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Written by David Bynon [3], Medicare Analyst since 2012.  Last updated July 15, 2025

MedicareWire is a public-trust resource. We do not sell plans or accept payment to influence content. Here's why you can trust our data and how we operate. Also see our references and how we're building EEAT trust.

Medicare Advantage
 » 
New York
 » 
Fulton County

Guide to Medicare Advantage Plans in Fulton County, NY for 2025

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

There are 39 Medicare Advantage plans available in Fulton County, NY for the 2025 plan year, including 16 plans with $0 premiums. Most plans include prescription drug coverage. These counts exclude Special Needs Plans.

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

  • Top 3 Plans by Enrollment:
    1. CDPHP $0 Medicare Rx (HMO) — 1,155 enrollees
    2. CDPHP Value Rx (HMO) — 926 enrollees
    3. MVP Medicare WellSelect with Part D (PPO) — 538 enrollees
  • Average Monthly Premium: $44.26
  • Average Maximum Out-of-Pocket Limit: $6,815
  • Average Prescription Drug Deductible: $333.67
  • Ratings (Plan Mix): 4+ Stars: 47% · 3 Stars: 42% · Below 3: 11%
  • Plan Type Breakdown 21 PPO · 6 HMO · 6 HMO-POS · 4 PFFS · 2 REGIONAL PPO

Fulton County, New York Medicare Advantage Plans

Medicare Advantage Plans in Fulton County, NY for 2024
Plan Name Type Premium MOOP Rx Ded. Rating
Aetna Medicare Discover Value* PPO $33 $7,900 $590
☆☆☆☆☆
Aetna Medicare Eagle* PPO $0 $8,900 N/A
☆☆☆☆☆
Aetna Medicare Platinum* PPO $139 $4,500 $590
☆☆☆☆☆
Aetna Medicare Premier* PPO $0 $7,900 $590
☆☆☆☆☆
CDPHP $0 Medicare Rx* HMO $0 $6,750 $250
☆☆☆☆☆
CDPHP Choice Rx* HMO $126 $6,000 $0
☆☆☆☆☆
CDPHP Core* HMO $15 $6,100 N/A
☆☆☆☆☆
CDPHP Focus* PPO $0 $6,100 N/A
☆☆☆☆☆
CDPHP Value Rx* HMO $62 $6,400 $0
☆☆☆☆☆
CDPHP Vital Rx* PPO $0 $6,750 $300
☆☆☆☆☆
Complete Rx* PPO $70 $6,000 $0
☆☆☆☆☆
Freedom Plus* HMO $37 $6,700 $0
☆☆☆☆☆
MVP Medicare Preferred Gold without Part D* HMO-POS $0 $7,200 N/A
☆☆☆☆☆
MVP Medicare Secure Plus with Part D* HMO-POS $96 $6,000 $0
☆☆☆☆☆
Senior Blue 652* HMO $107 $6,700 $0
☆☆☆☆☆
Forever Blue 770 PPO $198 $6,700 $0
☆☆☆☆☆
Medicare BluePlus PPO $113 $6,100 $590
☆☆☆☆☆
Medicare BlueSalute PPO $0 $4,500 N/A
☆☆☆☆☆
AARP Medicare Advantage from UHC NY-29 HMO-POS $0 $7,200 $340
☆☆☆☆☆
Aetna Medicare Value HMO-POS $0 $9,350 $450
☆☆☆☆☆
Humana USAA Honor Giveback PPO $0 $4,950 N/A
☆☆☆☆☆
HumanaChoice H5970-029 PPO $28 $9,350 $590
☆☆☆☆☆
MVP Medicare Patriot Plan with Part D PPO $44 $7,900 $350
☆☆☆☆☆
MVP Medicare WellSelect Plus with Part D PPO $119 $7,000 $0
☆☆☆☆☆
MVP Medicare WellSelect with Part D PPO $0 $7,800 $350
☆☆☆☆☆
Wellcare Advantage Premium Enhanced PFFS $32 $6,700 N/A
☆☆☆☆☆
Wellcare Advantage Simple PFFS $0 $6,700 N/A
☆☆☆☆☆
Wellcare Premium Enhanced PFFS $40 $3,400 $420
☆☆☆☆☆
Wellcare Premium Ultra PFFS $117 $3,400 $420
☆☆☆☆☆
AARP Medicare Advantage from UHC NY-0015 PPO $19 $7,900 $495
☆☆☆☆☆
UHC Medicare Advantage NY-0021 Regional PPO $75 $8,900 $570
☆☆☆☆☆
UHC Medicare Advantage Patriot No Rx NY-MA02 Regional PPO $0 $6,700 N/A
☆☆☆☆☆
Wellcare Fidelis Assist HMO-POS $38 $6,900 $460
☆☆☆☆☆
Wellcare Fidelis Simple HMO-POS $0 $8,300 $420
☆☆☆☆☆
Wellcare Assist Open PPO $28 $8,850 $580
☆☆☆☆☆
Wellcare Giveback Open PPO $0 $8,850 $420
☆☆☆☆☆
Wellcare Premium Ultra Open PPO $114 $3,400 $420
☆☆☆☆☆
Wellcare Simple Open PPO $0 $8,850 $420
☆☆☆☆☆
Anthem Medicare Advantage PPO $75 $6,200 $395
☆☆☆☆☆
**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 Fulton County
Average Monthly Premium
$44.26
Plans with $0 Premium
16
Average MOOP Limit
$6,815 ($9,350 max. in 2025)
Average Rx Deductible
$333.67
Plans Without Drug Coverage
4 (standalone New York Part D plans)
Plans with 5-Star Ratings
No 5-star plans available.
Stars  Ratings (Plan Mix)
4+ Stars: 47% · 3 Stars: 42% · Below 3: 11%
Plans Available
39 (excluding Fulton County SNP plans)
Plan Type Breakdown
21 PPO · 6 HMO · 6 HMO-POS · 4 PFFS · 2 REGIONAL PPO
Countywide Enrollments
5,284 (excluding SNP plans)
Top 3 Plans by Enrollment
1. CDPHP $0 Medicare Rx (HMO) — 1,155 enrollees
2. CDPHP Value Rx (HMO) — 926 enrollees
3. MVP Medicare WellSelect with Part D (PPO) — 538 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, 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 Fulton County throw in some nice extras - think prescription drug coverage, dental, vision, and wellness programs - making them a solid choice for those in Fulton 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 Fulton 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 2,376 residents enrolled in HMO plans in this county. The most popular plan is CDPHP $0 Medicare 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 2,020 Fulton County residents enrolled in PPO plans. The most popular of these plans by enrollments is MVP Medicare WellSelect with Part D .

🪟 Private Fee-for-Service (PFFS)

Allows members to visit any Medicare-approved doctor or hospital in their area that accepts the plan's payment terms. Medicare PFFS plans offer more flexibility but may result in higher costs. There are 42 Fulton County residents enrolled in PFFS plans. The most popular of these plans by enrollments is Wellcare Advantage Simple .

🔀 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 805 residents enrolled in HMO-POS plans in this Fulton County. The most popular plan by enrollments is AARP Medicare Advantage from UHC NY-29 .

If you qualify for Original Medicare or Medicare Advantage in Fulton 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

Many Medicare Advantage Plans offer extra benefits that go beyond Original Medicare, making them an attractive option for some people. These plans provide comprehensive coverage, often including additional services like prescription drug coverage, dental, vision, and wellness programs, all bundled into one plan. By choosing a Medicare Advantage Plan, you can simplify your healthcare and potentially save on costs.

Take a look at the main benefits provided by Medicare Advantage Plans in Fulton County:

🧑‍⚕️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 39 plans available in Fulton 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 Fulton County.

📅 Initial Enrollment Period (IEP)

This initial enrollment window starts three months before and ends three months after your 65th birthday, offering a total of seven months to enroll in a Medicare Advantage Plan.

🗓️ Annual Enrollment Period (AEP)

Every year from October 15 to December 7, you have the option to change, enroll, or disenroll from a Medicare Advantage Plan.

🔁 Open Enrollment Period (OEP)

Running from January 1 to March 31, this period allows changes to your Medicare Advantage Plan if you’re already enrolled or lets you switch back to Original Medicare.

For comprehensive details on how to enroll, visit our detailed guide on Medicare Enrollment.

Frequently Asked Questions

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

Based on the 2025 plan data, PPO plans are the most common in Fulton County. The full breakdown of plan types is: 21 PPO · 6 HMO · 6 HMO-POS · 4 PFFS · 2 REGIONAL PPO.

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

The average maximum out-of-pocket limit (MOOP) in Fulton County is $6,815 for 2025.

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

No 5-star rated Medicare Advantage plans are available in Fulton County for the 2025 plan year. However, 47% of plans have a rating of 4 stars or higher.

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

The average monthly premium for Medicare Advantage plans in Fulton County is $44.26. A total of 16 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 340, H5521 323, H5521 459, H5521 077, H3388 014, H3388 002, H3388 001, H5042 012, H3388 004, H5042 009, H5042 014, H3384 059, H3305 020, H3305 022, H3384 013, H5526 018, H3335 018, H3335 044, H3379 052, H3312 048, H5970 016, H5970 029, H9615 018, H9615 007, H9615 008, H2816 037, H2816 038, H2816 019, H2816 013, H3418 004, R5342 005, R5342 002, H5599 002, H5599 004, H2775 113, H2775 111, H2775 105, H2775 106, H3342 023 2

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 Broadalbin, Gloversville, Johnstown, Mayfield, Northville, and all other areas of Fulton County, New York, including the following zip codes: 12010, 12025, 12032, 12068, 12070, 12078, 12086, 12095, 12117, 12134, 13329, 13339, 13452, 13470.

Citations & References
  • Medicare.gov, "Understanding Medicare Advantage Plans", Last Accessed 19 March, 2025
  • CMS.gov, "Special Needs Plans (SNP)", Last Accessed 24 May, 2024
  • Medicare.gov, "What's Medicare Supplement Insurance (Medigap)?", 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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On This Page

  • List of Plans
  • Plan Overview
  • Benefits
  • How to Choose
  • Enrollment

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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 delivered independent, data-driven Medicare research to help seniors make informed, confident decisions.

David is also the founder of TrustPublishing.com and the inventor of the Memory-First Publishing and Semantic Digest protocols.

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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