There are 60 Medicare Advantage plans meeting your criteria.
2016 / 2017 Medicare Advantage Plan Information
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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 |
2016 Health Net Seniority Plus Amber II (HMO SNP)
| $31.00 |
n/a |
$280 | No additional gap coverage, only the Donut Hole Discount |
H0562 -110 -2 | $0.00 | $20.00 | $47.00 | $47.00 | 4,057
2016 Formulary |
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|
|
|
2017 Health Net Seniority Plus Amber II (HMO SNP)
| tbd |
n/a |
$155 | n/a | $0.00 | $20.00 | $47.00 | $47.00 | 4,290 2017 Formulary |
|
2016 Health Net Seniority Plus Sapphire (HMO)
| $31.00 |
$6,700 |
$290 | No additional gap coverage, only the Donut Hole Discount |
H0562 -111 -2 | $0.00 | $20.00 | $47.00 | $47.00 | 4,057
2016 Formulary |
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|
|
|
2017 Health Net Seniority Plus Sapphire (HMO)
| tbd |
n/a |
$140 | n/a | $0.00 | $20.00 | $47.00 | $47.00 | 4,290 2017 Formulary |
|
2016 AARP MedicareComplete SecureHorizons Essential (HMO)
| $0.00 |
$4,900 |
No Rx Coverage |
H0543 -121 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2017 AARP MedicareComplete SecureHorizons Essential (HMO)
| $0.00 |
$4,900 |
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 |
2016 AARP MedicareComplete SecureHorizons Plan 1 (HMO)
| $0.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0543 -007 -0 | $4.00 | $8.00 | $47.00 | $47.00 | 3,529
2016 Formulary |
|
|
|
|
2017 AARP MedicareComplete SecureHorizons Plan 1 (HMO)
| $0.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $8.00 | $47.00 | $47.00 | 3,683 2017 Formulary |
|
2016 AARP MedicareComplete SecureHorizons Plan 2 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0543 -144 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,529
2016 Formulary |
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|
|
|
2017 AARP MedicareComplete SecureHorizons Plan 2 (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $47.00 | $47.00 | 3,683 2017 Formulary |
|
2016 Aetna Medicare Select Plan (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0523 -022 -0 | $0.00 | $6.00 | $47.00 | $47.00 | 3,279
2016 Formulary |
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|
|
|
2017 Aetna Medicare Select Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,894 2017 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 |
2016 Heritage Preferred Choice (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3815 -012 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,200
2016 Formulary |
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|
|
|
2017 Alignment Health Plan Heritage Preferred Choice (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $30.00 | $30.00 | 3,249 2017 Formulary |
|
2016 My Choice Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3815 -001 -0 | $3.00 | $5.00 | $30.00 | $30.00 | 3,200
2016 Formulary |
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|
|
|
2017 Alignment Health Plan My Choice (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $5.00 | $30.00 | $30.00 | 3,249 2017 Formulary |
|
2016 Anthem MediBlue Plus (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H0564 -067 -2 | $5.00 | $15.00 | $42.00 | $42.00 | 3,266
2016 Formulary |
|
-- |
|
|
2017 Anthem MediBlue Plus (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $42.00 | $42.00 | 3,666 2017 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 |
2016 Anthem MediBlue Select (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0564 -077 -0 | $3.00 | $10.00 | $42.00 | $42.00 | 3,266
2016 Formulary |
|
-- |
|
|
2017 Anthem MediBlue Select (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $42.00 | $42.00 | 3,666 2017 Formulary |
|
2016 Blue Shield 65 Plus (HMO)
| $0.00 |
$3,200 |
$0 | Yes, some additional gap coverage. |
H0504 -026 -0 | $0.00 | $5.00 | $40.00 | $40.00 | 3,490
2016 Formulary |
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|
|
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2017 Blue Shield 65 Plus (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $40.00 | $40.00 | 3,616 2017 Formulary |
|
2016 Bridges Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0838 -028 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,222
2016 Formulary |
|
-- |
|
|
2017 Bridges Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,504 2017 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 |
2016 Classic Care (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0838 -025 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,222
2016 Formulary |
|
-- |
|
|
2017 Classic Care (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,504 2017 Formulary |
|
2016 Easy Choice Best Plan (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5087 -016 -0 | $7.00 | $15.00 | $47.00 | $47.00 | 4,065
2016 Formulary |
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|
|
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2017 Easy Choice Best Plan (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $7.00 | $15.00 | $47.00 | $47.00 | 4,156 2017 Formulary |
|
2016 Health Net Gold Select (HMO)
| $0.00 |
$2,200 |
$0 | Yes, some additional gap coverage. |
H0562 -101 -2 | $0.00 | $10.00 | $37.00 | $37.00 | 4,057
2016 Formulary |
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|
|
|
2017 Health Net Gold Select (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $37.00 | $37.00 | 4,290 2017 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 |
2016 Health Net Seniority Plus Green (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H0562 -044 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2017 Health Net Seniority Plus Green (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 Healthy Heart Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0838 -030 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,222
2016 Formulary |
|
-- |
|
|
2017 Healthy Heart Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,504 2017 Formulary |
|
2016 Heart First (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5425 -033 -0 | $5.00 | $12.00 | $47.00 | $47.00 | 3,048
2016 Formulary |
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|
|
|
2017 Heart First (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $7.00 | $42.00 | $42.00 | 3,190 2017 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 |
2016 Hope Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0838 -032 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,222
2016 Formulary |
|
-- |
|
|
2017 Hope Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,504 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H5619 -039 -1 | | | | | |
|
-- |
|
|
2017 Humana Gold Plus H5619-039 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $47.00 | $47.00 | 3,820 2017 Formulary |
|
2016 IEHP DualChoice (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5355 -001 -0 | $0.00 | $0.00 | $0.00 | | 2,850
2016 Formulary |
-- |
-- |
-- |
|
2017 IEHP DualChoice (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 2,975 2017 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 |
2016 In Control Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0838 -026 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,222
2016 Formulary |
|
-- |
|
|
2017 In Control Drug Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $45.00 | $45.00 | 3,504 2017 Formulary |
|
2016 Inter Valley Health Plan Desert Preferred Choice (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0545 -012 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,176
2016 Formulary |
|
|
|
|
2017 Inter Valley Health Plan Desert Preferred Choice (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $47.00 | $47.00 | 3,305 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H0545 -001 -0 | | | | | |
|
|
|
|
2017 Inter Valley Health Plan Service To Seniors (HMO)
| $0.00 |
$2,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $47.00 | $47.00 | 2,875 2017 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 |
2016 Kaiser Permanente Senior Advantage Inland Empire (HMO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. |
H0524 -015 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 5,780
2016 Formulary |
|
|
|
|
2017 Kaiser Permanente Senior Advantage Inland Empire (HMO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. | $5.00 | $12.00 | $45.00 | $45.00 | 5,995 2017 Formulary |
|
2016 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H8677 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,041
2016 Formulary |
-- |
-- |
-- |
|
2017 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,142 2017 Formulary |
|
2016 SCAN Classic (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5425 -008 -0 | $5.00 | $12.00 | $47.00 | $47.00 | 3,048
2016 Formulary |
|
|
|
|
2017 SCAN Classic (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.00 | $42.00 | $42.00 | 3,190 2017 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 |
2016 SCAN Healthy at Home (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H9104 -006 -0 | $3.00 | $10.00 | $47.00 | $47.00 | 3,048
2016 Formulary |
|
-- |
|
|
2017 SCAN Healthy at Home (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,190 2017 Formulary |
|
2016 Golden State Medicare Health Plan, Golden (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H2241 -006 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 3,969
2016 Formulary |
|
|
|
|
2017 Golden State Medicare Health Plan, Golden (HMO)
| $4.40 |
$3,400 |
$0 | Yes, some additional gap coverage. | $10.00 | $15.00 | $47.00 | $47.00 | 4,215 2017 Formulary |
|
2016 Humana Gold Plus H5619-037 (HMO)
| $23.40 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5619 -037 -0 | $2.00 | $8.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
-- |
|
|
2017 Humana Gold Plus H5619-037 (HMO)
| $16.50 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,820 2017 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 |
2016 SCAN Classic II (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H5425 -061 -0 | $7.00 | $12.00 | $47.00 | $47.00 | 3,048
2016 Formulary |
|
|
|
|
2017 SCAN Classic II (HMO)
| $24.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $2.00 | $7.00 | $42.00 | $42.00 | 3,190 2017 Formulary |
|
2016 AARP MedicareComplete SecureHorizons Plan 3 (HMO)
| $27.40 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H0543 -153 -0 | | | | | 3,529
2016 Formulary |
|
|
|
|
2017 AARP MedicareComplete SecureHorizons Plan 3 (HMO)
| $26.70 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,683 2017 Formulary |
|
2016 Easy Choice Plus Plan (HMO)
| $12.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5087 -002 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 4,065
2016 Formulary |
|
|
|
|
2017 Easy Choice Plus Plan (HMO)
| $27.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,156 2017 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 |
2016 Molina Medicare Options Plus (HMO SNP)
| $18.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5810 -001 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,041
2016 Formulary |
|
|
|
|
2017 Molina Medicare Options Plus (HMO SNP)
| $29.90 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $45.00 | $45.00 | 3,142 2017 Formulary |
|
2016 Health Net Healthy Heart (HMO)
| $30.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H0562 -100 -2 | $5.00 | $10.00 | $37.00 | $37.00 | 4,057
2016 Formulary |
|
|
|
|
2017 Health Net Healthy Heart (HMO)
| $30.00 |
$2,400 |
$0 | Yes, some additional gap coverage. | $5.00 | $10.00 | $37.00 | $37.00 | 4,290 2017 Formulary |
|
2016 SCAN Connections (HMO SNP)
| $31.10 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5425 -010 -0 | | | | | 3,048
2016 Formulary |
|
|
|
|
2017 SCAN Connections (HMO SNP)
| $30.80 |
n/a |
$400 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 3,190 2017 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 |
2016 SCAN Connections at Home (HMO SNP)
| $31.10 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5425 -030 -0 | | | | | 3,048
2016 Formulary |
|
|
|
|
2017 SCAN Connections at Home (HMO SNP)
| $31.70 |
n/a |
$400 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 3,190 2017 Formulary |
|
2016 Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
| $25.20 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0524 -029 -0 | $8.00 | $17.00 | $47.00 | $47.00 | 5,780
2016 Formulary |
|
|
|
|
2017 Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
| $32.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $20.00 | $47.00 | $47.00 | 5,995 2017 Formulary |
|
2016 Coordinated Choice Plan (HMO)
| $31.00 |
$6,700 |
$360 | Yes, some additional gap coverage. |
H5928 -037 -0 | $0.00 | 25% | 25% | 25% | 2,979
2016 Formulary |
|
|
|
|
2017 Coordinated Choice Plan (HMO)
| $36.20 |
$6,700 |
$400 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 3,110 2017 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 |
2016 Health Net Seniority Plus Amber I (HMO SNP)
| $31.00 |
n/a |
$270 | No additional gap coverage, only the Donut Hole Discount |
H0562 -055 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 4,057
2016 Formulary |
|
|
|
|
2017 Health Net Seniority Plus Amber I (HMO SNP)
| $36.20 |
n/a |
$175 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,290 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H0562 -110 -3 | | | | | |
|
|
|
|
2017 Health Net Seniority Plus Amber II (HMO SNP)
| $36.20 |
n/a |
$155 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,290 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H0562 -111 -3 | | | | | |
|
|
|
|
2017 Health Net Seniority Plus Sapphire (HMO)
| $36.20 |
$6,700 |
$140 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,290 2017 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 2016 --
|
H3561 -004 -0 | | | | | |
new |
new |
new |
|
2017 Health Net Seniority Plus Sapphire Premier (HMO)
| $36.20 |
$6,700 |
$185 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 4,290 2017 Formulary |
|
2016 CalPlus Plan (HMO)
| $31.00 |
$3,400 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3815 -009 -0 | | | | | 3,200
2016 Formulary |
|
|
|
|
2017 Alignment Health Plan CalPlus (HMO)
| $36.30 |
$3,400 |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,232 2017 Formulary |
|
2016 Anthem MediBlue Coordination Plus (HMO)
| $31.00 |
$6,700 |
$360 | Yes, some additional gap coverage. |
H0564 -079 -0 | $0.00 | $1.00 | $47.00 | $47.00 | 3,266
2016 Formulary |
|
-- |
|
|
2017 Anthem MediBlue Coordination Plus (HMO)
| $36.30 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $45.00 | $45.00 | 3,666 2017 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 |
2016 Bridges - Dual Access (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H0838 -029 -0 | 0% | 0% | 0% | 0% | 3,222
2016 Formulary |
|
-- |
|
|
2017 Bridges - Dual Access (HMO SNP)
| $36.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | 0% | 25% | 25% | 25% | 3,504 2017 Formulary |
|
2016 Classic Choice for Medi-Medi (HMO)
| $31.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H0838 -033 -0 | 0% | 0% | 0% | 0% | 3,222
2016 Formulary |
|
-- |
|
|
2017 Classic Choice for Medi-Medi (HMO)
| $36.30 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | 0% | 25% | 25% | 25% | 3,504 2017 Formulary |
|
2016 Dual Coverage (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H0838 -024 -0 | $0.00 | $0.00 | 25% | 25% | 3,222
2016 Formulary |
|
-- |
|
|
2017 Dual Coverage (HMO SNP)
| $36.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | 0% | 25% | 25% | 25% | 3,504 2017 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 |
2016 Harmony - Dual Access (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H0838 -020 -0 | $0.00 | $13.00 | 25% | 25% | 3,222
2016 Formulary |
|
-- |
|
|
2017 Harmony - Dual Access (HMO SNP)
| $36.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | 0% | 25% | 25% | 25% | 3,504 2017 Formulary |
|
2016 Healthy Heart - Dual Access (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H0838 -031 -0 | 0% | 0% | 0% | 0% | 3,222
2016 Formulary |
|
-- |
|
|
2017 Healthy Heart - Dual Access (HMO SNP)
| $36.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | 0% | 25% | 25% | 25% | 3,504 2017 Formulary |
|
2016 In Control - Dual Access (HMO SNP)
| $31.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H0838 -027 -0 | 0% | 0% | 0% | 0% | 3,222
2016 Formulary |
|
-- |
|
|
2017 In Control - Dual Access (HMO SNP)
| $36.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | 0% | 25% | 25% | 25% | 3,504 2017 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 |
2016 SCAN Plus (HMO)
| $31.10 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5425 -045 -0 | | | | | 3,048
2016 Formulary |
|
|
|
|
2017 SCAN Plus (HMO)
| $36.30 |
$4,500 |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | 25% | 25% | 25% | 3,190 2017 Formulary |
|
2016 VillageHealth (HMO-POS SNP)
| $31.10 |
n/a |
$310 | No additional gap coverage, only the Donut Hole Discount |
H5943 -001 -0 | $3.00 | $16.00 | 25% | 25% | 3,048
2016 Formulary |
|
-- |
|
|
2017 VillageHealth (HMO-POS SNP)
| $36.30 |
n/a |
$370 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | 25% | 25% | 3,190 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H5521 -126 -0 | | | | | |
|
|
|
|
2017 Aetna Medicare Choice Plan (PPO)
| $73.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,894 2017 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 |
2016 Anthem MediBlue Access (PPO)
| $157.00 |
$6,700 |
$75 | No additional gap coverage, only the Donut Hole Discount |
H8552 -021 -0 | $5.00 | $10.00 | $42.00 | $42.00 | 3,266
2016 Formulary |
|
|
|
|
2017 Anthem MediBlue Access (PPO)
| $165.00 |
$6,700 |
$165 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $42.00 | $42.00 | 3,666 2017 Formulary |
|
2016 Humana Gold Plus H5619-019 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5619 -019 -0 | $0.00 | $10.00 | $35.00 | $35.00 | 3,615
2016 Formulary |
|
-- |
|
|
-- Members will be assigned to Humana Gold Plus H5619-039 (HMO) H5619-039 --
| | | | | |
|
2016 Humana Gold Plus H5619-020 (HMO)
| $48.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5619 -020 -0 | $0.00 | $10.00 | $30.00 | $30.00 | 3,615
2016 Formulary |
|
-- |
|
|
-- Members will be assigned to Humana Gold Plus H5619-039 (HMO) H5619-039 --
| | | | | |
|
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 |
2016 Care1st AdvantageOptimum Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5928 -012 -0 | $0.00 | $5.00 | $40.00 | $40.00 | 2,979
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 Humana Gold Plus H5619-018 (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5619 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
|
-- |
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 Molina Medicare Options (HMO)
| $28.60 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5810 -011 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,041
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|