There are 63 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 8 (HMO)
| $0.00 |
$4,500 |
$255 | No additional gap coverage, only the Donut Hole Discount |
H5253 -057 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,529
2016 Formulary |
|
|
|
|
2017 AARP MedicareComplete Plan 8 (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 Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H7172 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,090
2016 Formulary |
-- |
-- |
-- |
|
2017 Aetna Better Health of Ohio, MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,410 2017 Formulary |
|
2016 Aetna Medicare Value Plan (PPO)
| $0.00 |
$6,100 |
$175 | No additional gap coverage, only the Donut Hole Discount |
H5521 -088 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,279
2016 Formulary |
|
|
|
|
2017 Aetna Medicare Value Plan (PPO)
| $0.00 |
$6,100 |
$150 | Yes, some additional gap coverage. | $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 |
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 |
|
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 |
|
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 |
|
-- This plan not offered in 2016 --
|
H5475 -006 -0 | | | | | |
|
|
|
|
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 SummaCare Medicare Topaz (HMO)
| $0.00 |
$6,000 |
$150 | Yes, some additional gap coverage. |
H3660 -049 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,446
2016 Formulary |
|
|
|
|
2017 SummaCare Medicare Topaz (HMO)
| $0.00 |
$3,800 |
$150 | Yes, some additional gap coverage. | $0.00 | $15.00 | $47.00 | $47.00 | 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 |
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 |
|
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 |
|
|
|
|
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 |
|
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 |
|
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 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. | |
|
-- This plan not offered in 2016 --
|
H6622 -016 -0 | | | | | |
|
|
|
|
2017 Humana Gold Plus H6622-016 (HMO)
| $17.90 |
$6,700 |
$175 | Yes, some additional gap coverage. | $7.00 | $17.00 | $47.00 | $47.00 | 3,820 2017 Formulary |
|
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 4 (HMO)
| $29.00 |
$3,900 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H5253 -056 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,529
2016 Formulary |
|
|
|
|
2017 AARP MedicareComplete Plan 4 (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 Aetna Medicare Select Plan (HMO)
| $29.00 |
$5,500 |
$225 | No additional gap coverage, only the Donut Hole Discount |
H3931 -109 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,279
2016 Formulary |
|
-- |
|
|
2017 Aetna Medicare Select Plan (HMO)
| $29.00 |
$5,500 |
$175 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,670 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 |
|
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 -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 |
|
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 |
|
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 --
|
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 |
|
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 |
|
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 --
|
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 |
|
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 |
|
|
|
|
2017 Meridian Extra (HMO SNP)
| $34.20 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | tbd |
|
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 |
|
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 SummaCare Medicare Ruby (HMO)
| $43.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H3660 -047 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,446
2016 Formulary |
|
|
|
|
2017 SummaCare Medicare Ruby (HMO)
| $43.00 |
$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 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 |
|
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 Plus (HMO)
| $70.00 |
$4,100 |
$60 | No additional gap coverage, only the Donut Hole Discount |
H3655 -034 -0 | $4.00 | $15.00 | $42.00 | $42.00 | 3,266
2016 Formulary |
|
|
|
|
2017 Anthem MediBlue Plus (HMO)
| $65.00 |
$4,100 |
$60 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 3,666 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 |
|
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 |
|
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)
| $73.00 |
$5,800 |
$50 | No additional gap coverage, only the Donut Hole Discount |
H4036 -010 -2 | $4.00 | $15.00 | $42.00 | $42.00 | 3,266
2016 Formulary |
|
-- |
|
|
2017 Anthem MediBlue Access (PPO)
| $73.00 |
$5,800 |
$50 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 3,666 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 HumanaChoice H6609-084 (PPO)
| $86.00 |
$6,700 |
$360 | Yes, some additional gap coverage. |
H6609 -084 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
2017 HumanaChoice H6609-084 (PPO)
| $84.00 |
$6,700 |
$175 | 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 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 |
|
-- 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 |
|
-- This plan not offered in 2016 --
|
H5521 -134 -0 | | | | | |
|
|
|
|
2017 Aetna Medicare Choice Plan (PPO)
| $90.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $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 |
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 |
|
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 |
|
2016 SummaCare Medicare Sapphire (HMO-POS)
| $98.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H3660 -048 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,446
2016 Formulary |
|
|
|
|
2017 SummaCare Medicare Sapphire (HMO-POS)
| $96.00 |
$3,600 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $47.00 | $47.00 | 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 --
|
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 |
|
2016 AARP MedicareComplete Plan 3 (HMO)
| $120.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5253 -055 -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 |
|
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 Standard Plan (PPO)
| $114.00 |
$5,000 |
$175 | No additional gap coverage, only the Donut Hole Discount |
H5521 -020 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,279
2016 Formulary |
|
|
|
|
2017 Aetna Medicare Standard Plan (PPO)
| $125.00 |
$5,000 |
$200 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,670 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 Humana Gold Plus H8953-010 (HMO)
| $29.00 |
$6,700 |
$360 | Yes, some additional gap coverage. |
H8953 -010 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H6622-016 (HMO) H6622-016 --
| | | | | |
|
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 --
| | | | | |
|
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 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 --
| | | | | |
|
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 --
| | | | | |
|
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 Connect Plus (PPO)
| $188.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H5521 -052 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,417
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
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 --
|
| | | | |
|
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 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 --
|
| | | | |
|
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 --
|
| | | | |
|