There are 68 Medicare Advantage plans meeting your criteria.
2017 / 2018 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 |
2017 Advantra Basic Medical (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H3959 -041 -0 | This plan does NOT include Prescription Drug coverage. | |
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2018 Advantra Basic Medical (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2017 Advantra Silver (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5522 -004 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,670
2017 Formulary |
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2018 Advantra Silver (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 5,223 2018 Formulary |
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-- This plan not offered in 2017 --
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H3962 -007 -0 | | | | | |
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2018 BlueJourney Essential (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $42.00 | $42.00 | 4,198 2018 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 |
2017 Cigna-HealthSpring Advantage (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H3949 -026 -0 | This plan does NOT include Prescription Drug coverage. | |
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2018 Cigna-HealthSpring Advantage (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2017 Cigna-HealthSpring PreventiveCare (HMO)
| $0.00 |
$6,700 |
$280 | No additional gap coverage, only the Donut Hole Discount |
H3949 -028 -0 | $4.00 | $10.00 | $42.00 | $42.00 | 3,420
2017 Formulary |
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2018 Cigna-HealthSpring PreventiveCare (HMO)
| $0.00 |
$6,700 |
$310 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $10.00 | $42.00 | $42.00 | 3,508 2018 Formulary |
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-- This plan not offered in 2017 --
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H3957 -042 -4 | | | | | |
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2018 Community Blue Medicare HMO Signature (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $42.00 | $42.00 | 3,555 2018 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 2017 --
|
H3954 -159 -3 | | | | | |
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2018 Geisinger Gold Essential Rx (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,788 2018 Formulary |
|
2017 Geisinger Gold Preferred Complete Rx (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3924 -060 -3 | $3.00 | $20.00 | $47.00 | $47.00 | 3,767
2017 Formulary |
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2018 Geisinger Gold Preferred Complete Rx (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,788 2018 Formulary |
|
2017 Health Partners Medicare Value (HMO)
| $0.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H9207 -009 -0 | $2.00 | $20.00 | $47.00 | $47.00 | 3,713
2017 Formulary |
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2018 Health Partners Medicare Value (HMO)
| $0.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $20.00 | $47.00 | $47.00 | 3,814 2018 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 2017 --
|
H6622 -035 -0 | | | | | |
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2018 Humana Gold Plus H6622-035 (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,666 2018 Formulary |
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-- This plan not offered in 2017 --
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H6622 -043 -0 | | | | | |
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2018 Humana Gold Plus H6622-043 (HMO)
| $0.00 |
$6,700 |
$300 | No additional gap coverage, only the Donut Hole Discount | $9.00 | $19.00 | $47.00 | $47.00 | 3,192 2018 Formulary |
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-- This plan not offered in 2017 --
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H5216 -116 -0 | | | | | |
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2018 HumanaChoice H5216-116 (PPO)
| $0.00 |
$4,500 |
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 |
-- This plan not offered in 2017 --
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R0923 -001 -0 | | | | | |
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2018 HumanaChoice R0923-001 (Regional PPO)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2017 Vibra Health Plan Essential Coverage (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H9408 -001 -0 | $0.00 | $15.00 | $42.00 | $42.00 | 3,247
2017 Formulary |
new |
new |
new |
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2018 Vibra Health Plan Essential Coverage (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $42.00 | $42.00 | 3,301 2018 Formulary |
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2017 AdvantraOne (PPO)
| $23.00 |
$6,700 |
$400 | Yes, some additional gap coverage. |
H5522 -017 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,670
2017 Formulary |
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2018 AdvantraOne (PPO)
| $19.00 |
$6,700 |
$195 | Yes, some additional gap coverage. | $2.00 | $5.00 | $42.00 | $42.00 | 5,223 2018 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 |
2017 UnitedHealthcare Dual Complete (HMO SNP)
| $34.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H3113 -009 -0 | | | | | 3,683
2017 Formulary |
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2018 UnitedHealthcare Dual Complete (HMO SNP)
| $19.00 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,779 2018 Formulary |
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2017 UPMC for Life HMO Deductible with Rx (HMO)
| $16.00 |
$4,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3907 -039 -0 | $14.00 | $47.00 | $100.00 | $100.00 | 3,736
2017 Formulary |
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2018 UPMC for Life HMO Deductible with Rx (HMO)
| $20.00 |
$4,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,762 2018 Formulary |
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-- This plan not offered in 2017 --
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H3962 -019 -0 | | | | | |
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2018 BlueJourney Alliance Heart and Diabetes Care (HMO SNP)
| $23.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $42.00 | $42.00 | 4,198 2018 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 |
2017 Cigna-HealthSpring Preferred (HMO)
| $20.00 |
$6,700 |
$280 | No additional gap coverage, only the Donut Hole Discount |
H3949 -030 -0 | $4.00 | $10.00 | $42.00 | $42.00 | 3,420
2017 Formulary |
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2018 Cigna-HealthSpring Preferred (HMO)
| $23.00 |
$6,700 |
$280 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $10.00 | $42.00 | $42.00 | 3,508 2018 Formulary |
|
-- This plan not offered in 2017 --
|
H3916 -034 -4 | | | | | |
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2018 Community Blue Medicare PPO Signature (PPO)
| $23.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $42.00 | $42.00 | 3,555 2018 Formulary |
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2017 UnitedHealthcare Dual Complete ONE (HMO SNP)
| $35.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H3113 -012 -0 | | | | | 3,683
2017 Formulary |
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2018 UnitedHealthcare Dual Complete ONE (HMO SNP)
| $23.50 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,779 2018 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 |
2017 AARP MedicareComplete Choice Plan 1 (PPO)
| $36.00 |
$6,700 |
$230 | No additional gap coverage, only the Donut Hole Discount |
H2228 -035 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,683
2017 Formulary |
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2018 AARP MedicareComplete Choice Plan 1 (PPO)
| $24.00 |
$6,700 |
$130 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,779 2018 Formulary |
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-- This plan not offered in 2017 --
|
H6622 -038 -0 | | | | | |
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2018 Humana Gold Plus SNP-DE H6622-038 (HMO SNP)
| $25.00 |
n/a |
$230 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $19.00 | $47.00 | $47.00 | 3,666 2018 Formulary |
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2017 Humana Gold Choice H8145-055 (PFFS)
| $24.00 |
n/a |
No Rx Coverage |
H8145 -055 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
2018 Humana Gold Choice H8145-055 (PFFS)
| $29.00 |
n/a |
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 |
2017 UnitedHealthcare Assisted Living Plan (PPO SNP)
| $19.00 |
n/a |
$50 | No additional gap coverage, only the Donut Hole Discount |
H0710 -018 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,683
2017 Formulary |
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-- |
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2018 UnitedHealthcare Assisted Living Plan (PPO SNP)
| $29.30 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,779 2018 Formulary |
|
2017 Cigna-HealthSpring TotalCare (HMO SNP)
| $28.80 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H3949 -009 -0 | | | | | n/a |
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2018 Cigna-HealthSpring TotalCare (HMO SNP)
| $29.90 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,508 2018 Formulary |
|
2017 UnitedHealthcare Nursing Home Plan (PPO SNP)
| $29.80 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H0710 -017 -0 | | | | | 3,683
2017 Formulary |
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-- |
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2018 UnitedHealthcare Nursing Home Plan 2 (PPO SNP)
| $32.70 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,779 2018 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 2017 --
|
H3962 -018 -0 | | | | | |
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|
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2018 BlueJourney Alliance Lung Care (HMO SNP)
| $33.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $42.00 | $42.00 | 4,198 2018 Formulary |
|
-- This plan not offered in 2017 --
|
H5533 -008 -0 | | | | | |
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2018 UPMC for Life PPO Rx Enhanced (PPO)
| $35.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,762 2018 Formulary |
|
2017 Advantra Silver Plus (HMO)
| $61.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3959 -039 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,670
2017 Formulary |
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2018 Advantra Silver Plus (HMO)
| $36.00 |
$6,700 |
$95 | Yes, some additional gap coverage. | $2.00 | $5.00 | $42.00 | $42.00 | 5,223 2018 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 |
2017 Health Partners Medicare Prime (HMO)
| $39.40 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H9207 -010 -0 | $7.00 | $20.00 | $47.00 | $47.00 | 3,713
2017 Formulary |
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2018 Health Partners Medicare Prime (HMO)
| $37.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $20.00 | $47.00 | $47.00 | 3,814 2018 Formulary |
|
2017 Health Partners Medicare Special (HMO SNP)
| $39.40 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H9207 -004 -0 | | | | | 3,603
2017 Formulary |
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2018 Health Partners Medicare Special (HMO SNP)
| $37.00 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,738 2018 Formulary |
|
2017 HumanaChoice H5525-006 (PPO)
| $37.00 |
$6,700 |
$360 | Yes, some additional gap coverage. |
H5525 -006 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,820
2017 Formulary |
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|
|
|
2018 HumanaChoice H5525-006 (PPO)
| $37.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,666 2018 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 |
2017 AmeriHealth VIP Care (HMO SNP)
| $39.40 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H4227 -002 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,201
2017 Formulary |
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2018 AmeriHealth Caritas VIP Care (HMO SNP)
| $37.20 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount | $19.00 | $20.00 | $47.00 | $47.00 | 3,363 2018 Formulary |
|
2017 Gateway Health Medicare Assured Diamond (HMO SNP)
| $39.40 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H5932 -001 -0 | | | | | 3,021
2017 Formulary |
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|
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2018 Gateway Health Medicare Assured Diamond (HMO SNP)
| $37.20 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,150 2018 Formulary |
|
2017 Gateway Health Medicare Assured Ruby (HMO SNP)
| $39.40 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H5932 -009 -0 | | | | | 3,021
2017 Formulary |
|
|
|
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2018 Gateway Health Medicare Assured Ruby (HMO SNP)
| $37.20 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,150 2018 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 |
2017 Geisinger Gold Secure Rx (HMO SNP)
| $39.40 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H3954 -097 -0 | | | | | 3,767
2017 Formulary |
|
|
|
|
2018 Geisinger Gold Secure Rx (HMO SNP)
| $37.20 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,788 2018 Formulary |
|
2017 Geisinger Gold Classic Complete Rx (HMO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H3954 -158 -3 | $3.00 | $20.00 | $47.00 | $47.00 | 3,767
2017 Formulary |
|
|
|
|
2018 Geisinger Gold Classic Complete Rx (HMO)
| $38.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,788 2018 Formulary |
|
2017 Geisinger Gold Classic Advantage (HMO)
| $70.00 |
$3,400 |
No Rx Coverage |
H3954 -156 -3 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2018 Geisinger Gold Classic Advantage (HMO)
| $40.00 |
$3,400 |
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 |
-- This plan not offered in 2017 --
|
H3962 -004 -0 | | | | | |
|
|
|
|
2018 BlueJourney Value (HMO)
| $48.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $42.00 | $42.00 | 4,198 2018 Formulary |
|
2017 Vibra Health Plan Enhanced Coverage (PPO)
| $49.50 |
$4,800 |
$0 | Yes, some additional gap coverage. |
H9408 -002 -0 | $0.00 | $10.00 | $35.00 | $35.00 | 3,247
2017 Formulary |
new |
new |
new |
|
2018 Vibra Health Plan Enhanced Coverage (PPO)
| $55.00 |
$4,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 3,301 2018 Formulary |
|
2017 Aetna Medicare Standard Plan (HMO)
| $49.00 |
$6,700 |
$100 | Yes, some additional gap coverage. |
H3931 -070 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,670
2017 Formulary |
|
|
|
|
2018 Aetna Medicare Silver Plan (HMO)
| $56.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 5,223 2018 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 |
2017 Cigna-HealthSpring Achieve (HMO SNP)
| $58.50 |
n/a |
$280 | No additional gap coverage, only the Donut Hole Discount |
H3949 -024 -0 | $4.00 | $10.00 | $42.00 | $42.00 | n/a |
|
|
|
|
2018 Cigna-HealthSpring Achieve (HMO SNP)
| $58.00 |
n/a |
$280 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $10.00 | $42.00 | $42.00 | 3,508 2018 Formulary |
|
2017 BlueJourney Classic (PPO)
| $55.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3923 -013 -0 | $3.00 | $15.00 | $42.00 | $42.00 | 3,098
2017 Formulary |
|
|
|
|
2018 BlueJourney Classic (PPO)
| $62.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $42.00 | $42.00 | 4,198 2018 Formulary |
|
2017 Humana Gold Choice H8145-052 (PFFS)
| $60.00 |
n/a |
$360 | Yes, some additional gap coverage. |
H8145 -052 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,820
2017 Formulary |
|
|
|
|
2018 Humana Gold Choice H8145-052 (PFFS)
| $63.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,666 2018 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 |
2017 AARP MedicareComplete Choice Plan 2 (PPO)
| $66.00 |
$4,900 |
$210 | No additional gap coverage, only the Donut Hole Discount |
H2228 -036 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,683
2017 Formulary |
|
|
|
|
2018 AARP MedicareComplete Choice Plan 2 (PPO)
| $64.00 |
$4,900 |
$110 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,779 2018 Formulary |
|
2017 Freedom Blue PPO ValueRx (PPO)
| $75.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3916 -018 -0 | $3.00 | $20.00 | $47.00 | $47.00 | 4,727
2017 Formulary |
|
|
|
|
2018 Freedom Blue PPO ValueRx (PPO)
| $73.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $42.00 | $42.00 | 4,214 2018 Formulary |
|
2017 Geisinger Gold Preferred Advantage Rx (PPO)
| $75.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H3924 -059 -3 | $3.00 | $20.00 | $47.00 | $47.00 | 3,767
2017 Formulary |
|
|
|
|
2018 Geisinger Gold Preferred Advantage Rx (PPO)
| $77.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,788 2018 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 |
2017 UPMC for Life HMO Rx (HMO)
| $95.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3907 -040 -0 | $12.00 | $47.00 | $100.00 | $100.00 | 3,736
2017 Formulary |
|
|
|
|
2018 UPMC for Life HMO Rx (HMO)
| $81.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,762 2018 Formulary |
|
2017 Advantra Silver Plus (PPO)
| $84.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5522 -013 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,670
2017 Formulary |
|
|
|
|
2018 Advantra Silver Plus (PPO)
| $86.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 5,215 2018 Formulary |
|
2017 Freedom Blue PPO Basic (PPO)
| $93.00 |
$6,700 |
No Rx Coverage |
H3916 -012 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2018 Freedom Blue PPO Basic (PPO)
| $93.00 |
$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 |
-- This plan not offered in 2017 --
|
R0923 -002 -0 | | | | | |
|
|
|
|
2018 HumanaChoice R0923-002 (Regional PPO)
| $95.00 |
$6,700 |
$315 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $47.00 | $47.00 | 3,666 2018 Formulary |
|
-- This plan not offered in 2017 --
|
H5216 -120 -0 | | | | | |
|
|
|
|
2018 HumanaChoice H5216-120 (PPO)
| $117.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $47.00 | $47.00 | 3,666 2018 Formulary |
|
2017 Aetna Medicare Premier Plan (PPO)
| $119.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5521 -012 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,670
2017 Formulary |
|
|
|
|
2018 Aetna Medicare Premier Plan (PPO)
| $126.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $2.00 | $5.00 | $42.00 | $42.00 | 5,223 2018 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 |
2017 Advantra Gold (PPO)
| $125.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5522 -002 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,894
2017 Formulary |
|
|
|
|
2018 Advantra Gold (PPO)
| $136.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 5,215 2018 Formulary |
|
2017 Cigna-HealthSpring Preferred Plus (HMO)
| $140.00 |
$6,700 |
$280 | No additional gap coverage, only the Donut Hole Discount |
H3949 -013 -0 | $2.00 | $8.00 | $42.00 | $42.00 | 3,420
2017 Formulary |
|
|
|
|
2018 Cigna-HealthSpring Preferred Plus (HMO)
| $139.00 |
$6,700 |
$280 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $8.00 | $42.00 | $42.00 | 3,508 2018 Formulary |
|
-- This plan not offered in 2017 --
|
H3962 -001 -0 | | | | | |
|
|
|
|
2018 BlueJourney Premier (HMO)
| $148.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $42.00 | $42.00 | 4,198 2018 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 |
2017 Geisinger Gold Classic Advantage Rx (HMO)
| $122.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3954 -157 -3 | $3.00 | $20.00 | $47.00 | $47.00 | 3,767
2017 Formulary |
|
|
|
|
2018 Geisinger Gold Classic Advantage Rx (HMO)
| $154.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,788 2018 Formulary |
|
2017 Aetna Medicare Gold Plan (PPO)
| $159.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H5521 -122 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,670
2017 Formulary |
|
|
|
|
2018 Aetna Medicare Gold Plan (PPO)
| $156.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $2.00 | $5.00 | $42.00 | $42.00 | 5,223 2018 Formulary |
|
2017 BlueJourney Prime (PPO)
| $175.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3923 -017 -0 | $3.00 | $15.00 | $42.00 | $42.00 | 4,163
2017 Formulary |
|
|
|
|
2018 BlueJourney Prime (PPO)
| $169.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $42.00 | $42.00 | 4,198 2018 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 |
2017 Freedom Blue PPO Standard (PPO)
| $190.50 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3916 -015 -0 | $3.00 | $20.00 | $47.00 | $47.00 | 4,727
2017 Formulary |
|
|
|
|
2018 Freedom Blue PPO Standard (PPO)
| $188.50 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $42.00 | $42.00 | 4,357 2018 Formulary |
|
2017 Freedom Blue PPO Deluxe (PPO)
| $293.50 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3916 -005 -0 | $3.00 | $20.00 | $47.00 | $47.00 | 4,727
2017 Formulary |
|
|
|
|
2018 Freedom Blue PPO Deluxe (PPO)
| $291.50 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $42.00 | $42.00 | 4,357 2018 Formulary |
|
2017 Humana Gold Plus H6859-001 (HMO)
| $0.00 |
$6,700 |
$360 | Yes, some additional gap coverage. |
H6859 -001 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,820
2017 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H6622-035 (HMO) H6622-035 --
| | | | | |
|
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 |
2017 Humana Gold Plus SNP-DE H6859-008 (HMO SNP)
| $34.90 |
n/a |
$150 | No additional gap coverage, only the Donut Hole Discount |
H6859 -008 -0 | $0.00 | $19.00 | $47.00 | $47.00 | 3,820
2017 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus SNP-DE H6622-038 (HMO SNP) H6622-038 --
| | | | | |
|
2017 HumanaChoice R5826-062 (Regional PPO)
| $0.00 |
$4,500 |
No Rx Coverage |
R5826 -062 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to HumanaChoice R0923-001 (Regional PPO) R0923-001 --
| | | | | |
|
2017 HumanaChoice R5826-002 (Regional PPO)
| $97.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount |
R5826 -002 -0 | $10.00 | $20.00 | $47.00 | $47.00 | n/a |
|
|
|
|
-- Members will be assigned to HumanaChoice R0923-002 (Regional PPO) R0923-002 --
| | | | | |
|
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 |
2017 UPMC for Life HMO (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H3907 -038 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2018 --
|
| | | | |
|
2017 Community Blue Medicare HMO Signature (HMO)
| $16.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3957 -040 -0 | $5.00 | $20.00 | $47.00 | $47.00 | 4,727
2017 Formulary |
|
|
|
|
-- This plan not offered in 2018 --
|
| | | | |
|