Company vs company · Warren County, NY · 2027 plan year
Wellcare vs CDPHP Medicare Advantage Medicare Advantage plans
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.
Pinnie Direct is a free text line. Pinnie does not sell plans.
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 $305 to $667 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 $305 a month and Wellcare Value Script (PDP)
$9,091 a year
- Premiums
- $6,624
- Medical costs
- $292
- Drugs
- $2,175
Most you can pay in a bad year, before drugs: $6,916.
Wellcare Fidelis Assist (HMO-POS)
HMO-POS from Wellcare
$5,839 a year
- Premiums
- $2,514
- Medical costs
- $1,150
- Drugs
- $2,175
Most you can pay in a bad year, before drugs: $12,364.
CDPHP $0 Medicare Rx (HMO)
HMO from CDPHP Medicare Advantage
$5,782 a year
- Premiums
- $2,514
- Medical costs
- $1,090
- Drugs
- $2,178
Most you can pay in a bad year, before drugs: $12,364.
With these settings, CDPHP $0 Medicare Rx (HMO) costs about $57 less a year than Wellcare Fidelis Assist (HMO-POS).
Tipping point for Wellcare Fidelis Assist (HMO-POS): with this drug use, if your medical copays and coinsurance in this plan pass $4,402 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $9,850.
Tipping point for CDPHP $0 Medicare Rx (HMO): with this drug use, if your medical copays and coinsurance in this plan pass $4,399 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
Wellcare Fidelis Simple (HMO-POS)
$0
Wellcare Simple Open (PPO)
$0
CDPHP $0 Medicare Rx (HMO)
$0
CDPHP Choice Rx (HMO)
$0
Specialist visit
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Wellcare Fidelis Simple (HMO-POS)
$50
Prior authorizationWellcare Simple Open (PPO)
$50
Prior authorizationCDPHP $0 Medicare Rx (HMO)
$0-$50
CDPHP Choice Rx (HMO)
$0-$35
Lab tests
Original Medicare + Medigap Plan G
$0
most Medicare-covered tests
Wellcare Fidelis Simple (HMO-POS)
$0-$50
Prior authorizationWellcare Simple Open (PPO)
$0-$50
Prior authorizationCDPHP $0 Medicare Rx (HMO)
$0-$10
Prior authorizationCDPHP Choice Rx (HMO)
$0-$5
Prior authorization
MRI or CT scan
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Wellcare Fidelis Simple (HMO-POS)
0%-30%
Prior authorizationWellcare Simple Open (PPO)
$0-$500
Prior authorizationCDPHP $0 Medicare Rx (HMO)
$260
Prior authorizationCDPHP Choice Rx (HMO)
$175
Prior authorization
Emergency room
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Wellcare Fidelis Simple (HMO-POS)
$115
Wellcare Simple Open (PPO)
$115
CDPHP $0 Medicare Rx (HMO)
$115
CDPHP Choice Rx (HMO)
$100
Urgent care
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Wellcare Fidelis Simple (HMO-POS)
$40
Wellcare Simple Open (PPO)
$35
CDPHP $0 Medicare Rx (HMO)
$40
CDPHP Choice Rx (HMO)
$50
Outpatient surgery
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Wellcare Fidelis Simple (HMO-POS)
$475
Prior authorizationWellcare Simple Open (PPO)
$475
Prior authorizationCDPHP $0 Medicare Rx (HMO)
$315
Prior authorizationCDPHP Choice Rx (HMO)
$200
Prior authorization
Ground ambulance
Original Medicare + Medigap Plan G
$0
after the $292 yearly Part B deductible
Wellcare Fidelis Simple (HMO-POS)
$320
Prior authorizationWellcare Simple Open (PPO)
$340
Prior authorizationCDPHP $0 Medicare Rx (HMO)
$265
Prior authorizationCDPHP Choice Rx (HMO)
$185
Prior authorization
Hospital stay, 5 days
Original Medicare + Medigap Plan G
$0
Plan G pays the $1,788 Part A deductible
Wellcare Fidelis Simple (HMO-POS)
$2,400
for a 5-day stay
Prior authorizationWellcare Simple Open (PPO)
$2,400
for a 5-day stay
Prior authorizationCDPHP $0 Medicare Rx (HMO)
$2,300
for a 5-day stay
Prior authorizationCDPHP Choice Rx (HMO)
$1,300
for a 5-day stay
Prior authorization
See every cost in one table
| What you pay in network | Original Medicare + Medigap Plan G | Wellcare Fidelis Simple (HMO-POS) | Wellcare Simple Open (PPO) | CDPHP $0 Medicare Rx (HMO) | CDPHP Choice Rx (HMO) |
|---|---|---|---|---|---|
| Monthly premium | Part B $209.50 + Medigap Plan G $305 + drug plan $37.30 | $0 + Part B $209.50 | $0 + Part B $209.50 | $0 + Part B $209.50 | $139 + 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; $14,800 in and out of network | $9,850 in network | $6,400 in network |
| Medical deductible | $292 Part B. Plan G pays the $1,788 Part A deductible. | $430 | $300 | $0 | $0 |
| Primary doctor visit | $0, after the $292 yearly Part B deductible | $0 copay | $0 copay | $0 copay | $0 copay |
| Specialist visit | $0, after the $292 yearly Part B deductible | $50 copayPrior authorization | $50 copayPrior authorization | $0-$50 copay | $0-$35 copay |
| Lab tests | $0, most Medicare-covered tests | $0-$50 copayPrior authorization | $0-$50 copayPrior authorization | $0-$10 copayPrior authorization | $0-$5 copayPrior authorization |
| MRI or CT scan | $0, after the $292 yearly Part B deductible | 0%-30% coinsurancePrior authorization | $0-$500 copayPrior authorization | $260 copayPrior authorization | $175 copayPrior authorization |
| X-rays | $0, after the $292 yearly Part B deductible | $50 copayPrior authorization | $50 copayPrior authorization | $10 copayPrior authorization | $5 copayPrior authorization |
| Emergency room | $0, after the $292 yearly Part B deductible | $115 copay | $115 copay | $115 copay | $100 copay |
| Urgent care | $0, after the $292 yearly Part B deductible | $40 copay | $35 copay | $40 copay | $50 copay |
| Outpatient hospital | $0, after the $292 yearly Part B deductible | 0%-30% coinsurancePrior authorization | $0-$500 copay, 30% coinsurancePrior authorization | $365 copayPrior authorization | $250 copayPrior authorization |
| Surgery center | $0, after the $292 yearly Part B deductible | $475 copayPrior authorization | $475 copayPrior authorization | $315 copayPrior authorization | $200 copayPrior authorization |
| Ground ambulance | $0, after the $292 yearly Part B deductible | $320 copayPrior authorization | $340 copayPrior authorization | $265 copayPrior authorization | $185 copayPrior authorization |
| Hospital stay | $0, Plan G pays the $1,788 Part A deductible | $600 per day for days 1-4; $0 per day for days 5-90Prior authorization | $600 per day for days 1-4; $0 per day for days 5-90Prior authorization | $460 per day for days 1-5; $0 per day for days 6-90Prior authorization | $260 per day for days 1-6; $0 per day for days 7-90Prior authorization |
| Skilled nursing facility | $0, Plan G pays days 21-100 | $0 per day for days 1-20; $221 per day for days 21-70; $0 per day for days 71-100Prior authorization | $0 per day for days 1-20; $221 per day for days 21-70; $0 per day for days 71-100Prior authorization | $0 per day for days 1-20; $221 per day for days 21-100Prior authorization | $0 per day for days 1-20; $120 per day for days 21-100Prior authorization |
| Mental health visit | $0, after the $292 yearly Part B deductible | $35 copayPrior authorization | $35 copayPrior authorization | $35 copay | $25 copay |
| Physical therapy | $0, after the $292 yearly Part B deductible | $35 copayPrior authorization | $35 copayPrior authorization | $30 copayPrior authorization | $25 copayPrior authorization |
| Home health care | $0, Medicare-covered home health | $0 copayPrior authorization | $0 copayPrior authorization | $0 copay | $0 copay |
| Medical equipment | $0, after the $292 yearly Part B deductible | 20% coinsurancePrior authorization | 20% coinsurancePrior authorization | 20% coinsurancePrior authorization | 20% coinsurancePrior authorization |
| Part B drugs | $0 after the $292 Part B deductible | 0%-20% coinsurancePrior authorization | 0%-20% coinsurancePrior authorization | $35 copay, 0%-20% coinsurancePrior authorization | $35 copay, 0%-20% coinsurancePrior authorization |
| Drug deductible (Part D) | $700 with Wellcare Value Script (PDP) | $700 | $700 | $700 | $250 |
| 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 | Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 37% coinsuranceInjectable Drugs: 1% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copay | Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 37% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copay | Preferred Generic: $5 copayGeneric: $11 copayPreferred Brand: 22% coinsuranceNon-Preferred Drug: 29% coinsuranceSpecialty Tier: 25% coinsurance | Preferred Generic: $0 copayGeneric: $2 copayPreferred Brand: 20% coinsuranceNon-Preferred Drug: 37% coinsuranceSpecialty Tier: 30% coinsurance |
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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
The two companies in Warren County
Wellcare
- 6 plans for 2027 (not counting special needs plans)
- 6 with a $0 premium; 1 pay back part of your Part B premium
- Yearly limits from $9,850 to $9,850
- Star ratings 3 to 3
- Wellcare Fidelis Simple (HMO-POS) · $0 a month · limit $9,850
- Wellcare Simple Open (PPO) · $0 a month · limit $9,850
- Wellcare Giveback Open (PPO) · $0 a month · limit $9,850
- Wellcare Fidelis Assist (HMO-POS) · $0 a month · limit $9,850
- Wellcare Assist Open (PPO) · $0 a month · limit $9,850
- Wellcare Fidelis Patriot Simple (HMO-POS) · $0 a month · limit $9,850
CDPHP Medicare Advantage
- 4 plans for 2027 (not counting special needs plans)
- 1 with a $0 premium; 0 pay back part of your Part B premium
- Yearly limits from $6,400 to $9,850
- Star ratings 3.5 to 3.5
- CDPHP $0 Medicare Rx (HMO) · $0 a month · limit $9,850
- CDPHP Choice Rx (HMO) · $139 a month · limit $6,400
- CDPHP Clear Rx (HMO) · $100 a month · limit $6,750
- CDPHP Core (HMO) · $15 a month · limit $6,400
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
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
Wellcare Simple Open (PPO)
PPO
- The plan has a network. You can go outside it, but you pay more.
- No referral needed 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
CDPHP $0 Medicare Rx (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
CDPHP Choice Rx (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
Extra benefits
| Extra benefit | Original Medicare | Wellcare Fidelis Simple (HMO-POS) | Wellcare Simple Open (PPO) | CDPHP $0 Medicare Rx (HMO) | CDPHP Choice Rx (HMO) |
|---|---|---|---|---|---|
| Dental | No | Preventive only | Preventive only | Comprehensive, up to $400 a year | Comprehensive, up to $1,500 a year |
| Eye exam | No | Yes | Yes | Yes | Yes |
| Glasses or contacts | No | No | No | No | No |
| Hearing aids | No | No | Yes, up to $750 | Yes, copays from $299 | Yes, copays from $299 |
| Over-the-counter allowance | No | No | No | No | No |
| Fitness benefit | No | No | No | Yes | Yes |
| Rides to care | No | No | No | No | No |
| Meals after a hospital stay | No | No | No | No | No |
| Emergency care abroad | Plan G and Plan N pay 80% after a $250 deductible | Yes | Yes | Yes | Yes |
| Part B premium giveback | No | No | No | No | No |
What changed for 2027
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
Wellcare Simple Open (PPO)
Renewal Plan with SAR · 2026 plan H2775-106-0
- In-network out-of-pocket maximum up from $9,250 to $9,850
- Medical deductible up from $250 to $300
- Drug deductible up from $615 to $700
- Specialist visit: $30 copay to $50 copay
- Ground ambulance: $350 copay to $340 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
- Fitness benefit removed
CDPHP $0 Medicare Rx (HMO)
Renewal Plan with SAR · 2026 plan H3388-014-0
- In-network out-of-pocket maximum up from $6,750 to $9,850
- Drug deductible up from $500 to $700
- Specialist visit: $0-$35 copay to $0-$50 copay
- Emergency care: $125 copay to $115 copay
- Urgent care: $50 copay to $40 copay
- Diagnostic radiology (MRI, CT): $195 copay to $260 copay
- Skilled nursing facility: $0 per day for days 1-20; $215 per day for days 21-100 to $0 per day for days 1-20; $221 per day for days 21-100
- Eyewear removed
- Rides to care removed
- Meals after a hospital stay removed
- Overall star rating down from 4.5 to 3.5
CDPHP Choice Rx (HMO)
Renewal Plan with SAR · 2026 plan H3388-002-0
- Monthly premium up from $135 to $139
- In-network out-of-pocket maximum up from $6,000 to $6,400
- Drug deductible up from $0 to $250
- Specialist visit: $0-$25 copay to $0-$35 copay
- Diagnostic radiology (MRI, CT): $100 copay to $175 copay
- Dental maximum down from $1,650 to $1,500
- Eyewear removed
- OTC allowance removed
- Rides to care removed
- Meals after a hospital stay removed
- Overall star rating down from 4.5 to 3.5
More 2027 plans in Warren County
- HumanaChoice H5970-029 (PPO) (page for Erie County, NY)
- Aetna Medicare Elite (PPO), H5521-119 (page for Orange County, NY)
- AARP Medicare Advantage from UHC NY-29 (HMO-POS), H3379-052 (page for Albany County, NY)
- MVP Medicare Secure Plus with Part D (HMO-POS), H3305-022 (page for Westchester County, NY)
- Humana USAA Honor Giveback (PPO), H5970-016 (page for Kings County, NY)
- AARP Medicare Advantage Patriot No Rx NY-MA3 (HMO-POS), H3379-060 (page for Kings County, NY)
- Aetna Medicare Eagle Giveback (PPO), H5521-323 (page for Erie County, NY)
- AARP Medicare Advantage from UHC NY-0015 (PPO), H3418-004 (page for Albany County, NY)
County guide: 2027 plans in Warren 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 12878. Totals use typical Medicare-allowed amounts for each service and typical drug prices.
- Wellcare Fidelis Simple (HMO-POS) on Medicare.gov · plan website · drug list · doctor directory
- Wellcare Simple Open (PPO) on Medicare.gov · plan website · drug list · doctor directory
- CDPHP $0 Medicare Rx (HMO) on Medicare.gov · plan website · drug list · doctor directory
- CDPHP Choice Rx (HMO) 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.