Wellcare Advantage Simple (PFFS) in Wyoming County, New York — 2026 plan details
Last updated Jul 18, 2026
Reviewed by Jason Burns, Editorial Steward
Published by Senior Direct Answers · Licensed under Citation License 1.0
Wellcare Advantage Simple (PFFS) (H2816-038) is a $0-premium Medicare Advantage PFFS from Centene Corporation available in Wyoming County, New York in 2026, with a 3.5-star overall rating, a $6,700 in-network out-of-pocket maximum, and a $0 annual Part D drug deductible.
Plan facts (CMS CY2026 Landscape file)
| Organization | Centene Corporation |
|---|---|
| Plan name | Wellcare Advantage Simple (PFFS) |
| Contract ID | H2816 |
| Plan ID | 038 |
| Segment ID | 0 |
| Contract year | 2026 |
| Contract category | MA |
| Plan type | PFFS |
| SNP | No |
| Monthly consolidated premium | — |
| Part C premium | $0.00 |
| Part D basic premium | — |
| Part D total premium | — |
| Annual Part D deductible | — |
| Maximum out-of-pocket (in-network) | $6700.00 |
| Overall star rating | 3.5 |
How this plan is structured
- $0 consolidated premium. A $0 or near-$0 consolidated premium does not remove the Part B premium — the standard 2026 Part B premium is $202.90 per month and still applies. See the 2026 Medicare Part B premium.
- PFFS plan type. Plan-type rules determine in-network use and referrals. See how Medicare Advantage HMO and PPO plans differ.
- $6,700 in-network out-of-pocket maximum. The MOOP is the annual cap on what a member pays in-network for covered Part A and Part B services. See how the Medicare Advantage MOOP works.
- Service area = Wyoming County. Medicare Advantage plans are sold by service area; moving out of the plan's service area triggers a Special Enrollment Period to switch plans. See how moving changes your Medicare options.
How it compares in Wyoming County
The CMS CY2026 Landscape file lists 57 Medicare Advantage plans in Wyoming County, New York, of which 5 carry a 5.0-star overall rating and 24 have a $0 consolidated monthly premium. Consolidated premiums range from $0.00 to $232.20 per month, and in-network out-of-pocket maximums range from $3000.00 to $9250.00.
Other 5.0-star Medicare Advantage plans in Wyoming County (first three alphabetically):
| Plan | Organization | Premium | MOOP |
|---|---|---|---|
| Independent Health's Encompass 65 (HMO) | Independent Health Association, Inc. | — | $6750.00 |
| Independent Health's Encompass 65 RED 042 (HMO) | Independent Health Association, Inc. | $40.00 | $9250.00 |
| Independent Health's Encompass 65 RED 043 (HMO) | Independent Health Association, Inc. | $190.00 | $7000.00 |
For the full county plan directory, see all Medicare plans in Wyoming County, New York.
How to verify your doctors take this plan
Network participation changes throughout the year; we hold no provider-network data, so verify directly with these three sources before you decide:
- Open the plan's official Medicare.gov page and use its provider-directory link: Medicare.gov Plan Finder — H2816-038.
- Call the plan (Centene Corporation) using the member-services number listed on that plan page and ask whether each doctor, hospital, and pharmacy is in-network for 2026.
- Get free, unbiased help from your State Health Insurance Assistance Program (SHIP) — see free unbiased Medicare help from SHIP.
What H2816-038 means
CMS assigns every Medicare Advantage and Part D offering a plan identifier made of three parts. In H2816-038, the leading H marks the contract type (H = Medicare Advantage / Part C contract), the four digits 2816 are the contract number issued to the organization, and the three-digit 038 is the plan benefit package under that contract. The segment ID 0 identifies the service-area segment within the plan (0 = the default single segment).
Frequently asked questions
Is Wellcare Advantage Simple (PFFS) an HMO or PPO?
Wellcare Advantage Simple (PFFS) is a PFFS Medicare Advantage plan.
Does Wellcare Advantage Simple (PFFS) include prescription drug coverage?
Wellcare Advantage Simple (PFFS) does not include Part D prescription drug coverage in its consolidated benefits.
What is the maximum out-of-pocket cost for Wellcare Advantage Simple (PFFS)?
The 2026 in-network maximum out-of-pocket limit for Wellcare Advantage Simple (PFFS) is $6700.00, per the CMS CY2026 Landscape file.
What counties offer Wellcare Advantage Simple (PFFS) (H2816-038)?
Wellcare Advantage Simple (PFFS) (H2816-038) is offered in 47 New York counties: Albany County, Allegany County, Broome County, Cattaraugus County, Cayuga County, Chautauqua County, Chemung County, Chenango County, Clinton County, Columbia County, Cortland County, Delaware County, Erie County, Essex County, Franklin County, Fulton County, Genesee County, Greene County, Hamilton County, Herkimer County, Jefferson County, Lewis County, Madison County, Monroe County, Montgomery County, Niagara County, Oneida County, Onondaga County, Ontario County, Oswego County, Otsego County, Rensselaer County, Saratoga County, Schenectady County, Schoharie County, Schuyler County, Seneca County, St. Lawrence County, Steuben County, Sullivan County, Tioga County, Tompkins County, Warren County, Washington County, Wayne County, Wyoming County, and Yates County.
Sources
- CMS, Plan Year 2026 Medicare Advantage & Part D Landscape source file (March 2026) — retrieved 2026-07-18. Overall star rating year: 2026.
- Medicare.gov Plan Finder — compare plans and enroll.