOOP) in Worcester County is $5,111 for 2025.

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

No 5-star rated Medicare Advantage plans are available in Worcester County for the 2025 plan year. However, 46% of plans have a rating of 4 stars or higher.

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

The average monthly premium for Medicare Advantage plans in Worcester County is $54.48. A total of 25 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.

H5521 450, H5521 296, H5521 509, H5521 160, H5253 159, H5253 157 1, H5793 014, H9001 031 15, H9001 030 15, H9001 038, H9001 039, H2256 041, H2256 036, H2256 039, H2256 033, H2256 028, H2256 046, H2256 040, H2256 034, H5216 059, H5216 138, H5216 424, H5216 249, H5216 250, H7670 001, H7670 002, H9485 001, H9485 002, H9485 003, H2261 023 2, H2261 005, H2261 024, H2261 022 2, H2230 002, H2230 017, H2230 018 2, H9907 001, H8768 055 1, H8768 045, H9904 002, H9904 001, H1280 001, H2694 001, H2694 002, H6847 001

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 Ashburnham, Athol, Auburn, Baldwinville, Barre, Berlin, Blackstone, Bolton, Boylston, Brookfield, Charlton, Cherry Valley, Clinton, Douglas, Dudley, East Brookfield, Fiskdale, Fitchburg, Gardner, Gilbertville, Grafton, Harvard, Holden, Hopedale, Hubbardston, Jefferson, Lancaster, Leicester, Leominster, Lunenburg, Mendon, Milford, Millbury, Millville, North Brookfield, North Grafton, North Oxford, Northborough, Northbridge, Oakham, Oxford, Paxton, Petersham, Princeton, Rochdale, Royalston, Rutland, Shrewsbury, South Grafton, Southborough, Southbridge, Spencer, Sterling, Sturbridge, Sutton, Templeton, Upton, Uxbridge, Warren, Webster, West Boylston, West Brookfield, West Warren, Westborough, Westminster, Whitinsville, Winchendon, Worcester, and all other areas of Worcester County, Massachusetts, including the following zip codes: 01005, 01010, 01031, 01037, 01068, 01074, 01082, 01083, 01092, 01094, 01331, 01366, 01368, 01420, 01430, 01434, 01436, 01438, 01440, 01441, 01451, 01452, 01453, 01462, 01467, 01468, 01473, 01475, 01501, 01503, 01504, 01505, 01506, 01507, 01508, 01509, 01510, 01515, 01516, 01518, 01519, 01520, 01522, 01523, 01524, 01525, 01526, 01527, 01529, 01531, 01532, 01534, 01535, 01536, 01537, 01538, 01540, 01541, 01542, 01543, 01545, 01546, 01550, 01560, 01561, 01562, 01564, 01566, 01568, 01569, 01570, 01571, 01581, 01583, 01585, 01586, 01588, 01590, 01601, 01602, 01603, 01604, 01605, 01606, 01607, 01608, 01609, 01610, 01611, 01612, 01613, 01614, 01615, 01653, 01655, 01740, 01745, 01747, 01756, 01757, 01772.

Citations & References
  • Medicare.gov, "Compare types of Medicare Advantage Plans", Last Accessed 19 March, 2025
  • Medicare.gov, "Special Needs Plans (SNP)", Last Accessed 11 June, 2024
  • Medicare.gov, "Learn How Medigap Works", Last Accessed 19 March, 2025
  • Plan and enrollment data provided by the Centers for Medicare & Medicaid Services (CMS)
  • Data processed and interpreted by MedicareWire.com editorial team.
  • Read our methodology and sourcing policy.

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Many of the plans featured on MedicareWire are offered through our trusted partner, HealthCompare Insurance Services, Inc., a licensed sales agency. HealthCompare may compensate us if you enroll in a plan through their services. Online enrollment services are provided by MedicareEnrollment.com, a HealthCompare affiliate.

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[3]About the Author

David Bynon is a Medicare analyst, published author, and U.S. Navy veteran with over 40 years of experience in cryptology, cybersecurity, and healthcare systems. Since founding MedicareWire in 2012, he has provided unbiased, data-driven Medicare plan research to assist seniors in making informed decisions.

Previously, David served as Vice President of Global Systems at Sony Pictures Entertainment and Director of Systems and Networks at HealthNet, focusing on secure HMO and Medicare infrastructures. His military career includes serving as Command Chief at TACRON-11, earning multiple Navy Commendation Medals and other commendations.

Connect with David on LinkedIn or view his Amazon Author Profile. His latest book, Why Medicare Advantage Plans Are Bad, is available on Amazon.

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