There are 64 Medicare Advantage plans meeting your criteria.
2015 / 2016 Medicare Advantage Plan Information
Click here to jump to the Chart Legend |
Plan Name |
Monthly Premium |
Part A&B Maximum Out-Of Pocket |
Part D Deduct- ible | (Donut Hole) Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Formulary Drugs |
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
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H5253 -049 -0 | | | | | |
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2016 AARP MedicareComplete Plan 7 (HMO)
| $0.00 |
$4,500 |
$255 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,529 2016 Formulary |
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-- This plan not offered in 2015 --
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H1608 -029 -0 | | | | | |
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2016 Advantra Silver (PPO)
| $0.00 |
$5,400 |
$225 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,417 2016 Formulary |
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-- This plan not offered in 2015 --
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H3931 -107 -0 | | | | | |
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2016 Aetna Medicare Value Plan (HMO)
| $0.00 |
$5,700 |
$175 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,279 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Anthem Senior Advantage Basic (HMO)
| $0.00 |
$4,000 |
$153 | No additional gap coverage, only the Donut Hole Discount | H3655 -032 -0 | $5.00 | $20.00 | $37.00 | $37.00 | 3,016
2015 Formulary |
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|
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2016 Anthem MediBlue Essential (HMO)
| $0.00 |
$4,900 |
$60 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $42.00 | $42.00 | 3,266 2016 Formulary |
|
2015 Buckeye Health Plan - MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | H0022 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,000
2015 Formulary |
new |
new |
new |
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2016 Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | | 3,194 2016 Formulary |
|
2015 CareSource MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | H8452 -001 -0 | $0.00 | tbd | tbd | tbd | 2,896
2015 Formulary |
new |
new |
new |
|
2016 CareSource MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,030 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Gateway Health Medicare Assured Select (HMO)
| $0.00 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | H9190 -019 -0 | $3.00 | $12.00 | $45.00 | $45.00 | 2,634
2015 Formulary |
-- |
-- |
|
|
2016 Gateway Health Medicare Assured Select (HMO)
| $0.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $16.00 | $45.00 | $45.00 | 2,902 2016 Formulary |
|
2015 HealthSpan Medicare Core 1 (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | H6298 -005 -0 | This plan does NOT include Prescription Drug coverage. | |
new |
new |
new |
|
2016 HealthSpan Medicare Core 1 (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 HealthSpan Medicare Only Basic (Cost)
| $0.00 |
$3,400 |
No Rx Coverage | H6360 -012 -0 | This plan does NOT include Prescription Drug coverage. | |
-- |
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|
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2016 HealthSpan Medicare Only Basic (Cost)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 HealthSpan Medicare Plus Basic II (Cost)
| $0.00 |
$3,400 |
No Rx Coverage | H6360 -007 -0 | This plan does NOT include Prescription Drug coverage. | |
-- |
|
|
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2016 HealthSpan Medicare Plus Basic II (Cost)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 HealthSpan Medicare Plus Basic III (Cost)
| $0.00 |
$3,400 |
No Rx Coverage | H6360 -008 -0 | This plan does NOT include Prescription Drug coverage. | |
-- |
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|
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2016 HealthSpan Medicare Plus Basic III (Cost)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 HealthSpan Medicare Plus Basic IV (Cost)
| $0.00 |
$3,400 |
No Rx Coverage | H6360 -011 -0 | This plan does NOT include Prescription Drug coverage. | |
-- |
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2016 HealthSpan Medicare Plus Basic IV (Cost)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H6298 -001 -0 | | | | | |
new |
new |
new |
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2016 HealthSpan Medicare Value (HMO)
| $0.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $45.00 | $45.00 | 5,736 2016 Formulary |
|
2015 HumanaChoice R5826-021 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | R5826 -021 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 HumanaChoice R5826-021 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2015 --
|
H6723 -001 -1 | | | | | |
new |
new |
new |
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2016 MedMutual Advantage Classic (HMO)
| $0.00 |
$3,950 |
$165 | Yes, some additional gap coverage. | $4.00 | $17.00 | $47.00 | $47.00 | 3,611 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H3660 -050 -0 | | | | | |
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|
|
2016 SummaCare Medicare Topaz (HMO)
| $0.00 |
$6,000 |
$150 | Yes, some additional gap coverage. | $0.00 | $20.00 | $47.00 | $47.00 | 3,446 2016 Formulary |
|
2015 UnitedHealthcare Connected for MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | H2531 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,263
2015 Formulary |
new |
new |
new |
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2016 UnitedHealthcare Connected for MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | | 3,279 2016 Formulary |
|
2015 HealthSpan Medicare Core 2 (HMO)
| $2.00 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | H6298 -007 -0 | | | | | 5,460
2015 Formulary |
new |
new |
new |
|
2016 HealthSpan Medicare Core 2 (HMO)
| $2.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 5,736 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Blue Medicare Access Classic (Regional PPO)
| $18.00 |
$5,400 |
No Rx Coverage | R5941 -013 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
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2016 Anthem MediBlue Access Core (Regional PPO)
| $17.00 |
$5,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2015 --
|
H5253 -050 -0 | | | | | |
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|
|
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2016 AARP MedicareComplete Plan 1 (HMO)
| $29.00 |
$3,900 |
$200 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,529 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H6723 -002 -1 | | | | | |
new |
new |
new |
|
2016 MedMutual Advantage Choice (HMO)
| $29.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,611 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Anthem Dual Advantage (HMO SNP)
| $0.00 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | H3655 -033 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,025
2015 Formulary |
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|
|
|
2016 Anthem MediBlue Dual Advantage (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $1.00 | $45.00 | $45.00 | 3,266 2016 Formulary |
|
2015 Buckeye Health Plan Advantage (HMO SNP)
| $28.60 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | H0908 -001 -0 | | | | | 2,999
2015 Formulary |
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|
|
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2016 Buckeye Health Plan Advantage (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,191 2016 Formulary |
|
2015 Gateway Health Medicare Assured Diamond (HMO SNP)
| $28.60 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount | H9190 -001 -0 | | | | | 2,634
2015 Formulary |
-- |
-- |
|
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2016 Gateway Health Medicare Assured Diamond (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,902 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Gateway Health Medicare Assured Ruby (HMO SNP)
| $28.60 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | H9190 -002 -0 | | | | | 2,634
2015 Formulary |
-- |
-- |
|
|
2016 Gateway Health Medicare Assured Ruby (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,902 2016 Formulary |
|
2015 HealthSpan Medicare Plus IV (Cost)
| $27.20 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | H6360 -010 -0 | $6.00 | $30.00 | $45.00 | $45.00 | 5,460
2015 Formulary |
-- |
|
|
|
2016 HealthSpan Medicare Plus IV (Cost)
| $34.20 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $9.00 | $20.00 | $47.00 | $47.00 | 5,736 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H8953 -002 -0 | | | | | |
|
|
|
|
2016 Humana Gold Plus H8953-002 (HMO)
| $37.00 |
$6,700 |
$360 | Yes, some additional gap coverage. | $7.00 | $17.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H4497 -001 -1 | | | | | |
new |
new |
new |
|
2016 MedMutual Advantage Select (PPO)
| $39.00 |
$6,400 |
$165 | Yes, some additional gap coverage. | $4.00 | $17.00 | $47.00 | $47.00 | 3,611 2016 Formulary |
|
2015 SummaCare Medicare Ruby (HMO)
| $32.00 |
$4,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | H3660 -044 -0 | $0.00 | $10.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2016 SummaCare Medicare Ruby (HMO)
| $40.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $20.00 | $47.00 | $47.00 | 3,446 2016 Formulary |
|
2015 HealthSpan Medicare Plus III (Cost)
| $37.10 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | H6360 -006 -0 | $5.00 | $20.00 | $45.00 | $45.00 | 5,460
2015 Formulary |
-- |
|
|
|
2016 HealthSpan Medicare Plus III (Cost)
| $44.10 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $18.00 | $47.00 | $47.00 | 5,736 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H5253 -058 -0 | | | | | |
|
|
|
|
2016 AARP MedicareComplete Essential (HMO)
| $45.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2015 --
|
H6298 -002 -0 | | | | | |
new |
new |
new |
|
2016 HealthSpan Medicare Standard (HMO)
| $49.00 |
$3,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $45.00 | $45.00 | 5,736 2016 Formulary |
|
2015 HealthSpan Medicare Plus II (Cost)
| $42.10 |
$3,400 |
$0 | Yes, some additional gap coverage. | H6360 -002 -0 | $4.00 | $14.00 | $45.00 | $45.00 | 5,460
2015 Formulary |
-- |
|
|
|
2016 HealthSpan Medicare Plus II (Cost)
| $49.10 |
$3,400 |
$0 | Yes, some additional gap coverage. | $2.00 | $16.00 | $45.00 | $45.00 | 5,736 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H1608 -030 -0 | | | | | |
|
|
|
|
2016 Advantra Gold (PPO)
| $59.00 |
$4,300 |
$225 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,417 2016 Formulary |
|
2015 Gateway Health Medicare Assured Gold (HMO SNP)
| $39.80 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | H9190 -003 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 2,634
2015 Formulary |
-- |
-- |
|
|
2016 Gateway Health Medicare Assured Gold (HMO SNP)
| $59.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $45.00 | $45.00 | 2,902 2016 Formulary |
|
2015 Blue Medicare Access Value (Regional PPO)
| $67.00 |
$6,000 |
$115 | No additional gap coverage, only the Donut Hole Discount | R5941 -014 -0 | $5.00 | $17.00 | $40.00 | $40.00 | n/a |
|
|
|
|
2016 Anthem MediBlue Access (Regional PPO)
| $68.00 |
$6,000 |
$20 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $42.00 | $42.00 | tbd |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H4497 -002 -1 | | | | | |
new |
new |
new |
|
2016 MedMutual Advantage Preferred (PPO)
| $69.00 |
$4,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,611 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H4036 -010 -2 | | | | | |
|
|
|
|
2016 Anthem MediBlue Access (PPO)
| $73.00 |
$5,800 |
$50 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $42.00 | $42.00 | 3,266 2016 Formulary |
|
2015 SummaCare Medicare Sapphire (HMO-POS)
| $78.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | H3660 -029 -0 | $0.00 | $15.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2016 SummaCare Medicare Sapphire (HMO-POS)
| $78.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $20.00 | $47.00 | $47.00 | 3,446 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 HumanaChoice H6609-082 (PPO)
| $72.00 |
$6,700 |
$320 | Yes, some additional gap coverage. | H6609 -082 -0 | $6.00 | $18.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
|
|
|
2016 HumanaChoice H6609-082 (PPO)
| $85.00 |
$6,700 |
$360 | Yes, some additional gap coverage. | $7.00 | $17.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H4036 -012 -2 | | | | | |
|
|
|
|
2016 Anthem MediBlue Access Enhanced (PPO)
| $92.00 |
$4,100 |
$40 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $42.00 | $42.00 | 3,266 2016 Formulary |
|
2015 Gateway Health Medicare Assured Prime (HMO)
| $82.80 |
$4,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | H9190 -006 -0 | $4.00 | $20.00 | $45.00 | $45.00 | 2,634
2015 Formulary |
-- |
-- |
|
|
2016 Gateway Health Medicare Assured Prime (HMO)
| $96.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $45.00 | $45.00 | 2,902 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Gateway Health Medicare Assured Platinum (HMO SNP)
| $77.80 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | H9190 -004 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 2,634
2015 Formulary |
-- |
-- |
|
|
2016 Gateway Health Medicare Assured Platinum (HMO SNP)
| $97.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $45.00 | $45.00 | 2,902 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H6298 -009 -0 | | | | | |
new |
new |
new |
|
2016 HealthSpan Medicare Enhanced (HMO)
| $99.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $45.00 | $45.00 | 5,736 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H8953 -017 -0 | | | | | |
|
|
|
|
2016 Humana Gold Plus H8953-017 (HMO)
| $99.00 |
$3,900 |
$100 | Yes, some additional gap coverage. | $1.00 | $4.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 HealthSpan Medicare Plus Basic I (Cost)
| $101.00 |
$2,500 |
No Rx Coverage | H6360 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
-- |
|
|
|
2016 HealthSpan Medicare Plus Basic I (Cost)
| $101.00 |
$2,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 HumanaChoice R5826-007 (Regional PPO)
| $112.00 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount | R5826 -007 -0 | $5.00 | $11.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2016 HumanaChoice R5826-007 (Regional PPO)
| $101.00 |
$6,700 |
$330 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | tbd |
|
-- This plan not offered in 2015 --
|
H4497 -003 -1 | | | | | |
new |
new |
new |
|
2016 MedMutual Advantage Premium (PPO)
| $109.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,611 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Aetna Medicare Standard Plan (PPO)
| $100.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | H5521 -020 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
|
-- |
|
|
2016 Aetna Medicare Standard Plan (PPO)
| $114.00 |
$5,000 |
$175 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $47.00 | $47.00 | 3,279 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H5253 -051 -0 | | | | | |
|
|
|
|
2016 AARP MedicareComplete Plan 3 (HMO)
| $120.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,529 2016 Formulary |
|
2015 HealthSpan Medicare Plus I (Cost)
| $148.00 |
$2,960 |
$0 | Yes, some additional gap coverage. | H6360 -001 -0 | $4.00 | $14.00 | $45.00 | $45.00 | 5,460
2015 Formulary |
-- |
|
|
|
2016 HealthSpan Medicare Plus I (Cost)
| $148.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $2.00 | $16.00 | $45.00 | $45.00 | 5,736 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H3655 -035 -0 | | | | | |
|
|
|
|
2016 Anthem MediBlue Connect for OPERS (HMO)
| $151.00 |
$3,500 |
$20 | Yes, some additional gap coverage. | $3.00 | $11.00 | $42.00 | $42.00 | 3,266 2016 Formulary |
|
-- This plan not offered in 2015 --
|
R6694 -003 -0 | | | | | |
new |
new |
new |
|
2016 Aetna Medicare OH Connect Gold (Regional PPO)
| $154.00 |
$3,500 |
$200 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $9.00 | $47.00 | $47.00 | tbd |
|
-- This plan not offered in 2015 --
|
H5525 -030 -0 | | | | | |
|
|
|
|
2016 HumanaChoice H5525-030 (PPO)
| $163.00 |
$3,400 |
$100 | Yes, some additional gap coverage. | $1.00 | $4.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 SummaCare Medicare Emerald (HMO-POS)
| $182.00 |
$4,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | H3660 -028 -0 | $0.00 | $10.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2016 SummaCare Medicare Emerald (HMO-POS)
| $182.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,446 2016 Formulary |
|
2015 Aetna Medicare Select Plus Plan (PPO)
| $139.00 |
$3,300 |
$0 | Yes, some additional gap coverage. | H5521 -052 -0 | $0.00 | $3.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
|
-- |
|
|
2016 Aetna Medicare Connect Plus (PPO)
| $188.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.00 | $47.00 | $47.00 | 3,417 2016 Formulary |
|
2015 Advantra Gold (PPO)
| $47.00 |
$4,300 |
$0 | Yes, some additional gap coverage. | H8980 -004 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,463
2015 Formulary |
|
|
|
|
-- Members will be assigned to Advantra Gold (PPO) H1608-030 --
| | | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Advantra Silver (PPO)
| $0.00 |
$5,700 |
$0 | Yes, some additional gap coverage. | H8980 -002 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,463
2015 Formulary |
|
|
|
|
-- Members will be assigned to Advantra Silver (PPO) H1608-029 --
| | | | | |
|
2015 Aetna Medicare Value Plan (HMO)
| $0.00 |
$5,700 |
$0 | Yes, some additional gap coverage. | H3623 -004 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
|
|
|
|
-- Members will be assigned to Aetna Medicare Value Plan (HMO) H3931-107 --
| | | | | |
|
2015 Anthem Medicare Preferred Standard (PPO)
| $71.00 |
$6,000 |
$165 | No additional gap coverage, only the Donut Hole Discount | H5529 -008 -2 | $5.00 | $18.00 | $40.00 | $40.00 | 3,016
2015 Formulary |
|
|
|
|
-- Members will be assigned to Anthem MediBlue Access (PPO) H4036-010 --
| | | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Anthem Medicare Preferred Select (PPO)
| $91.00 |
$4,100 |
$151 | No additional gap coverage, only the Donut Hole Discount | H5529 -009 -2 | $5.00 | $20.00 | $40.00 | $40.00 | 3,016
2015 Formulary |
|
|
|
|
-- Members will be assigned to Anthem MediBlue Access Enhanced (PPO) H4036-012 --
| | | | | |
|
2015 Gateway Health Medicare Assured Choice (HMO)
| $57.80 |
$6,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | H9190 -005 -0 | $4.00 | $20.00 | $45.00 | $45.00 | 2,634
2015 Formulary |
-- |
-- |
|
|
-- Members will be assigned to Gateway Health Medicare Assured Select (HMO) H9190-019 --
| | | | | |
|
2015 HealthSpan Medicare Premier (HMO)
| $97.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | H6298 -004 -0 | $4.00 | $14.00 | $45.00 | $45.00 | 5,460
2015 Formulary |
new |
new |
new |
|
-- Members will be assigned to HealthSpan Medicare Standard (HMO) H6298-002 --
| | | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible | Additional Gap Coverage | Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 HealthSpan Medicare Basic (HMO)
| $50.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | H6298 -003 -0 | $4.00 | $14.00 | $45.00 | $45.00 | 5,460
2015 Formulary |
new |
new |
new |
|
-- Members will be assigned to HealthSpan Medicare Value (HMO) H6298-001 --
| | | | | |
|