There are 66 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 |
2015 AARP MedicareComplete Choice Essential (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5287 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
2016 AARP MedicareComplete Choice Essential (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 AARP MedicareComplete Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount |
R5287 -001 -0 | $2.00 | $8.00 | $45.00 | $45.00 | n/a |
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2016 AARP MedicareComplete Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | tbd |
|
2015 BlueMedicare HMO LifeTime (HMO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H1026 -038 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,778
2015 Formulary |
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2016 BlueMedicare HMO LifeTime (HMO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $5.00 | $15.00 | $42.00 | $42.00 | 3,993 2016 Formulary |
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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 --
|
H1026 -058 -0 | | | | | |
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|
2016 BlueMedicare HMO MyTime (HMO)
| $0.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $2.00 | $10.00 | $42.00 | $42.00 | 3,993 2016 Formulary |
|
2015 CareFree (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1019 -065 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
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2016 CareFree (HMO)
| $0.00 |
$6,700 |
$100 | Yes, some additional gap coverage. | $6.00 | $15.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
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-- This plan not offered in 2015 --
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H5414 -033 -0 | | | | | |
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2016 Coventry Summit Ideal (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | 50% | 50% | 3,543 2016 Formulary |
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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 --
|
H5414 -034 -0 | | | | | |
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2016 Coventry Summit Maximum (HMO SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $47.00 | 50% | 50% | 3,543 2016 Formulary |
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-- This plan not offered in 2015 --
|
H0981 -002 -0 | | | | | |
new |
new |
new |
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2016 Eden Gold (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $20.00 | $20.00 | tbd |
|
2015 Freedom Medicare Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5427 -060 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 2,830
2015 Formulary |
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2016 Freedom Medicare Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $45.00 | $95.00 | $95.00 | 2,955 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 Freedom Savings Plan (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H5427 -052 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 Freedom Savings Plan (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 Freedom VIP Care (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5427 -070 -0 | $0.00 | $25.00 | $75.00 | $75.00 | 2,830
2015 Formulary |
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2016 Freedom VIP Care (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $25.00 | $75.00 | $75.00 | 2,955 2016 Formulary |
|
2015 Freedom VIP Savings (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5427 -072 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 2,830
2015 Formulary |
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2016 Freedom VIP Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | $80.00 | $80.00 | 2,955 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 Freedom VIP Savings COPD (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5427 -077 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 2,830
2015 Formulary |
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2016 Freedom VIP Savings COPD (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | $80.00 | $80.00 | 2,955 2016 Formulary |
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2015 Humana Gold Plus - Diabetes (HMO SNP)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1036 -130 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,617
2015 Formulary |
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2016 Humana Gold Plus - Diabetes (HMO SNP)
| $0.00 |
n/a |
$150 | Yes, some additional gap coverage. | $0.00 | $7.00 | $47.00 | $47.00 | 3,607 2016 Formulary |
|
2015 Humana Gold Plus H1036-062C (HMO)
| $0.00 |
$5,700 |
$0 | Yes, some additional gap coverage. |
H1036 -062 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,617
2015 Formulary |
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2016 Humana Gold Plus H1036-062C (HMO)
| $0.00 |
$6,700 |
$150 | Yes, some additional gap coverage. | $0.00 | $7.00 | $47.00 | $47.00 | 3,607 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 Humana Gold Plus H1036-063A (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H1036 -063 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 Humana Gold Plus H1036-063A (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 Humana Gold Plus H1036-199 (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1036 -199 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
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2016 Humana Gold Plus H1036-199 (HMO)
| $0.00 |
$6,700 |
$100 | Yes, some additional gap coverage. | $6.00 | $15.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
2015 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$5,000 |
No Rx Coverage |
R5826 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$5,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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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 R5826-074 (Regional PPO)
| $0.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount |
R5826 -074 -0 | $6.00 | $15.00 | $45.00 | $45.00 | n/a |
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2016 HumanaChoice R5826-074 (Regional PPO)
| $0.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | tbd |
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-- This plan not offered in 2015 --
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H1045 -037 -0 | | | | | |
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2016 Preferred Choice Palm Beach (HMO)
| $0.00 |
$5,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $20.00 | $20.00 | 3,531 2016 Formulary |
|
2015 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1032 -179 -0 | $3.00 | $10.00 | $35.00 | $35.00 | 2,947
2015 Formulary |
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2016 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $42.00 | $42.00 | 2,801 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 --
|
H1032 -183 -0 | | | | | |
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2016 WellCare Reserve (HMO)
| $14.50 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $45.00 | $45.00 | 2,801 2016 Formulary |
|
2015 WellCare Liberty (HMO SNP)
| $18.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H1032 -175 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,946
2015 Formulary |
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2016 WellCare Liberty (HMO SNP)
| $16.30 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $13.00 | $47.00 | $47.00 | 2,801 2016 Formulary |
|
2015 WellCare Access (HMO SNP)
| $17.70 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H1032 -124 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,946
2015 Formulary |
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2016 WellCare Access (HMO SNP)
| $17.20 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $47.00 | $47.00 | 2,801 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 --
|
H1019 -023 -0 | | | | | |
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2016 CareNeeds PLUS (HMO SNP)
| $17.90 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,607 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H1019 -081 -0 | | | | | |
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2016 CareNeeds (HMO SNP)
| $18.10 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,607 2016 Formulary |
|
2015 UnitedHealthcare Dual Complete RP (Regional PPO SNP)
| $25.80 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
R5287 -003 -0 | | | | | n/a |
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2016 UnitedHealthcare Dual Complete RP (Regional PPO SNP)
| $20.60 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 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 |
2015 Humana Gold Plus SNP-DE H1036-104A (HMO SNP)
| $20.70 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H1036 -104 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,617
2015 Formulary |
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2016 Humana Gold Plus SNP-DE H1036-104A (HMO SNP)
| $21.30 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,607 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H1036 -259 -0 | | | | | |
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2016 Humana Gold Plus SNP-DE H1036-259 (HMO SNP)
| $21.60 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,607 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H1032 -182 -0 | | | | | |
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2016 WellCare Select (HMO SNP)
| $22.30 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $44.00 | $44.00 | 2,801 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 --
|
H0710 -012 -0 | | | | | |
|
-- |
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2016 UnitedHealthcare Assisted Living Plan (PPO SNP)
| $22.90 |
n/a |
$75 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,529 2016 Formulary |
|
2015 Molina Medicare Options Plus (HMO SNP)
| $24.80 |
$6,700 |
$320 | Yes, some additional gap coverage. |
H8130 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,895
2015 Formulary |
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2016 Molina Medicare Options Plus (HMO SNP)
| $26.10 |
n/a |
$360 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,041 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H1045 -038 -0 | | | | | |
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2016 Preferred Medicare Assist Palm Beach (HMO SNP)
| $26.60 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 3,531 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 Freedom Medi-Medi Full (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5427 -087 -0 | | | | | 2,828
2015 Formulary |
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2016 Freedom Medi-Medi Full (HMO SNP)
| $28.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,955 2016 Formulary |
|
2015 Freedom Medi-Medi Partial (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5427 -078 -0 | | | | | 2,828
2015 Formulary |
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2016 Freedom Medi-Medi Partial (HMO SNP)
| $28.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,955 2016 Formulary |
|
2015 Optimum Emerald Full (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5594 -017 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,830
2015 Formulary |
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2016 Optimum Emerald Full (HMO SNP)
| $28.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $45.00 | $95.00 | $95.00 | 2,955 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 Optimum Emerald Partial (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5594 -016 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,830
2015 Formulary |
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|
|
|
2016 Optimum Emerald Partial (HMO SNP)
| $28.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $45.00 | $95.00 | $95.00 | 2,955 2016 Formulary |
|
2015 Sunshine Health Advantage (HMO SNP)
| $25.80 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5190 -003 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,999
2015 Formulary |
-- |
-- |
|
|
2016 Sunshine Health Advantage (HMO SNP)
| $28.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,191 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H0710 -010 -0 | | | | | |
|
-- |
|
|
2016 UnitedHealthcare Nursing Home Plan (PPO SNP)
| $28.10 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,529 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 BlueMedicare Regional PPO (Regional PPO)
| $36.10 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount |
R3332 -001 -0 | $5.00 | $28.00 | $40.00 | $40.00 | n/a |
|
|
|
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2016 BlueMedicare Regional PPO (Regional PPO)
| $39.90 |
$6,700 |
$260 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $15.00 | $42.00 | $42.00 | tbd |
|
2015 Aetna Medicare Premier Plan (PPO)
| $35.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5521 -033 -0 | $0.00 | $3.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
|
-- |
|
|
2016 Aetna Medicare Premier Plan (PPO)
| $49.00 |
$6,700 |
$150 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $8.00 | $45.00 | $45.00 | 3,417 2016 Formulary |
|
2015 HumanaChoice H5415-056 (PPO)
| $43.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H5415 -056 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
-- |
|
|
2016 HumanaChoice H5415-056 (PPO)
| $55.00 |
$6,700 |
$350 | Yes, some additional gap coverage. | $5.00 | $15.00 | $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 HumanaChoice R5826-005 (Regional PPO)
| $95.00 |
$6,700 |
$100 | Yes, some additional gap coverage. |
R5826 -005 -0 | $3.00 | $8.00 | $40.00 | $40.00 | n/a |
|
|
|
|
2016 HumanaChoice R5826-005 (Regional PPO)
| $95.00 |
$6,700 |
$100 | Yes, some additional gap coverage. | $3.00 | $8.00 | $40.00 | $40.00 | tbd |
|
2015 Humana Gold Choice H8145-061 (PFFS)
| $101.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H8145 -061 -0 | $6.00 | $15.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
|
|
|
2016 Humana Gold Choice H8145-061 (PFFS)
| $106.00 |
n/a |
$200 | Yes, some additional gap coverage. | $7.00 | $17.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
2015 Aetna Medicare Select Plus Plan (HMO)
| $139.00 |
$3,300 |
$0 | Yes, some additional gap coverage. |
H5414 -025 -0 | $0.00 | $3.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
|
|
|
|
2016 Aetna Medicare Connect Plus (HMO)
| $138.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.00 | $47.00 | $47.00 | 3,417 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 BlueMedicare PPO (PPO)
| $127.10 |
$3,200 |
$0 | Yes, some additional gap coverage. |
H5434 -002 -0 | $2.00 | $5.00 | $30.00 | $30.00 | 3,778
2015 Formulary |
|
|
|
|
2016 BlueMedicare PPO (PPO)
| $147.80 |
$5,900 |
$285 | No additional gap coverage, only the Donut Hole Discount | $14.00 | $15.00 | $42.00 | $42.00 | 3,993 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 BlueMedicare HMO PrimeTime (HMO)
| $0.00 |
$3,250 |
$0 | Yes, some additional gap coverage. |
H1026 -051 -0 | $2.00 | $5.00 | $40.00 | $40.00 | 3,778
2015 Formulary |
|
|
|
|
-- Members will be assigned to BlueMedicare HMO LifeTime (HMO) H1026-038 --
| | | | | |
|
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 CareNeeds (HMO SNP)
| $22.30 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H1019 -025 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,617
2015 Formulary |
|
|
|
|
-- Members will be assigned to CareNeeds PLUS (HMO SNP) H1019-023 --
| | | | | |
|
2015 Coventry Summit Ideal (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1013 -033 -0 | $0.00 | $25.00 | 50% | 50% | 3,236
2015 Formulary |
|
|
|
|
-- Members will be assigned to Coventry Summit Ideal (HMO) H5414-033 --
| | | | | |
|
2015 Coventry Summit Maximum (HMO SNP)
| $9.70 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1013 -034 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,236
2015 Formulary |
|
|
|
|
-- Members will be assigned to Coventry Summit Maximum (HMO SNP) H5414-034 --
| | | | | |
|
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 Amerivantage Specialty + Rx (HMO SNP)
| $0.00 |
$6,700 |
$320 | Yes, some additional gap coverage. |
H8991 -017 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,025
2015 Formulary |
|
|
|
|
-- Members will be assigned to Simply Complete (HMO SNP) H5471-001 --
| | | | | |
|
2015 Amerivantage Classic + Rx (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H8991 -028 -0 | $5.00 | $15.00 | $40.00 | $40.00 | 3,025
2015 Formulary |
|
|
|
|
-- Members will be assigned to Simply More (HMO) H5471-002 --
| | | | | |
|
2015 UnitedHealthcare Nursing Home Plan (PPO SNP)
| $24.30 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5417 -001 -0 | | | | | 3,649
2015 Formulary |
|
|
|
|
-- Members will be assigned to UnitedHealthcare Nursing Home Plan (PPO SNP) H0710-010 --
| | | | | |
|
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 CareOne (HMO)
| $0.00 |
$5,700 |
$0 | Yes, some additional gap coverage. |
H1019 -010 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,617
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 WellCare Value (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1032 -091 -0 | $0.00 | $10.00 | $25.00 | $25.00 | 2,947
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Aetna Medicare Value Plan (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5414 -019 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
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 WellCare Select (HMO SNP)
| $19.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H1032 -061 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,946
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 WellCare Advance (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H1032 -037 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Sunrise (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4199 -012 -0 | $0.00 | $20.00 | $50.00 | $50.00 | n/a |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
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 Day Break (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4199 -013 -0 | $0.00 | $45.00 | $95.00 | $95.00 | n/a |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 CareHeart (HMO SNP)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1019 -064 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,617
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Humana Gold Plus - Heart (HMO SNP)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1036 -190 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,617
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
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 Clear Skies (HMO SNP)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4199 -015 -0 | $0.00 | $20.00 | $50.00 | $50.00 | n/a |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Sunny Days (HMO SNP)
| $25.80 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4199 -016 -0 | $0.00 | $0.00 | $0.00 | $0.00 | n/a |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 CareDirect (HMO SNP)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1019 -070 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,617
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|