By Paul Barrett, CMIP — Founder, The Modern Medicare Agency Licensed in 37 states · Serving Massapequa, Massapequa Park & all of Nassau County · Last updated July 23, 2026
Key Takeaways
- Massapequa residents have 31 Medicare Advantage plans to choose from in 2026, spanning HMO, PPO, and HMO-POS designs, from 11 different carriers.
- 16 of those plans carry a $0 monthly premium — but a $0 premium tells you nothing about your actual out-of-pocket exposure or whether your doctors are in-network. That’s the part most guides skip.
- Two plans in this market carry a genuine 5-star CMS rating for 2026 — a real distinction, since only about 6% of plans nationwide achieve it. Both are Anthem HMO-POS plans.
- The single most important local fact for 2026: Anthem’s Medicare Advantage plans remain out-of-network with the entire Mount Sinai Health System — including Mount Sinai South Nassau — even though Anthem restored its commercial Mount Sinai contract in April. Meanwhile, Aetna’s strong PPO network covers Mount Sinai but excludes Stony Brook — nearly a mirror image of Anthem’s own gap. If you or your doctor have any Mount Sinai or Stony Brook affiliation, this changes the calculus significantly.
- Two carriers have pulled back hard in this market: HealthSpring has gone from three PPO plans to one, dropped Optum Healthcare, and cut Northwell entirely. UnitedHealthcare is down to two plans and quietly made its most popular 2025 plan non-commissionable for 2026 — often a sign a carrier wants to slow enrollment growth.
- Wellcare also let its contract with Northwell Health lapse effective July 1, 2026 — worth checking if your providers are Northwell-affiliated.
- No sales pitch here — just what the plans actually cost, what they actually cover, and what the network fine print actually says.
Fast Facts: Medicare Advantage in Massapequa, NY (2026)
Sources: Medicare.gov Plan Finder; CMS Medicare Advantage/Part D Contract and Enrollment Data; CMS Landscape and Plan Benefits Package files.
The Full 2026 Massapequa Medicare Advantage Plan List
Here’s every plan CMS lists as available in the Massapequa ZIP code (11758) for 2026, sorted by star rating. Premiums shown are the plan premium only — you’ll still pay your Medicare Part B premium ($202.90/month in 2026) on top of this in every case.
| Plan Name | Type | Monthly Premium | Max Out-of-Pocket | Rx Deductible | Star Rating |
|---|---|---|---|---|---|
| Anthem Medicare Advantage 2 (HMO-POS) | HMO-POS | $56.00 | $8,300 | $275 | 5.0 |
| Anthem Veteran 2 (HMO-POS) | HMO-POS | $0 | $6,800 | N/A | 5.0 |
| Healthfirst 65 Plus Plan (HMO) | HMO | $0 | $9,250 | $615 | 4.5 |
| Healthfirst Increased Benefits Plan (HMO) | HMO | $24.20 | $9,250 | $615 | 4.5 |
| Aetna Medicare Elite (PPO) | PPO | $0 | $9,250 | $615 | 4.5 |
| Aetna Medicare Eagle Giveback (PPO) | PPO | $0 | $9,250 | N/A | 4.5 |
| Aetna Medicare Enhanced (PPO) | PPO | $134.00 | $6,750 | $615 | 4.5 |
| Aetna Medicare Elite Extra (PPO) | PPO | $54.00 | $9,250 | $615 | 4.5 |
| EmblemHealth VIP Gold (HMO) | HMO | $114.00 | $9,250 | $200 | 4.0 |
| EmblemHealth VIP Gold Plus (HMO) | HMO | $252.00 | $9,250 | $200 | 4.0 |
| Elderplan Extra Help (HMO-POS) | HMO-POS | $58.80 | $7,550 | $375 | 3.5 |
| Elderplan Flex (HMO-POS) | HMO-POS | $0 | $7,550 | $375 | 3.5 |
| AARP Medicare Advantage from UHC NY-0009 (HMO-POS) | HMO-POS | $29.00 | $8,500 | $520 | 3.5 |
| AARP Medicare Advantage Patriot No Rx NY-MA3 (HMO-POS) | HMO-POS | $0 | $6,700 | N/A | 3.5 |
| VNS Health EasyCare (HMO) | HMO | $25.00 | $9,250 | $500 | 3.5 |
| Healthfirst Signature (HMO) | HMO | $0 | $9,250 | $615 | 3.5 |
| Anthem Medicare Advantage (HMO) | HMO | $80.00 | $9,250 | $200 | 3.5 |
| Wellcare Simple Open (PPO) | PPO | $0 | $9,250 | $615 | 3.0 |
| Wellcare Giveback Open (PPO) | PPO | $0 | $9,250 | $615 | 3.0 |
| Wellcare Assist Open (PPO) | PPO | $58.80 | $9,250 | $530 | 3.0 |
| Aetna Medicare Enhanced (HMO) | HMO | $94.00 | $9,250 | $615 | 3.0 |
| Aetna Medicare Signature Care (HMO) | HMO | $0 | $9,250 | $615 | 3.0 |
| Humana Gold Plus Giveback (HMO) | HMO | $0 | $9,250 | $615 | 3.0 |
| Wellcare Simple (HMO-POS) | HMO-POS | $0 | $9,250 | $615 | 3.0 |
| Wellcare Fidelis Patriot Simple (HMO-POS) | HMO-POS | N/A | $9,250 | N/A | 3.0 |
| Humana USAA Honor Giveback (PPO) | PPO | N/A | $4,950 | N/A | 3.0 |
| HumanaChoice (PPO) | PPO | $32.00 | $9,250 | $615 | 3.0 |
| Humana Direct Choice Giveback (PPO) | PPO | $0 | $9,250 | $475 | 3.0 |
| HealthSpring True Choice (PPO) | PPO | $0 | $6,800 | $250 | 3.0 |
| Healthfirst Signature (PPO) | PPO | $55.00 | $9,250 | $615 | 3.0 |
What’s Really Happening With These Carriers in 2026
A plan list sorted by star rating tells you what’s available. It doesn’t tell you what’s actually changing underneath these plans right now — and in the Massapequa market, a lot is changing. Here’s the carrier-by-carrier picture, based on what I’m seeing directly in this market.
HealthSpring (formerly Cigna Medicare) — a carrier in real decline here. A couple of years ago, HealthSpring had three PPO plans in this market. For 2026, they’re down to one: HealthSpring True Choice. On top of that, they’ve dropped Optum Healthcare from their network, and — as covered in detail elsewhere on this site — HealthSpring terminated its entire relationship with Northwell Health effective December 31, 2025. That means every Northwell hospital, physician group, and ancillary facility has been out-of-network for HealthSpring members since January 1, 2026. This is exactly the scenario I warn people about: someone goes to Medicare.gov, enters their prescriptions, and HealthSpring’s $0 premium looks great — without ever seeing that their cardiologist or hospital fell out of network months ago.
UnitedHealthcare — scaled back to two plans, and one of them is sending a signal. UHC now offers just two plans in Massapequa: an MA-only plan with no drug coverage, and an HMO-POS plan (AARP NY-0009) that was popular in 2025. That popularity is exactly why it’s worth watching — UHC made this plan non-commissionable for 2026, and that’s more significant than most consumers realize. Carriers rely heavily on independent brokers to drive enrollment. When a plan that performed well gets pulled from commission eligibility after just one strong year, it’s typically a sign the carrier wasn’t happy with how members were using it and wants to slow new enrollment growth — brokers simply stop actively recommending a plan that doesn’t pay them, which throttles volume without the carrier having to say so publicly. The next step carriers sometimes take after that is mid-year provider network reductions. UHC also quietly discontinued its long-standing Regional PPO plans (1, 2, and 3) for 2026 — plans that were never heavily marketed but were part of their lineup for years.
Aetna — currently the strongest network story in this market. Aetna offers four PPO plans here (Elite, Eagle Giveback, Enhanced, and Elite Extra), spreading their risk across different plan designs. Their longest-standing plan, Aetna Medicare Elite (PPO), remains the single most-enrolled Medicare Advantage plan in all of Nassau County. Their PPO network covers every major Long Island hospital except Stony Brook — including Mount Sinai, NYU, Good Samaritan, St. Francis, and Northwell — and PPOs don’t require referrals to see specialists. That combination of network breadth and flexibility is exactly why Aetna has become one of the more popular choices in this area recently.
Anthem Blue Cross Blue Shield — the only 5-star carrier here, with one real trade-off. Anthem’s HMO-POS plans carry a genuine 5-star CMS rating, and their network is strong — Stony Brook Hospital is in-network, which stands in direct contrast to Aetna’s one network gap. But Anthem’s Medicare Advantage plans remain out-of-network with the entire Mount Sinai Health System, including Mount Sinai South Nassau. Anthem restored its Mount Sinai relationship for commercial, Medicaid, and Essential Plan members in April 2026 — but that agreement specifically excludes Anthem Medicare Advantage. So the network picture is close to a mirror image of Aetna’s: Anthem has Stony Brook, Aetna doesn’t; Aetna has Mount Sinai, Anthem doesn’t. Anthem’s main HMO-POS plan also carries a real monthly premium ($56), which makes it slightly less immediately attractive on price than some $0 options — even with the 5-star rating.
EmblemHealth — priced noticeably higher than the field. Their two plans in this market, VIP Gold and VIP Gold Plus, run $114 and $252 a month respectively — meaningfully more expensive than comparable plans from other carriers here.
Humana — a long-time Long Island favorite that’s pulled back. Humana used to be one of the go-to names on Long Island. In 2026, their remaining plans here have scaled-back carrier investment behind them, which is worth factoring in alongside the plan benefits themselves — it’s the same kind of signal as UHC’s non-commissionable move above, just showing up differently. I’d put Humana in the “ask more questions before enrolling” category this year rather than a default recommendation.
Paul’s Honest Take
I’ve been doing this since 2007, and if there’s one thing nearly two decades in this business teaches you, it’s that the Medicare Advantage landscape never sits still. Plans come, plans go, and carriers that were the obvious choice five years ago aren’t always the obvious choice today. Right now in Massapequa, that shows up clearly: Aetna’s become the strong, popular network option; Anthem is the quality leader with a real hospital trade-off; HealthSpring and Humana are carriers I’d approach with real caution; and UnitedHealthcare’s own moves this year — a non-commissionable plan, quietly dropped Regional PPOs — tell you something about where that carrier’s head is at, whether they say it out loud or not.
None of that means any of these plans are automatically wrong for you. There are some genuinely good plans in this market, some perfectly fine ones, and yes, a couple I think are pretty weak — but everyone’s situation is different, and the right plan depends entirely on your doctors, your hospital, your prescriptions, and your budget, not on which carrier had the flashiest commercial this year.
One more thing worth saying plainly: with Medigap premiums climbing as fast as they have in the Massapequa area, Medicare Advantage isn’t a fallback option anymore — for a lot of people, it’s genuinely needed, maybe more than ever. That’s exactly why having the most complete, accurate picture of every option matters so much. My job isn’t to steer you toward the plan that’s easiest for me — it’s to make sure you have every real option in front of you and can pick the one that actually fits your life. If you’re a Massapequa resident with any connection to Mount Sinai South Nassau, Northwell, or Optum-affiliated providers, that’s a conversation worth having before AEP opens on October 15.
Types of Medicare Advantage Plans Available in Massapequa
HMO (Health Maintenance Organization) — 18 of the 31 plans. You choose a primary care doctor and generally need referrals to see specialists. Care is limited to in-network providers except in emergencies. Usually the lowest-cost option, but the least flexible.
PPO (Preferred Provider Organization) — 12 of the 31 plans. No referrals needed, and you can see out-of-network providers at a higher cost. More flexibility, typically at a higher premium or trade-off elsewhere in the plan design.
HMO-POS (HMO with Point-of-Service option) — a hybrid: HMO-style network rules with limited ability to step outside the network for certain services. Both 5-star Anthem plans in this market use this structure.
When to Enroll in Massapequa
- Initial Enrollment Period (IEP): The 7-month window around your 65th birthday — the best time to enroll for the first time.
- Annual Enrollment Period (AEP): October 15 – December 7 each year. This is when you can switch plans, drop Medicare Advantage for Original Medicare, or enroll for the first time if you missed your IEP (with possible penalties).
- Medicare Advantage Open Enrollment Period (MA OEP): January 1 – March 31. If you’re already in a Medicare Advantage plan, you get one chance to switch to a different MA plan or move back to Original Medicare.
- Special Enrollment Period (SEP): Triggered by specific life events — moving, losing other coverage, and others.
With AEP just a couple of months out, now is the right time to start planning — make sure you’re watching your mailbox for your 2027 Annual Notice of Change (ANOC), which carriers mail every September. Given how much movement this market has already seen in 2026 — carrier network drops, plan discontinuations, and shifting commission structures — the changes in this year’s ANOC letters could be especially impactful. Don’t wait until October to start looking; read your ANOC as soon as it arrives and flag anything that’s changed before AEP opens.
31 plans are available to Massapequa residents (ZIP 11758) in 2026, from 11 different carriers, spanning HMO, PPO, and HMO-POS plan types.
There isn’t a single “best” plan — the right plan depends on your specific doctors, hospital preferences, prescriptions, and budget. A plan that’s excellent for your neighbor may be the wrong fit for you, particularly given the current Anthem/Mount Sinai network situation described above.
Yes — 16 of the 31 available plans carry a $0 monthly premium. A $0 premium doesn’t mean $0 cost overall; you’ll still owe your Part B premium, and your out-of-pocket costs depend on the specific copays, coinsurance, and deductible structure of the plan.
It depends on the carrier. As of mid-2026, Mount Sinai South Nassau is out-of-network with Anthem Medicare Advantage plans specifically, even after Anthem’s commercial contract with Mount Sinai was restored in April 2026 — that restoration explicitly excluded Medicare Advantage plans. Aetna’s PPO network, by contrast, does include Mount Sinai — though Aetna’s network excludes Stony Brook Hospital, which Anthem does cover. Other carriers’ network status should be verified individually before enrolling.
It depends on the carrier, and two have already cut ties. HealthSpring (formerly Cigna Medicare) terminated its entire Northwell Health relationship effective December 31, 2025 — every Northwell hospital, physician group, and ancillary facility has been out-of-network for HealthSpring members since January 1, 2026. Wellcare separately let its own Northwell contract lapse effective July 1, 2026. If your doctors are Northwell-affiliated, confirm current network status before choosing either carrier.
CMS rates Medicare Advantage plans annually from 1 to 5 stars based on quality measures including member satisfaction, preventive care, chronic condition management, and customer service. Plans with 4 stars or higher are considered “top-rated” and qualify for CMS quality bonus payments. In Massapequa, 2 plans currently hold 5 stars and 10 hold 4 stars or higher.
Yes. You can switch during the Annual Enrollment Period (October 15 – December 7) for a January 1 effective date, or during the Medicare Advantage Open Enrollment Period (January 1 – March 31) if you’re already enrolled in an MA plan.
UnitedHealthcare has scaled back significantly in this market — down to just two plans, one with no drug coverage. Their popular 2025 HMO-POS plan (AARP NY-0009) was also made non-commissionable for 2026, which in the industry often signals a carrier wants to slow new enrollment growth after a plan performs better than expected. UHC also quietly discontinued its long-standing Regional PPO plans for 2026. It’s worth a closer look before assuming it’s the same UHC plan experience as prior years.
Not automatically — but both warrant extra caution in 2026. HealthSpring has gone from three PPO plans to one, dropped Optum Healthcare from its network, and cut Northwell entirely. Humana, long a popular Long Island carrier, has pulled back carrier investment behind its remaining plans this year. Neither is disqualifying on its own, but both deserve a closer look at your specific providers before enrolling.
Most do — of the 31 plans available, the large majority include Part D drug coverage built in (MAPD plans). A small number are drug-plan-free, intended for people who get drug coverage elsewhere (such as through the VA).
Every Medicare Advantage plan must cap in-network out-of-pocket costs at $9,250 or less for 2026 — this is a federal maximum. In Massapequa, plan-specific caps range from $4,950 to $9,250 depending on the plan.
It depends on your priorities. Medicare Advantage typically offers lower premiums and added benefits like dental and vision but limits you to a network. Medigap offers broader provider access nationwide with more predictable costs but usually carries a higher monthly premium and no extra benefits. A side-by-side comparison based on your specific situation is the only reliable way to decide.
