There are 71 Medicare Advantage plans meeting your criteria.
2018 / 2019 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 |
2018 AARP MedicareComplete Plan 7 (HMO)
| $0.00 |
$4,500 |
$255 | No additional gap coverage, only the Donut Hole Discount |
H5253 -049 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,779
2018 Formulary |
|
|
|
|
2019 AARP MedicareComplete Plan 7 (HMO)
| $0.00 |
$4,500 |
$225 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $47.00 | $47.00 | 3,516 2019 Formulary |
|
2018 Aetna Medicare Value Plan (HMO)
| $0.00 |
$4,650 |
$75 | Yes, some additional gap coverage. |
H3931 -107 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Aetna Medicare Value Plan (HMO)
| $0.00 |
$3,600 |
$95 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,744 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H0724 -001 -0 | | | | | |
new |
new |
new |
|
2019 Allwell Medicare (HMO)
| $0.00 |
$4,900 |
$125 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $37.00 | $37.00 | 3,811 2019 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 |
2018 Anthem MediBlue Essential (HMO)
| $0.00 |
$4,900 |
$60 | Yes, some additional gap coverage. |
H3655 -032 -0 | $4.00 | $15.00 | $42.00 | $42.00 | 3,752
2018 Formulary |
|
|
|
|
2019 Anthem MediBlue Essential (HMO)
| $0.00 |
$4,900 |
$60 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 3,606 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3655 -040 -0 | | | | | |
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|
|
|
2019 Anthem MediBlue Preferred (HMO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $4.00 | $10.00 | $42.00 | $42.00 | 3,606 2019 Formulary |
|
2018 Anthem MediBlue Prime Select (HMO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H3655 -038 -0 | $2.00 | $12.00 | $42.00 | $42.00 | 3,752
2018 Formulary |
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|
|
|
2019 Anthem MediBlue Prime Select (HMO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $2.00 | $12.00 | $42.00 | $42.00 | 3,606 2019 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 2018 --
|
H6396 -004 -0 | | | | | |
|
|
|
|
2019 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 | 3,078 2019 Formulary |
|
2018 CareSource MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H8452 -001 -0 | 0% | 0% | 0% | | 3,153
2018 Formulary |
-- |
-- |
-- |
|
2019 CareSource MyCare Ohio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | | 3,163 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H6622 -023 -0 | | | | | |
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|
|
|
2019 Humana Cleveland Clinic Preferred (HMO)
| $0.00 |
$3,200 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,368 2019 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 |
2018 Humana Gold Plus H6622-014 (HMO)
| $0.00 |
$4,900 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H6622 -014 -0 | $2.00 | $8.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
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|
|
|
2019 Humana Gold Plus H6622-014 (HMO)
| $0.00 |
$4,300 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $47.00 | $47.00 | 3,368 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H5525 -042 -0 | | | | | |
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|
|
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2019 HumanaChoice H5525-042 (PPO)
| $0.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,368 2019 Formulary |
|
2018 HumanaChoice R5495-001 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5495 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
|
2019 HumanaChoice R5495-001 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2018 MedMutual Advantage Classic (HMO)
| $0.00 |
$4,300 |
$195 | Yes, some additional gap coverage. |
H6723 -001 -1 | $5.00 | $19.00 | $47.00 | $47.00 | 3,863
2018 Formulary |
|
|
|
|
2019 MedMutual Advantage Classic (HMO)
| $0.00 |
$4,300 |
$160 | Yes, some additional gap coverage. | $0.00 | $15.00 | $42.00 | $42.00 | 3,549 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H5475 -022 -0 | | | | | |
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|
|
|
2019 MeridianCare Essential (HMO)
| $0.00 |
$4,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $47.00 | $47.00 | 3,575 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3653 -015 -0 | | | | | |
|
|
|
|
2019 Paramount Elite - Standard Medical and Drug (HMO)
| $0.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $45.00 | $45.00 | 3,078 2019 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 |
2018 PrimeTime Health Plan Aultimate (HMO-POS)
| $0.00 |
$5,900 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H3664 -021 -0 | $3.00 | $15.00 | $45.00 | $45.00 | 4,675
2018 Formulary |
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|
|
|
2019 PrimeTime Health Plan Aultimate (HMO-POS)
| $0.00 |
$4,900 |
$200 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $45.00 | $45.00 | 3,911 2019 Formulary |
|
2018 PrimeTime Health Plan Basic - MA Only (HMO-POS)
| $0.00 |
$3,400 |
No Rx Coverage |
H3664 -014 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2019 PrimeTime Health Plan Basic - MA Only (HMO-POS)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2018 SummaCare Medicare Topaz (HMO)
| $0.00 |
$3,800 |
$150 | Yes, some additional gap coverage. |
H3660 -050 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,817
2018 Formulary |
|
|
|
|
2019 SummaCare Medicare Topaz (HMO)
| $0.00 |
$3,800 |
$150 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,562 2019 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 |
2018 The Health Plan SecureCare - Option I, MA Only (HMO)
| $0.00 |
$4,500 |
No Rx Coverage |
H3672 -014 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2019 The Health Plan SecureCare - Option I, MA Only (HMO)
| $0.00 |
$3,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2018 The Health Plan SecureCare - Option IV (HMO)
| $0.00 |
$3,750 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H3672 -018 -0 | $5.00 | $10.00 | $35.00 | $35.00 | 3,614
2018 Formulary |
|
|
|
|
2019 The Health Plan SecureCare - Option IV (HMO)
| $0.00 |
$4,200 |
$200 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $35.00 | $35.00 | 3,319 2019 Formulary |
|
2018 UnitedHealthcare Connected for MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H2531 -001 -0 | 0% | 0% | 0% | | 3,502
2018 Formulary |
-- |
-- |
-- |
|
2019 UnitedHealthcare Connected for MyCareOhio (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | | | 3,299 2019 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 |
2018 Anthem MediBlue Access Core (Regional PPO)
| $18.00 |
$5,400 |
No Rx Coverage |
R5941 -013 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2019 Anthem MediBlue Access Core (Regional PPO)
| $15.00 |
$5,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2018 --
|
H5216 -106 -0 | | | | | |
|
|
|
|
2019 HumanaChoice H5216-106 (PPO)
| $15.00 |
$3,400 |
$125 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $47.00 | $47.00 | 3,368 2019 Formulary |
|
2018 AARP MedicareComplete Plan 1 (HMO)
| $19.00 |
$3,600 |
$170 | No additional gap coverage, only the Donut Hole Discount |
H5253 -050 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,779
2018 Formulary |
|
|
|
|
2019 AARP MedicareComplete Plan 1 (HMO)
| $18.00 |
$3,600 |
$170 | Yes, some additional gap coverage. | $2.00 | $8.00 | $45.00 | $45.00 | 3,516 2019 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 |
2018 UnitedHealthcare Dual Complete (HMO SNP)
| $20.20 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H5253 -059 -0 | | | | | 3,779
2018 Formulary |
|
|
|
|
2019 UnitedHealthcare Dual Complete (HMO SNP)
| $25.60 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | 15% | 15% | 15% | 15% | 3,516 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3653 -022 -0 | | | | | |
|
|
|
|
2019 Paramount Elite - Prime Medical and Drug (HMO)
| $28.00 |
$4,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $45.00 | $45.00 | 3,078 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H1119 -001 -0 | | | | | |
new |
new |
new |
|
2019 Valor Health Plan (HMO SNP)
| $30.90 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | 25% | | | | 3,615 2019 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 |
2018 Humana Gold Plus SNP-DE H6622-015 (HMO SNP)
| $20.40 |
n/a |
$220 | No additional gap coverage, only the Donut Hole Discount |
H6622 -015 -0 | $0.00 | $13.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
|
|
|
|
2019 Humana Gold Plus SNP-DE H6622-015 (HMO SNP)
| $31.20 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $13.00 | $47.00 | $47.00 | 3,368 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H5337 -001 -0 | | | | | |
new |
new |
new |
|
2019 Aetna Better Health of Ohio Dual Preferred (HMO SNP)
| $32.10 |
n/a |
$220 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $5.00 | $47.00 | $47.00 | 3,744 2019 Formulary |
|
2018 Allwell Dual Medicare (HMO SNP)
| $31.90 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0908 -001 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,470
2018 Formulary |
-- |
-- |
|
|
2019 Allwell Dual Medicare (HMO SNP)
| $32.90 |
n/a |
$50 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,297 2019 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 |
2018 Anthem MediBlue Dual Advantage (HMO SNP)
| $32.00 |
n/a |
$405 | Yes, some additional gap coverage. |
H3655 -033 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,752
2018 Formulary |
|
|
|
|
2019 Anthem MediBlue Dual Advantage (HMO SNP)
| $32.90 |
n/a |
$415 | Yes, some additional gap coverage. | $0.00 | $4.00 | $47.00 | $47.00 | 3,606 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3655 -041 -0 | | | | | |
|
|
|
|
2019 Anthem MediBlue Extra (HMO)
| $32.90 |
$6,700 |
$415 | Yes, some additional gap coverage. | $0.00 | $7.00 | $47.00 | $47.00 | 3,606 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H6396 -001 -0 | | | | | |
|
|
|
|
2019 CareSource Advantage (HMO)
| $32.90 |
$4,600 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $47.00 | $47.00 | 3,078 2019 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 |
2018 Gateway Health Medicare Assured Diamond (HMO SNP)
| $31.90 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H9190 -001 -0 | | | | | 3,150
2018 Formulary |
|
|
|
|
2019 Gateway Health Medicare Assured Diamond (HMO SNP)
| $32.90 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,113 2019 Formulary |
|
2018 Gateway Health Medicare Assured Ruby (HMO SNP)
| $31.90 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H9190 -002 -0 | | | | | 3,150
2018 Formulary |
|
|
|
|
2019 Gateway Health Medicare Assured Ruby (HMO SNP)
| $32.90 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,113 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H5475 -021 -0 | | | | | |
|
|
|
|
2019 MeridianCare Extra (HMO SNP)
| $32.90 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,575 2019 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 2018 --
|
H7119 -001 -0 | | | | | |
new |
new |
new |
|
2019 Provider Partners Health Plan of Ohio (HMO SNP)
| $32.90 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | 25% | | | | 3,615 2019 Formulary |
|
2018 UnitedHealthcare Nursing Home Plan 1 (PPO SNP)
| $32.00 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H2406 -001 -0 | | | | | 3,779
2018 Formulary |
|
|
|
|
2019 UnitedHealthcare Nursing Home Plan 1 (PPO SNP)
| $32.90 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,516 2019 Formulary |
|
2018 UnitedHealthcare Nursing Home Plan 2 (PPO SNP)
| $32.00 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H0710 -027 -0 | | | | | 3,779
2018 Formulary |
|
-- |
|
|
2019 UnitedHealthcare Nursing Home Plan 2 (PPO SNP)
| $32.90 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,516 2019 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 |
2018 The Health Plan SecureCare SNP (HMO SNP)
| $36.70 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H3672 -019 -0 | | | | | 3,614
2018 Formulary |
|
|
|
|
2019 The Health Plan SecureCare SNP (HMO SNP)
| $36.70 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | 15% | 15% | 15% | 15% | 3,319 2019 Formulary |
|
2018 MedMutual Advantage Choice (HMO)
| $38.00 |
$3,950 |
$95 | Yes, some additional gap coverage. |
H6723 -002 -1 | $2.00 | $14.00 | $47.00 | $47.00 | 3,863
2018 Formulary |
|
|
|
|
2019 MedMutual Advantage Choice (HMO)
| $38.00 |
$3,950 |
$55 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,549 2019 Formulary |
|
2018 MedMutual Advantage Select (PPO)
| $35.00 |
$6,500 |
$195 | Yes, some additional gap coverage. |
H4497 -001 -1 | $5.00 | $19.00 | $47.00 | $47.00 | 3,863
2018 Formulary |
|
|
|
|
2019 MedMutual Advantage Select (PPO)
| $38.00 |
$6,500 |
$160 | Yes, some additional gap coverage. | $0.00 | $15.00 | $42.00 | $42.00 | 3,549 2019 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 |
2018 PrimeTime Health Plan Classic (HMO-POS)
| $42.00 |
$4,900 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H3664 -020 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 4,675
2018 Formulary |
|
|
|
|
2019 PrimeTime Health Plan Classic (HMO-POS)
| $39.00 |
$4,200 |
$150 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,911 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3653 -018 -0 | | | | | |
|
|
|
|
2019 Paramount Elite - Enhanced Medical Only (HMO)
| $40.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2018 SummaCare Medicare Ruby (HMO)
| $40.00 |
$3,600 |
$0 | Yes, some additional gap coverage. |
H3660 -044 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,817
2018 Formulary |
|
|
|
|
2019 SummaCare Medicare Ruby (HMO)
| $43.00 |
$3,600 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,562 2019 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 |
2018 The Health Plan SecureCare - Option II (HMO)
| $46.00 |
$4,500 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H3672 -013 -0 | $3.00 | $10.00 | $35.00 | $35.00 | 3,614
2018 Formulary |
|
|
|
|
2019 The Health Plan SecureCare - Option II (HMO)
| $46.00 |
$3,900 |
$100 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $35.00 | $35.00 | 3,319 2019 Formulary |
|
2018 Anthem MediBlue Plus (HMO)
| $62.00 |
$4,100 |
$60 | Yes, some additional gap coverage. |
H3655 -034 -0 | $4.00 | $15.00 | $42.00 | $42.00 | 3,752
2018 Formulary |
|
|
|
|
2019 Anthem MediBlue Plus (HMO)
| $63.00 |
$4,100 |
$60 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 3,606 2019 Formulary |
|
2018 The Health Plan SecureChoice - Option II (PPO)
| $66.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H8604 -010 -0 | $3.00 | $10.00 | $35.00 | $35.00 | 3,614
2018 Formulary |
|
|
|
|
2019 The Health Plan SecureChoice - Option II (PPO)
| $66.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $35.00 | $35.00 | 3,319 2019 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 2018 --
|
H6396 -002 -0 | | | | | |
|
|
|
|
2019 CareSource Advantage Plus (HMO)
| $67.00 |
$3,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,078 2019 Formulary |
|
2018 Anthem MediBlue Access (PPO)
| $70.00 |
$6,200 |
$50 | Yes, some additional gap coverage. |
H4036 -010 -2 | $4.00 | $15.00 | $42.00 | $42.00 | 3,752
2018 Formulary |
|
|
|
|
2019 Anthem MediBlue Access (PPO)
| $68.00 |
$6,200 |
$50 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 3,606 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3653 -004 -0 | | | | | |
|
|
|
|
2019 Paramount Elite - Enhanced Medical and Drug (HMO)
| $68.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $45.00 | $45.00 | 4,086 2019 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 |
2018 Anthem MediBlue Access Basic (Regional PPO)
| $75.00 |
$6,000 |
$200 | Yes, some additional gap coverage. |
R5941 -014 -0 | $6.00 | $15.00 | $42.00 | $42.00 | 3,752
2018 Formulary |
|
|
|
|
2019 Anthem MediBlue Access Basic (Regional PPO)
| $70.00 |
$6,000 |
$200 | Yes, some additional gap coverage. | $6.00 | $15.00 | $42.00 | $42.00 | tbd |
|
2018 MedMutual Advantage Preferred (PPO)
| $70.00 |
$5,700 |
$95 | Yes, some additional gap coverage. |
H4497 -002 -1 | $2.00 | $14.00 | $47.00 | $47.00 | 3,863
2018 Formulary |
|
|
|
|
2019 MedMutual Advantage Preferred (PPO)
| $74.00 |
$5,700 |
$55 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,549 2019 Formulary |
|
2018 HumanaChoice H5216-024 (PPO)
| $87.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H5216 -024 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
|
|
|
|
2019 HumanaChoice H5216-024 (PPO)
| $75.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,368 2019 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 |
2018 SummaCare Medicare Sapphire (HMO-POS)
| $76.00 |
$3,600 |
$0 | Yes, some additional gap coverage. |
H3660 -029 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,817
2018 Formulary |
|
|
|
|
2019 SummaCare Medicare Sapphire (HMO-POS)
| $76.00 |
$3,600 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,562 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H4036 -017 -0 | | | | | |
|
|
|
|
2019 Anthem MediBlue Access Plus (PPO)
| $87.00 |
$4,300 |
$40 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 3,606 2019 Formulary |
|
2018 Humana Gold Plus H6622-019 (HMO)
| $87.00 |
$3,900 |
$125 | No additional gap coverage, only the Donut Hole Discount |
H6622 -019 -0 | $1.00 | $4.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
|
|
|
|
2019 Humana Gold Plus H6622-019 (HMO)
| $87.00 |
$3,900 |
$125 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $4.00 | $47.00 | $47.00 | 3,368 2019 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 |
2018 PrimeTime Health Plan Plus (HMO-POS)
| $89.00 |
$3,900 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H3664 -017 -0 | $0.00 | $6.00 | $45.00 | $45.00 | 4,675
2018 Formulary |
|
|
|
|
2019 PrimeTime Health Plan Plus (HMO-POS)
| $89.00 |
$3,600 |
$100 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $45.00 | $45.00 | 3,911 2019 Formulary |
|
2018 Aetna Medicare Choice Plan (PPO)
| $92.00 |
$4,100 |
$0 | Yes, some additional gap coverage. |
H5521 -134 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Aetna Medicare Choice Plan (PPO)
| $98.00 |
$4,100 |
$0 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,744 2019 Formulary |
|
2018 MedMutual Advantage Plus (HMO)
| $99.00 |
$3,400 |
$95 | Yes, some additional gap coverage. |
H6723 -003 -1 | $2.00 | $14.00 | $47.00 | $47.00 | 3,863
2018 Formulary |
|
|
|
|
2019 MedMutual Advantage Plus (HMO)
| $99.00 |
$3,400 |
$55 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,549 2019 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 |
2018 HumanaChoice R5495-002 (Regional PPO)
| $96.00 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
R5495 -002 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
|
|
|
|
2019 HumanaChoice R5495-002 (Regional PPO)
| $100.00 |
$6,700 |
$395 | No additional gap coverage, only the Donut Hole Discount | $9.00 | $19.00 | $47.00 | $47.00 | tbd |
|
2018 AARP MedicareComplete Plan 3 (HMO)
| $115.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5253 -051 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,779
2018 Formulary |
|
|
|
|
2019 AARP MedicareComplete Plan 3 (HMO)
| $111.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $45.00 | $45.00 | 3,516 2019 Formulary |
|
2018 MedMutual Advantage Premium (PPO)
| $110.00 |
$3,400 |
$95 | Yes, some additional gap coverage. |
H4497 -003 -1 | $2.00 | $14.00 | $47.00 | $47.00 | 3,863
2018 Formulary |
|
|
|
|
2019 MedMutual Advantage Premium (PPO)
| $119.00 |
$3,400 |
$55 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,549 2019 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 |
2018 Aetna Medicare Standard Plan (PPO)
| $122.00 |
$4,750 |
$150 | Yes, some additional gap coverage. |
H5521 -020 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Aetna Medicare Standard Plan (PPO)
| $120.00 |
$4,750 |
$0 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,744 2019 Formulary |
|
2018 HumanaChoice H5525-030 (PPO)
| $163.00 |
$3,400 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H5525 -030 -0 | $1.00 | $4.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
|
|
|
|
2019 HumanaChoice H5525-030 (PPO)
| $155.00 |
$3,400 |
$100 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $4.00 | $47.00 | $47.00 | 3,368 2019 Formulary |
|
2018 SummaCare Medicare Emerald (HMO-POS)
| $180.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3660 -028 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,817
2018 Formulary |
|
|
|
|
2019 SummaCare Medicare Emerald (HMO-POS)
| $180.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $45.00 | $45.00 | 3,562 2019 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 |
2018 Aetna Medicare OH Connect Gold 2 (Regional PPO)
| $177.00 |
$3,500 |
$150 | No additional gap coverage, only the Donut Hole Discount |
R6694 -005 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Aetna Medicare OH Connect Gold 2 (Regional PPO)
| $190.00 |
$3,500 |
$350 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $5.00 | $47.00 | $47.00 | tbd |
|
2018 Aetna Medicare OH Connect Gold (Regional PPO)
| $187.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
R6694 -003 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Aetna Medicare OH Connect Gold (Regional PPO)
| $204.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | tbd |
|
2018 Anthem MediBlue Access Plus (PPO)
| $89.00 |
$4,300 |
$40 | Yes, some additional gap coverage. |
H4036 -012 -2 | $4.00 | $15.00 | $42.00 | $42.00 | 3,752
2018 Formulary |
|
|
|
|
-- Members will be assigned to Anthem MediBlue Access Plus (PPO) H4036-017 --
| | | | | |
|
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 |
2018 Gateway Health Medicare Assured Prime (HMO)
| $107.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H9190 -006 -0 | $0.00 | $20.00 | $45.00 | $45.00 | 3,150
2018 Formulary |
|
|
|
|
-- This plan not offered in 2019 --
|
| | | | |
|
2018 Gateway Health Medicare Assured Select (HMO)
| $0.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H9190 -019 -0 | $1.00 | $16.00 | $45.00 | $45.00 | 3,150
2018 Formulary |
|
|
|
|
-- This plan not offered in 2019 --
|
| | | | |
|