Plan vs plan · Orleans County, NY · 2027 plan year
Univera SeniorChoice Basic (HMO) vs Wellcare Fidelis Simple (HMO-POS)
Medicare.gov compares Medicare Advantage plans with each other. This page also shows Original Medicare, so you can see the full trade-off: premiums, copays, the yearly limit, extra benefits, and the rules about doctors and approvals.
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Univera SeniorChoice Basic (HMO)
- Plan premium
- $0 a month
- Yearly limit, in network
- $9,850
- 2027 star rating
- 4 of 5
- Prior authorization needed for
- 13 services
Wellcare Fidelis Simple (HMO-POS)
- Plan premium
- $0 a month
- Yearly limit, in network
- $9,850
- 2027 star rating
- 3 of 5
- Prior authorization needed for
- 20 services
In New York, you can go back to Medigap later
New York requires Medigap companies to sell you a plan at any time of year, and your health does not change the price. So you can try Medicare Advantage and go back to Original Medicare with Medigap later.
Read about Medigap rights on Medicare.govYour yearly cost, side by side
Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.
Want to check your exact drugs? Medicare.gov lets you enter each drug and shows what each plan charges for it. Enter your drugs on Medicare.gov
New York Department of Financial Services, community rated Medicare Supplement premiums (in effect as of October 1, 2026) lists $265 to $601 a month for a 65-year-old woman who does not use tobacco. We start at the lowest price. Health questions can raise the price after your first 6 months with Part B.
Original Medicare
With Medigap Plan G at $265 a month and Wellcare Value Script (PDP)
$8,606 a year
- Premiums
- $6,139
- Medical costs
- $292
- Drugs
- $2,175
Most you can pay in a bad year, before drugs: $6,431.
Univera SeniorChoice Basic (HMO)
HMO from Excellus Health Plan, Inc
$6,068 a year
- Premiums
- $2,514
- Medical costs
- $1,435
- Drugs
- $2,119
Most you can pay in a bad year, before drugs: $12,364.
Wellcare Fidelis Simple (HMO-POS)
HMO-POS from Wellcare
$6,566 a year
- Premiums
- $2,514
- Medical costs
- $1,877
- Drugs
- $2,175
Most you can pay in a bad year, before drugs: $12,364.
With these settings, Univera SeniorChoice Basic (HMO) costs about $498 less a year than Wellcare Fidelis Simple (HMO-POS).
Tipping point for Univera SeniorChoice Basic (HMO): with this drug use, if your medical copays and coinsurance in this plan pass $3,973 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $9,850.
Tipping point for Wellcare Fidelis Simple (HMO-POS): with this drug use, if your medical copays and coinsurance in this plan pass $3,917 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $9,850.
These are estimates, not quotes. Check every number with Medicare (Medicare.gov or 1-800-MEDICARE) and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Drug costs use typical prices for generic and brand-name drugs. Original Medicare amounts are 2027 projections from the 2026 Medicare Trustees Report. CMS sets the final amounts in November.
Text us about this comparisonWhat you pay each time you get care
In-network costs for one visit or one stay. The Original Medicare amounts follow your Medigap choice above: Plan G.
Primary doctor visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Univera SeniorChoice Basic (HMO)
$5
Wellcare Fidelis Simple (HMO-POS)
$0
Specialist visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Univera SeniorChoice Basic (HMO)
$35
Wellcare Fidelis Simple (HMO-POS)
$50
Prior authorization
Lab tests
Original Medicare + Medigap Plan G
$0
most Medicare-covered tests
Univera SeniorChoice Basic (HMO)
$0 copay
Prior authorizationWellcare Fidelis Simple (HMO-POS)
$0-$50
Prior authorization
MRI or CT scan
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Univera SeniorChoice Basic (HMO)
$255
Prior authorizationWellcare Fidelis Simple (HMO-POS)
0%-30%
Prior authorization
Emergency room
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Univera SeniorChoice Basic (HMO)
$115
Wellcare Fidelis Simple (HMO-POS)
$115
Urgent care
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Univera SeniorChoice Basic (HMO)
$40
Wellcare Fidelis Simple (HMO-POS)
$40
Outpatient surgery
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Univera SeniorChoice Basic (HMO)
$400
Prior authorizationWellcare Fidelis Simple (HMO-POS)
$475
Prior authorization
Ground ambulance
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Univera SeniorChoice Basic (HMO)
$250
Prior authorizationWellcare Fidelis Simple (HMO-POS)
$320
Prior authorization
Hospital stay, 5 days
Original Medicare + Medigap Plan G
$0
Plan G pays the $1,788 Part A deductible
Univera SeniorChoice Basic (HMO)
$2,025
for a 5-day stay
Prior authorizationWellcare Fidelis Simple (HMO-POS)
$2,400
for a 5-day stay
Prior authorization
See every cost in one table
| What you pay in network | Original Medicare + Medigap Plan G | Univera SeniorChoice Basic (HMO) | Wellcare Fidelis Simple (HMO-POS) |
|---|---|---|---|
| Monthly premium | Part B $209.50 + Medigap Plan G $265 + drug plan $37.30 | $0 + Part B $209.50 | $0 + Part B $209.50 |
| Yearly limit on what you pay | You pay the $292 Part B deductible. Plan G pays the rest. | $9,850 in network | $9,850 in network |
| Medical deductible | $292 Part B. Plan G pays the $1,788 Part A deductible. | $0 | $430 |
| Primary doctor visit | $0, after the $292 yearly Part B deductible | $5 copay | $0 copay |
| Specialist visit | $0, after the $292 yearly Part B deductible | $35 copay | $50 copayPrior authorization |
| Lab tests | $0, most Medicare-covered tests | $0 copayPrior authorization | $0-$50 copayPrior authorization |
| MRI or CT scan | $0, after the $292 yearly Part B deductible | $255 copayPrior authorization | 0%-30% coinsurancePrior authorization |
| X-rays | $0, after the $292 yearly Part B deductible | $55 copayPrior authorization | $50 copayPrior authorization |
| Emergency room | $0, after the $292 yearly Part B deductible | $115 copay | $115 copay |
| Urgent care | $0, after the $292 yearly Part B deductible | $40 copay | $40 copay |
| Outpatient hospital | $0, after the $292 yearly Part B deductible | $400 copayPrior authorization | 0%-30% coinsurancePrior authorization |
| Surgery center | $0, after the $292 yearly Part B deductible | $400 copayPrior authorization | $475 copayPrior authorization |
| Ground ambulance | $0, after the $292 yearly Part B deductible | $250 copayPrior authorization | $320 copayPrior authorization |
| Hospital stay | $0, Plan G pays the $1,788 Part A deductible | $405 per day for days 1-5; $0 per day for days 6-90Prior authorization | $600 per day for days 1-4; $0 per day for days 5-90Prior authorization |
| Skilled nursing facility | $0, Plan G pays days 21-100 | $0 per day for days 1-20; $221 per day for days 21-100Prior authorization | $0 per day for days 1-20; $221 per day for days 21-70; $0 per day for days 71-100Prior authorization |
| Mental health visit | $0, after the $292 yearly Part B deductible | 20% coinsurance | $35 copayPrior authorization |
| Physical therapy | $0, after the $292 yearly Part B deductible | $35 copayPrior authorization | $35 copayPrior authorization |
| Home health care | $0, Medicare-covered home health | $0 copay | $0 copayPrior authorization |
| Medical equipment | $0, after the $292 yearly Part B deductible | 20% coinsurancePrior authorization | 20% coinsurancePrior authorization |
| Part B drugs | $0 after the $292 Part B deductible | 0%-20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization |
| Drug deductible (Part D) | $700 with Wellcare Value Script (PDP) | $700 | $700 |
| Drug tiers (one month, retail) | Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 39% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $11 copay | Preferred Generic: $5 copayGeneric: $15 copayPreferred Brand: 21% coinsuranceNon-Preferred Drug: 23% coinsuranceSpecialty Tier: 25% coinsurance | Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 37% coinsuranceInjectable Drugs: 1% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copay |
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A higher drug plan premium is not, by itself, a reason to switch
With Original Medicare, you buy a separate drug plan. In New York, 9 drug plans are for sale for 2027, from $37.30 to $238.30 a month. Half of them cost $169.30 a month or less.
- Every 2027 drug plan limits what you pay for covered drugs to $2,400 a year. The drug coverage in Medicare Advantage plans has the same limit.
- The premium is one part of your yearly cost. The calculator above adds premiums, medical costs, and drug costs, so you can see the whole year.
- A Medicare Advantage plan can cost less in a light year. But you also take on its network and prior authorization rules.
- If your income is limited, Extra Help can pay most of your drug plan premium and drug costs. Check Extra Help at SSA.gov
Doctors, referrals, and prior authorization
Cost is one side. The other side is how you get care. These rules come from the CMS plan files. Prior authorization means the plan must approve a service before you get it.
Original Medicare
- Any doctor or hospital in the U.S. that takes Medicare
- No referrals
- Prior authorization only for a short list of services
Univera SeniorChoice Basic (HMO)
HMO
- You use doctors and hospitals in the plan network. Outside the network, the plan pays for emergencies and urgent care.
- No referral needed to see a specialist.
Prior authorization for 13 services
Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Physical therapy, Medical equipment, Prosthetics, Diabetic supplies, Hospital stay, Skilled nursing, Part B drugs
Wellcare Fidelis Simple (HMO-POS)
HMO-POS
- You use the plan network. Some care outside the network is covered at a higher cost.
- You need a referral to see a specialist.
Prior authorization for 20 services
Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Medical equipment, Prosthetics, Diabetic supplies, Substance use care, Hospital stay, Skilled nursing, Part B drugs
Extra benefits
| Extra benefit | Original Medicare | Univera SeniorChoice Basic (HMO) | Wellcare Fidelis Simple (HMO-POS) |
|---|---|---|---|
| Dental | No | Comprehensive, up to $500 a year | Preventive only |
| Eye exam | No | Yes | Yes |
| Glasses or contacts | No | No | No |
| Hearing aids | No | Yes, copays from $299 | No |
| Over-the-counter allowance | No | No | No |
| Fitness benefit | No | Yes | No |
| Rides to care | No | No | No |
| Meals after a hospital stay | No | No | No |
| Emergency care abroad | Plan G and Plan N pay 80% after a $250 deductible | Yes | Yes |
| Part B premium giveback | No | No | No |
What changed for 2027
Univera SeniorChoice Basic (HMO)
Consolidated Renewal Plan · 2026 plan H3351-017-0
- In-network out-of-pocket maximum up from $8,500 to $9,850
- Drug deductible up from $615 to $700
- Specialist visit: $30 copay to $35 copay
- Diagnostic radiology (MRI, CT): $200 copay to $255 copay
- Outpatient hospital: $375 copay to $400 copay
- Inpatient hospital: $390 per day for days 1-5; $0 per day for days 6-90 to $405 per day for days 1-5; $0 per day for days 6-90
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
- Dental maximum down from $1,000 to $500
- Eyewear removed
- OTC allowance removed
Wellcare Fidelis Simple (HMO-POS)
Consolidated Renewal Plan · 2026 plan H4868-019-0
- In-network out-of-pocket maximum up from $9,250 to $9,850
- Medical deductible up from $150 to $430
- Drug deductible up from $615 to $700
- Specialist visit: $25 copay to $50 copay
- Outpatient hospital: $0 copay, 30% coinsurance to 0%-30% coinsurance
- Ground ambulance: $340 copay to $320 copay
- Skilled nursing facility: $0 per day for days 1-20; $218 per day for days 21-70; $0 per day for days 71-100 to $0 per day for days 1-20; $221 per day for days 21-70; $0 per day for days 71-100
- Eyewear removed
- Hearing aids removed
- Fitness benefit removed
More 2027 plans in Orleans County
- AARP Medicare Advantage from UHC NY-0007 (HMO-POS), H3379-040 (page for Erie County, NY)
- HumanaChoice H5970-029 (PPO) (page for Erie County, NY)
- Independent Health's Encompass 65 RED 044 (HMO), H3362-044 (page for Erie County, NY)
- Community Blue Medicare HMO Signature (HMO), H3384-069 (page for Genesee County, NY)
- Wellcare Fidelis Assist (HMO-POS), H5599-002 (page for Kings County, NY)
- Humana USAA Honor Giveback (PPO), H5970-016 (page for Kings County, NY)
- Independent Health's Encompass 65 RED 042 (HMO), H3362-042 (page for Erie County, NY)
- Univera SeniorChoice Advanced (HMO-POS), H3351-019 (page for Erie County, NY)
County guide: 2027 plans in Orleans CountyState guide: New York
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Sources and method
Plan data comes from the CMS 2027 Plan Benefit Package and landscape files. The data is from 2026-10-10. We checked a sample of plans field by field against Medicare.gov. Original Medicare amounts are the 2027 projections in the 2026 Medicare Trustees Report (Tables V.E1 and V.E2). CMS sets the final amounts in November. Medigap prices come from New York Department of Financial Services, community rated Medicare Supplement premiums (in effect as of October 1, 2026), pulled 2026-10-13. They are for the price area that includes ZIP 14411. Totals use typical Medicare-allowed amounts for each service and typical drug prices.
- Univera SeniorChoice Basic (HMO) on Medicare.gov · plan website · drug list · doctor directory
- Wellcare Fidelis Simple (HMO-POS) on Medicare.gov · plan website · drug list · doctor directory
- Medigap prices: New York Department of Financial Services, community rated Medicare Supplement premiums (in effect as of October 1, 2026)
- CMS Plan Benefit Package files, 2027
- CMS 2027 landscape files (premiums and limits)
- CMS 2027 plan crosswalk
- CMS 2027 Star Ratings
- 2026 Medicare Trustees Report: projected 2027 Part A and Part B amounts (Tables V.E1 and V.E2)
- CMS 2026 Part A and Part B amounts
- Medicare.gov: Medigap guaranteed issue rights
These are estimates, not quotes, and they are for education only. Check every number with Medicare and with the plan before you choose. What you pay depends on your doctors and hospitals, your drugs and pharmacy, and the care you use. Plans can change their benefits, premiums, drug lists, and networks each year.
Pinnie is not an insurance agent or broker and does not sell Medicare plans. Pinnie is not connected with or endorsed by the U.S. government or the federal Medicare program. For all your options, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.