There are 55 Medicare Advantage plans meeting your criteria.
2016 / 2017 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 |
2016 Aetna Better Health Premier Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H8026 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,090
2016 Formulary |
new |
new |
new |
|
2017 Aetna Better Health Premier Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,410 2017 Formulary |
|
2016 AmeriHealth Caritas VIP Care PLUS (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0192 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,260
2016 Formulary |
new |
new |
new |
|
2017 AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,168 2017 Formulary |
|
2016 BCN Advantage HMO-POS Basic (HMO-POS)
| $0.00 |
$4,200 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5883 -004 -5 | | | | | 3,693
2016 Formulary |
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2017 BCN Advantage HMO-POS Basic (HMO-POS)
| $0.00 |
$4,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $18.00 | $47.00 | $47.00 | 3,778 2017 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 |
2016 Fidelis SecureLife (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H9487 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,298
2016 Formulary |
new |
new |
new |
|
2017 Fidelis SecureLife (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,518 2017 Formulary |
|
2016 HAP Midwest MI Health Link (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H9712 -001 -0 | $0.00 | $0.00 | | | 3,122
2016 Formulary |
new |
new |
new |
|
2017 HAP Midwest MI Health Link (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | | | 3,762 2017 Formulary |
|
2016 HealthPlus MedicarePlus Option 0 (HMO)
| $0.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H2354 -015 -0 | $2.00 | $11.00 | $45.00 | $45.00 | 3,222
2016 Formulary |
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2017 HAP Senior Plus (HMO)
| $0.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $11.00 | $45.00 | $45.00 | 3,690 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 --
|
H2354 -019 -0 | | | | | |
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|
|
2017 HAP Senior Plus Medical Only (HMO)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 Harbor Medicare (HMO)
| $0.00 |
$3,400 |
$240 | No additional gap coverage, only the Donut Hole Discount |
H7960 -002 -0 | $10.00 | $20.00 | $45.00 | $45.00 | 5,318
2016 Formulary |
-- |
-- |
|
|
2017 Harbor Medicare (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $45.00 | $45.00 | 5,481 2017 Formulary |
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-- This plan not offered in 2016 --
|
H5216 -012 -0 | | | | | |
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2017 HumanaChoice H5216-012 (PPO)
| $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 |
2016 HumanaChoice R5826-053 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5826 -053 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
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2017 HumanaChoice R5826-053 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2016 --
|
H5475 -006 -0 | | | | | |
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2017 Meridian Essential (HMO)
| $0.00 |
$5,200 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | tbd |
|
2016 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H7844 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,041
2016 Formulary |
new |
new |
new |
|
2017 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,142 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 PriorityMedicare Key (HMO-POS)
| $0.00 |
$4,200 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H2320 -022 -5 | | | | | 3,754
2016 Formulary |
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|
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2017 PriorityMedicare Key (HMO-POS)
| $0.00 |
$4,200 |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,936 2017 Formulary |
|
2016 Molina Medicare Options Plus (HMO SNP)
| $33.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5926 -001 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,041
2016 Formulary |
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2017 Molina Medicare Options Plus (HMO SNP)
| $5.10 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,142 2017 Formulary |
|
2016 Meridian Prime (HMO)
| $0.00 |
$4,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5475 -002 -0 | $0.00 | $5.00 | $47.00 | $47.00 | n/a |
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2017 Meridian Easy (HMO)
| $15.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | tbd |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2016 PriorityMedicare Ideal (PPO)
| $15.00 |
$6,400 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H4875 -018 -5 | | | | | 3,754
2016 Formulary |
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2017 PriorityMedicare Ideal (PPO)
| $18.00 |
$6,400 |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,936 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H5883 -010 -0 | | | | | |
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|
|
2017 BCN Advantage HMO-POS Core (HMO-POS)
| $20.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2016 --
|
H5883 -009 -3 | | | | | |
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|
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2017 BCN Advantage HMO HealthySaver (HMO)
| $25.00 |
$4,500 |
$100 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $20.00 | $47.00 | $47.00 | 3,778 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 Medicare Plus Blue PPO Essential (PPO)
| $20.50 |
$6,400 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H9572 -004 -6 | | | | | 3,651
2016 Formulary |
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|
|
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2017 Medicare Plus Blue PPO Essential (PPO)
| $25.50 |
$6,400 |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,714 2017 Formulary |
|
2016 HAP Midwest Health Plan (HMO SNP)
| $33.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5685 -001 -0 | $7.00 | 25% | | | 3,122
2016 Formulary |
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|
|
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2017 HAP Midwest Health Plan (HMO SNP)
| $34.20 |
n/a |
$370 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | | | 3,762 2017 Formulary |
|
2016 Meridian Advantage Plan of Michigan (HMO SNP)
| $33.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5475 -001 -0 | | | | | n/a |
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|
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2017 Meridian Extra (HMO SNP)
| $34.20 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | tbd |
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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 2016 --
|
H2354 -020 -0 | | | | | |
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|
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2017 HAP Senior Plus Option 1 (HMO-POS)
| $48.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $11.00 | $45.00 | $45.00 | 3,690 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H9572 -005 -0 | | | | | |
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|
|
2017 Medicare Plus Blue PPO Core (PPO)
| $55.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 BCN Advantage HMO ConnectedCare (HMO)
| $47.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5883 -007 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,693
2016 Formulary |
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|
|
|
2017 BCN Advantage HMO ConnectedCare (HMO)
| $58.00 |
$3,800 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $47.00 | $47.00 | 3,778 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 Harbor Medicare Select (HMO)
| $47.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H7960 -001 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 5,318
2016 Formulary |
-- |
-- |
|
|
2017 Harbor Medicare Select (HMO)
| $60.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $4.00 | $10.00 | $45.00 | $45.00 | 5,481 2017 Formulary |
|
2016 PriorityMedicare Value (HMO-POS)
| $66.00 |
$4,500 |
$75 | No additional gap coverage, only the Donut Hole Discount |
H2320 -021 -0 | $5.00 | $12.00 | $45.00 | $45.00 | 3,754
2016 Formulary |
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|
|
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2017 PriorityMedicare Value (HMO-POS)
| $66.00 |
$4,500 |
$75 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $42.00 | $42.00 | 3,936 2017 Formulary |
|
2016 BCN Advantage HMO-POS Elements (HMO-POS)
| $59.00 |
$3,600 |
No Rx Coverage |
H5883 -001 -5 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2017 BCN Advantage HMO-POS Elements (HMO-POS)
| $69.00 |
$4,500 |
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 Humana Gold Plus H8908-001 (HMO)
| $89.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H8908 -001 -0 | $6.00 | $15.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
-- |
|
|
2017 Humana Gold Plus H8908-001 (HMO)
| $73.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $6.00 | $15.00 | $47.00 | $47.00 | 3,820 2017 Formulary |
|
2016 McLaren Advantage Sapphire (HMO)
| $81.00 |
$6,500 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H0141 -005 -3 | $5.00 | $35.00 | $85.00 | $85.00 | 3,122
2016 Formulary |
-- |
-- |
|
|
2017 McLaren Advantage Sapphire (HMO)
| $73.00 |
$6,500 |
$150 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $35.00 | $85.00 | $85.00 | 3,776 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H5521 -149 -0 | | | | | |
|
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|
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2017 Aetna Medicare Premier Plan (PPO)
| $75.00 |
$5,000 |
$245 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $5.00 | $47.00 | $47.00 | 3,670 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 --
|
H2354 -018 -0 | | | | | |
|
|
|
|
2017 HAP Senior Plus Henry Ford Tiered Access (HMO)
| $77.00 |
$4,500 |
$200 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $45.00 | $45.00 | 3,690 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H5475 -003 -0 | | | | | |
|
|
|
|
2017 Meridian Elite (HMO)
| $77.00 |
$4,200 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $45.00 | $45.00 | tbd |
|
2016 PriorityMedicare Merit (PPO)
| $95.00 |
$4,500 |
$75 | No additional gap coverage, only the Donut Hole Discount |
H4875 -016 -3 | $4.00 | $12.00 | $45.00 | $45.00 | 3,754
2016 Formulary |
|
|
|
|
2017 PriorityMedicare Merit (PPO)
| $95.00 |
$3,750 |
$75 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $42.00 | $42.00 | 3,936 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 --
|
H2354 -021 -0 | | | | | |
|
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|
|
2017 HAP Senior Plus Option 2 (HMO-POS)
| $97.00 |
$4,200 |
$100 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $45.00 | $45.00 | 3,690 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H5216 -011 -0 | | | | | |
|
|
|
|
2017 HumanaChoice H5216-011 (PPO)
| $108.00 |
$6,700 |
$400 | Yes, some additional gap coverage. | $6.00 | $15.00 | $47.00 | $47.00 | 3,820 2017 Formulary |
|
2016 Medicare Plus Blue PPO Vitality (PPO)
| $106.00 |
$5,400 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H9572 -002 -6 | | | | | 3,651
2016 Formulary |
|
|
|
|
2017 Medicare Plus Blue PPO Vitality (PPO)
| $111.00 |
$5,400 |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,714 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 Alliance Medicare PPO (PPO)
| $126.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2322 -008 -0 | $2.00 | $15.00 | $45.00 | $45.00 | 3,516
2016 Formulary |
|
|
|
|
2017 HAP Senior Plus Option 1 (PPO)
| $124.00 |
$4,200 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $45.00 | $45.00 | 3,690 2017 Formulary |
|
2016 HumanaChoice R5826-006 (Regional PPO)
| $121.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
R5826 -006 -0 | | | | | n/a |
|
|
|
|
2017 HumanaChoice R5826-006 (Regional PPO)
| $129.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | 20% | 25% | 25% | 25% | tbd |
|
2016 McLaren Advantage Diamond (HMO)
| $117.00 |
$3,200 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H0141 -004 -2 | $5.00 | $35.00 | $85.00 | $85.00 | 3,122
2016 Formulary |
-- |
-- |
|
|
2017 McLaren Advantage Diamond (HMO)
| $132.00 |
$3,200 |
$150 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $35.00 | $85.00 | $85.00 | 3,776 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 PriorityMedicare (HMO-POS)
| $146.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2320 -019 -0 | $4.00 | $10.00 | $40.00 | $40.00 | 3,754
2016 Formulary |
|
|
|
|
2017 PriorityMedicare (HMO-POS)
| $145.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $8.00 | $38.00 | $38.00 | 3,936 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H0141 -006 -2 | | | | | |
-- |
-- |
|
|
2017 McLaren Advantage Diamond + (HMO)
| $160.00 |
$2,500 |
$150 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $35.00 | $85.00 | $85.00 | 3,776 2017 Formulary |
|
2016 BCN Advantage HMO-POS Classic (HMO-POS)
| $154.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5883 -002 -7 | $3.00 | $10.00 | $40.00 | $40.00 | 3,693
2016 Formulary |
|
|
|
|
2017 BCN Advantage HMO-POS Classic (HMO-POS)
| $166.00 |
$3,800 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $40.00 | $40.00 | 3,778 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 Medicare Plus Blue PPO Signature (PPO)
| $169.00 |
$4,400 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H9572 -001 -6 | $3.00 | $15.00 | $45.00 | $45.00 | 3,651
2016 Formulary |
|
|
|
|
2017 Medicare Plus Blue PPO Signature (PPO)
| $174.00 |
$4,700 |
$105 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $45.00 | $45.00 | 3,714 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H4262 -001 -6 | | | | | |
|
|
|
|
2017 Blue Cross Medicare Private Fee for Service (PFFS)
| $200.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 PriorityMedicare Select (PPO)
| $193.00 |
$3,750 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4875 -017 -5 | $4.00 | $9.00 | $40.00 | $40.00 | 3,754
2016 Formulary |
|
|
|
|
2017 PriorityMedicare Select (PPO)
| $201.00 |
$3,750 |
$0 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $7.00 | $37.00 | $37.00 | 3,936 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 Alliance Medicare PPO (PPO)
| $210.00 |
$3,400 |
$150 | Yes, some additional gap coverage. |
H2322 -004 -0 | $4.00 | $10.00 | $40.00 | $40.00 | 3,516
2016 Formulary |
|
|
|
|
2017 HAP Senior Plus Option 2 (PPO)
| $208.00 |
$4,000 |
$150 | Yes, some additional gap coverage. | $4.00 | $10.00 | $40.00 | $40.00 | 3,690 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H2354 -022 -0 | | | | | |
|
|
|
|
2017 HAP Senior Plus Option 3 (HMO-POS)
| $218.00 |
$4,000 |
$50 | Yes, some additional gap coverage. | $4.00 | $10.00 | $45.00 | $45.00 | 3,690 2017 Formulary |
|
2016 BCN Advantage HMO-POS Prestige (HMO-POS)
| $283.00 |
$3,200 |
$0 | Yes, some additional gap coverage. |
H5883 -003 -5 | $3.00 | $10.00 | $35.00 | $35.00 | 3,693
2016 Formulary |
|
|
|
|
2017 BCN Advantage HMO-POS Prestige (HMO-POS)
| $303.00 |
$3,800 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $35.00 | $35.00 | 3,778 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 Medicare Plus Blue PPO Assure (PPO)
| $294.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H9572 -003 -6 | $3.00 | $14.00 | $40.00 | $40.00 | 3,696
2016 Formulary |
|
|
|
|
2017 Medicare Plus Blue PPO Assure (PPO)
| $314.00 |
$4,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $14.00 | $40.00 | $40.00 | 3,714 2017 Formulary |
|
2016 HAP Senior Plus - Henry Ford (HMO)
| $79.00 |
$3,400 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H2312 -004 -0 | $2.00 | $15.00 | $45.00 | $45.00 | 3,516
2016 Formulary |
|
|
|
|
-- Members will be assigned to HAP Senior Plus Henry Ford Tiered Access (HMO) H2354-018 --
| | | | | |
|
2016 HAP Senior Plus - Henry Ford (HMO)
| $55.00 |
$3,400 |
No Rx Coverage |
H2312 -006 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to HAP Senior Plus Medical Only (HMO) H2354-019 --
| | | | | |
|
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 |
2016 HAP Senior Plus - Expanded Network (HMO-POS)
| $59.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2312 -012 -0 | $6.00 | $11.00 | $45.00 | $45.00 | 3,516
2016 Formulary |
|
|
|
|
-- Members will be assigned to HAP Senior Plus Option 1 (HMO-POS) H2354-020 --
| | | | | |
|
2016 HAP Senior Plus - Expanded Network (HMO-POS)
| $109.00 |
$3,400 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H2312 -007 -0 | $2.00 | $15.00 | $45.00 | $45.00 | 3,516
2016 Formulary |
|
|
|
|
-- Members will be assigned to HAP Senior Plus Option 2 (HMO-POS) H2354-021 --
| | | | | |
|
2016 HealthPlus MedicarePlus Option 1 (HMO)
| $98.00 |
$4,900 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H2354 -001 -0 | $3.00 | $15.00 | $47.00 | $47.00 | 3,222
2016 Formulary |
|
|
|
|
-- Members will be assigned to HAP Senior Plus Option 2 (HMO-POS) H2354-021 --
| | | | | |
|
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 HAP Senior Plus - Expanded Network (HMO-POS)
| $220.00 |
$3,400 |
$50 | Yes, some additional gap coverage. |
H2312 -010 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,516
2016 Formulary |
|
|
|
|
-- Members will be assigned to HAP Senior Plus Option 3 (HMO-POS) H2354-022 --
| | | | | |
|