There are 64 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 AARP MedicareComplete Plan 7 (HMO)
| $0.00 |
$4,500 |
$255 | No additional gap coverage, only the Donut Hole Discount |
H5253 -049 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,529
2016 Formulary |
|
|
|
|
2017 AARP MedicareComplete Plan 7 (HMO)
| $0.00 |
$4,500 |
$225 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,683 2017 Formulary |
|
2016 Aetna Medicare Value Plan (HMO)
| $0.00 |
$5,700 |
$175 | No additional gap coverage, only the Donut Hole Discount |
H3931 -107 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,279
2016 Formulary |
|
-- |
|
|
2017 Aetna Medicare Value Plan (HMO)
| $0.00 |
$5,700 |
$175 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,670 2017 Formulary |
|
2016 Anthem MediBlue Essential (HMO)
| $0.00 |
$4,900 |
$60 | No additional gap coverage, only the Donut Hole Discount |
H3655 -032 -0 | $4.00 | $15.00 | $42.00 | $42.00 | 3,266
2016 Formulary |
|
|
|
|
2017 Anthem MediBlue Essential (HMO)
| $0.00 |
$4,900 |
$60 | Yes, some additional gap coverage. | $4.00 | $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 Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0022 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,194
2016 Formulary |
-- |
-- |
-- |
|
2017 Buckeye Health Plan - MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,382 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H6396 -004 -0 | | | | | |
new |
new |
new |
|
2017 CareSource Advantage Zero Premium (HMO)
| $0.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $15.00 | $47.00 | $47.00 | 3,098 2017 Formulary |
|
2016 CareSource MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H8452 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,030
2016 Formulary |
-- |
-- |
-- |
|
2017 CareSource MyCare Ohio (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 Gateway Health Medicare Assured Select (HMO)
| $0.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H9190 -019 -0 | $3.00 | $16.00 | $45.00 | $45.00 | 2,902
2016 Formulary |
|
|
|
|
2017 Gateway Health Medicare Assured Select (HMO)
| $0.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $16.00 | $45.00 | $45.00 | 3,021 2017 Formulary |
|
2016 HumanaChoice R5826-021 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5826 -021 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2017 HumanaChoice R5826-021 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 MedMutual Advantage Classic (HMO)
| $0.00 |
$3,950 |
$165 | Yes, some additional gap coverage. |
H6723 -001 -1 | $4.00 | $17.00 | $47.00 | $47.00 | 3,611
2016 Formulary |
new |
new |
new |
|
2017 MedMutual Advantage Classic (HMO)
| $0.00 |
$3,950 |
$195 | Yes, some additional gap coverage. | $5.00 | $19.00 | $47.00 | $47.00 | 3,786 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 --
|
H6298 -010 -1 | | | | | |
|
-- |
|
|
2017 MedMutual Advantage Value (HMO)
| $0.00 |
$3,950 |
$195 | Yes, some additional gap coverage. | $5.00 | $19.00 | $47.00 | $47.00 | 3,786 2017 Formulary |
|
2016 UnitedHealthcare Connected for MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H2531 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,279
2016 Formulary |
-- |
-- |
-- |
|
2017 UnitedHealthcare Connected for MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,400 2017 Formulary |
|
2016 Paramount Elite - Standard Medical and Drug (HMO)
| $0.00 |
$6,100 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3653 -015 -0 | $5.00 | $20.00 | $45.00 | $45.00 | 3,802
2016 Formulary |
|
|
|
|
2017 Paramount Elite - Standard Medical and Drug (HMO)
| $10.00 |
$6,100 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $20.00 | $45.00 | $45.00 | 3,184 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 Assisted Living Plan (HMO-POS SNP)
| $23.80 |
n/a |
$80 | No additional gap coverage, only the Donut Hole Discount |
H5253 -061 -0 | $2.00 | $12.00 | $46.00 | $46.00 | 3,529
2016 Formulary |
|
|
|
|
2017 UnitedHealthcare Assisted Living Plan (HMO-POS SNP)
| $16.30 |
n/a |
$120 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,683 2017 Formulary |
|
2016 Anthem MediBlue Access Core (Regional PPO)
| $17.00 |
$5,400 |
No Rx Coverage |
R5941 -013 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2017 Anthem MediBlue Access Core (Regional PPO)
| $17.00 |
$5,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 UnitedHealthcare Nursing Home Plan (HMO-POS SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5253 -060 -0 | | | | | 3,529
2016 Formulary |
|
|
|
|
2017 UnitedHealthcare Nursing Home Plan (HMO-POS SNP)
| $23.10 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 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 AARP MedicareComplete Plan 1 (HMO)
| $29.00 |
$3,900 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H5253 -050 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,529
2016 Formulary |
|
|
|
|
2017 AARP MedicareComplete Plan 1 (HMO)
| $26.00 |
$3,900 |
$200 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,683 2017 Formulary |
|
2016 MedMutual Advantage Choice (HMO)
| $29.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H6723 -002 -1 | $0.00 | $12.00 | $47.00 | $47.00 | 3,611
2016 Formulary |
new |
new |
new |
|
2017 MedMutual Advantage Choice (HMO)
| $29.00 |
$3,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,786 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H6298 -011 -1 | | | | | |
|
-- |
|
|
2017 MedMutual Advantage Standard (HMO)
| $29.00 |
$3,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,786 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 Dual Advantage (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H3655 -033 -0 | $0.00 | $1.00 | $45.00 | $45.00 | 3,266
2016 Formulary |
|
|
|
|
2017 Anthem MediBlue Dual Advantage (HMO SNP)
| $32.30 |
n/a |
$400 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,666 2017 Formulary |
|
2016 Buckeye Health Plan Advantage (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H0908 -001 -0 | | | | | 3,191
2016 Formulary |
|
|
|
|
2017 Buckeye Health Plan Medicare Advantage (HMO SNP)
| $32.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,382 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H6396 -001 -0 | | | | | |
new |
new |
new |
|
2017 CareSource Advantage (HMO)
| $32.30 |
$4,600 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $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 Gateway Health Medicare Assured Diamond (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H9190 -001 -0 | | | | | 2,902
2016 Formulary |
|
|
|
|
2017 Gateway Health Medicare Assured Diamond (HMO SNP)
| $32.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,021 2017 Formulary |
|
2016 Gateway Health Medicare Assured Ruby (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H9190 -002 -0 | | | | | 2,902
2016 Formulary |
|
|
|
|
2017 Gateway Health Medicare Assured Ruby (HMO SNP)
| $32.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,021 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H5322 -028 -0 | | | | | |
|
|
|
|
2017 UnitedHealthcare Dual Complete (HMO-POS SNP)
| $32.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 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 MedMutual Advantage Select (PPO)
| $39.00 |
$6,400 |
$165 | Yes, some additional gap coverage. |
H4497 -001 -1 | $4.00 | $17.00 | $47.00 | $47.00 | 3,611
2016 Formulary |
new |
new |
new |
|
2017 MedMutual Advantage Select (PPO)
| $39.00 |
$6,350 |
$195 | Yes, some additional gap coverage. | $5.00 | $19.00 | $47.00 | $47.00 | 3,786 2017 Formulary |
|
2016 SummaCare Medicare Ruby (HMO)
| $40.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H3660 -044 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,446
2016 Formulary |
|
|
|
|
2017 SummaCare Medicare Ruby (HMO)
| $40.00 |
$3,600 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $47.00 | $47.00 | 3,740 2017 Formulary |
|
-- This plan not offered in 2016 --
|
H6622 -011 -0 | | | | | |
|
|
|
|
2017 Humana Gold Plus H6622-011 (HMO)
| $44.00 |
$6,700 |
$200 | Yes, some additional gap coverage. | $7.00 | $17.00 | $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 Paramount Elite - Enhanced Medical Only (HMO)
| $36.00 |
$3,400 |
No Rx Coverage |
H3653 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2017 Paramount Elite - Enhanced Medical Only (HMO)
| $46.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2016 --
|
H6396 -002 -0 | | | | | |
new |
new |
new |
|
2017 CareSource Advantage Plus (HMO)
| $57.60 |
$4,600 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,098 2017 Formulary |
|
2016 Anthem MediBlue Access (Regional PPO)
| $68.00 |
$6,000 |
$20 | No additional gap coverage, only the Donut Hole Discount |
R5941 -014 -0 | $4.00 | $15.00 | $42.00 | $42.00 | n/a |
|
|
|
|
2017 Anthem MediBlue Access (Regional PPO)
| $69.00 |
$6,000 |
$20 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 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 MedMutual Advantage Preferred (PPO)
| $69.00 |
$4,800 |
$0 | Yes, some additional gap coverage. |
H4497 -002 -1 | $0.00 | $12.00 | $47.00 | $47.00 | 3,611
2016 Formulary |
new |
new |
new |
|
2017 MedMutual Advantage Preferred (PPO)
| $69.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,786 2017 Formulary |
|
2016 SummaCare Medicare Sapphire (HMO-POS)
| $78.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H3660 -029 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,446
2016 Formulary |
|
|
|
|
2017 SummaCare Medicare Sapphire (HMO-POS)
| $76.00 |
$3,600 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $47.00 | $47.00 | 3,740 2017 Formulary |
|
2016 Paramount Elite - Enhanced Medical and Drug (HMO)
| $78.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3653 -004 -0 | $2.00 | $15.00 | $45.00 | $45.00 | 3,802
2016 Formulary |
|
|
|
|
2017 Paramount Elite - Enhanced Medical and Drug (HMO)
| $87.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $45.00 | $45.00 | 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 --
|
H6298 -012 -1 | | | | | |
|
-- |
|
|
2017 MedMutual Advantage Enhanced (HMO)
| $89.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,786 2017 Formulary |
|
2016 Anthem MediBlue Access Enhanced (PPO)
| $92.00 |
$4,100 |
$40 | No additional gap coverage, only the Donut Hole Discount |
H4036 -012 -2 | $4.00 | $15.00 | $42.00 | $42.00 | 3,266
2016 Formulary |
|
-- |
|
|
2017 Anthem MediBlue Access Enhanced (PPO)
| $92.00 |
$4,300 |
$40 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 3,666 2017 Formulary |
|
2016 Gateway Health Medicare Assured Prime (HMO)
| $96.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H9190 -006 -0 | $0.00 | $20.00 | $45.00 | $45.00 | 2,902
2016 Formulary |
|
|
|
|
2017 Gateway Health Medicare Assured Prime (HMO)
| $92.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $45.00 | $45.00 | 3,021 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 HumanaChoice R5826-007 (Regional PPO)
| $101.00 |
$6,700 |
$330 | No additional gap coverage, only the Donut Hole Discount |
R5826 -007 -0 | $7.00 | $17.00 | $47.00 | $47.00 | n/a |
|
|
|
|
2017 HumanaChoice R5826-007 (Regional PPO)
| $94.00 |
$6,700 |
$340 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | tbd |
|
-- This plan not offered in 2016 --
|
H6622 -020 -0 | | | | | |
|
|
|
|
2017 Humana Gold Plus H6622-020 (HMO)
| $97.00 |
$3,900 |
$100 | Yes, some additional gap coverage. | $1.00 | $4.00 | $47.00 | $47.00 | 3,820 2017 Formulary |
|
2016 MedMutual Advantage Premium (PPO)
| $109.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H4497 -003 -1 | $0.00 | $12.00 | $47.00 | $47.00 | 3,611
2016 Formulary |
new |
new |
new |
|
2017 MedMutual Advantage Premium (PPO)
| $109.00 |
$3,600 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,786 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 AARP MedicareComplete Plan 3 (HMO)
| $120.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5253 -051 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,529
2016 Formulary |
|
|
|
|
2017 AARP MedicareComplete Plan 3 (HMO)
| $117.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $45.00 | $45.00 | 3,683 2017 Formulary |
|
2016 HumanaChoice H5525-030 (PPO)
| $163.00 |
$3,400 |
$100 | Yes, some additional gap coverage. |
H5525 -030 -0 | $1.00 | $4.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
2017 HumanaChoice H5525-030 (PPO)
| $161.00 |
$3,400 |
$100 | Yes, some additional gap coverage. | $1.00 | $4.00 | $47.00 | $47.00 | 3,820 2017 Formulary |
|
-- This plan not offered in 2016 --
|
R6694 -005 -0 | | | | | |
new |
new |
new |
|
2017 Aetna Medicare OH Connect Gold 2 (Regional PPO)
| $165.00 |
$3,500 |
$245 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $5.00 | $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 Aetna Medicare OH Connect Gold (Regional PPO)
| $154.00 |
$3,500 |
$200 | No additional gap coverage, only the Donut Hole Discount |
R6694 -003 -0 | $2.00 | $9.00 | $47.00 | $47.00 | n/a |
new |
new |
new |
|
2017 Aetna Medicare OH Connect Gold (Regional PPO)
| $179.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | tbd |
|
2016 SummaCare Medicare Emerald (HMO-POS)
| $182.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H3660 -028 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,446
2016 Formulary |
|
|
|
|
2017 SummaCare Medicare Emerald (HMO-POS)
| $180.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,740 2017 Formulary |
|
2016 Humana Gold Plus H8953-002 (HMO)
| $37.00 |
$6,700 |
$360 | Yes, some additional gap coverage. |
H8953 -002 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H6622-011 (HMO) H6622-011 --
| | | | | |
|
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 H8953-017 (HMO)
| $99.00 |
$3,900 |
$100 | Yes, some additional gap coverage. |
H8953 -017 -0 | $1.00 | $4.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H6622-020 (HMO) H6622-020 --
| | | | | |
|
2016 HealthSpan Medicare Plus I (Cost)
| $148.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H6360 -001 -0 | $2.00 | $16.00 | $45.00 | $45.00 | 5,736
2016 Formulary |
|
|
|
|
-- Members will be assigned to MedMutual Advantage Enhanced (HMO) H6298-012 --
| | | | | |
|
2016 HealthSpan Medicare Enhanced (HMO)
| $99.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H6298 -009 -0 | $0.00 | $14.00 | $45.00 | $45.00 | 5,736
2016 Formulary |
|
-- |
|
|
-- Members will be assigned to MedMutual Advantage Enhanced (HMO) H6298-012 --
| | | | | |
|
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 HealthSpan Medicare Plus II (Cost)
| $49.10 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H6360 -002 -0 | $2.00 | $16.00 | $45.00 | $45.00 | 5,736
2016 Formulary |
|
|
|
|
-- Members will be assigned to MedMutual Advantage Standard (HMO) H6298-011 --
| | | | | |
|
2016 HealthSpan Medicare Plus III (Cost)
| $44.10 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6360 -006 -0 | $3.00 | $18.00 | $47.00 | $47.00 | 5,736
2016 Formulary |
|
|
|
|
-- Members will be assigned to MedMutual Advantage Standard (HMO) H6298-011 --
| | | | | |
|
2016 HealthSpan Medicare Plus IV (Cost)
| $34.20 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6360 -010 -0 | $9.00 | $20.00 | $47.00 | $47.00 | 5,736
2016 Formulary |
|
|
|
|
-- Members will be assigned to MedMutual Advantage Standard (HMO) H6298-011 --
| | | | | |
|
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 HealthSpan Medicare Standard (HMO)
| $49.00 |
$3,700 |
$0 | Yes, some additional gap coverage. |
H6298 -002 -0 | $0.00 | $14.00 | $45.00 | $45.00 | 5,736
2016 Formulary |
|
-- |
|
|
-- Members will be assigned to MedMutual Advantage Standard (HMO) H6298-011 --
| | | | | |
|
2016 HealthSpan Medicare Value (HMO)
| $0.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H6298 -001 -0 | $0.00 | $14.00 | $45.00 | $45.00 | 5,736
2016 Formulary |
|
-- |
|
|
-- Members will be assigned to MedMutual Advantage Value (HMO) H6298-010 --
| | | | | |
|
2016 HealthSpan Medicare Plus Basic I (Cost)
| $101.00 |
$2,500 |
No Rx Coverage |
H6360 -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 HealthSpan Medicare Plus Basic II (Cost)
| $0.00 |
$3,400 |
No Rx Coverage |
H6360 -007 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 HealthSpan Medicare Plus Basic III (Cost)
| $0.00 |
$3,400 |
No Rx Coverage |
H6360 -008 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 HealthSpan Medicare Plus Basic IV (Cost)
| $0.00 |
$3,400 |
No Rx Coverage |
H6360 -011 -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 HealthSpan Medicare Only Basic (Cost)
| $0.00 |
$3,400 |
No Rx Coverage |
H6360 -012 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 Gateway Health Medicare Assured Gold (HMO SNP)
| $59.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H9190 -003 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 2,902
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 Gateway Health Medicare Assured Platinum (HMO SNP)
| $97.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount |
H9190 -004 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 2,902
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 HealthSpan Medicare Core 1 (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H6298 -005 -0 | This plan does NOT include Prescription Drug coverage. | |
|
-- |
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 HealthSpan Medicare Core 2 (HMO)
| $2.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H6298 -007 -0 | | | | | 5,736
2016 Formulary |
|
-- |
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
2016 Anthem MediBlue Connect for OPERS (HMO)
| $151.00 |
$3,500 |
$20 | Yes, some additional gap coverage. |
H3655 -035 -0 | $3.00 | $11.00 | $42.00 | $42.00 | 3,266
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 AARP MedicareComplete Essential (HMO)
| $45.00 |
$5,900 |
No Rx Coverage |
H5253 -058 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|