2026 York County Maine Medicare Advantage Overview!
If you're a York County senior exploring Medicare Advantage plans for 2026, you're in the right place. As a licensed independent Medicare agent serving Southern Maine, I’ve reviewed every major Medicare Advantage plan available to residents of Kennebunk, Saco, Berwick, and surrounding towns.
This guide goes beyond generic statewide lists and focuses on what actually matters where you live: provider networks, benefits, costs, and town-specific access. York County is my home, and I built this guide to help neighbors make confident, informed decisions.
🏖️What Makes York County Medicare Advantage Unique?
York County offers a special mix of urban and rural healthcare options. While some carriers serve the entire county, network restrictions can vary significantly between towns. Your access to specialists, preferred pharmacies, and even dental coverage might depend on your exact ZIP code.
Based on current 2026 plan data, here are the key trends for York County:
Top-Performing $0 Premium Plans (Without Drug Coverage)
These plans are perfect for seniors who want hospital/medical coverage but get their prescriptions through other means (like VA benefits):
Plan Name Giveback Max Out-of-Pocket Dental Best For
AARP Medicare Advantage Patriot $110/month $5,900/$10,100 $1,000 Comprehensive Veterans maximizing giveback
Humana USAA Honor Giveback $100/month $4,950/$8,950 $2,000 Comprehensive Military families
Aetna Medicare Eagle Giveback $80/month $5,900/$9,500 $2,000 Comprehensive Balanced coverage
Martin's Point Alliance (HMO) $50/month $5,000 $2,500 Comprehensive MaineHealth loyalists
What is a “Giveback”?
A giveback is a benefit where a Medicare Advantage plan pays part of your Part B premium for you. This results in real monthly savings.
Important: If your Part B premium is already paid by MaineCare (Medicaid), you will not receive the giveback. Givebacks have become increasingly popular as OTC benefits are reduced across many plans.
Great $0 Premium Plans WITH Drug Coverage
Most York County seniors need prescription coverage. Here are the standout $0 premium options:
Plan Name Health Deductible Rx Deductible Dental Special Features
Humana Gold Plus H5619-001 $0 $615 $1,250 Comprehensive Excellent basic coverage
Martin's Point Essential $0 $300 $250Preventative Low Rx deductible
Aetna Medicare Signature $0 $500 Preventative Only Strong network
Wellcare Simple $0 $615 $1,000 Comprehensive Good all-around coverage
Humana Gold Plus Giveback $0 $340 Preventative Only Highest Giveback $78/Mo
Special Needs Plans
There are currently 13 Special needs plans in York County. A Special Needs Plan, is a Medicare Advantage plan that are designed for beneficiaries that have special needs. Some are financial, for people with both Medicare and Medicaid(MaineCare), these are call Dual Special Needs Plans (or DSNP’s). There are also Chronic Special Needs Plans (or CSNP’s), for people that have certain qualifying medical conditions. Here’s what’s I have found:
DSNP’s
There are 11 DSNP’s. UHC has 2, Aetna has 2, Anthem has 1, Humana has 3, and WellCare has 3. Four are only available for people with a Medicaid level of QMB+, or FBDE. Seven also include the level QMB. Since most of the co-pays, deductibles, and co-insurances are paid for by Medicaid, then these plans are all about the extra benefits. One of the Humana plans has $4000 in comprehensive Dental, and one of the Aetna plans and one of the Humana plans has $150 per month in Over-The-Counter or flex benefits.
CSNP’s
There are two CSNP’s. One from Humana and one from UHC. Both are for people with Cardiovascular Disorders, Chronic Heart Failure, and Diabetes. In order to qualify, a physician must verify that you have one of the qualifying conditions. These plans are designed to help coordinate care for members managing multiple chronic conditions. I do think that moving forward next year there will be more of these plans offered as these come with their own Special Election Period.
🪖Specialized Plans for York County Veterans
If you're a veteran using VA benefits, consider these "No Rx" plans that work perfectly with your VA pharmacy coverage:
AARP Patriot No Rx - Highest giveback ($110)
Humana USAA Honor - Best for military families
Anthem Veteran Plan - Specifically designed for veterans
These plans provide excellent medical/hospital coverage while letting you use your VA benefits for prescriptions.
Town-Specific Considerations for York County
Kennebunk Residents:
You have access to ALL listed plans, including Martin's Point. If you use MaineHealth providers, Martin's Point offers exceptional integration. For those who travel or see specialists in Portsmouth, PPO options from Humana or Aetna provide more flexibility, and some HMO’s with extended developed networks work well too.
Saco & Biddeford Area:
Southern Maine Health Care (MaineHealth) is your main hospital system. Some plans are specifically designed for this network - if SMHC is your preferred provider, these plans deserve serious consideration. UHC Northern Light Health plans also serve this area well.
Berwick & Northern York County:
Berwick residents should note that while Martin's Point is available, network coverage might be more limited than in coastal towns. PPO plans (like those from Humana and Aetna, with very developed networks) often provide better access to providers across the state line in New Hampshire.
The Hidden Costs: What Those Numbers Really Mean💵
When comparing York County Medicare Advantage plans, don't just look at the premium. Consider:
Giveback Amount: How much will you get back on your Part B premium? This can be $600-$1,320+ annually.
Maximum Out-of-Pocket: Your worst-case yearly cost on Medical expenses. Ranges from $4,950 to $13,900 in our data.
Drug Deductibles: Vary from $0 to $615 annually. Although it may depend on the Tiers of your medications.
Dental Coverage: Ranges from preventative only to $2,500 comprehensive. Not all procedures are covered the same way.
Your 5-Step Decision Process for 2026
List Your Current Providers: Are your doctors in the plan's network?
Check Your Medications: Use the plan's formulary tool - this is CRITICAL.
Calculate Total Annual Cost: Premium + Deductibles + Copays for your expected usage.
Consider Additional Benefits: Dental, vision, hearing, OTC allowances, transportation.
Review Star Ratings: Medicare.gov rates plans 1-5 stars based on quality.
Why York County Seniors Choose Independent Guidance🤷
The plans shown above represent 25+ options just in Kennebunk, Saco, and Berwick. Each has different:
Provider networks
Drug formularies
Referral requirements
Prior authorization rules
Out-of-area coverage
As an independent agent, I help York County seniors navigate these complexities daily. I'm not limited to one company's plans - I can show you ALL available options in your specific ZIP code.
Free 2026 York County Plan Comparison
Every Medicare decision is personal. What works for your neighbor in Kennebunk might not work for you in Berwick. That's why I offer:
✅ Town-specific plan analysis for your exact location
✅ Personalized drug cost comparisons using the 2026 formularies
✅ Provider network verification for your doctors
✅ Total cost projections based on your health needs
✅ No-cost, no-pressure consultation
Ready to find your best 2026 Medicare Advantage plan?
📞 Call 508-684-2194 for your free York County plan comparison
📧 Or email: jonfitch64@gmail.com
Serving Kennebunk, Kennebunkport, Arundel, Biddeford, Saco, Old Orchard Beach, Scarborough, Berwick, North Berwick, Wells, Ogunquit, York, Kittery, and all of York County.
FAQ: York County Medicare Advantage 2026
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It depends on the plan and your specific provider. Medicare Advantage plans use networks, and those networks can vary by town and ZIP code. I verify doctor participation for every client before enrollment.
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The Annual Enrollment Period runs October 15 - December 7, 2025, for coverage starting January 1, 2026. Obviously, that has past!
We are now in the Medicare Advantage Open Enrollment period from January 1st to March 31st 2026, which allows you to switch Medicare Advantage plans one time per year.
There are also Special Enrollment Periods for certain life events.
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PPO plans and some HMOs with extended networks may be a better fit. We look at where you actually receive care, not just where you live.
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Yes. Dual Special Needs Plans (DSNPs) are available for individuals with Medicare and MaineCare. These plans often include enhanced dental, OTC, flex benefits, and lower cost sharing.
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That depends on the time of year and your eligibility. Some members qualify for Special Enrollment Periods outside of Open Enrollment. I can help determine if you qualify. For more detail check out:
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Medicare Supplements (Medigap) are a separate option that offer predictable costs and no networks. They are not part of Medicare Advantage, but for some people, they are the better long-term fit.
To see if Medicare Supplements make sense for you, check out:
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Just three things:
• Your Medicare card
• A list of medications
• Your doctors’ namesThat’s it. I handle the rest.
Note: All plan data is current as of 2026 plan year, may vary by individual zip code, and verified on Medicare.gov at time of writing. Premiums, benefits, and availability may change throughout the year. We recommend a personalized verification at the time of enrollment.
