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Company vs company · Hamilton County, NY · 2027 plan year

Wellcare vs Humana 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.

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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.gov

Your yearly cost, side by side

Move the controls to match your year. Totals include premiums, the Part B premium, copays, and drug costs.

How much care do you expect?

Ongoing specialist care

Medigap plan with Original Medicare

Plan G pays almost everything after the $292 yearly Part B deductible.

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.

HumanaChoice H5970-029 (PPO)

PPO from Humana

$7,337 a year

Premiums
$3,294
Medical costs
$2,340
Drugs
$1,703

Most you can pay in a bad year, before drugs: $12,544.

With these settings, Wellcare Fidelis Assist (HMO-POS) costs about $1,498 less a year than HumanaChoice H5970-029 (PPO).

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 HumanaChoice H5970-029 (PPO): with this drug use, if your medical copays and coinsurance in this plan pass $4,094 in a year, Original Medicare with Plan G costs less. The plan caps those costs at $9,250.

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.

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What 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

  • HumanaChoice H5970-029 (PPO)

    $0

  • Humana USAA Honor Giveback (PPO)

    $0

Specialist visit

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Wellcare Fidelis Simple (HMO-POS)

    $50

    Prior authorization

  • Wellcare Simple Open (PPO)

    $50

    Prior authorization

  • HumanaChoice H5970-029 (PPO)

    $40

    Prior authorization

  • Humana USAA Honor Giveback (PPO)

    $40

    Prior authorization

Lab tests

  • Original Medicare + Medigap Plan G

    $0

    most Medicare-covered tests

  • Wellcare Fidelis Simple (HMO-POS)

    $0-$50

    Prior authorization

  • Wellcare Simple Open (PPO)

    $0-$50

    Prior authorization

  • HumanaChoice H5970-029 (PPO)

    $0

    Prior authorization

  • Humana USAA Honor Giveback (PPO)

    $0

    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 authorization

  • Wellcare Simple Open (PPO)

    $0-$500

    Prior authorization

  • HumanaChoice H5970-029 (PPO)

    $0-$780

    Prior authorization

  • Humana USAA Honor Giveback (PPO)

    $0-$780

    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

  • HumanaChoice H5970-029 (PPO)

    $115

  • Humana USAA Honor Giveback (PPO)

    $130

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

  • HumanaChoice H5970-029 (PPO)

    $40

  • Humana USAA Honor Giveback (PPO)

    $50

Outpatient surgery

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Wellcare Fidelis Simple (HMO-POS)

    $475

    Prior authorization

  • Wellcare Simple Open (PPO)

    $475

    Prior authorization

  • HumanaChoice H5970-029 (PPO)

    $0-$650

    Prior authorization

  • Humana USAA Honor Giveback (PPO)

    $0-$650

    Prior authorization

Ground ambulance

  • Original Medicare + Medigap Plan G

    $0

    after the $292 yearly Part B deductible

  • Wellcare Fidelis Simple (HMO-POS)

    $320

    Prior authorization

  • Wellcare Simple Open (PPO)

    $340

    Prior authorization

  • HumanaChoice H5970-029 (PPO)

    $325

    Prior authorization

  • Humana USAA Honor Giveback (PPO)

    $325

    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 authorization

  • Wellcare Simple Open (PPO)

    $2,400

    for a 5-day stay

    Prior authorization

  • HumanaChoice H5970-029 (PPO)

    $1,900

    for a 5-day stay

    Prior authorization

  • Humana USAA Honor Giveback (PPO)

    $2,475

    for a 5-day stay

    Prior authorization
See every cost in one table
What you pay in networkOriginal Medicare + Medigap Plan GWellcare Fidelis Simple (HMO-POS)Wellcare Simple Open (PPO)HumanaChoice H5970-029 (PPO)Humana USAA Honor Giveback (PPO)
Monthly premiumPart B $209.50 + Medigap Plan G $305 + drug plan $37.30$0 + Part B $209.50$0 + Part B $209.50$65 + Part B $209.50$0 (pays back $110 a month of your Part B premium) + Part B $209.50
Yearly limit on what you payYou 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$9,250 in network; $14,800 in and out of network$4,950 in network; $8,950 in and out of 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$40 copayPrior authorization$40 copayPrior authorization
Lab tests$0, most Medicare-covered tests$0-$50 copayPrior authorization$0-$50 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization
MRI or CT scan$0, after the $292 yearly Part B deductible0%-30% coinsurancePrior authorization$0-$500 copayPrior authorization$0-$780 copayPrior authorization$0-$780 copayPrior authorization
X-rays$0, after the $292 yearly Part B deductible$50 copayPrior authorization$50 copayPrior authorization$0-$145 copayPrior authorization$0-$145 copayPrior authorization
Emergency room$0, after the $292 yearly Part B deductible$115 copay$115 copay$115 copay$130 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 deductible0%-30% coinsurancePrior authorization$0-$500 copay, 30% coinsurancePrior authorization$0-$900 copayPrior authorization$0-$900 copayPrior authorization
Surgery center$0, after the $292 yearly Part B deductible$475 copayPrior authorization$475 copayPrior authorization$0-$650 copayPrior authorization$0-$650 copayPrior authorization
Ground ambulance$0, after the $292 yearly Part B deductible$320 copayPrior authorization$340 copayPrior authorization$325 copayPrior authorization$325 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$380 per day for days 1-7; $0 per day for days 8-90Prior authorization$495 per day for days 1-5; $0 per day for days 6-90Prior 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$10 per day for days 1-20; $221 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 copayPrior authorization$0 copayPrior authorization
Physical therapy$0, after the $292 yearly Part B deductible$35 copayPrior authorization$35 copayPrior authorization$35 copayPrior authorization$40 copayPrior authorization
Home health care$0, Medicare-covered home health$0 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization$0 copayPrior authorization
Medical equipment$0, after the $292 yearly Part B deductible20% coinsurancePrior authorization20% coinsurancePrior authorization20% coinsurancePrior authorization15% coinsurancePrior authorization
Part B drugs$0 after the $292 Part B deductible0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization0%-20% coinsurancePrior authorization
Drug deductible (Part D)$700 with Wellcare Value Script (PDP)$700$700$700No drug coverage
Drug tiers (one month, retail)Generic: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 39% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $11 copayGeneric: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 37% coinsuranceInjectable Drugs: 1% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copayGeneric: $0 copayPreferred Brand: 25% coinsuranceNon-Preferred Drug: 37% coinsuranceInjectable Drugs: 15% coinsuranceSpecialty Tier: 25% coinsuranceSelect Care Drugs: $0 copayPreferred Generic: $0 copayGeneric: $5 copayPreferred Brand: 17% coinsuranceNon-Preferred Drug: 37% coinsuranceSpecialty Tier: 25% coinsuranceNo drug coverage

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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 Hamilton 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

Humana

  • 2 plans for 2027 (not counting special needs plans)
  • 1 with a $0 premium; 1 pay back part of your Part B premium
  • Yearly limits from $4,950 to $9,250
  • Star ratings 3 to 3

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

HumanaChoice H5970-029 (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 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Humana USAA Honor Giveback (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 24 services

Specialist visits, Diagnostic tests, MRI or CT, Radiation therapy, Outpatient hospital, Observation stay, Surgery center, Ambulance, Mental health visits, Psychiatrist visits, Physical therapy, Occupational therapy, Home health, Partial hospitalization, Cardiac rehab, Pulmonary rehab, Medical equipment, Prosthetics, Diabetic supplies, Dialysis, Substance use care, Hospital stay, Skilled nursing, Part B drugs

Extra benefits

Extra benefitOriginal MedicareWellcare Fidelis Simple (HMO-POS)Wellcare Simple Open (PPO)HumanaChoice H5970-029 (PPO)Humana USAA Honor Giveback (PPO)
DentalNoPreventive onlyPreventive onlyComprehensive, up to $1,000 a yearComprehensive, up to $2,000 a year
Eye examNoYesYesYesYes
Glasses or contactsNoNoNoYes, $200 allowanceYes, $250 allowance
Hearing aidsNoNoYes, up to $750Yes, copays from $299Yes, copays from $399
Over-the-counter allowanceNoNoNoNo$200 a year
Fitness benefitNoNoNoYesYes
Rides to careNoNoNoNoYes
Meals after a hospital stayNoNoNoYesYes
Emergency care abroadPlan G and Plan N pay 80% after a $250 deductibleYesYesYesYes
Part B premium givebackNoNoNoNo$110 a month

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

HumanaChoice H5970-029 (PPO)

Renewal Plan with SAR · 2026 plan H5970-029-0

  • Monthly premium up from $32 to $65
  • Drug deductible up from $615 to $700
  • Outpatient hospital: $0-$850 copay to $0-$900 copay
  • Ground ambulance: $335 copay to $325 copay
  • 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 $2,000 to $1,000
  • Eyewear allowance down from $250 to $200

Humana USAA Honor Giveback (PPO)

Renewal Plan with SAR · 2026 plan H5970-016-0

  • Outpatient hospital: $0-$800 copay to $0-$900 copay
  • Ground ambulance: $315 copay to $325 copay
  • Skilled nursing facility: $10 per day for days 1-20; $218 per day for days 21-100 to $10 per day for days 1-20; $221 per day for days 21-100

More 2027 plans in Hamilton County

County guide: 2027 plans in Hamilton 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 12847. Totals use typical Medicare-allowed amounts for each service and typical drug prices.

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.

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