Medicare Advantage

Rochester NY Medicare Advantage Plans 2027

People in Rochester can choose from 33 Medicare Advantage plans for 2027, against 43 this year. 16 of this year’s plans are gone, 6 are new to Monroe County, and 14 that continue have changed their premium, deductible, plan type or name, 3 of them under a new name.

Medicare AdvantageRochester, NY

If you live in Rochester and want to see every Medicare Advantage plan you can actually pick for 2027, this is the roundup. Rochester sits in Monroe County, and Medicare Advantage availability is set at the county level. For plan year 2027, CMS lists 30 Medicare Advantage plans in Monroe County from 9 carriers. Every one of those 30 plans includes prescription drug coverage. The table below lists each plan, its carrier, its plan type, and whether it has drug coverage.

What "available in Rochester" really means

Medicare uses your county of residence to decide which Medicare Advantage plans you can join. Because Rochester is in Monroe County, the roster below is the Monroe County list from the CMS Medicare Advantage Landscape Source File for 2027. If you move to a neighboring county — even a short drive away — the list of plans available to you can change.

One quick note: there are 0 stand-alone Part D drug plans built into this Medicare Advantage roster, because all 43 Advantage plans in Monroe County already include drug coverage. Stand-alone Part D plans do exist separately for people who stay with Original Medicare.

The plan types you'll see on the list

Monroe County's 43 plans break down like this:

• 18 HMO plans
• 12 HMO-POS plans
• 11 PPO plans
• 2 PFFS plans
• 24 of the 43 are Special Needs Plans (SNPs)

HMO plans usually ask you to use an in-network provider and to pick a primary care doctor. HMO-POS plans work like an HMO but let you go out of network for certain services. PPO plans give you more flexibility to see out-of-network providers, usually at a higher cost. PFFS (Private Fee-for-Service) plans set their own payment terms with providers.

SNPs are only for people who meet specific rules — for example, having both Medicare and Medicaid (D-SNP), living in a nursing home (I-SNP), or having certain chronic conditions (C-SNP). If you don't qualify, you can't enroll in one.

The carriers offering plans in Monroe County

Ten carriers offer Medicare Advantage plans with drug coverage in the area. Listed alphabetically, with the number of plans each has in the county:

• Aetna (CVS Health): 5 plans (HMO, PPO; 2 SNPs)
• Centene (WellCare): 8 plans (HMO, HMO-POS, PFFS; 3 SNPs)
• Elderplan: 2 plans (HMO-POS; 2 SNPs)
• Excellus Health Plan Community Care LLC: 2 plans (HMO; 2 SNPs)
• Excellus Health Plan, Inc: 4 plans (HMO, HMO-POS)
• Humana: 5 plans (HMO, PPO; 2 SNPs)
• iCircle Services of the Finger Lakes, Inc: 1 plan (HMO; 1 SNP)
• MVP Health Care: 5 plans (HMO, HMO-POS, PPO; 2 SNPs)
• Nascentia Health Plus: 3 plans (HMO; 3 SNPs)
• UnitedHealthcare: 5 plans (HMO-POS, PPO; 5 SNPs)
• VNS Health Medicare: 3 plans (HMO; 2 SNPs)

The full plan-by-plan list — including names like Medicare Blue Choice Core, MVP Medicare Preferred Gold with Part D, HumanaChoice H5970-029, Wellcare Simple, and UHC Dual Complete NY-Q001 — is in the table on this page.

How to narrow the list down

With 43 plans on the table, most people won't compare them all. A few filters help:

1. Are you eligible for a SNP? If you have Medicaid, live in a nursing home, or have certain conditions, ask about D-SNP or I-SNP options. If not, you can skip those 24 plans. 2. Do you want HMO simplicity or PPO flexibility? That choice cuts the list roughly in half. 3. Are your doctors, hospitals and preferred pharmacy in the plan's network? This is the single biggest reason people switch plans later. 4. Are your prescriptions on the plan's formulary, and at what tier?

The Medicare Plan Finder at medicare.gov lets you enter your ZIP code, your drug list and your pharmacy, and it will show plan-specific premiums, deductibles, copays and star ratings side by side. Each plan's Summary of Benefits and Evidence of Coverage documents give the full detail.

Program-level Part D figures for 2027

Even though drug coverage differs by plan, some Part D rules apply everywhere:

• The Part D out-of-pocket cap is $2,100 in 2026 and $2,400 in 2027. Once your covered drug costs reach that ceiling, you pay nothing for covered drugs the rest of the year.
• The Part D maximum deductible is $615 in 2026 ($700 in 2027).
• The old coverage gap ("donut hole") was eliminated in 2025; Part D now has three phases.
• The Medicare Prescription Payment Plan is optional and lets you spread your yearly drug costs into monthly payments.
• IRMAA surcharges (higher Part B and Part D premiums for higher incomes) start above $109,000 in income for a single filer in 2026.

Key dates to keep in mind

• Annual Enrollment Period (AEP): Oct. 15 – Dec. 7. This is when most people join, switch or drop a Medicare Advantage or Part D plan for the following year.
• Medicare Advantage Open Enrollment: Jan. 1 – March 31. If you're already in a Medicare Advantage plan, you can switch to another MA plan or return to Original Medicare (and add a stand-alone Part D plan).

If you miss a window, you may still qualify for a Special Enrollment Period — for example, if you move out of your plan's service area or lose other coverage.