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 6 (HMO)
| $0.00 |
$6,400 |
$255 | No additional gap coverage, only the Donut Hole Discount | H5253 -052 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,529
2016 Formulary |
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|
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2017 AARP MedicareComplete Plan 6 (HMO)
| $0.00 |
$6,400 |
$255 | 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 (PPO)
| $0.00 |
$6,100 |
$175 | No additional gap coverage, only the Donut Hole Discount | H5521 -090 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,279
2016 Formulary |
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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 |
|
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 |
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|
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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 |
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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 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 |
|
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 |
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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 |
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-- This plan not offered in 2016 --
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H6622 -017 -0 | | | | | |
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2017 Humana Gold Plus - Diabetes and Heart (HMO SNP)
| $0.00 |
n/a |
$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 |
-- This plan not offered in 2016 --
|
H6622 -013 -0 | | | | | |
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|
|
2017 Humana Gold Plus H6622-013 (HMO)
| $0.00 |
$6,700 |
$200 | Yes, some additional gap coverage. | $7.00 | $17.00 | $47.00 | $47.00 | 3,820 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. | |
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|
|
2017 HumanaChoice R5826-021 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2016 MediGold Essential Care (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | H3668 -011 -0 | $0.00 | $18.00 | $45.00 | $45.00 | 4,063
2016 Formulary |
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2017 MediGold Essential Care (HMO)
| $0.00 |
$3,900 |
$150 | Yes, some additional gap coverage. | $2.00 | $18.00 | $45.00 | $45.00 | 4,189 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 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 |
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-- This plan not offered in 2016 --
|
H6298 -010 -1 | | | | | |
|
-- |
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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 Molina Dual Options – MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | H5280 -001 -0 | $0.00 | $0.00 | $0.00 | | 3,041
2016 Formulary |
-- |
-- |
-- |
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2017 Molina Dual Options
| $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 Premier Health Advantage (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | H3233 -001 -0 | $3.00 | $15.00 | $47.00 | $47.00 | 3,574
2016 Formulary |
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|
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2017 Premier Health Advantage (HMO)
| $0.00 |
$3,900 |
$100 | Yes, some additional gap coverage. | $3.00 | $15.00 | $47.00 | $47.00 | 3,709 2017 Formulary |
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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 |
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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. | |
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2017 Anthem MediBlue Access Core (Regional PPO)
| $17.00 |
$5,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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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 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 |
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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 |
|
2016 UnitedHealthcare Dual Complete (HMO SNP)
| $17.90 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | H5253 -059 -0 | | | | | 3,529
2016 Formulary |
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2017 UnitedHealthcare Dual Complete (HMO SNP)
| $26.90 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 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 |
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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 Molina Medicare Options Plus (HMO SNP)
| $25.90 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | H0490 -004 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,041
2016 Formulary |
-- |
-- |
|
|
2017 Molina Medicare Options Plus (HMO SNP)
| $29.80 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $46.00 | $46.00 | 3,142 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 |
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|
|
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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 |
|
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 Advantage (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | H0908 -001 -0 | | | | | 3,191
2016 Formulary |
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|
|
|
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 |
|
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 |
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|
|
|
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 |
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|
|
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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 --
|
H6622 -015 -0 | | | | | |
|
|
|
|
2017 Humana Gold Plus SNP-DE H6622-015 (HMO SNP)
| $32.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $13.00 | $47.00 | $47.00 | 3,820 2017 Formulary |
|
2016 Premier Health Advantage VIP (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | H3233 -002 -0 | | | | | 3,574
2016 Formulary |
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|
|
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2017 Premier Health Advantage VIP (HMO SNP)
| $32.30 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,709 2017 Formulary |
|
2016 AARP MedicareComplete Plan 2 (HMO)
| $45.00 |
$5,900 |
$170 | No additional gap coverage, only the Donut Hole Discount | H5253 -053 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,529
2016 Formulary |
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|
|
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2017 AARP MedicareComplete Plan 2 (HMO)
| $36.00 |
$4,900 |
$170 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $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 Select Plan (HMO)
| $36.00 |
$5,600 |
$230 | No additional gap coverage, only the Donut Hole Discount | H3931 -110 -0 | $0.00 | $11.00 | $47.00 | $47.00 | 3,279
2016 Formulary |
|
-- |
|
|
2017 Aetna Medicare Select Plan (HMO)
| $36.00 |
$5,600 |
$200 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,670 2017 Formulary |
|
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 |
|
-- This plan not offered in 2016 --
|
H1846 -004 -0 | | | | | |
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|
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2017 MediGold Flexible Choice (PPO)
| $55.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $18.00 | $47.00 | $47.00 | 4,189 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 H6609-081 (PPO)
| $59.00 |
$6,700 |
$360 | Yes, some additional gap coverage. | H6609 -081 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
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|
|
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2017 HumanaChoice H6609-081 (PPO)
| $57.00 |
$6,700 |
$175 | Yes, some additional gap coverage. | $7.00 | $17.00 | $47.00 | $47.00 | 3,820 2017 Formulary |
|
2016 MediGold Medical Only (HMO)
| $50.00 |
$3,200 |
No Rx Coverage | H3668 -013 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2017 MediGold Medical Only (HMO)
| $60.00 |
$3,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
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 |
|
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|
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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 |
|
-- This plan not offered in 2016 --
|
H6622 -019 -0 | | | | | |
|
|
|
|
2017 Humana Gold Plus H6622-019 (HMO)
| $77.00 |
$3,900 |
$100 | Yes, some additional gap coverage. | $1.00 | $4.00 | $47.00 | $47.00 | 3,820 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 |
|
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 -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 |
|
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 |
|
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 Choice H8145-032 (PFFS)
| $95.00 |
n/a |
$360 | Yes, some additional gap coverage. | H8145 -032 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
2017 Humana Gold Choice H8145-032 (PFFS)
| $97.00 |
n/a |
$200 | Yes, some additional gap coverage. | $7.00 | $17.00 | $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 -054 -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 MediGold Classic Preferred (HMO)
| $110.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | H3668 -005 -0 | $0.00 | $15.00 | $45.00 | $45.00 | 4,063
2016 Formulary |
|
|
|
|
2017 MediGold Classic Preferred (HMO)
| $120.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $45.00 | $45.00 | 4,189 2017 Formulary |
|
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 |
|
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 --
|
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 |
|
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 - Diabetes and Heart (HMO SNP)
| $0.00 |
n/a |
$360 | Yes, some additional gap coverage. | H8953 -011 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus - Diabetes and Heart (HMO SNP) H6622-017 --
| | | | | |
|
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 H8953-005 (HMO)
| $0.00 |
$6,700 |
$360 | Yes, some additional gap coverage. | H8953 -005 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H6622-013 (HMO) H6622-013 --
| | | | | |
|
2016 Humana Gold Plus H8953-016 (HMO)
| $79.00 |
$3,900 |
$100 | Yes, some additional gap coverage. | H8953 -016 -0 | $1.00 | $4.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H6622-019 (HMO) H6622-019 --
| | | | | |
|
2016 Humana Gold Plus SNP-DE H8953-007 (HMO SNP)
| $29.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | H8953 -007 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,615
2016 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus SNP-DE H6622-015 (HMO SNP) H6622-015 --
| | | | | |
|
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 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 --
|
| | | | |
|
2016 MediGold Value Choice (PPO)
| $55.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | H1846 -003 -0 | $0.00 | $18.00 | $45.00 | $45.00 | 4,063
2016 Formulary |
|
|
|
|
-- This plan not offered in 2017 --
|
| | | | |
|
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 --
|
| | | | |
|
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 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 MediGold Network Choice (PPO)
| $155.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | H1846 -001 -0 | $0.00 | $15.00 | $45.00 | $45.00 | 4,063
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 --
|
| | | | |
|
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 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 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 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 --
|
| | | | |
|