Medicare Advantage Plans in Queens, NY: The Complete 2026 Guide

Medicare Advantage Plans in Queens, NY: The Complete 2026 Guide

By Paul Barrett, CMIP | The Modern Medicare Agency | Melville, NY 18+ years Medicare-exclusive experience | Licensed in 37 states | 40+ carriers Last updated: July 2026 Queens has 37 traditional Medicare Advantage plans to choose from in 2026, with roughly 86,500 residents already enrolled in one. That’s more total enrollment than Brooklyn, and it makes Queens one of the largest Medicare Advantage markets anywhere in New York City. This guide breaks it down honestly: real numbers, every standard plan available, and a live network situation worth knowing about if you’re on a certain carrier right now. I’m independent — I represent more than 40 carriers, so nothing here is written to steer you toward one company. It’s written so you can see the whole picture clearly.

CRITICAL NETWORK WARNING: UNITEDHEALTHCARE AND NEWYORK-PRESBYTERIAN

If you’re considering — or already enrolled in — an AARP Medicare Advantage plan from UnitedHealthcare, this matters right now. UnitedHealthcare and NewYork-Presbyterian are in active contract negotiations, and in-network access for most UnitedHealthcare Medicare Advantage members has been extended through July 31, 2026. This directly touches Queens: NewYork-Presbyterian Queens and its Queens Medical Group practices are named among the facilities that would go out-of-network if no new agreement is reached — not just the Manhattan campuses. Starting August 1, 2026, those facilities could become out-of-network for most UHC Medicare Advantage members. If this affects your doctors, a network exit like this can qualify you for a Special Enrollment Period — meaning you may not have to wait for the next Annual Enrollment Period to switch plans.

A SECOND NETWORK NOTE: MOUNT SINAI QUEENS AND HEALTHFIRST

This one matters even more than it might first appear, because it touches Queens’ single most popular Medicare Advantage plan. According to Mount Sinai’s own published 2026 participation list, Mount Sinai’s primary care providers are not currently accepting new Healthfirst Medicare Advantage patients. Healthfirst 65 Plus Plan is the most-enrolled Medicare Advantage plan in Queens by a wide margin — 18,957 members, or roughly 22% of everyone on a standard Medicare Advantage plan in the county. If you’re shopping that plan specifically to establish care with a Mount Sinai Queens doctor, confirm directly with the practice before enrolling. Two related details worth knowing if Mount Sinai Queens matters to you:

• Elderplan is only accepted at select Mount Sinai hospitals — Mount Sinai Brooklyn, Mount Sinai Morningside, Mount Sinai West, and New York Eye and Ear Infirmary of Mount Sinai. Mount Sinai Queens is not on that list.
• UnitedHealthcare/Oxford plans are generally accepted, but Mount Sinai specifically excludes UnitedHealthcare’s Community Plan line. This is a different product line than the AARP-branded UHC plans most Queens shoppers see, but it’s worth confirming which UHC product you’re looking at before assuming it’s covered.

This is exactly the kind of detail that a plan’s star rating or premium won’t tell you, and it can change from year to year — always confirm directly with the practice, not just the insurance card.

QUEENS MEDICARE ADVANTAGE: FAST FACTS

What You’re Looking At	The 2026 Number
Total Medicare Advantage plans available	37 traditional MA plans*
Plans with a $0 monthly premium	20
Average premium (across all plan types)	$29.91/month
Average out-of-pocket maximum	$8,678/year
Average Rx deductible (plans with drug coverage)	$531.94/year
Plans rated 4 stars or higher	10 (27%)
Average CMS star rating	3.57
Plan types available	HMO (12 plans), PPO (14 plans), HMO-POS (11 plans)
Total Medicare Advantage enrollment in Queens	86,500

Plans and prices can change, and availability depends on your exact address within Queens. Always confirm current details for your specific ZIP code using Medicare.gov’s Plan Finder before enrolling. *This 37-plan count reflects standard, non-Special-Needs Medicare Advantage plans. Special Needs Plans (D-SNP, C-SNP, I-SNP) are offered separately and aren’t included in this count.

QUEENS BY PLAN TYPE: THE SAME PATTERN WE FOUND IN BROOKLYN

If you’ve read our Brooklyn HMO vs. PPO breakdown, this number will look familiar — and it should, because it’s the same pattern repeating in a different borough:

	HMO	PPO	HMO-POS
Total plans	12	14	11
Beneficiaries enrolled	38,630	33,712	14,158
Average monthly premium	$42.90	$22.99	$24.56
$0-premium plans available	5	9	6
Average out-of-pocket maximum	$9,192	$8,564	$8,264
Plans without Part D coverage	0	2	4
Most enrolled plan	Healthfirst 65 Plus Plan — 18,957 members	AARP Medicare Advantage from UHC NY-0012 — 11,218 members	AARP Medicare Advantage from UHC NY-0005 — 4,861 members

Just like in Brooklyn, PPO plans in Queens average a lower monthly premium than HMO plans — $22.99 versus $42.90, an even wider gap than what we found in Kings County. If you’ve been told HMOs are the “budget option” and PPOs cost more, Queens is now the second NYC borough in a row where the real numbers say otherwise.

TOP-RATED PLANS IN QUEENS (4 STARS OR HIGHER)

Rating Category	Number of Plans	Percent of Plans
5 Stars	2	5%
4 Stars (includes 5 Stars)	10	27%
3 Stars	27	73%
Below 3 Stars	0	0%
Average Rating	3.57

Notice something important here: the highest-rated plans aren’t necessarily the cheapest, and the cheapest plans aren’t necessarily the highest-rated. Several $0-premium plans in Queens carry only 3.0-star ratings, while some of the strongest-rated plans carry real monthly costs. This is exactly why “lowest premium” and “best plan” are two different questions.

MEDICARE ADVANTAGE PPO PLANS IN QUEENS

Preferred Provider Organization (PPO) plans let you see out-of-network doctors and specialists without a referral, usually at a higher cost, giving you more flexibility than an HMO.

Health Plan Name	Premium/Mo	MOOP	Rx Deductible
Aetna Medicare Eagle Giveback	$0	$9,250	N/A
Aetna Medicare Elite	$0	$9,250	$615
AARP Medicare Advantage from UHC NY-0012	$0	$8,900	$600
HealthSpring True Choice	$0	$6,800	$250
Humana Direct Choice Giveback	$0	$9,250	$475
Humana USAA Honor Giveback	$0	$4,950	N/A
HumanaChoice H5970-028	$0	$9,250	$615
Wellcare Giveback Open	$0	$9,250	$615
Wellcare Simple Open	$0	$9,250	$615
Aetna Medicare Elite Extra	$44	$9,250	$615
Healthfirst Signature (PPO)	$55	$9,250	$615
Aetna Medicare Enhanced	$60	$9,250	$615
Wellcare Assist Open	$59	$9,250	$530
Aetna Medicare Enhanced Extra	$104	$6,750	$615

9 of Queens’ 14 PPO plans charge $0 monthly premium. 2 PPO plans do not include Part D drug coverage.

MEDICARE ADVANTAGE HMO PLANS IN QUEENS

HMO plans generally require you to use in-network doctors and get a referral to see specialists. Out-of-network care typically isn’t covered except in an emergency.

Health Plan Name	Premium/Mo	MOOP	Rx Deductible
Healthfirst 65 Plus Plan	$0	$9,250	$615
Healthfirst Signature (HMO)	$0	$9,250	$615
Aetna Medicare Signature Care	$0	$9,250	$615
Humana Gold Plus Giveback H3533-027	$0	$9,250	$615
Humana Gold Plus H3533-033	$0	$8,550	$615
Healthfirst Increased Benefits Plan	$24	$9,250	$615
VNS Health EasyCare	$25	$9,250	$500
Humana Gold Plus H3533-035	$22	$9,250	$615
Aetna Medicare Enhanced (HMO)	$74	$9,250	$615
MetroPlus Platinum Plan	$59	$9,250	$615
VillageCareMAX Medicare Select Advantage Plan	$59	$9,250	$615
EmblemHealth VIP Gold Plus	$252	$9,250	$200

Only 5 of Queens’ 12 HMO plans charge $0 monthly premium — notably fewer than the PPO category. All HMO plans in Queens include Part D drug coverage.

MEDICARE ADVANTAGE HMO-POS PLANS IN QUEENS

HMO-POS plans blend HMO and PPO coverage — mostly HMO rules, but with a limited allowance to go out-of-network for certain services at a higher cost.

Health Plan Name	Premium/Mo	MOOP	Rx Deductible
Anthem Veteran 2	$0	$6,800	N/A
Anthem Veteran	$0	$6,800	N/A
AARP Medicare Advantage Patriot No Rx NY-MA3	$0	$6,700	N/A
Wellcare Fidelis Patriot Simple	$0	$9,250	N/A
Wellcare Simple	$0	$9,250	$615
Elderplan Flex	$0	$7,550	$375
Anthem Medicare Advantage 2	$34	$9,250	$240
Anthem Medicare Advantage	$44	$9,250	$150
Wellcare Assist	$51	$9,250	$590
Elderplan Extra Help	$59	$7,550	$375
AARP Medicare Advantage from UHC NY-0005	$82	$9,250	$520

4 of Queens’ 11 HMO-POS plans do not include Part D drug coverage — more than either HMO or PPO categories.

WHO OFFERS MEDICARE ADVANTAGE IN QUEENS

The carrier lineup in Queens closely mirrors Brooklyn’s, which makes sense given the shared NYC hospital systems both boroughs draw on:

• Healthfirst — A New York-based, not-for-profit plan with a dominant local presence. Its 65 Plus Plan alone covers nearly 22% of all Queens Medicare Advantage enrollment. Healthfirst’s largest Medicare Advantage contract — which covers both the 65 Plus Plan and the Increased Benefits Plan, alongside several of its D-SNP options — earned a 4.5-star CMS rating for the 2026 Star Program Year, the second consecutive year at that level. CMS rates contracts, not individual plans, so this score is shared across the plans in that contract rather than earned separately by each.
• Aetna and UnitedHealthcare (AARP) — The two largest national carriers by enrollment in Queens, both offering multiple $0-premium PPO options.
• Humana — Offers several Giveback-style plans (including a Part B premium reduction) across both HMO and PPO categories.
• MetroPlus Health Plan — Affiliated with NYC Health + Hospitals, which can matter if you already receive care through Elmhurst Hospital or another public hospital in Queens.
• Elderplan and VNS Health — Both NYC-focused carriers with plans designed for people who qualify for both Medicare and Medicaid.

MEDICARE AND VA BENEFITS

If you or your spouse are a veteran with VA benefits, the VA still recommends enrolling in Medicare as soon as you’re eligible. Having Medicare means you’re covered for care outside VA facilities, VA benefits and healthcare policy can change over time, and skipping Medicare now can mean permanent late enrollment penalties later if you ever need to add it. Several plans in Queens, including Anthem’s Veteran-branded HMO-POS plans and Humana’s USAA Honor plan, are specifically built with veterans in mind.

WHEN TO ENROLL

Enrolling for the first time: Your Initial Enrollment Period runs 7 months — 3 months before your 65th birthday month, your birthday month, and 3 months after. Missing this window means waiting for the General Enrollment Period (January 1 – March 31), likely with penalties.

Changing plans: The Annual Enrollment Period runs October 15 – December 7 each year. There’s also a Medicare Advantage Open Enrollment Period from January 1 – March 31, when you can switch to a different Medicare Advantage plan or move back to Original Medicare.

Special situations: Moving, losing coverage, or a network change like the UnitedHealthcare/NewYork-Presbyterian situation above can all qualify you for a Special Enrollment Period outside the normal windows.

PAUL’S HONEST TAKE

Queens is a genuinely strong Medicare Advantage market — 37 plans, 20 of them free, and real competition among Healthfirst, Aetna, UnitedHealthcare, and Humana for your business. But the same pattern I flagged in Brooklyn holds true here, maybe even more so: the “HMO is cheaper” assumption is backwards in this borough. PPO plans average nearly half the premium of HMO plans in Queens, and several of the highest-rated plans aren’t the $0 ones. I’d rather walk you through your specific doctors, hospital, and prescriptions against this list than have you pick based on which commercial you saw most recently.