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Your Guide to Medicare Advantage in Ontario County, NY

by , last updated

In Ontario County, New York, there are 35 Medicare Advantage Plans available for the current plan year. From basics to specialized care, each of the 35 plans caters to distinct health needs and priorities.

Our guide will help you weigh your options so you can make an informed decision.

Available Medicare Advantage Plans in Ontario County, NY

Find your Medicare Advantage Plan options in Ontario County, NY below. Click on any of the 35 plans to access full details, including coverage and costs.

2025 Medicare Advantage Plans

2025 Medicare Advantage Plan information will not be available until early October. We will let you know when the new data is available from CMS.

Sign-Up for 2025 Medicare Advantage Plan Notification. The 2025 Annual Enrollment Period begins October 15.

Ontario County, New York Medicare Advantage Plans

Medicare Advantage Plans in Ontario County, NY for 2024
Plan Name Type Premium MOOP Rx Ded. Rating
CDPHP Flex Rx* PPO $35 $6,100 $0
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CDPHP Vital Rx* PPO $0 $7,500 $300
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Medicare Blue Choice Access* PPO $14 $7,900 $350
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MVP Medicare Preferred Gold with Part D* HMO-POS $222 $6,500 $0
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MVP Medicare Secure with Part D* HMO-POS $25 $7,900 $300
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AARP Medicare Advantage from UHC NY-0008 HMO-POS $0 $7,550 $350
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Aetna Medicare Credit Plan PPO $0 $8,500 $250
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Aetna Medicare Discover Value Plan PPO $19 $8,500 $250
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Aetna Medicare Eagle Plan PPO $0 $7,000 N/A
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Aetna Medicare Platinum Plan PPO $150 $4,300 $250
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Aetna Medicare Premier Plan PPO $44 $8,500 $150
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Aetna Medicare Value Plan PPO $0 $8,500 $300
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Medicare Blue Choice Advanced HMO-POS $32 $7,200 $300
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Medicare Blue Choice Extra HMO $0 $7,900 $400
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Medicare Blue Choice Freedom HMO-POS $0 $4,500 N/A
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Medicare Blue Choice Optimum HMO-POS $203 $6,700 $0
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Medicare Blue Choice Select HMO $0 $7,900 $380
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Medicare Blue Choice Value Plus HMO-POS $66 $6,700 $0
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MVP Medicare Preferred Gold without Part D HMO-POS $0 $6,700 N/A
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Wellcare Premium Enhanced PFFS $47 $0
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Wellcare Premium Ultra PFFS $136 $0
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MVP Medicare Gold Giveback with Part D PPO $0 $7,900 $400
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MVP Medicare Patriot Plan with Part D PPO $40 $7,550 $250
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MVP Medicare WellSelect Plus with Part D PPO $86 $7,550 $250
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UHC Medicare Advantage NY-0020 PPO $29 $7,900 $295
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UHC Medicare Advantage NY-0021 PPO $56 $7,500 $195
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UHC Medicare Advantage NY-0022 PPO $88 $7,200 $0
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Wellcare Advantage No Premium PFFS $0 N/A
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Wellcare Advantage Premium Enhanced PFFS $40 N/A
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AARP Medicare Advantage from UHC NY-0025 PPO $19 $7,550 $195
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UHC Medicare Advantage Patriot No Rx NY-MA02 PPO $0 $6,700 N/A
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Wellcare Assist Open PPO $21 $6,700 $510
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Wellcare Giveback Open PPO $0 $8,300 $500
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Wellcare No Premium Open PPO $0 $6,700 $450
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Wellcare Premium Ultra Open PPO $110 $3,400 $0
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**Certain PFFS, MSA, and HMO-POS plans have a combined in and out-of-network maximum. Limits are detailed on the plan pages.

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 Ontario County throw in some nice extras - think prescription drug coverage, dental, vision, and wellness programs - making them a solid choice for those in Mohave County looking for something more than Original Medicare.

  • Health Maintenance Organization (HMO): Members must use the plan's network of doctors and hospitals in Ontario 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.
  • Preferred Provider Organization (PPO): Offers more provider flexibility, allowing members to see any doctor or specialist without a referral, often at a higher cost. Medicare Advantage PPO Plans generally have higher premiums and out-of-pocket expenses compared to HMOs.
  • Private Fee-for-Service (PFFS): Allows members to visit any Medicare-approved doctor or hospital in Ontario County that accepts the plan's payment terms. Medicare PFFS plans offer more flexibility but may result in higher costs.
  • Medicare Savings Account (MSA): Combines a high-deductible Medicare Advantage plan with a tax-advantaged savings account. The plan deposits money into the account each year, which you can use for healthcare expenses before your deductible is met. MSAs offer control over healthcare spending, with the potential to save on future costs if the savings account funds are not fully used.

Another option you might encounter is the HMO-POS plan, a type of Medicare Advantage plan that provides more flexibility compared to a standard HMO. While it still requires members to use a network of doctors and hospitals and typically requires referrals to see specialists, an HMO-POS plan stands out by allowing members to access certain healthcare services outside of the network, though at a higher cost.

If you qualify for Original Medicare or Medicare Advantage in Ontario 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 8am-9pm, Sat 9pm-8pm EST) and help you get enrolled. There's no obligation.

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 Ontario County with a Medicare Advantage Plan:

  • Coordinated Care: Plans often include care coordination services, which helps 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 Ontario 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 Ontario 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.

Getting Enrolled in a Ontario County Medicare Advantage Plan: Know Your 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 2024 in Ontario 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.

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 8am-9pm, Sat 9pm-8pm EST.

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 and all other areas of Ontario County, New York.

Plans Offered

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

Citations & References