Compare & Enroll — Part C & Part D

Compare & Enroll in Medicare Plans in 01002, MA

With 42 Medicare Advantage options from 8 insurers, 01002, MA has plan availability roughly in line with the national average, suggesting a highly competitive market where insurers often lower premiums to attract members. Approximately 60% of local MA plans charge $0 beyond the standard Part B premium, reflecting strong price competition. The 9 hospitals within 25.0 miles provide reasonable inpatient access for most plan networks. We've organized the CMS data below to help you cross-reference plan costs, quality ratings, and local provider access. Compare plans below, and when you're ready, enroll directly at Medicare.gov.

📊 Direct from CMS 🚫 No agents or commissions ✓ Just the data, no sales pitch
Compare Plans at Medicare.gov →

Data freshness: CMS data as of February 2026 • ACS data as of 2023 • Reviewed & approved on 2026-02-16
Reviewed by: Wes Ward, Founder & Data Lead • View our methodology

Important: We are not affiliated with Medicare or any government agency. This site displays publicly available CMS data to help you compare plans. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227).

Important: Plan availability, benefits, and CMS Star Ratings shown here come directly from CMS public files. Plan details can change—always verify with the insurer and at Medicare.gov.
Part C Plans
42
Part D Plans
11
Top MA Star
4.5
Top Drug Star
4.0
Happy senior couple reviewing Medicare plan options together

Medicare Eligibility in 01002, MA

Approximately 1,159 residents (12.5% of the population) in 01002, MA are 65 or older and likely Medicare-eligible. Whether you're approaching 65, already enrolled, or a caregiver comparing options, the plan data below is organized to help you evaluate Part C (Medicare Advantage) and Part D (prescription drug) coverage side by side.

The median household income in 01002, MA is $78,224 (4.1% above the National Average), which may affect eligibility for Extra Help with Part D drug costs.

Part C: Medicare Advantage Plans

Medicare Advantage (Part C) replaces Original Medicare through private insurers who bundle hospital, medical, and often drug coverage into a single plan. 01002, MA's 42 Medicare Advantage plans are predominantly HMO-based (35 HMO vs. 7 PPO), meaning most require referrals and in-network care. 25 plans offer $0 monthly premiums. The average local star rating is 3.8 out of 5, with the top plan earning 4.5 ★.

Top Medicare Advantage Plans in 01002, MA

We organize CMS plan data into separate leaderboards so you can compare based on what matters most to you. Part C premiums in 01002, MA range from $0 to $190/month. Among rated plans, 26 plans rated 4+ stars.

Highest CMS Star Ratings

Star Ratings are assigned by CMS based on quality measures including customer service, preventive care, and managing chronic conditions.

Plan NameInsurerStar RatingPremiumType
Medicare Ppo Blue Valuerx (PPO)Blue Cross Blue Shield Of Massachusetts4.5 ★$27.70/moPPOEnroll
Medicare Hmo Blue Saverrx (HMO-POS)Blue Cross Blue Shield Of Massachusetts4.5 ★$0.00/moHMO-POSEnroll
Medicare Ppo Blue Essentialrx (PPO)Blue Cross Blue Shield Of Massachusetts4.5 ★$25.20/moPPOEnroll
Medicare Hmo Blue Valuerx (HMO)Blue Cross Blue Shield Of Massachusetts4.5 ★$29.00/moHMOEnroll
Medicare Ppo Blue Plusrx (PPO)Blue Cross Blue Shield Of Massachusetts4.5 ★$175.60/moPPOEnroll

Lowest Monthly Premium

Lower premiums can save money, but check total costs including deductibles, copays, and MOOP.

Plan NameInsurerMonthly PremiumMOOPStar Rating
Medicare Hmo Blue Saverrx (HMO-POS)Blue Cross Blue Shield Of Massachusetts$0.00/mo$9,2004.5 ★
Health New England Medicare Value (HMO)Health New England Medicare Advantage Plans$0.00/mo$6,7503.0 ★
Cca One Care (HMO D-SNP)Commonwealth Care Alliance, Inc.$0.00/mo$8,845N/A
Aarp Medicare Advantage From Uhc Ma-0003 (HMO-POS)Unitedhealthcare$0.00/mo$5,9004.0 ★
Aarp Medicare Advantage From Uhc Ma-0006 (PPO)Unitedhealthcare$0.00/mo$6,7003.5 ★

Lowest Maximum Out-of-Pocket (MOOP)

MOOP caps your financial risk. Once you hit this limit, the plan covers 100% of covered services for the rest of the year.

Plan NameInsurerMOOP (In-Network)PremiumStar Rating
Molina One Care (HMO D-SNP)Molina Healthcare$1,500$0.00/moN/A
Fallon Medicare Plus Blue (HMO)Fallon Health$3,400$38.90/mo4.0 ★
Medicare Hmo Blue Valuerx (HMO)Blue Cross Blue Shield Of Massachusetts$3,750$29.00/mo4.5 ★
Medicare Hmo Blue Plusrx (HMO)Blue Cross Blue Shield Of Massachusetts$3,800$190.40/mo4.5 ★
Tufts Medicare Preferred Hmo Basic Rx (HMO)Tufts Health Plan$3,850$36.10/mo4.0 ★

Plan Type Mix in 01002, MA

HMO plans require referrals and in-network care. PPO plans offer more flexibility. SNP (Special Needs Plans) serve specific populations. MAPD plans include drug coverage.

Plan TypeCountPercentageDescription
HMO1638.1%Requires referrals; in-network only
HMO D-SNP1433.3%Medicare Advantage plan
PPO716.7%No referrals; in and out-of-network
HMO-POS49.5%HMO with some out-of-network options
HMO-POS C-SNP12.4%Medicare Advantage plan

Choosing the Right Medicare Advantage Plan

The best Part C plan depends on your doctors, medications, and budget. Key factors to evaluate:

  • Provider network: Verify your doctors and hospitals near 01002, MA are in-network before enrolling
  • Total cost: A $0 premium may have higher copays—calculate your annual cost
  • Star Ratings: 4+ stars indicate above-average quality and member satisfaction

Read our full guide on choosing Medicare Advantage → · Print our enrollment checklist →
Medicare Glossary: HMO, PPO, MOOP & more →

Medicare Advantage Insurers in 01002, MA

8 insurance companies offer Medicare Advantage plans in 01002, MA. Below, we group plans by insurer so you can compare options from each company. More insurers generally means more competition and better benefits for consumers.

Blue Cross Blue Shield Of Massachusetts
Avg Star Rating
4.5 ★
7 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Medicare Hmo Blue Saverrx (HMO-POS)
$0.00/mo
$9,200
4.5 ★
HMO-POS
Medicare Ppo Blue Essentialrx (PPO)
$25.20/mo
$9,250
4.5 ★
PPO
Medicare Ppo Blue Valuerx (PPO)
$27.70/mo
$6,600
4.5 ★
PPO
Medicare Hmo Blue Valuerx (HMO)
$29.00/mo
$3,750
4.5 ★
HMO
Medicare Hmo Blue Flexrx (HMO-POS)
$54.70/mo
$4,100
4.5 ★
HMO-POS
Medicare Ppo Blue Plusrx (PPO)
$175.60/mo
$4,200
4.5 ★
PPO
Medicare Hmo Blue Plusrx (HMO)
$190.40/mo
$3,800
4.5 ★
HMO
Fallon Health
Avg Star Rating
4.0 ★
5 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Navicare (HMO D-SNP)
$0.00/mo
$7,550
4.0 ★
HMO D-SNP
Fallon Medicare Plus Saver No Rx (HMO)
$0.00/mo
$6,700
4.0 ★
HMO
Fallon Medicare Plus Orange (HMO)
$0.00/mo
$7,550
4.0 ★
HMO
Fallon Medicare Plus Green (HMO)
$10.60/mo
$5,200
4.0 ★
HMO
Fallon Medicare Plus Blue (HMO)
$38.90/mo
$3,400
4.0 ★
HMO
Molina Healthcare
Avg Star Rating
4.0 ★
3 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Senior Whole Health Sco (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Senior Whole Health Sco Nhc (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Molina One Care (HMO D-SNP)
$0.00/mo
$1,500
N/A
HMO D-SNP
Tufts Health Plan
Avg Star Rating
3.9 ★
10 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Tufts Medicare Preferred Hmo Smart Saver Rx (HMO)
$0.00/mo
$6,400
4.0 ★
HMO
Tufts Health One Care (HMO D-SNP)
$0.00/mo
$9,250
N/A
HMO D-SNP
Tufts Health One Care Cw (HMO D-SNP)
$0.00/mo
$9,250
N/A
HMO D-SNP
Tufts Health Plan Senior Care Options (HMO D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO D-SNP
Tufts Health Plan Senior Care Options Cw (HMO D-SNP)
$0.00/mo
$9,250
3.5 ★
HMO D-SNP
Tufts Medicare Preferred Ppo Rx (PPO)
$20.00/mo
$6,750
4.0 ★
PPO
Tufts Medicare Preferred Hmo Basic Rx (HMO)
$36.10/mo
$3,850
4.0 ★
HMO
Tufts Medicare Preferred Hmo Value Rx (HMO)
$41.10/mo
$3,850
4.0 ★
HMO
Tufts Medicare Preferred Hmo Prime Rx Plus (HMO)
$68.00/mo
$3,850
4.0 ★
HMO
Tufts Medicare Preferred Hmo Prime Rx (HMO)
$74.70/mo
$3,850
4.0 ★
HMO
Unitedhealthcare
Avg Star Rating
3.9 ★
9 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Aarp Medicare Advantage Patriot No Rx Ma-Ma01 (PPO)
$0.00/mo
$6,700
3.5 ★
PPO
Uhc Senior Care Options Ma-Y001 (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Uhc Senior Care Options Nhc Ma-Y002 (HMO D-SNP)
$0.00/mo
$9,250
4.0 ★
HMO D-SNP
Uhc One Care Ma-Y3 (HMO D-SNP)
$0.00/mo
$9,250
N/A
HMO D-SNP
Uhc Complete Care Ma-7 (HMO-POS C-SNP)
$0.00/mo
$5,900
4.0 ★
HMO-POS C-SNP
Aarp Medicare Advantage From Uhc Ma-0003 (HMO-POS)
$0.00/mo
$5,900
4.0 ★
HMO-POS
Aarp Medicare Advantage Careflex From Uhc Ma-9 (HMO-POS)
$0.00/mo
$6,700
4.0 ★
HMO-POS
Aarp Medicare Advantage From Uhc Ma-0006 (PPO)
$0.00/mo
$6,700
3.5 ★
PPO
Uhc One Care Ma-Y4 (HMO D-SNP)
$0.00/mo
$9,250
N/A
HMO D-SNP
Commonwealth Care Alliance Massachusetts
Avg Star Rating
3.5 ★
1 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Cca Senior Care Options (HMO D-SNP)
$0.00/mo
$8,980
3.5 ★
HMO D-SNP
Health New England Medicare Advantage Plans
Avg Star Rating
2.9 ★
6 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Health New England Medicare Value (HMO)
$0.00/mo
$6,750
3.0 ★
HMO
Health New England Medicare Basic No Rx (HMO)
$0.00/mo
$5,500
3.0 ★
HMO
Health New England Medicare Compass (PPO)
$29.00/mo
$6,750
2.5 ★
PPO
Health New England Medicare Premium No Rx (HMO)
$44.00/mo
$4,500
3.0 ★
HMO
Health New England Medicare Plus (HMO)
$54.60/mo
$5,000
3.0 ★
HMO
Health New England Medicare Premium (HMO)
$152.20/mo
$4,500
3.0 ★
HMO
Commonwealth Care Alliance, Inc.
Avg Star Rating
N/A
1 plans
From $0.00/mo
Plan
Premium
MOOP
Stars
Type
Cca One Care (HMO D-SNP)
$0.00/mo
$8,845
N/A
HMO D-SNP

Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.

Part D: Prescription Drug Plans (PDP)

Part D covers prescription drugs through standalone plans for those on Original Medicare, or as part of a Medicare Advantage bundle. Among the 11 standalone Part D plans in 01002, MA, some offer $0 annual deductibles while others charge up to the 2026 maximum of $590. 4 plans are at or below the regional premium benchmark, making them eligible for Low Income Subsidy auto-enrollment. The 2026 $2,000 out-of-pocket cap means drug costs are now more predictable regardless of which plan you choose, but formulary coverage still varies significantly—always verify your medications are covered before enrolling.

Part D Formulary Notice: Each Part D plan has its own formulary (list of covered drugs). The same medication may be on different tiers—or not covered at all—depending on the plan. Always check that your specific medications are covered before enrolling.
2026 Out-of-Pocket Cap: Thanks to the Inflation Reduction Act, your total out-of-pocket drug costs are capped at $2,000 per year in 2026. Once you reach this limit, you pay nothing more for covered Part D drugs for the rest of the year. This eliminates the old "donut hole" coverage gap that previously caused higher costs.
Low Income Subsidy (LIS / Extra Help): If you have limited income and resources, you may qualify for Extra Help paying Part D costs. Visit SSA.gov or call 1-800-MEDICARE.

Top Part D Drug Plans in 01002, MA

We organize Part D plans by CMS Star Ratings, premiums, and deductibles so you can find the best fit for your prescription needs. Part D premiums in 01002, MA range from $8 to $239/month. Remember: all Part D plans now cap your annual out-of-pocket drug costs at $2,000 thanks to the Inflation Reduction Act.

Highest CMS Star Ratings (Part D)

Part D Star Ratings measure drug pricing, customer service, member complaints, and pharmacy access.

Plan NameInsurerStar RatingPremiumDeductible
Blue Medicarerx Value Plus (PDP)Blue Medicarerx4.0 ★$20.70/mo$615Enroll
Blue Medicarerx Premier (PDP)Blue Medicarerx4.0 ★$238.60/mo$0Enroll
Wellcare Value Script (PDP)Wellcare3.5 ★$16.40/mo$615Enroll
Wellcare Classic (PDP)Wellcare3.5 ★$21.70/mo$615Enroll
Silverscript Choice (PDP)Aetna Medicare3.0 ★$32.70/mo$615Enroll

Lowest Monthly Premium

Lower premiums help with monthly cash flow, but check drug tier costs and the deductible.

Plan NameInsurerMonthly PremiumDrug DeductibleStar Rating
Humana Basic Rx Plan (PDP)Humana$8.40/mo$6153.0 ★
Wellcare Value Script (PDP)Wellcare$16.40/mo$6153.5 ★
Blue Medicarerx Value Plus (PDP)Blue Medicarerx$20.70/mo$6154.0 ★
Wellcare Classic (PDP)Wellcare$21.70/mo$6153.5 ★
Silverscript Choice (PDP)Aetna Medicare$32.70/mo$6153.0 ★

Lowest Annual Drug Deductible

The deductible is what you pay out-of-pocket before the plan starts covering drug costs. The 2026 maximum Part D deductible is $590. Many plans offer $0 deductible options.

Plan NameInsurerDrug DeductibleMonthly PremiumStar Rating
Humana Premier Rx Plan (PDP)Humana$0$138.60/mo3.0 ★
Blue Medicarerx Premier (PDP)Blue Medicarerx$0$238.60/mo4.0 ★
Aarp Medicare Rx Preferred From Uhc (PDP)Unitedhealthcare$130$155.10/mo2.0 ★
Humana Value Rx Plan (PDP)Humana$601$73.60/mo3.0 ★
Humana Basic Rx Plan (PDP)Humana$615$8.40/mo3.0 ★
Understanding drug tiers: Part D plans organize medications into 5 cost tiers — Tier 1 (Preferred Generic) is cheapest; Tier 5 (Specialty) is most expensive. Two plans with the same premium can have very different costs for your drugs depending on tier placement. Learn more about drug tiers →

Choosing the Right Part D Drug Plan

The right Part D plan depends on your specific medications. Key factors to evaluate:

  • Formulary: Verify your drugs are covered before enrolling
  • Preferred pharmacies: Lower copays at certain locations—check your pharmacy is in-network
  • Total annual cost: Premium + deductible + copays for your drugs

Read our full guide on choosing Part D →
What is a formulary? See our Medicare Glossary →

Part D Drug Plan Insurers in 01002, MA

6 insurance companies offer standalone Part D drug plans in 01002, MA. Below, we group plans by insurer.

Blue Medicarerx
Avg Star Rating
4.0 ★
2 plans
From $20.70/mo
Plan
Premium
Deductible
Stars
Type
Blue Medicarerx Value Plus (PDP)
$20.70/mo
$615
4.0 ★
PDP
Blue Medicarerx Premier (PDP)
$238.60/mo
$0
4.0 ★
PDP
Wellcare
Avg Star Rating
3.5 ★
2 plans
From $16.40/mo
Plan
Premium
Deductible
Stars
Type
Wellcare Value Script (PDP)
$16.40/mo
$615
3.5 ★
PDP
Wellcare Classic (PDP)
$21.70/mo
$615
3.5 ★
PDP
Humana
Avg Star Rating
3.0 ★
3 plans
From $8.40/mo
Plan
Premium
Deductible
Stars
Type
Humana Basic Rx Plan (PDP)
$8.40/mo
$615
3.0 ★
PDP
Humana Value Rx Plan (PDP)
$73.60/mo
$601
3.0 ★
PDP
Humana Premier Rx Plan (PDP)
$138.60/mo
$0
3.0 ★
PDP
Aetna Medicare
Avg Star Rating
3.0 ★
1 plans
From $32.70/mo
Plan
Premium
Deductible
Stars
Type
Silverscript Choice (PDP)
$32.70/mo
$615
3.0 ★
PDP
Healthspring
Avg Star Rating
2.5 ★
1 plans
From $139.30/mo
Plan
Premium
Deductible
Stars
Type
Healthspring Assurance Rx (PDP)
$139.30/mo
$615
2.5 ★
PDP
Unitedhealthcare
Avg Star Rating
2.0 ★
2 plans
From $38.70/mo
Plan
Premium
Deductible
Stars
Type
Aarp Medicare Rx Saver From Uhc (PDP)
$38.70/mo
$615
2.0 ★
PDP
Aarp Medicare Rx Preferred From Uhc (PDP)
$155.10/mo
$130
2.0 ★
PDP

Plan availability, premiums, and benefits shown are based on CMS data and may change. Always verify current details with the insurer and at Medicare.gov before enrolling.

Ready to Enroll in 01002, MA?

Compare plans side-by-side at Medicare.gov or speak with a licensed Medicare specialist.

Compare Plans at Medicare.gov Call 1-800-MEDICARE

📋 Print our Medicare Enrollment Checklist — gather your info before you compare.

📅 Enrollment Dates & Deadlines · 🩺 Questions to Ask Your Doctor

Medicare.gov is the official U.S. government site for Medicare. Available 24/7.

Pharmacy Access in 01002, MA

Part D plans have preferred pharmacy networks where you'll pay lower copays. Here's a look at pharmacy options in and around 01002, MA.

Total Pharmacies

9
within 5.0 miles

Chain Pharmacies

5
CVS, Walgreens, etc.

Independent Pharmacies

4
locally owned
PharmacyAddress & PhoneDistanceType
CVS PHARMACY INC76 N PLEASANT ST AMHERST, MA 010021703📞 413-325-93071.0 miChain
AMHERST PHARMACY LLC381 COLLEGE ST AMHERST, MA 010022391📞 413-369-31391.0 miIndependent
UMASS HEALTH SERVICES AMHERST150 INFIRMARY WAY AMHERST, MA 01003📞 413-357-50001.3 miIndependent
AMHERST FAMILY PHARMACY INC.31 HALL DR AMHERST, MA 010022751📞 413-325-14281.6 miIndependent
CVS PHARMACY INC165 UNIVERSITY DR AMHERST, MA 010028900📞 413-325-04211.7 miChain
THE STOP & SHOP SUPERMARKET COMPANY, LLC456 RUSSELL ST HADLEY, MA 010359591📞 413-325-41672.1 miChain
AMHERST PHARMACY LLC19 MONTAGUE RD AMHERST, MA 010021027📞 413-399-21452.7 miIndependent
CVS PHARMACY INC.367 RUSSELL ST HADLEY, MA 010359456📞 413-358-66812.8 miChain
WAL-MART STORES EAST LP337 RUSSELL STREET HADLEY, MA 01035📞 413-358-42653.2 miChain
WALGREEN CO225R KING ST NORTHAMPTON, MA 010602361📞 413-358-28027.5 miChain

Pharmacy data from CMS. Network participation varies by plan—always verify with your specific Part D plan.

Local Healthcare Access in 01002, MA

Before choosing a plan, consider the healthcare infrastructure in 01002, MA. Medicare Advantage plans restrict you to in-network hospitals, so understanding local hospital quality helps you pick the right plan — not just the cheapest one.

Note: The facilities below do not indicate which providers are in-network for any specific plan. Always verify network status with your plan before enrolling.

Hospitals Nearby

9
within 25.0 miles

Top-Rated Hospitals near 01002, MA

If hospital access matters to your plan choice, check quality ratings before you enroll. These are the highest CMS-rated hospitals near 01002, MA — click a hospital name to see its full profile and verify it's in your plan's network.

HospitalCMS RatingDistanceBeds
Baystate Wing Hospital5 ★16.6 mi41
Baystate Franklin Medical Center4 ★15.7 mi92
Cooley Dickinson Hospital Inc,The3 ★8.4 mi142
Heywood Hospital -3 ★29.9 mi134
Holyoke Medical Center2 ★13.8 mi164
Mercy Medical Ctr2 ★18.7 mi339
Baystate Noble Hospital2 ★22.3 mi97
Baystate Medical Center1 ★18.5 mi716
Valley Springs Behavioral Health HospitalNot Rated15.7 mi150
Miravista Behavioral Health CenterNot Rated16.1 mi36

View all 9 hospitals near 01002, MA to check quality before you enroll →

Hospital data from CMS Hospital Compare and Provider of Services file. Distance calculated from center of 01002, MA.

Questions to ask your doctor about Medicare coverage →

Telehealth in 01002, MA: Is Your Internet Ready?

Many Medicare Advantage and some Part D plans now include telehealth benefits, making routine check-ins and prescription refills easier from home. But telehealth requires reliable internet—here's a look at connectivity in 01002, MA. For official guidance on virtual visits, see Telehealth.HHS.gov from the U.S. Department of Health & Human Services.

Internet Coverage in 01002, MA

Fiber Available
29.5%
of households
Cable/DSL Available
99.8%
of households
Top Provider
XFINITY
99.3% coverage
No Broadband
4.7%
of households

Internet coverage data from ISP Reports. View full internet report for 01002, MA.

Medicare-Relevant Demographics in 01002, MA

Understanding 01002, MA's demographics helps contextualize why insurers offer the plans they do. Areas with more seniors and higher incomes tend to attract more insurer competition, while areas with higher Medicaid enrollment may have more Dual-Eligible Special Needs Plans (D-SNP) available.

Total Population
9,268
Population 65+
1,159
12.5% of total
Median Age
28
10.5 years younger than the national average
Median Income
$78,224
4.1% above the National Average
On Medicare
995
10.7% of residents
On Medicaid
1,224
13.2% of residents
Uninsured
170
1.8% of residents
Social Security Recipients
1,680
18.1% of population

Demographic data from U.S. Census Bureau American Community Survey (2023). View full 01002, MA demographics (BestNeighborhood.org).

Local Medicare FAQ: 01002, MA

Common decision points based on 01002, MA's specific plan market and local healthcare landscape.

How does 01002, MA's Medicare Advantage market compare?

01002, MA has 42 Medicare Advantage plans from 8 insurers. This is roughly in line with the national average of approximately 57 plans per area. The local mix includes 35 HMO and 7 PPO plans. Plan availability updates annually during the Medicare Annual Enrollment Period (October 15 – December 7).

Should I choose an HMO or PPO Medicare Advantage plan in 01002, MA?

With 9 hospitals within 25.0 miles, 01002, MA has strong provider density. HMO plans (35 available) typically have lower premiums but require referrals and in-network care. PPO plans (7 available) offer more flexibility to see out-of-network providers at higher cost. In 01002, MA, HMO plans dominate the market, which often means more competitive HMO pricing. Always verify your doctors are in-network before enrolling in any plan.

What's the real cost of $0 premium plans in 01002, MA?

25 plans (60% of available options) in 01002, MA charge $0 beyond the standard Part B premium. This high percentage reflects strong insurer competition in the area. However, $0 premium doesn't mean $0 cost. These plans may have higher copays, coinsurance, or out-of-pocket maximums. In 01002, MA, maximum out-of-pocket limits range from $1,500 to an average of $6,585. We recommend calculating your total expected annual cost (premium + copays + drug costs) rather than choosing based on premium alone.

How does the 2026 $2,000 drug cap affect 01002, MA beneficiaries?

The Inflation Reduction Act capped annual out-of-pocket drug spending at $2,000 starting in 2025, eliminating the old "donut hole" coverage gap. This applies to all 11 standalone Part D plans in 01002, MA.

What this means locally:

  • Cost predictability — No matter which of the 11 Part D plans you choose, your drug costs are capped at $2,000/year
  • $0 deductible options — Some local plans offer $0 deductibles, meaning coverage starts immediately
  • Low-income options — 4 plans meet the regional benchmark for Extra Help/LIS eligibility

While the out-of-pocket cap standardizes maximum costs, formulary coverage still varies significantly between plans. A drug that costs $5/month on one plan's formulary might cost $50 on another. Always check that your specific medications are covered and compare tier placement before enrolling.

See all Medicare FAQs in our complete guide → · Enrollment checklist →
Medicare Glossary · Enrollment Dates & Deadlines · Doctor Questions

About the Data & Editorial Team

Wes Ward

Wes Ward

Founder & Data Lead

Wes Ward is the founder of InsuranceDataNow.org and reviews all content for data accuracy and methodology compliance.

With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to consumer data tools. He is also a co-founder of BestNeighborhood.org, CrimeGrade.org, and ISPReports.org.

Role: Reviews and approves all content for data accuracy, source verification, and methodology compliance.

View full profile →LinkedIn

Transparency & Disclosures

InsuranceDataNow is an advertising-supported publisher based in South Jordan, Utah. We are not affiliated with or endorsed by Medicare or the U.S. government.

TPMO Disclaimer: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (24 hours a day/7 days a week) to get information on all of your options.

Sources

All data is sourced from official government databases and trusted third-party providers. Data is updated regularly—see page header for last refresh dates.

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