There are 53 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 Advantra Silver (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3959 -011 -0 | $7.00 | $12.00 | $45.00 | $45.00 | 3,463
2015 Formulary |
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|
|
|
2016 Advantra Silver (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $15.00 | $47.00 | $47.00 | 3,417 2016 Formulary |
|
2015 Advantra Silver (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5522 -004 -0 | $7.00 | $13.00 | $45.00 | $45.00 | 3,463
2015 Formulary |
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2016 Advantra Silver (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $9.00 | $15.00 | $47.00 | $47.00 | 3,417 2016 Formulary |
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-- This plan not offered in 2015 --
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H3949 -026 -0 | | | | | |
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2016 Cigna-HealthSpring Advantage (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 |
-- This plan not offered in 2015 --
|
H3949 -028 -0 | | | | | |
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|
|
|
2016 Cigna-HealthSpring PreventiveCare (HMO)
| $0.00 |
$6,700 |
$280 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $47.00 | $47.00 | 3,253 2016 Formulary |
|
2015 Geisinger Gold Classic Complete Rx (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3954 -158 -4 | $6.00 | $20.00 | $39.00 | $39.00 | 3,379
2015 Formulary |
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|
|
|
2016 Geisinger Gold Classic Complete Rx (HMO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,569 2016 Formulary |
|
2015 Geisinger Gold Preferred Complete Rx (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3924 -060 -4 | $6.00 | $20.00 | $39.00 | $39.00 | 3,379
2015 Formulary |
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|
|
2016 Geisinger Gold Preferred Complete Rx (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,569 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 R5826-062 (Regional PPO)
| $0.00 |
$3,400 |
No Rx Coverage |
R5826 -062 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
2016 HumanaChoice R5826-062 (Regional PPO)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 SeniorBlue - Option 3 (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3962 -007 -0 | $4.00 | $12.00 | $38.00 | $38.00 | n/a |
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2016 SeniorBlue - Option 3 (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $38.00 | $38.00 | 3,020 2016 Formulary |
|
2015 Advantra Cares (HMO SNP)
| $33.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H3959 -036 -0 | | | | | 3,221
2015 Formulary |
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2016 Advantra Cares (HMO SNP)
| $11.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,090 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 --
|
H3957 -040 -0 | | | | | |
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2016 Community Blue Medicare HMO Signature (HMO)
| $15.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $20.00 | $47.00 | $47.00 | 4,465 2016 Formulary |
|
2015 Advantra Basic Medical (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H3959 -041 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 Advantra Basic Medical (HMO)
| $19.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 Humana Gold Plus H6859-003 (HMO)
| $0.00 |
$6,700 |
$320 | Yes, some additional gap coverage. |
H6859 -003 -0 | $6.00 | $18.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
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-- |
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2016 Humana Gold Plus H6859-003 (HMO)
| $19.00 |
$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 --
|
H3949 -030 -0 | | | | | |
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2016 Cigna-HealthSpring Preferred (HMO)
| $20.00 |
$6,700 |
$280 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,253 2016 Formulary |
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-- This plan not offered in 2015 --
|
H0710 -018 -0 | | | | | |
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-- |
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2016 UnitedHealthcare Assisted Living Plan (PPO SNP)
| $25.70 |
n/a |
$50 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $11.00 | $47.00 | $47.00 | 3,529 2016 Formulary |
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-- This plan not offered in 2015 --
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H3113 -009 -0 | | | | | |
|
-- |
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2016 UnitedHealthcare Dual Complete (HMO SNP)
| $29.70 |
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 Geisinger Gold Classic Advantage (HMO)
| $50.00 |
$3,400 |
No Rx Coverage |
H3954 -156 -4 | This plan does NOT include Prescription Drug coverage. | |
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2016 Geisinger Gold Classic Advantage (HMO)
| $30.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2015 --
|
H3949 -009 -0 | | | | | |
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|
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2016 Cigna-HealthSpring TotalCare (HMO SNP)
| $35.10 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,253 2016 Formulary |
|
2015 AmeriHealth VIP Care (HMO SNP)
| $33.90 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H4227 -002 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,163
2015 Formulary |
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2016 AmeriHealth VIP Care (HMO SNP)
| $35.30 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $14.00 | $47.00 | $47.00 | 3,316 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 Diamond (HMO SNP)
| $33.90 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5932 -001 -0 | | | | | 2,634
2015 Formulary |
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2016 Gateway Health Medicare Assured Diamond (HMO SNP)
| $35.30 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,902 2016 Formulary |
|
2015 Gateway Health Medicare Assured Ruby (HMO SNP)
| $33.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5932 -009 -0 | | | | | 2,634
2015 Formulary |
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2016 Gateway Health Medicare Assured Ruby (HMO SNP)
| $35.30 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,902 2016 Formulary |
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2015 Geisinger Gold Secure Rx (HMO SNP)
| $33.90 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H3954 -097 -0 | | | | | 3,379
2015 Formulary |
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2016 Geisinger Gold Secure Rx (HMO SNP)
| $35.30 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,569 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 -017 -0 | | | | | |
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-- |
|
|
2016 UnitedHealthcare Nursing Home Plan (PPO SNP)
| $35.30 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,529 2016 Formulary |
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-- This plan not offered in 2015 --
|
H2228 -035 -0 | | | | | |
|
-- |
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2016 AARP MedicareComplete Choice Plan 1 (PPO)
| $39.00 |
$6,700 |
$230 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,529 2016 Formulary |
|
2015 HumanaChoice H5525-006 (PPO)
| $34.00 |
$6,700 |
$320 | Yes, some additional gap coverage. |
H5525 -006 -0 | $6.00 | $18.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
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|
|
|
2016 HumanaChoice H5525-006 (PPO)
| $39.00 |
$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 --
|
H3949 -027 -0 | | | | | |
|
|
|
|
2016 Cigna-HealthSpring Premier (HMO-POS)
| $39.50 |
$6,700 |
$280 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $10.00 | $40.00 | $40.00 | 3,253 2016 Formulary |
|
2015 SeniorBlue - Option 2 (PPO)
| $72.40 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3923 -013 -0 | $5.00 | $17.00 | $38.00 | $38.00 | n/a |
|
|
|
|
2016 SeniorBlue - Option 2 (PPO)
| $50.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $39.00 | $39.00 | 3,020 2016 Formulary |
|
2015 Advantra Silver Plus (HMO)
| $49.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3959 -039 -0 | $4.00 | $22.00 | $45.00 | $45.00 | 3,463
2015 Formulary |
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|
|
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2016 Advantra Silver Plus (HMO)
| $55.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $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 Freedom Blue PPO ValueRx (PPO)
| $95.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3916 -018 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 4,522
2015 Formulary |
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|
|
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2016 Freedom Blue PPO ValueRx (PPO)
| $59.50 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $47.00 | $47.00 | 4,465 2016 Formulary |
|
2015 Freedom Blue PPO Value (PPO)
| $95.00 |
$6,700 |
No Rx Coverage |
H3916 -012 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2016 Freedom Blue PPO Basic (PPO)
| $64.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 Gateway Health Medicare Assured Gold (HMO SNP)
| $46.30 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5932 -007 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 2,634
2015 Formulary |
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|
|
|
2016 Gateway Health Medicare Assured Gold (HMO SNP)
| $67.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $45.00 | $45.00 | 2,902 2016 Formulary |
|
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 --
|
H2228 -036 -0 | | | | | |
|
-- |
|
|
2016 AARP MedicareComplete Choice Plan 2 (PPO)
| $69.00 |
$4,900 |
$210 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,529 2016 Formulary |
|
2015 Aetna Medicare Standard Plan (HMO)
| $49.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3931 -070 -0 | $0.00 | $15.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
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|
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2016 Aetna Medicare Standard Plan (HMO)
| $69.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $46.00 | $46.00 | 3,417 2016 Formulary |
|
2015 Geisinger Gold Preferred Advantage Rx (PPO)
| $75.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3924 -059 -4 | $3.00 | $18.00 | $39.00 | $39.00 | 3,379
2015 Formulary |
|
|
|
|
2016 Geisinger Gold Preferred Advantage Rx (PPO)
| $69.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,569 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 Advantra Silver Plus (PPO)
| $67.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5522 -013 -0 | $7.00 | $9.00 | $45.00 | $45.00 | 3,463
2015 Formulary |
|
|
|
|
2016 Advantra Silver Plus (PPO)
| $83.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $47.00 | $100.00 | $100.00 | 3,543 2016 Formulary |
|
2015 SeniorBlue - Option 2 (HMO)
| $117.50 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3962 -004 -0 | $4.00 | $12.00 | $38.00 | $38.00 | n/a |
|
|
|
|
2016 SeniorBlue - Option 2 (HMO)
| $95.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $38.00 | $38.00 | 4,063 2016 Formulary |
|
2015 Gateway Health Medicare Assured Platinum (HMO SNP)
| $77.80 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5932 -008 -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 |
2015 HumanaChoice R5826-002 (Regional PPO)
| $97.00 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
R5826 -002 -0 | $7.00 | $18.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2016 HumanaChoice R5826-002 (Regional PPO)
| $99.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | $9.00 | $20.00 | $47.00 | $47.00 | tbd |
|
2015 Geisinger Gold Classic Advantage Rx (HMO)
| $119.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3954 -157 -4 | $3.00 | $18.00 | $39.00 | $39.00 | 3,379
2015 Formulary |
|
|
|
|
2016 Geisinger Gold Classic Advantage Rx (HMO)
| $119.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,569 2016 Formulary |
|
2015 Aetna Medicare Premier Plan (PPO)
| $124.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5521 -012 -0 | $0.00 | $15.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
|
-- |
|
|
2016 Aetna Medicare Premier Plan (PPO)
| $123.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $47.00 | 50% | 50% | 3,543 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 Advantra Gold (PPO)
| $116.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5522 -002 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,463
2015 Formulary |
|
|
|
|
2016 Advantra Gold (PPO)
| $125.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $4.00 | $10.00 | $47.00 | $47.00 | 3,417 2016 Formulary |
|
2015 SeniorBlue - Option 1 (HMO)
| $167.50 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3962 -001 -0 | $3.00 | $9.00 | $38.00 | $38.00 | n/a |
|
|
|
|
2016 SeniorBlue - Option 1 (HMO)
| $165.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $9.00 | $38.00 | $38.00 | 4,063 2016 Formulary |
|
2015 Freedom Blue PPO Standard (PPO)
| $246.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3916 -015 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 5,455
2015 Formulary |
|
|
|
|
2016 Freedom Blue PPO Standard (PPO)
| $174.50 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $47.00 | $47.00 | 4,465 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 SeniorBlue - Option 1 (PPO)
| $191.90 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3923 -017 -0 | $4.00 | $10.00 | $38.00 | $38.00 | n/a |
|
|
|
|
2016 SeniorBlue - Option 1 (PPO)
| $175.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $38.00 | $38.00 | 4,063 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 Humana Gold Choice H8145-053 (PFFS)
| $195.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H8145 -053 -0 | $6.00 | $18.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
|
|
|
2016 Humana Gold Choice H8145-053 (PFFS)
| $195.00 |
n/a |
$0 | 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 Freedom Blue PPO Deluxe (PPO)
| $296.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3916 -005 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 5,455
2015 Formulary |
|
|
|
|
2016 Freedom Blue PPO Deluxe (PPO)
| $279.50 |
$6,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $15.00 | $47.00 | $47.00 | 4,465 2016 Formulary |
|
2015 AARP MedicareComplete Choice Plan 1 (PPO)
| $39.00 |
$6,700 |
$230 | No additional gap coverage, only the Donut Hole Discount |
H3921 -008 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
|
|
|
|
-- Members will be assigned to AARP MedicareComplete Choice Plan 1 (PPO) H2228-035 --
| | | | | |
|
2015 AARP MedicareComplete Choice Plan 2 (PPO)
| $59.00 |
$5,500 |
$210 | No additional gap coverage, only the Donut Hole Discount |
H3921 -009 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
|
|
|
|
-- Members will be assigned to AARP MedicareComplete Choice Plan 2 (PPO) H2228-036 --
| | | | | |
|
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 Blue PPO HD Rx (PPO)
| $70.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3916 -025 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 4,522
2015 Formulary |
|
|
|
|
-- Members will be assigned to Freedom Blue PPO ValueRx (PPO) H3916-018 --
| | | | | |
|
2015 Geisinger Gold Preferred Essential Rx (PPO)
| $31.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3924 -054 -0 | $6.00 | $20.00 | $39.00 | $39.00 | 3,379
2015 Formulary |
|
|
|
|
-- Members will be assigned to Geisinger Gold Preferred Advantage Rx (PPO) H3924-059 --
| | | | | |
|
2015 UnitedHealthcare Nursing Home Plan (PPO SNP)
| $27.80 |
$3,500 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H3912 -001 -0 | | | | | 3,649
2015 Formulary |
|
|
|
|
-- Members will be assigned to UnitedHealthcare Nursing Home Plan (PPO SNP) H0710-017 --
| | | | | |
|
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 Geisinger Gold Reserve (MSA)
| $0.00 |
n/a |
No Rx Coverage |
H8468 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Aetna Medicare Basic Plan (HMO)
| $25.00 |
$6,700 |
No Rx Coverage |
H3931 -054 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|