There are 59 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 --
|
H5253 -052 -0 | | | | | |
|
|
|
|
2016 AARP MedicareComplete Plan 6 (HMO)
| $0.00 |
$6,400 |
$255 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,529 2016 Formulary |
|
2015 Aetna Medicare Value Plan (PPO)
| $0.00 |
$6,100 |
$0 | Yes, some additional gap coverage. |
H5521 -090 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 2,817
2015 Formulary |
|
-- |
|
|
2016 Aetna Medicare Value Plan (PPO)
| $0.00 |
$6,100 |
$175 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $47.00 | $47.00 | 3,279 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H3655 -032 -0 | | | | | |
|
|
|
|
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 |
|
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 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 |
|
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 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. | |
|
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 Standard (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6298 -001 -0 | $4.00 | $14.00 | $45.00 | $45.00 | 5,460
2015 Formulary |
new |
new |
new |
|
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 |
|
-- This plan not offered in 2015 --
|
H8953 -011 -0 | | | | | |
|
|
|
|
2016 Humana Gold Plus - Diabetes and Heart (HMO SNP)
| $0.00 |
n/a |
$360 | Yes, some additional gap coverage. | $7.00 | $17.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
2015 Humana Gold Plus H8953-005 (HMO)
| $0.00 |
$5,900 |
$250 | Yes, some additional gap coverage. |
H8953 -005 -0 | $6.00 | $16.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
|
|
|
2016 Humana Gold Plus H8953-005 (HMO)
| $0.00 |
$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 |
2015 HumanaChoice R5826-021 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5826 -021 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2016 HumanaChoice R5826-021 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 MediGold Essential Care (HMO)
| $0.00 |
$3,200 |
$0 | Yes, some additional gap coverage. |
H3668 -011 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 4,973
2015 Formulary |
|
|
|
|
2016 MediGold Essential Care (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $18.00 | $45.00 | $45.00 | 4,063 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H6723 -001 -1 | | | | | |
new |
new |
new |
|
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 |
2015 Molina Dual Options – MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5280 -001 -0 | $0.00 | $0.00 | $0.00 | | 2,896
2015 Formulary |
new |
new |
new |
|
2016 Molina Dual Options – MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | | 3,041 2016 Formulary |
|
2015 Premier Health Advantage (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H3233 -001 -0 | $3.00 | $9.00 | $45.00 | $45.00 | 3,345
2015 Formulary |
new |
new |
new |
|
2016 Premier Health Advantage (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $3.00 | $15.00 | $47.00 | $47.00 | 3,574 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. | |
|
|
|
|
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 -059 -0 | | | | | |
|
|
|
|
2016 UnitedHealthcare Dual Complete (HMO SNP)
| $17.90 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,529 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H5253 -061 -0 | | | | | |
|
|
|
|
2016 UnitedHealthcare Assisted Living Plan (HMO-POS SNP)
| $23.80 |
n/a |
$80 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $46.00 | $46.00 | 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 Molina Medicare Options Plus (HMO SNP)
| $28.60 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H0490 -004 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,895
2015 Formulary |
-- |
-- |
|
|
2016 Molina Medicare Options Plus (HMO SNP)
| $25.90 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $47.00 | $47.00 | 3,041 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 |
|
-- This plan not offered in 2015 --
|
H3655 -033 -0 | | | | | |
|
|
|
|
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 |
|
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 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 |
|
|
|
|
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 |
-- |
-- |
|
|
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 |
|
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 |
|
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 --
|
H8953 -007 -0 | | | | | |
|
|
|
|
2016 Humana Gold Plus SNP-DE H8953-007 (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
2015 Premier Health Advantage VIP (HMO SNP)
| $28.60 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H3233 -002 -0 | | | | | 3,345
2015 Formulary |
new |
new |
new |
|
2016 Premier Health Advantage VIP (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,574 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H5253 -060 -0 | | | | | |
|
|
|
|
2016 UnitedHealthcare Nursing Home Plan (HMO-POS SNP)
| $29.50 |
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 |
-- This plan not offered in 2015 --
|
H3931 -110 -0 | | | | | |
|
|
|
|
2016 Aetna Medicare Select Plan (HMO)
| $36.00 |
$5,600 |
$230 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $11.00 | $47.00 | $47.00 | 3,279 2016 Formulary |
|
-- 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 |
|
-- 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. | |
|
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 -053 -0 | | | | | |
|
|
|
|
2016 AARP MedicareComplete Plan 2 (HMO)
| $45.00 |
$5,900 |
$170 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,529 2016 Formulary |
|
2015 HealthSpan Medicare Enhanced (HMO)
| $52.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6298 -002 -0 | $4.00 | $14.00 | $45.00 | $45.00 | 5,460
2015 Formulary |
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 MediGold Medical Only (HMO)
| $45.00 |
$3,200 |
No Rx Coverage |
H3668 -013 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2016 MediGold Medical Only (HMO)
| $50.00 |
$3,200 |
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 MediGold Value Choice (PPO)
| $43.00 |
$3,200 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1846 -003 -0 | $0.00 | $15.00 | $45.00 | $45.00 | 4,973
2015 Formulary |
|
|
|
|
2016 MediGold Value Choice (PPO)
| $55.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $18.00 | $45.00 | $45.00 | 4,063 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 HumanaChoice H6609-081 (PPO)
| $53.00 |
$6,700 |
$320 | Yes, some additional gap coverage. |
H6609 -081 -0 | $6.00 | $18.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
|
|
|
2016 HumanaChoice H6609-081 (PPO)
| $59.00 |
$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 |
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 |
|
-- 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 --
|
H8953 -016 -0 | | | | | |
|
|
|
|
2016 Humana Gold Plus H8953-016 (HMO)
| $79.00 |
$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 Humana Gold Choice H8145-032 (PFFS)
| $87.00 |
n/a |
$320 | Yes, some additional gap coverage. |
H8145 -032 -0 | $4.00 | $13.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
|
|
|
2016 Humana Gold Choice H8145-032 (PFFS)
| $95.00 |
n/a |
$360 | Yes, some additional gap coverage. | $7.00 | $17.00 | $47.00 | $47.00 | 3,615 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 |
|
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 |
|
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 -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 |
|
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 MediGold Classic Preferred (HMO)
| $99.00 |
$3,200 |
$0 | Yes, some additional gap coverage. |
H3668 -005 -0 | $0.00 | $15.00 | $38.00 | $38.00 | 4,973
2015 Formulary |
|
|
|
|
2016 MediGold Classic Preferred (HMO)
| $110.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $45.00 | $45.00 | 4,063 2016 Formulary |
|
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 -054 -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 |
|
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 |
|
2015 MediGold Network Choice (PPO)
| $143.00 |
$3,200 |
$0 | Yes, some additional gap coverage. |
H1846 -001 -0 | $0.00 | $12.00 | $45.00 | $45.00 | 4,973
2015 Formulary |
|
|
|
|
2016 MediGold Network Choice (PPO)
| $155.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $45.00 | $45.00 | 4,063 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 --
|
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 |
|
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 AARP MedicareComplete Essential (HMO)
| $45.00 |
$6,700 |
No Rx Coverage |
H3659 -054 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to AARP MedicareComplete Essential (HMO) H5253-058 --
| | | | | |
|
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 AARP MedicareComplete Plan 2 (HMO)
| $45.00 |
$6,700 |
$170 | No additional gap coverage, only the Donut Hole Discount |
H3659 -031 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
|
|
|
|
-- Members will be assigned to AARP MedicareComplete Plan 2 (HMO) H5253-053 --
| | | | | |
|
2015 Aetna Medicare Select Plan (HMO)
| $15.00 |
$5,600 |
$0 | Yes, some additional gap coverage. |
H3623 -020 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 2,817
2015 Formulary |
|
|
|
|
-- Members will be assigned to Aetna Medicare Select Plan (HMO) H3931-110 --
| | | | | |
|
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 --
| | | | | |
|
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 UnitedHealthcare Dual Complete (HMO SNP)
| $11.60 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H3659 -056 -0 | | | | | 3,649
2015 Formulary |
|
|
|
|
-- Members will be assigned to UnitedHealthcare Dual Complete (HMO SNP) H5253-059 --
| | | | | |
|
2015 UnitedHealthcare Nursing Home Plan (HMO-POS SNP)
| $28.60 |
$5,000 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H3659 -058 -0 | | | | | 3,649
2015 Formulary |
|
|
|
|
-- Members will be assigned to UnitedHealthcare Nursing Home Plan (HMO-POS SNP) H5253-060 --
| | | | | |
|