There are 74 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 SmartFund (MSA)
| $0.00 |
n/a |
No Rx Coverage |
H5613 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
|
2017 SmartFund (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 AARP MedicareComplete Essential (HMO)
| $0.00 |
$5,200 |
No Rx Coverage |
H3307 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
2017 AARP MedicareComplete Essential (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 AARP MedicareComplete Plan 1 (HMO)
| $0.00 |
$6,700 |
$245 | No additional gap coverage, only the Donut Hole Discount |
H3307 -012 -0 | $2.00 | $10.00 | $45.00 | $45.00 | 3,529
2016 Formulary |
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|
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2017 AARP MedicareComplete Plan 1 (HMO)
| $0.00 |
$6,700 |
$245 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $45.00 | $45.00 | 3,683 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 |
-- This plan not offered in 2016 --
|
H5521 -120 -0 | | | | | |
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|
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2017 Aetna Medicare Elite Plan (PPO)
| $0.00 |
$6,700 |
$250 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,670 2017 Formulary |
|
2016 Affinity Medicare Passport Essentials (HMO)
| $0.00 |
$6,700 |
$250 | Yes, some additional gap coverage. |
H5991 -003 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,020
2016 Formulary |
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-- |
|
|
2017 Affinity Medicare Passport Essentials (HMO)
| $0.00 |
$6,700 |
$250 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,098 2017 Formulary |
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-- This plan not offered in 2016 --
|
H4922 -005 -1 | | | | | |
-- |
-- |
-- |
|
2017 AgeWell New York LiveWell (HMO)
| $0.00 |
$6,700 |
$370 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $20.00 | $47.00 | $47.00 | 3,176 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 BasiCare with Part D (PPO)
| $50.00 |
$4,000 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H9615 -010 -0 | $3.00 | $15.00 | $45.00 | $45.00 | 3,672
2016 Formulary |
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|
|
|
2017 BasiCare with Part D (PPO)
| $0.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $47.00 | $47.00 | 3,760 2017 Formulary |
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-- This plan not offered in 2016 --
|
H3330 -036 -0 | | | | | |
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|
|
|
2017 EmblemHealth VIP Value (HMO)
| $0.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $16.00 | $42.00 | $42.00 | 3,551 2017 Formulary |
|
2016 Empire MediBlue Core (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H3370 -033 -0 | This plan does NOT include Prescription Drug coverage. | |
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2017 Empire MediBlue Core (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 |
2016 Fidelis Medicare Advantage without Rx (HMO-POS)
| $0.00 |
$6,700 |
No Rx Coverage |
H3328 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
|
2017 Fidelis Medicare Advantage without Rx (HMO-POS)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 PHP Care Complete FIDA (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H9869 -001 -0 | 0% | 0% | 0% | | 3,391
2016 Formulary |
new |
new |
new |
|
2017 PHP Care Complete FIDA-IDD Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,173 2017 Formulary |
|
2016 UnitedHealthcare MedicareComplete Choice Essential (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5342 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
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2017 UnitedHealthcare MedicareComplete Choice Essential (Regional 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 UnitedHealthcare MedicareComplete Choice Plan 1 (Regional PPO)
| $0.00 |
$6,700 |
$290 | No additional gap coverage, only the Donut Hole Discount |
R5342 -001 -0 | $2.00 | $12.00 | $47.00 | $47.00 | n/a |
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|
|
|
2017 UnitedHealthcare MedicareComplete Choice Plan 1 (Regional PPO)
| $0.00 |
$6,700 |
$290 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | tbd |
|
2016 WellCare Advance (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H3361 -059 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
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2017 WellCare Advance (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 WellCare Access (HMO SNP)
| $21.80 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3361 -065 -0 | $0.00 | $10.00 | $46.00 | $46.00 | 2,801
2016 Formulary |
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|
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2017 WellCare Access (HMO SNP)
| $15.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $44.00 | $44.00 | 3,113 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 UnitedHealthcare Nursing Home Plan (HMO SNP)
| $39.30 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3379 -002 -0 | | | | | 3,529
2016 Formulary |
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-- |
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2017 UnitedHealthcare Nursing Home Plan (HMO SNP)
| $34.80 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,683 2017 Formulary |
|
2016 UnitedHealthcare MedicareComplete Choice Plan 3 (Regional PPO)
| $39.00 |
$5,700 |
$150 | No additional gap coverage, only the Donut Hole Discount |
R5342 -005 -0 | $2.00 | $8.00 | $45.00 | $45.00 | n/a |
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|
|
|
2017 UnitedHealthcare MedicareComplete Choice Plan 3 (Regional PPO)
| $36.00 |
$5,900 |
$150 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | tbd |
|
2016 Affinity Medicare Solutions (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5991 -002 -0 | $0.00 | $11.00 | $47.00 | $47.00 | 3,020
2016 Formulary |
|
-- |
|
|
2017 Affinity Medicare Solutions (HMO SNP)
| $38.10 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $47.00 | $47.00 | 3,098 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 CenterLight Healthcare Direct Complete Plan (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5989 -002 -0 | $9.50 | 25% | | | 3,678
2016 Formulary |
|
-- |
|
|
2017 CenterLight Healthcare Direct Complete Plan (HMO SNP)
| $38.10 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | $9.00 | 25% | | | 3,855 2017 Formulary |
|
2016 Affinity Medicare Ultimate (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5991 -001 -0 | $0.00 | $6.00 | $47.00 | $47.00 | 3,020
2016 Formulary |
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-- |
|
|
2017 Affinity Medicare Ultimate (HMO SNP)
| $40.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,098 2017 Formulary |
|
2016 Elderplan Advantage For Nursing Home Residents (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3347 -003 -0 | | | | | 3,250
2016 Formulary |
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-- |
|
|
2017 Elderplan Advantage For Nursing Home Residents (HMO SNP)
| $40.90 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,098 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 Elderplan Extra Help (HMO)
| $39.70 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3347 -009 -0 | | | | | 3,250
2016 Formulary |
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-- |
|
|
2017 Elderplan Extra Help (HMO)
| $40.90 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,098 2017 Formulary |
|
2016 Elderplan For Medicaid Beneficiaries (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3347 -002 -0 | | | | | 3,250
2016 Formulary |
|
-- |
|
|
2017 Elderplan For Medicaid Beneficiaries (HMO SNP)
| $40.90 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,098 2017 Formulary |
|
2016 Elderplan Plus Long Term Care (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3347 -007 -0 | | | | | 3,250
2016 Formulary |
|
-- |
|
|
2017 Elderplan Plus Long Term Care (HMO SNP)
| $40.90 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,098 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 AgeWell New York BeWell (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H4922 -002 -0 | | | | | 3,068
2016 Formulary |
-- |
-- |
-- |
|
2017 AgeWell New York BeWell (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,176 2017 Formulary |
|
2016 AgeWell New York CareWell (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H4922 -004 -0 | | | | | 3,068
2016 Formulary |
-- |
-- |
-- |
|
2017 AgeWell New York CareWell (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,176 2017 Formulary |
|
2016 AgeWell New York FeelWell (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H4922 -003 -0 | | | | | 3,068
2016 Formulary |
-- |
-- |
-- |
|
2017 AgeWell New York FeelWell (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,176 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 ArchCare Advantage (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H1777 -007 -0 | | | | | 2,933
2016 Formulary |
|
-- |
|
|
2017 ArchCare Advantage (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 2,999 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H3330 -037 -0 | | | | | |
|
|
|
|
2017 EmblemHealth VIP Dual (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,551 2017 Formulary |
|
2016 Empire MediBlue Dual Advantage (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3370 -028 -0 | $0.00 | $4.00 | $45.00 | $45.00 | 3,266
2016 Formulary |
|
|
|
|
2017 Empire MediBlue Dual Advantage (HMO SNP)
| $41.00 |
n/a |
$400 | Yes, some additional gap coverage. | $0.00 | $20.00 | $47.00 | $47.00 | 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 Fidelis Dual Advantage Flex (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3328 -017 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,966
2016 Formulary |
|
|
|
|
2017 Fidelis Dual Advantage Flex (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 2,999 2017 Formulary |
|
2016 Fidelis Medicare Advantage Flex (HMO-POS)
| $39.70 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H3328 -003 -0 | $0.00 | $15.00 | $35.00 | $35.00 | 3,966
2016 Formulary |
|
|
|
|
2017 Fidelis Medicare Advantage Flex (HMO-POS)
| $41.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $35.00 | $35.00 | 5,280 2017 Formulary |
|
2016 Healthfirst CompleteCare (HMO SNP)
| $39.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3359 -034 -0 | | | | | 3,020
2016 Formulary |
|
-- |
|
|
2017 Healthfirst CompleteCare (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,098 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 Healthfirst Life Improvement Plan (HMO SNP)
| $39.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3359 -021 -0 | | | | | 3,020
2016 Formulary |
|
-- |
|
|
2017 Healthfirst Life Improvement Plan (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,098 2017 Formulary |
|
2016 RiverSpring Star (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H6776 -001 -0 | | | | | 3,586
2016 Formulary |
new |
new |
new |
|
2017 RiverSpring Star (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | tbd |
|
-- This plan not offered in 2016 --
|
H5992 -007 -0 | | | | | |
|
-- |
|
|
2017 Senior Whole Health of New York NHC (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,766 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 VNSNY CHOICE Medicare Classic (HMO)
| $39.70 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5549 -008 -0 | | | | | 3,446
2016 Formulary |
|
|
|
|
2017 VNSNY CHOICE Medicare Classic (HMO)
| $41.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,740 2017 Formulary |
|
2016 VNSNY CHOICE Medicare Preferred (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5549 -002 -0 | | | | | 3,446
2016 Formulary |
|
|
|
|
2017 VNSNY CHOICE Medicare Preferred (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,740 2017 Formulary |
|
2016 VNSNY CHOICE Total (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5549 -003 -0 | | | | | 3,446
2016 Formulary |
|
|
|
|
2017 VNSNY CHOICE Total (HMO SNP)
| $41.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,740 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 --
|
H3305 -020 -0 | | | | | |
|
|
|
|
2017 Preferred Gold without Part D (HMO-POS)
| $42.20 |
$5,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 Affinity Medicare Passport Select (HMO)
| $41.00 |
$5,400 |
$0 | Yes, some additional gap coverage. |
H5991 -004 -0 | $0.00 | $8.00 | $42.00 | $42.00 | 3,020
2016 Formulary |
|
-- |
|
|
2017 Affinity Medicare Passport Select (HMO)
| $45.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $42.00 | $42.00 | 3,098 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H3361 -135 -0 | | | | | |
|
|
|
|
2017 WellCare Preferred (HMO-POS)
| $45.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $47.00 | $47.00 | 2,914 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 Today's Options Advantage Plus 650B (PPO)
| $54.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2775 -100 -0 | $2.00 | $7.00 | $37.00 | $37.00 | 3,020
2016 Formulary |
|
|
|
|
2017 Today's Options Advantage Plus 750B (PPO)
| $56.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $7.00 | $37.00 | $37.00 | 3,123 2017 Formulary |
|
2016 EmblemHealth Essential (HMO)
| $69.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3330 -032 -4 | $0.00 | $15.00 | $47.00 | $47.00 | 3,376
2016 Formulary |
|
|
|
|
2017 EmblemHealth VIP Essential (HMO)
| $57.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $16.00 | $42.00 | $42.00 | 3,551 2017 Formulary |
|
2016 AARP MedicareComplete Plan 2 (HMO)
| $69.00 |
$4,000 |
$240 | No additional gap coverage, only the Donut Hole Discount |
H3307 -023 -0 | $2.00 | $10.00 | $45.00 | $45.00 | 3,529
2016 Formulary |
|
|
|
|
2017 AARP MedicareComplete Plan 2 (HMO)
| $66.00 |
$4,000 |
$240 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $45.00 | $45.00 | 3,683 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 UnitedHealthcare MedicareComplete Choice Plan 4 (Regional PPO)
| $69.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
R5342 -006 -0 | $2.00 | $8.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2017 UnitedHealthcare MedicareComplete Choice Plan 4 (Regional PPO)
| $66.00 |
$5,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | tbd |
|
2016 Empire MediBlue Plus (HMO)
| $86.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H3370 -030 -0 | $5.00 | $10.00 | $42.00 | $42.00 | 3,266
2016 Formulary |
|
|
|
|
2017 Empire MediBlue Plus (HMO)
| $86.00 |
$6,700 |
$275 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $42.00 | $42.00 | 3,666 2017 Formulary |
|
2016 Elderplan Healthy Balance (HMO-POS)
| $85.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3347 -013 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,250
2016 Formulary |
|
-- |
|
|
2017 Elderplan Healthy Balance (HMO-POS)
| $93.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $47.00 | $47.00 | 4,163 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 --
|
H3305 -022 -0 | | | | | |
|
|
|
|
2017 GoldValue with Part D (HMO-POS)
| $98.80 |
$6,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $45.00 | $45.00 | 3,760 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H5521 -121 -0 | | | | | |
|
|
|
|
2017 Aetna Medicare Premier Plan (PPO)
| $99.00 |
$6,700 |
$200 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,670 2017 Formulary |
|
2016 Today's Options Advantage Plus 350A (PPO)
| $99.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2775 -099 -0 | $0.00 | $5.00 | $35.00 | $35.00 | 3,020
2016 Formulary |
|
|
|
|
2017 Today's Options Advantage Plus 450A (PPO)
| $103.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $35.00 | $35.00 | 3,123 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 Aetna Medicare Value Plan (HMO)
| $100.00 |
$6,700 |
$160 | No additional gap coverage, only the Donut Hole Discount |
H3312 -018 -0 | $2.00 | $8.00 | $47.00 | $47.00 | 3,417
2016 Formulary |
|
|
|
|
2017 Aetna Medicare Value Plan (HMO)
| $107.00 |
$6,700 |
$250 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,670 2017 Formulary |
|
2016 VNSNY CHOICE Medicare Maximum (HMO SNP)
| $115.80 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5549 -006 -0 | | | | | 3,446
2016 Formulary |
|
|
|
|
2017 VNSNY CHOICE Medicare Maximum (HMO SNP)
| $109.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,740 2017 Formulary |
|
2016 Gold PPO with Part D (PPO)
| $117.30 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H9615 -009 -0 | $0.00 | $10.00 | $35.00 | $35.00 | 3,672
2016 Formulary |
|
|
|
|
2017 Gold PPO with Part D (PPO)
| $117.40 |
$6,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 3,760 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 --
|
H3305 -021 -0 | | | | | |
|
|
|
|
2017 Preferred Gold with Part D (HMO-POS)
| $166.80 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 3,760 2017 Formulary |
|
2016 EmblemHealth VIP (HMO)
| $229.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3330 -021 -4 | $0.00 | $15.00 | $47.00 | $47.00 | 3,376
2016 Formulary |
|
|
|
|
2017 EmblemHealth VIP Gold (HMO)
| $229.00 |
$6,700 |
$330 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $40.00 | $40.00 | 3,551 2017 Formulary |
|
2016 EmblemHealth VIP High Option (HMO)
| $388.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3330 -033 -4 | $0.00 | $15.00 | $47.00 | $47.00 | 3,376
2016 Formulary |
|
|
|
|
2017 EmblemHealth VIP Gold Plus (HMO)
| $320.00 |
$6,700 |
$330 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $40.00 | $40.00 | 3,551 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 AgeWell New York LiveWell (HMO)
| $0.00 |
$6,700 |
$275 | Yes, some additional gap coverage. |
H4922 -001 -0 | $5.00 | $15.00 | $45.00 | $45.00 | 3,068
2016 Formulary |
-- |
-- |
-- |
|
-- Members will be assigned to AgeWell New York LiveWell (HMO) H4922-005 --
| | | | | |
|
2016 EmblemHealth Dual Eligible (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3330 -029 -0 | $2.00 | $9.00 | 25% | 25% | 3,376
2016 Formulary |
|
|
|
|
-- Members will be assigned to EmblemHealth VIP Dual (HMO SNP) H3330-037 --
| | | | | |
|
2016 GoldValue with Part D (HMO-POS)
| $98.70 |
$6,000 |
$0 | Yes, some additional gap coverage. |
H9859 -013 -0 | $0.00 | $10.00 | $35.00 | $35.00 | 3,672
2016 Formulary |
|
|
|
|
-- Members will be assigned to GoldValue with Part D (HMO-POS) H3305-022 --
| | | | | |
|
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 Preferred Gold with Part D (HMO-POS)
| $166.70 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H9859 -002 -0 | $0.00 | $10.00 | $35.00 | $35.00 | 3,672
2016 Formulary |
|
|
|
|
-- Members will be assigned to Preferred Gold with Part D (HMO-POS) H3305-021 --
| | | | | |
|
2016 Preferred Gold without Part D (HMO-POS)
| $31.50 |
$4,500 |
No Rx Coverage |
H9859 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to Preferred Gold without Part D (HMO-POS) H3305-020 --
| | | | | |
|
2016 EmblemHealth PPO I (PPO)
| $88.00 |
$6,700 |
No Rx Coverage |
H5528 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
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 Touchstone Health Medicare Power (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3327 -001 -0 | $3.00 | $20.00 | $47.00 | $47.00 | 3,178
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 Touchstone Health Medicare Total (HMO)
| $39.70 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3327 -002 -0 | $3.00 | $15.00 | $47.00 | $47.00 | 3,178
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 EmblemHealth Dual Eligible (PPO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5528 -018 -0 | $2.00 | $9.00 | 25% | 25% | 3,376
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
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 Touchstone Health Medicare Prestige (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3327 -026 -0 | | | | | 3,178
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 VNSNY CHOICE Medicare Enhanced (HMO)
| $0.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5549 -004 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,446
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 Touchstone Health Medicare Grand (HMO SNP)
| $39.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3327 -043 -0 | | | | | 3,178
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
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 EmblemHealth Advantage (PPO)
| $202.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5528 -026 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,376
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 Elderplan Diabetes Care (HMO SNP)
| $0.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3347 -012 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,250
2016 Formulary |
|
-- |
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 Today's Options Premier 300 (PFFS)
| $75.00 |
n/a |
No Rx Coverage |
H2816 -031 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
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 Today's Options Premier 600 (PFFS)
| $25.00 |
n/a |
No Rx Coverage |
H2816 -032 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 VNSNY CHOICE Medicare Ultra (HMO-POS)
| $96.40 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5549 -009 -0 | $0.00 | $9.00 | $45.00 | $45.00 | 3,446
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|