By Paul Barrett, CMIP | The Modern Medicare Agency | Melville, NY 18+ years Medicare-exclusive experience | Licensed in 34 states | 40+ carriers
If you live in Farmingdale and you’re trying to figure out Medicare Advantage for 2026, here’s what I want you to know before we dive in:
There are 31 plans available to you in Nassau County this year. Eleven of them have a $0 monthly premium. And yet the most important number in this entire guide isn’t the premium at all — it’s whether your doctor at Northwell Health or St. Joseph University Medical Center is actually covered under the plan you choose.
I’ve been helping Long Island residents navigate Medicare since 2007. I’ve seen the confusion, the aggressive mailers, the TV commercials that promise everything. This guide is different. It’s written by someone who has sat across the kitchen table from Farmingdale residents and helped them make this decision — not by an algorithm generating location pages.
Let’s get into it.
2026 Medicare Advantage Fast Facts for Farmingdale (ZIP 11735)
For a deeper look at how Medicare Advantage compares to your other options in Nassau County, see our Medicare Advantage vs. Medigap guide for Farmingdale and our Medicare Agent Near Farmingdale local guide.
Source: CMS Medicare Advantage Enrollment Data 2026 | Medicare.org Nassau County Plan Data
The Carriers Operating in Farmingdale in 2026
Eleven insurance companies offer Medicare Advantage plans in Nassau County for 2026:
Aetna Medicare
Anthem Blue Cross and Blue Shield
Elderplan
EmblemHealth
HealthSpring
Healthfirst Medicare Plan
Humana
UnitedHealthcare
VNS Health Medicare
VillageCareMAX
Wellcare
The top 5 by enrollment in Nassau County:
Healthfirst Health Plan — leading HMO, 4,286+ members locally
Aetna Life Insurance Company — largest PPO, 15,740+ enrollees (Aetna Medicare Elite PPO)
UnitedHealthcare — AARP Medicare Advantage HMO-POS, 7,052+ members
Sierra Health and Life Insurance Company (Anthem network)
Anthem HP, LLC
Paul's Take: What I Actually Think About These Carriers in 2026
This is the section you won’t find on any other website. I’m not a 1-800 call center. I’m an independent broker with 18 years in this market. Here’s my honest read on the major players for Farmingdale residents right now:
Aetna — The Aetna Medicare Elite PPO is the single most enrolled plan in Nassau County, and for good reason. It offers PPO flexibility, strong provider access, and a track record of solid customer service. If you have doctors at both Northwell and NYU Langone and want the freedom to see both without a referral, this is often the first plan I look at. Aetna has been taking rate corrections in recent cycles — something to monitor going forward — but for 2026, it remains one of the strongest options in Nassau County for people who want maximum flexibility.
UnitedHealthcare (AARP branded) — UHC is the largest Medicare Advantage carrier in the country, and the AARP-branded HMO-POS has historically been the most popular plan of its type in Nassau. However, in 2026, I want Farmingdale residents to understand a few things before assuming UHC is the right call. First, UHC removed their Regional PPO plans from this market for 2026, eliminating a plan type that gave members broader provider flexibility. Second, their remaining HMO-POS plan is what I’d describe as going through enrollment management — the plan has been structured in a way that makes it more difficult for agents to enroll consumers online, and agent compensation on this plan has been suspended. Carriers do this when they are not actively seeking enrollment growth. That’s not a knock on UHC as a company — all carriers go through cycles — but it is something worth knowing when you’re evaluating your options. Third, and most importantly: UHC’s network depth on Long Island is not what it is nationally. In the five boroughs, their provider relationships are strong. As you move east into Nassau and Suffolk, the network thins out noticeably compared to what you’d find in other markets. I always do a live provider search for any client before recommending this plan.
Healthfirst — A legitimate, locally rooted health plan with strong roots in the New York area. They offer several plans, each with slightly different network configurations and benefit structures, which means there’s a Healthfirst plan that fits certain client profiles very well. The important thing to know: Healthfirst’s network strength is considerably stronger in the five boroughs of New York City than it is on Long Island. If your doctors are primarily in Nassau County — as most Farmingdale residents’ are — I always verify your specific providers against their Long Island network before recommending any Healthfirst plan. Don’t assume that because a plan is popular in Queens or Brooklyn it will cover your Farmingdale or Nassau specialists.
Humana — I started my Medicare career with Humana and have a great deal of respect for them as a national carrier. But I’d be doing you a disservice if I didn’t tell you what’s been happening locally. Over the past few years, Humana has stumbled in the New York and Long Island market specifically. They’ve reduced their available plan options in this area, and for 2026, the plans they do have available in Nassau County are currently non-commissionable to agents — which, again, signals they are managing enrollment rather than growing it here. Their star ratings have also declined from where they were a few years ago. Nationally, Humana is a solid company. In Farmingdale and Nassau County specifically for 2026, I’d encourage you to compare carefully and not choose them on brand name alone.
Anthem Blue Cross Blue Shield (formerly Empire BCBS) — This is the carrier I’m most enthusiastic about for Farmingdale residents in 2026 — and the data backs it up. Anthem (known locally for years as Empire BCBS — same company, rebranded in 2023 under Elevance Health) has made a real comeback in this market. Their Medicare Advantage 2 HMO-POS plan earned a 5-star rating from CMS for 2026 — the highest possible score, and the only 5-star Medicare Advantage plan available on Long Island this year. CMS confirms this rating, with Anthem’s plan scoring well above New York’s state average of 3.8 stars. Their provider network on Long Island is strong, their customer service has been solid, and they offer an HMO-POS structure that gives clients meaningful flexibility when they need to go outside the primary network. For many Farmingdale and Nassau County residents, Anthem is the first plan I’m looking at seriously in 2026.
Wellcare and HealthSpring (formerly Cigna) — CRITICAL 2026 WARNING for Farmingdale residents: Two major carriers have severed their network relationships with Northwell Health, and every Nassau County resident needs to know about both.
HealthSpring (formerly Cigna Medicare): Northwell Health left the HealthSpring Medicare Advantage network effective December 31, 2025. This means that as of January 1, 2026, all Northwell hospitals, ancillary facilities, provider groups, and their clinically integrated network are out-of-network for HealthSpring Medicare Advantage members. This is not a future risk — it has already happened. If you are currently enrolled in a HealthSpring plan and see any Northwell providers, you are already paying out-of-network rates or facing access issues right now.
Wellcare: Northwell Health is also leaving the Wellcare Medicare Advantage network effective July 1, 2026. Established Wellcare patients may continue care at Northwell through August 29, 2026 subject to Wellcare’s authorization, but after that date, Northwell is fully out-of-network for Wellcare members as well. See Northwell’s official update for full details.
If you are enrolled in either a HealthSpring or Wellcare Medicare Advantage plan and rely on Northwell for any of your care — please call me immediately. You may qualify for a Special Enrollment Period to make a plan change. This is exactly the kind of local intelligence that no national website or 1-800 number is going to give you.
The Northwell Problem Every Farmingdale Resident Needs to Know
Northwell Health is the largest health system in New York State. Chances are, at least one of your doctors — your cardiologist, your orthopedist, your primary care physician — is affiliated with Northwell.
Here is what changes in 2026 that nobody in your mailbox is going to tell you:
Wellcare has chosen not to renew its contract with Northwell. As of July 1, 2026, Northwell is out-of-network for Wellcare Medicare Advantage members. This affects Nassau County, Long Island, and the broader New York area.
This is the exact reason I tell every Farmingdale client the same thing before we look at a single plan: give me your doctor’s name first, not the plan name.
A $0 premium plan that takes your Northwell cardiologist out-of-network isn’t a deal. It’s a problem.
Other major systems in the Farmingdale area — including St. Joseph University Medical Center and NYU Langone — have their own network arrangements that vary by carrier and by plan type. I verify every physician’s status before any client enrolls.
HMO vs. PPO vs. HMO-POS: What Actually Matters for Farmingdale Residents
HMO (Health Maintenance Organization)
Requires you to use in-network providers only (except emergencies)
Requires a primary care physician to coordinate referrals
Typically the lowest premiums — many $0 options available
Best for: Farmingdale residents whose doctors are all within one system (Northwell OR NYU Langone, not both)
Restriction: If you want to see a specialist in Manhattan or split care across systems, this can create friction
PPO (Preferred Provider Organization)
See any Medicare-accepting provider — in-network or out
No referrals required for specialists
Average PPO premium in Nassau County: $27.82/month
12 PPO plans available in 2026 covering 25,000+ Nassau enrollees
Best for: Snowbirds, travelers, anyone with specialists at multiple systems, or anyone who values total freedom of choice
The Aetna Medicare Elite PPO is the most popular plan in all of Nassau County
HMO-POS (Point of Service)
A middle ground — HMO structure with limited out-of-network access for select services
The AARP/UHC HMO-POS is the most popular plan of this type in Nassau (7,000+ members)
Best for: People who want HMO pricing but occasionally need to go outside the network
My honest take: For most healthy Farmingdale residents turning 65 with predictable doctor relationships, an HMO or HMO-POS can work beautifully and save money. For anyone managing a complex or chronic condition, seeing multiple specialists, or valuing flexibility above all else — a PPO is almost always worth the modest premium difference.
The One Number Most People Ignore (That Matters Most)
Everyone focuses on the $0 premium. I get it — it sounds like a great deal.
Here’s what I want you to look at instead: the out-of-pocket maximum.
The average out-of-pocket maximum for Medicare Advantage plans in Nassau County is $8,625 per year for in-network services. For combined in and out-of-network, some plans go higher.
That means if you have a serious illness, a surgery, or a significant hospital stay — you could owe up to $8,625 before the plan pays 100%. That’s real money.
Now compare that to a Medigap Plan G: your total out-of-pocket exposure for covered Medicare services is $283 for the year — the Part B deductible. After that, nothing.
I’m not saying Medicare Advantage is wrong for you. For many Farmingdale residents, it’s an excellent choice. I’m saying: look at the full picture, not just the monthly premium. That’s the honest conversation most agents won’t have with you because it’s easier to just enroll you in the $0 plan.
What About Medigap (Medicare Supplement) in Farmingdale?
Because New York is a community-rated, guaranteed-issue state, Medigap works very differently here than in most of the country. For a full breakdown of how Medigap works in New York and when switching makes sense, see our Medicare Supplement Plan G guide and our Medigap switching rules article.
In New York, you can apply for a Medigap plan at any time of year — not just during a one-time window. You cannot be denied for health reasons. Every carrier must offer you coverage at standard rates regardless of your health history. This is an enormous consumer protection that most people don’t know about — and it’s unique to New York.
But let’s be honest about what Medigap actually costs in 2026 — because this matters.
Medigap Plan G is the most popular supplement plan for new enrollees in New York. It covers nearly all of your Medicare-approved costs after a single $283 Part B deductible. After that, your out-of-pocket exposure for covered services is essentially zero.
Here’s the full picture though:
Plan G premium in New York: approximately $373/month ($4,476/year)
Annual Part B deductible: $283
Plan G does not include prescription drug coverage — you need a separate Part D plan
The lowest-cost Part D plan available in New York adds additional monthly cost on top
Add it all up — Plan G premium + Part B deductible + even a modest Part D plan — and your minimum annual commitment as a Medigap enrollee in New York easily exceeds $5,100 per year before you use a single medical service.
That is not a knock on Plan G. For someone with serious health conditions, significant specialist needs, or anyone who values absolute certainty in their costs, Plan G’s near-zero out-of-pocket exposure when you actually use care can easily justify that annual commitment. If you have a hospitalization, a surgery, or a complex treatment course, Plan G often saves you significantly compared to hitting an Advantage plan’s out-of-pocket maximum.
But for a generally healthy person on a fixed income who wants to minimize what they spend every month, a well-chosen $0 Medicare Advantage plan with a manageable out-of-pocket maximum can make real financial sense too.
There is no universally right answer. There is only the right answer for your specific situation — your health, your doctors, your drugs, your finances, and your risk tolerance. That’s the conversation I have with every Farmingdale client before we look at a single plan.
The Farmingdale Enrollment Deadlines You Cannot Miss
For a complete guide to Medicare enrollment windows and penalty rules, visit Medicare.gov’s official enrollment page or our Original Medicare Explained guide.
Initial Enrollment Period (IEP) Seven months: starts 3 months before your 65th birthday, includes your birth month, ends 3 months after. This is your first chance to enroll with no penalties.
Annual Enrollment Period (AEP) October 15 – December 7 each year. Changes take effect January 1. This is when most plan switching happens.
Medicare Advantage Open Enrollment Period (OEP) January 1 – March 31. If you enrolled in an MA plan and want to switch to another MA plan or return to Original Medicare, you can do so during this window.
Special Enrollment Periods (SEPs) Triggered by specific life events: moving, losing other coverage, your plan exiting the market. The Wellcare/Northwell situation may trigger SEP rights for affected members — contact me to discuss your specific situation.
Late enrollment penalties are permanent. A missed Part B enrollment window can cost you 10% added to your premium for every 12-month period you were eligible but didn’t enroll — and it follows you for life.
My 5-Step Process for Farmingdale Residents
After 18 years of doing this, here’s the process I walk every client through:
Step 1: List your doctors. Every physician, specialist, and facility you currently see. We check every single one against the 2026 plan networks before we look at anything else.
Step 2: List your medications. Every prescription by name and dosage. Under the new 2026 rules, the out-of-pocket cap on drugs is $2,100. But what you pay within that cap depends entirely on how your drugs are tiered in each plan’s formulary.
Step 3: Look at your TOTAL annual cost picture — not just the monthly premium. This is where most people get confused, and where I want to be completely straight with you.
A $0 Medicare Advantage plan still has costs — copays, coinsurance, and an out-of-pocket maximum that averages $8,625 in Nassau County. If you have a significant health event, you could owe thousands before the plan covers everything.
A Medigap Plan G, on the other hand, covers nearly all of your Medicare-approved costs after a single $283 annual deductible. But Plan G is not free either. In New York, Plan G premiums run approximately $373 per month — that’s $4,476 per year in premiums alone, plus the $283 Part B deductible. And Plan G does not include prescription drug coverage — you need a separate Part D plan for that, which in New York adds cost on top. When you add a Plan G premium, the Part B deductible, and even the lowest-cost Part D plan available in New York, your minimum annual out-of-pocket commitment easily exceeds $5,100 per year before you use a single medical service.
So the honest comparison is not “$0 vs. Plan G.” It’s a full side-by-side of your total likely annual spend under each path — premiums, deductibles, copays, drug costs, and realistic usage — against the financial protection each one provides if something serious happens. That’s the conversation I have with every client, because the right answer is genuinely different depending on your health, your doctors, your medications, and your financial situation.
Step 4: Consider your lifestyle. Do you travel? Spend winters in Florida? Split time between New York and another state? PPO or Medigap. Do you stay local, see the same doctors, and want to keep things simple? HMO may work beautifully.
Step 5: Talk to an independent broker. Not a call center. Not a carrier-captive agent who only shows you one company’s plans. Someone who represents 40+ carriers and can lay everything out side by side without an agenda.
That’s what I do. My consultation is free. My advice is honest. And I’m not going anywhere after you enroll — I’m here year-round when questions come up.
Frequently Asked Questions: Medicare Advantage in Farmingdale, NY
There are 31 Medicare Advantage plans available to Farmingdale residents in Nassau County for 2026. These include HMO, PPO, and HMO-POS plan types from 11 different insurance carriers
Yes. Eleven plans available in the 11735 zip code have a $0 monthly premium for 2026. However, $0 premium does not mean $0 cost — you still pay for care through copays and coinsurance, and your out-of-pocket maximum in Nassau County averages $8,625 per year.
No — and two major network changes are directly affecting Northwell access for Nassau County residents right now. HealthSpring (formerly Cigna Medicare) terminated its relationship with Northwell effective December 31, 2025, meaning all Northwell hospitals, provider groups, ancillaries, and their clinically integrated network have been out-of-network for HealthSpring members since January 1, 2026. Wellcare is also losing Northwell from its network effective July 1, 2026. If you are enrolled in either a HealthSpring or Wellcare Medicare Advantage plan and see any Northwell providers, call me immediately — you may qualify for a Special Enrollment Period. I verify every client’s specific provider network status before enrollment, without exception.
Medicare Advantage replaces Original Medicare with a private plan that has network restrictions, copays when you use care, and additional benefits like dental and vision. Medigap (Medicare Supplement) works alongside Original Medicare, covering most out-of-pocket costs with no network restrictions. In New York, you can switch Medigap plans year-round with no medical underwriting — a protection most states don’t offer.
Paul Barrett of The Modern Medicare Agency has served Farmingdale and Nassau County residents since 2007. He is an independent broker licensed in 34 states who represents 40+ Medicare carriers. Consultations are free. Call 631-358-5793 or visit paulbinsurance.com.
There is no single “best” plan — it depends entirely on your doctors, your medications, your budget, and your lifestyle. The most enrolled plan in Nassau County is the Aetna Medicare Elite PPO (15,740+ members). The most popular HMO-POS is AARP Medicare Advantage from UHC (7,052+ members). I compare all 31 plans against your specific situation before making any recommendation.
If your plan exits the market or makes a significant network change mid-year, you may qualify for a Special Enrollment Period to choose a new plan. CMS continuity of care rules also require plans to allow you to continue active treatment with a non-network provider for up to 90 days at in-network rates when you first join a plan. Call me immediately if your plan has dropped your doctor — I help navigate exactly these situations.
The 11735 zip code spans both counties. Your county of legal residence — not your mailing address — determines which Medicare Advantage plans you’re eligible for. Nassau County residents have access to 31 plans. Suffolk County residents have a different set of options. Confirm your county using your voter registration or property tax records before comparing plans. We’ve written a full guide to this exact question: Medicare in Farmingdale: Why Your County Matters.
Ready to Compare Your 2026 Options?
I serve Farmingdale, Nassau County, and Long Island residents from my office in Melville. My consultations are always free, always honest, and always in plain English — no pressure, no sales pitch, no disappearing after enrollment.
Paul Barrett, CMIP The Modern Medicare Agency 📞 631-358-5793 ✉️ medicare@paulbinsurance.com 🌐 paulbinsurance.com 📍 445 Broad Hollow Rd, Melville, NY 11747
Licensed in 34 states | 40+ carriers | 18+ years Medicare-exclusive experience | 5,000+ clients served
Related guides from Paul Barrett:
External sources cited:
Disclaimer: The Modern Medicare Agency is not connected with or endorsed by the United States government or the federal Medicare program. Plan data reflects CMS-published figures for 2026. Provider network information is subject to change — always verify your specific physicians’ network status before enrolling. We do not offer every plan available in your area. Contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.
Northwell/Wellcare network change information sourced from Northwell Health’s official notice, May 2026. HealthSpring/Northwell termination sourced from direct HealthSpring broker partner communication, effective December 31, 2025.
