Medicare Plans in Clay County, FL: Your 2027 Guide
For 2027, Clay County has 40 Medicare Advantage plans (not counting Special Needs Plans). 35 charge a $0 Part C premium, 31 include Part D drug coverage, and 82% carry a 2027 CMS rating of 4 stars or higher. In-network out-of-pocket limits run from $2,500 to $9,850.
Page last revised 15 October 2026. Plan data: CMS CY2027 landscape file (September 2026) and 2027 Star Ratings (released 8 October 2026).
Clay County residents choose from 40 Medicare Advantage plans for 2027. The premium is rarely the difference: 35 of them cost $0 a month. The out-of-pocket limit ($2,500 to $9,850), the hospital network and your drug list are what separate them.
Clay County runs south and west of Jacksonville along the St. Johns River, from Orange Park and Fleming Island down to Green Cove Springs, the county seat, and out to Middleburg and Keystone Heights. Many residents work in Duval, so a plan that covers Jacksonville doctors is often the deciding feature.
Clay has two acute-care hospitals with a CMS rating, HCA Florida Orange Park Hospital and Ascension St. Vincent’s Clay County, both rated 3 stars. For specialty care most people still travel into Jacksonville, which is why we check the Duval hospitals in a Clay resident’s network too.
2027 Medicare in Clay County by the numbers
Non-SNP Medicare Advantage plans unless noted. The small line under each figure is the 2026 value for comparison.
Source: CMS — Prescription Drug Coverage: CY2026 and CY2027 MA / Part D Landscape Source Files (Downloads); CMS — Part C and D Performance Data (2027 Star Ratings, released October 2026). Pulled 15 October 2026.
What changed in Clay County from 2026 to 2027?
The shelf shrank from 45 to 40 Medicare Advantage plans, and the highest out-of-pocket limit moved from $9,250 to $9,850. Nationally, the Part D deductible cap rises from $615 to $700 and the yearly drug out-of-pocket cap from $2,100 to $2,400. If you are in a plan today, read the Annual Notice of Change your plan mailed in September before you let it renew.
| Measure | 2026 | 2027 |
|---|---|---|
| Medicare Advantage plans (non-SNP) | 45 | 40 |
| $0 Part C premium | 41 | 35 |
| With Part D drug coverage | 34 | 31 |
| Median in-network out-of-pocket limit | $6,750 | $6,750 |
| Highest out-of-pocket limit | $9,250 | $9,850 |
| Average Part D deductible | $499 | $643 |
| Average CMS star rating | 4.18 | 4.01 |
| Special Needs Plans | 40 | 39 |
| Part D deductible cap (national) | $615 | $700 |
| Part D out-of-pocket cap (national) | $2,100 | $2,400 |
Sources: CMS CY2026/CY2027 landscape; 2026 and 2027 Star Ratings; Medicare.gov (Part D caps).
Every 2027 Medicare Advantage plan in Clay County, by type
40 plans across 4 plan types. Open a type to see every plan with its 2027 CMS star rating, premiums, out-of-pocket limit and Part D deductible. Ratings are shown as published, not as a recommendation.
HMO plans
HMO plans use a set network of doctors and hospitals and usually need a referral from your primary care doctor to see a specialist. Care outside the network is generally not covered except in emergencies.
- Average Part C premium: $0.00 a month
- Lowest in-network out-of-pocket limit: $3,000
- 2 of these plans do not include Part D drug coverage
| Plan | 2027 rating | Part C premium | C + D premium | In-network MOOP | Part D deductible | CMS plan ID |
|---|---|---|---|---|---|---|
| CareOne Plus (HMO) CarePlus Health Plans, Inc. | 4.0★ | $0 | $0 | $3,000 | $700 | H1019-113 |
| Humana Gold Plus H1036-068 (HMO) Humana | 4.5★ | $0 | $0 | $3,300 | $700 | H1036-068 |
| CareFree Platinum Giveback (HMO) CarePlus Health Plans, Inc. | 4.0★ | $0 | $0 | $3,750 | $700 | H1019-094 |
| Humana Gold Plus Giveback H1036-270 (HMO) Humana | 4.5★ | $0 | $0 | $3,900 | $0 | H1036-270 |
| Aetna Medicare Select (HMO) Aetna Medicare | 4.0★ | $0 | $0 | $3,900 | $200 | H1609-021 |
| CareAccess (HMO) CarePlus Health Plans, Inc. | 4.0★ | $0 | $0 | $4,000 | $700 | H1019-144 |
| CareSalute (HMO) CarePlus Health Plans, Inc. | 4.0★ | $0 | — | $4,150 | No drug coverage | H1019-132 |
| DEVOTED CORE 059 FL (HMO) Devoted Health | 4.5★ | $0 | $0 | $4,800 | $650 | H1290-059 |
| DEVOTED PREMIUM 044 FL (HMO) Devoted Health | 4.5★ | $0 | $7.30 | $4,900 | $650 | H1290-044-2 |
| DEVOTED CORE 029 FL (HMO) Devoted Health | 4.5★ | $0 | $0 | $4,950 | $650 | H1290-029 |
| BlueMedicare Premier (HMO) Florida Blue HMO | 3.5★ | $0 | $0 | $5,500 | $700 | H1035-033 |
| DEVOTED GIVEBACK EXTRAS 107 FL (HMO) Devoted Health | 4.5★ | $0 | $0 | $5,800 | $700 | H1290-107 |
| Humana USAA Honor Giveback (HMO) Humana | 4.5★ | $0 | — | $6,700 | No drug coverage | H1036-290 |
| BlueMedicare Classic (HMO) Florida Blue HMO | 3.5★ | $0 | $0 | $6,750 | $700 | H1035-019 |
| DEVOTED GIVEBACK 031 FL (HMO) Devoted Health | 4.5★ | $0 | $0 | $7,750 | $650 | H1290-031 |
HMO-POS plans
HMO-POS plans work like an HMO but let you use some out-of-network services, usually at a higher cost. Read which services the point-of-service option covers before you count on it.
- Average Part C premium: $0.00 a month
- Lowest in-network out-of-pocket limit: $2,500
- Every plan of this type includes Part D drug coverage
| Plan | 2027 rating | Part C premium | C + D premium | In-network MOOP | Part D deductible | CMS plan ID |
|---|---|---|---|---|---|---|
| Wellcare Simple (HMO-POS) Wellcare | 4.0★ | $0 | $0 | $2,500 | $700 | H1032-205 |
| AARP Medicare Advantage from UHC FL-0005 (HMO-POS) UnitedHealthcare | 4.0★ | $0 | $0 | $3,900 | $405 | H1045-026 |
| Aetna Medicare Select Extra (HMO-POS) Aetna Medicare | 4.0★ | $0 | $0 | $6,750 | $700 | H1609-028 |
| AARP Medicare Advantage Giveback from UHC FL-40 (HMO-POS) UnitedHealthcare | 4.0★ | $0 | $0 | $7,150 | $685 | H1045-071 |
| AARP Medicare Advantage CareFlex from UHC FL-37 (HMO-POS) UnitedHealthcare | 4.0★ | $0 | $0 | $7,150 | $685 | H1045-067 |
| Wellcare Giveback (HMO-POS) Wellcare | 4.0★ | $0 | $0 | $7,200 | $700 | H1032-204 |
PPO plans
PPO plans let you see out-of-network providers without a referral, at a higher share of the cost. A PPO lists two out-of-pocket limits: the in-network one shown below and a higher combined one.
- Average Part C premium: $2.41 a month
- Lowest in-network out-of-pocket limit: $6,000
- 5 of these plans do not include Part D drug coverage
| Plan | 2027 rating | Part C premium | C + D premium | In-network MOOP | Part D deductible | CMS plan ID |
|---|---|---|---|---|---|---|
| Humana USAA Honor Giveback (PPO) Humana | 4.0★ | $0 | — | $6,000 | No drug coverage | H5216-257 |
| Aetna Medicare Signature Legacy (PPO) Aetna Medicare | 4.0★ | $0 | $0 | $6,750 | $700 | H5521-269 |
| BlueMedicare Patriot (PPO) Florida Blue | 3.0★ | $0 | — | $6,750 | No drug coverage | H5434-041 |
| Humana USAA Honor Giveback (PPO) Humana | 4.5★ | $0 | — | $6,750 | No drug coverage | H7617-108 |
| Humana Essentials Plus Giveback (PPO) Humana | 4.5★ | $0 | $0 | $7,150 | $700 | H7617-126 |
| Aetna Medicare Signature (PPO) Aetna Medicare | 4.0★ | $0 | $0 | $7,150 | $700 | H5521-705 |
| Aetna Medicare Signature Extra (PPO) Aetna Medicare | 4.0★ | $0 | $0 | $7,150 | $700 | H5521-434 |
| Humana Value Choice (PPO) Humana | 4.0★ | $0 | $0 | $7,150 | $700 | H5216-070 |
| AARP Medicare Advantage from UHC FL-0021 (PPO) UnitedHealthcare | 4.0★ | $0 | $0 | $7,150 | $685 | H2406-013 |
| Aetna Medicare Eagle Giveback (PPO) Aetna Medicare | 4.0★ | $0 | — | $7,150 | No drug coverage | H5521-306 |
| BlueMedicare Value (PPO) Florida Blue | 3.0★ | $0 | $0 | $7,900 | $700 | H5434-031 |
| AARP Medicare Advantage Patriot No Rx FL-MA2 (PPO) UnitedHealthcare | 4.0★ | $0 | — | $8,900 | No drug coverage | H2406-130 |
| HumanaChoice Florida H7284-009 (PPO) Humana | 3.5★ | $1.90 | $38.90 | $6,750 | $700 | H7284-009 |
| Aetna Medicare Premier (PPO) Aetna Medicare | 4.0★ | $31.90 | $100 | $7,150 | $700 | H5521-706 |
Regional PPO plans
Regional PPOs cover a whole multi-county CMS region rather than single counties. They work like local PPOs, and their premiums and out-of-pocket limits are often higher.
- Average Part C premium: $18.68 a month
- Lowest in-network out-of-pocket limit: $6,700
- 2 of these plans do not include Part D drug coverage
| Plan | 2027 rating | Part C premium | C + D premium | In-network MOOP | Part D deductible | CMS plan ID |
|---|---|---|---|---|---|---|
| HumanaChoice R5826-074 (Regional PPO) Humana | 4.0★ | $0 | $35 | $7,550 | $700 | R5826-074 |
| AARP Medicare Advantage Patriot No Rx FL-MA01 (Regional PPO) UnitedHealthcare | 3.5★ | $0 | — | $9,250 | No drug coverage | R0759-002 |
| HumanaChoice R5826-018 (Regional PPO) Humana | 4.0★ | $9 | — | $7,550 | No drug coverage | R5826-018 |
| AARP Medicare Advantage from UHC FL-0031 (Regional PPO) UnitedHealthcare | 3.5★ | $12.20 | $127 | $9,850 | $685 | R0759-001 |
| HumanaChoice R5826-005 (Regional PPO) Humana | 4.0★ | $72.20 | $161 | $6,700 | $700 | R5826-005 |
Source: CMS CY2027 MA/Part D landscape file; 2027 Overall Star Ratings by contract. Green pill: 4 stars or higher; gold: 3.5; rust: below 3.5. A rating is a published CMS score for the contract, not a statement about your care.
How are Clay County plans rated for 2027?
82% of the 40 plans carry a 2027 CMS Overall Star Rating of 4 stars or higher, and the average is 4.01 stars, compared with 4.18 for 2026. No Medicare Advantage plan in Clay County carries a 5-star rating for 2027. Star ratings are set at the contract level, so every plan under one contract shares the same score.
| Overall rating | Plans | Share |
|---|---|---|
| 4.5 stars | 10 | 25% |
| 4 stars | 23 | 58% |
| 3.5 stars | 5 | 13% |
| 3 stars | 2 | 5% |
Source: CMS — Part C and D Performance Data (2027 Star Ratings, released October 2026).
Chronic conditions in Clay County and the plans built for them
CDC’s county estimates show how common the conditions that drive Medicare costs are among adults in Clay County. Each bar shows the crude to age-adjusted range.
Show the data table
| Measure (adults) | Estimate |
|---|---|
| Diagnosed diabetes | 10.3–12.2% |
| Obesity | 34.5–34.9% |
| High blood pressure | 32.9–36.9% |
| Coronary heart disease | 5.5–6.6% |
| COPD | 6.0–7.0% |
| Uninsured, adults 18–64 | 11.7–12.3% |
CDC PLACES — Local Data for Better Health, county estimates, 2023 county estimates; adult population 232,439.
39 Special Needs Plans for 2027
Special Needs Plans (SNPs) are Medicare Advantage plans limited to people with particular needs. They are kept out of every Medicare Advantage figure above. With 10.3–12.2% of adults living with diabetes, 9 of the county’s chronic-condition plans are built for diabetes. 9 cover heart failure or cardiovascular disorders, where CDC estimates coronary heart disease at 5.5–6.6% of adults.
Dual-eligible SNPs (D-SNP): 23
For people who qualify for both Medicare and Medicaid.
| Highest-rated plans | Rating | C + D premium | MOOP |
|---|---|---|---|
| Humana Dual Select H1036-314 (HMO D-SNP) | 4.5★ | $0 | $3,400 |
| Humana Dual Select H1036-210 (HMO D-SNP) | 4.5★ | $0 | $3,400 |
| DEVOTED DUAL 023 FL (HMO D-SNP) | 4.5★ | $0 | $5,300 |
Chronic-condition SNPs (C-SNP): 14
For people living with specific chronic or disabling conditions named by the plan.
| Highest-rated plans | Rating | C + D premium | MOOP |
|---|---|---|---|
| Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | 4.5★ | $0 | $3,300 |
| Humana Gold Plus Lung (HMO C-SNP) | 4.5★ | $0 | $3,300 |
| DEVOTED C-SNP ENHANCED 071 FL (HMO C-SNP) | 4.5★ | $0 | $5,300 |
Institutional SNPs (I-SNP): 2
For people who live in an institution, such as a nursing home, or who need nursing-home-level care at home.
| Highest-rated plans | Rating | C + D premium | MOOP |
|---|---|---|---|
| UHC Nursing Home Plan FL-F001 (PPO I-SNP) | 5.0★ | $6.10 | $9,850 |
| Longevity Health Plan (HMO I-SNP) | 5.0★ | $7.30 | $9,850 |
Conditions named by C-SNPs in this county: cardiovascular disorders (9) · chronic heart failure (9) · diabetes (9) · chronic lung disorders (3) · chronic kidney disease (2). A plan does not mean you qualify; the plan verifies your condition.
Stand-alone Part D drug plans for Clay County residents
If you keep Original Medicare, alone or with a Medigap plan, or choose a Medicare Advantage plan without drug coverage, drugs come from a stand-alone Part D plan (PDP). PDPs are sold statewide: 11 are offered in Florida for 2027, with premiums from $5.30 to $326 a month. For 2027, no plan can charge a deductible above $700, and once your own spending on covered drugs reaches $2,400 you pay nothing more that year.
| Plan | Monthly premium | Deductible | 2027 Part D rating | Plan ID |
|---|---|---|---|---|
| Wellcare Classic (PDP) | $7.30 | $700 | 3.0★ | S4802-083 |
| HealthSpring Assurance Rx (PDP) | $9.30 | $700 | 2.5★ | S5715-032 |
| Humana Basic Rx Plan (PDP) | $90.30 | $700 | 4.5★ | S5884-105 |
| Plan | Monthly premium | Deductible | 2027 Part D rating | Plan ID |
|---|---|---|---|---|
| Wellcare Value Script (PDP) | $5.30 | $700 | 3.0★ | S4802-146 |
| Humana Value Rx Plan (PDP) | $45.20 | $687 | 4.5★ | S5884-190 |
| Humana Premier Rx Plan (PDP) | $135.20 | $350 | 4.5★ | S5884-157 |
Sorted by premium because CMS enrollment by plan was not available to us. Source: CMS CY2027 landscape (PDP rows, region 11); 2027 Part D summary ratings; Medicare.gov for the $700 and $2,400 limits.
Price your own drug list with our Part D drug cost estimator.
How does Medigap work in Clay County?
A Medicare Supplement (Medigap) policy pays some or all of what Original Medicare leaves you: the Part A deductible, Part B coinsurance and more, depending on the plan letter. It works at any doctor or hospital in the country that accepts Medicare, which is why people who travel or split the year between states often prefer it.
Florida has no Medigap birthday rule. Outside your open enrollment or a guaranteed-issue situation, a Florida carrier can medically underwrite you and can decline you. Every Medigap policy sold in Florida is guaranteed renewable and comes with a 30-day free look (Florida OIR, 2026 Medigap FAQ).
We don’t publish Medigap prices: they depend on your age, the plan letter and the carrier, and no public rate file covers them. Compare real quotes side by side with our Medigap cost comparison calculator.
Hospitals in and around Orange Park
A plan’s network decides which of these hospitals you can use at in-network prices. Ratings are CMS’s overall hospital star ratings, reported as published.
| Hospital | ZIP | CMS overall rating |
|---|---|---|
| HCA Florida Orange Park Hospital | 32073 | 3.0★ |
| Ascension St. Vincent's Clay County | 32068 | 3.0★ |
Source: CMS Care Compare — Hospital General Information (overall star rating), retrieved 15 October 2026. Grouped by the ZIP code in each hospital’s CMS address.
Under 65 in Clay County: Marketplace coverage
Florida uses HealthCare.gov. For the 2026 plan year, the benchmark Silver plan in Clay County (the second-lowest-cost Silver, which sets your subsidy) costs $556 a month at age 21 before any tax credit. A single 21-year-old earning $40,000 qualifies for an estimated $270 a month in premium tax credits, per HealthCare.gov. Prices rise with age on the federal age curve:
| Age | Benchmark Silver | Lowest Bronze |
|---|---|---|
| 21 | $556 | $403.99 |
| 40 | $710.57 | $516.30 |
| 60 | $1,508.98 | $1,096.43 |
Source: HealthCare.gov Marketplace API (2026 plan year, ZIP 32073) via the Ambrose Insurance Brain, 15 October 2026; ages 40 and 60 scaled with the CMS federal default age curve. 2027 prices appear on HealthCare.gov for open enrollment starting November 1, 2026.
For 2027 coverage, open enrollment runs November 1, 2026 to January 15, 2027; enroll by December 15 for a January 1 start. The tax credit stops above 400% of the poverty line. Estimate yours with the ACA premium tax credit calculator or price your household with the premium estimator.
How and when to enroll in Clay County
- Initial Enrollment Period: 7 months around your 65th birthday, starting 3 months before the month you turn 65. Find your dates
- Open Enrollment (all Medicare): October 15 to December 7, 2026, for coverage starting January 1, 2027.
- Medicare Advantage Open Enrollment: January 1 to March 31, for people already in a Medicare Advantage plan: one switch, or a return to Original Medicare.
- Special Enrollment Periods: triggered by events such as moving, losing employer coverage, or qualifying for Extra Help or Medicaid.
You can enroll through a licensed agent such as us, directly with the plan, or at Medicare.gov or 1-800-MEDICARE. To join a Medicare Advantage plan you must have Medicare Part A and Part B and live in the plan’s service area.
Plan availability: plans are filed by county, so the 2027 plans above are available to Medicare beneficiaries throughout Clay County, including Orange Park, Fleming Island, Middleburg, Green Cove Springs, Keystone Heights, Lakeside.
Where to get help in Clay County
- McDowell Business Resources: free plan reviews in person near Jacksonville or by phone, 888-661-0126.
- Medicare: Medicare.gov or 1-800-MEDICARE (1-800-633-4227) for every plan in your area.
- Social Security: to sign up for Part A and Part B, or to ask for an IRMAA review after a life-changing event.
- Medicaid and Medicare Savings Programs: Florida Department of Children and Families (ACCESS Florida). Check first with our Medicare Savings Program estimator.
- Veterans: VA health care can work alongside Medicare, and veterans can hold both.
How we help in Clay County
Medicare
Advantage, Medigap & Part D
ACA / Marketplace
Individual & family plans, subsidies
Life Insurance
Term & whole life, sized to you
Final Expense
Cover end-of-life costs
Supplemental
Dental, vision, hospital, disability & LTC
Indexed UL
Protection + tax-advantaged cash value
Annuities
Guaranteed income you can’t outlive
Business & Notary
Group benefits, P&C & notary
Clay County: frequently asked
City guides in Clay County
Orange Park, FL
Orange Park, about 20 minutes from our office. Medicare, Marketplace, life and final expense help for the town and the US-17 corridor.
City guideFleming Island, FL
Fleming Island, the highest-income community in Clay County. Medicare, Medigap, annuity and life insurance guidance near our office.
City guideMiddleburg, FL
Middleburg in western Clay County. Medicare, Marketplace and final expense help, with the county’s Ascension hospital in the same ZIP code.
City guideGreen Cove Springs, FL
Green Cove Springs, the Clay County seat on the St. Johns River. Medicare, Marketplace and life insurance help near our office.
Nearby areas
Related calculators
Sources & methodology
- CMS — Prescription Drug Coverage: CY2026 and CY2027 MA / Part D Landscape Source Files (Downloads) · CY2026 and CY2027 files, pulled 15 October 2026
- CMS — Part C and D Performance Data (2027 Star Ratings, released October 2026) · 2027 Star Ratings (8 Oct 2026)
- Medicare.gov — Costs for Medicare drug coverage · 2026 and 2027 plan years
- CMS — 2026 Medicare Parts A & B Premiums and Deductibles · 2026 plan year
- CDC PLACES — Local Data for Better Health, county estimates · 2023 county estimates
- U.S. Census Bureau — American Community Survey 2023 5-year estimates · ACS 2023
- CMS Care Compare — Hospital General Information (overall star rating) · retrieved 15 October 2026
- HealthCare.gov Marketplace API — 2026 plan year plans and subsidy estimates · 2026 plan year
- CMS — State Specific Age Curve Variations (federal default age curve) · federal default curve
- Florida Office of Insurance Regulation — 2026 Medigap Frequently Asked Questions · 2026 plan year
Medicare Advantage figures cover non-SNP HMO, HMO-POS, PPO and Regional PPO plan segments in the CMS landscape file for Clay County; Special Needs Plans are counted separately and stand-alone Part D plans are statewide. “$0 premium” and average premium use the Part C premium; the table also shows the consolidated Part C + D premium. Star ratings are the 2027 contract-level Overall Star Ratings joined by contract ID. CMS enrollment by county was not available to us, so no plan is described as most popular. Health figures are CDC model-based estimates shown as a crude to age-adjusted range. Pulled through the Ambrose Insurance Brain on 15 October 2026.
Compiled by the McDowell Business Resources Data Desk. Last reviewed: October 2026.
Local help in Clay County, at no cost
Free, no-pressure help comparing Medicare, Marketplace, life and supplemental coverage. Call or book a time that suits you.
Medicare 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 to get information on all of your options.
McDowell Business Resources is not affiliated with or endorsed by the U.S. government, the federal Medicare program, or CMS.
This page is general education, not insurance, tax, legal or investment advice. Figures are dated where shown and can change; your situation may differ, and product availability varies by state and carrier. McDowell Business Resources (MBR Insurance & Financial Services) is an independent agency, not an insurance carrier.