There are 64 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 |
-- This plan not offered in 2018 --
|
H1924 -001 -0 | | | | | |
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|
|
|
2019 Lasso Healthcare (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2018 Advantra Basic Medical (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H3959 -041 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2019 Advantra Basic Medical (HMO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2018 Advantra Silver (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5522 -004 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
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|
2019 Advantra Silver (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,744 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 AdvantraOne (PPO)
| $19.00 |
$6,700 |
$195 | Yes, some additional gap coverage. |
H5522 -017 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
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|
|
|
2019 AdvantraOne (PPO)
| $0.00 |
$6,700 |
$395 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,744 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H5521 -263 -0 | | | | | |
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|
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2019 Aetna Medicare Silver (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $2.00 | $5.00 | $47.00 | $47.00 | 3,744 2019 Formulary |
|
2018 BlueJourney Essential (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3962 -007 -0 | $3.00 | $15.00 | $42.00 | $42.00 | 4,198
2018 Formulary |
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|
|
|
2019 BlueJourney Essential (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $42.00 | $42.00 | 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 Community Blue Medicare HMO Signature (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3957 -042 -4 | $0.00 | $15.00 | $42.00 | $42.00 | 3,555
2018 Formulary |
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|
|
|
2019 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 | 3,491 2019 Formulary |
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-- This plan not offered in 2018 --
|
H3954 -159 -17 | | | | | |
|
|
|
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2019 Geisinger Gold Classic Essential Rx (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,667 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3924 -060 -17 | | | | | |
|
|
|
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2019 Geisinger Gold Preferred Complete Rx (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,667 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 H6622-035 (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6622 -035 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
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|
|
|
2019 Humana Gold Plus H6622-035 (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $47.00 | $47.00 | 3,368 2019 Formulary |
|
2018 Humana Gold Plus H6622-043 (HMO)
| $0.00 |
$6,700 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H6622 -043 -0 | $9.00 | $19.00 | $47.00 | $47.00 | 3,192
2018 Formulary |
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|
|
|
2019 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 | 3,098 2019 Formulary |
|
2018 HumanaChoice H5216-116 (PPO)
| $0.00 |
$4,500 |
No Rx Coverage |
H5216 -116 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
2019 HumanaChoice H5216-116 (PPO)
| $0.00 |
$4,500 |
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 2018 --
|
H5525 -038 -0 | | | | | |
|
|
|
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2019 HumanaChoice H5525-038 (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,368 2019 Formulary |
|
2018 HumanaChoice R0923-001 (Regional PPO)
| $0.00 |
$4,500 |
No Rx Coverage |
R0923 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
|
2019 HumanaChoice R0923-001 (Regional PPO)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2018 UPMC for Life HMO Premier Rx (HMO)
| $0.00 |
$6,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3907 -045 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,631
2018 Formulary |
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|
|
|
2019 UPMC for Life HMO Premier Rx (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,360 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 Vibra Health Plan Essential Coverage (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H9408 -001 -0 | $0.00 | $15.00 | $42.00 | $42.00 | 3,301
2018 Formulary |
|
|
|
|
2019 Vibra Health Plan Essential (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $42.00 | $42.00 | 3,238 2019 Formulary |
|
2018 AARP MedicareComplete (HMO)
| $14.00 |
$6,700 |
$230 | No additional gap coverage, only the Donut Hole Discount |
H1944 -024 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,779
2018 Formulary |
|
|
|
|
2019 AARP MedicareComplete (HMO)
| $8.00 |
$5,900 |
$130 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,516 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H2228 -035 -0 | | | | | |
|
|
|
|
2019 AARP MedicareComplete Choice Plan 1 (PPO)
| $18.00 |
$6,700 |
$95 | No additional gap coverage, only the Donut Hole Discount | $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 Community Blue Medicare PPO Signature (PPO)
| $23.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3916 -034 -4 | $0.00 | $15.00 | $42.00 | $42.00 | 3,555
2018 Formulary |
|
|
|
|
2019 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 | 3,491 2019 Formulary |
|
2018 HumanaChoice H5525-006 (PPO)
| $37.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5525 -006 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
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|
|
|
2019 HumanaChoice H5525-006 (PPO)
| $25.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $47.00 | $47.00 | 3,368 2019 Formulary |
|
2018 UnitedHealthcare Dual Complete (HMO SNP)
| $19.00 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H3113 -009 -0 | | | | | 3,779
2018 Formulary |
|
|
|
|
2019 UnitedHealthcare Dual Complete (HMO SNP)
| $25.90 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 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 ONE (HMO SNP)
| $23.50 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H3113 -012 -0 | | | | | 3,779
2018 Formulary |
|
|
|
|
2019 UnitedHealthcare Dual Complete ONE (HMO SNP)
| $26.70 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $0.00 | $0.00 | 3,516 2019 Formulary |
|
2018 Advantra Silver Plus (HMO)
| $36.00 |
$6,700 |
$95 | Yes, some additional gap coverage. |
H3959 -039 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Advantra Silver Plus (HMO)
| $27.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,864 2019 Formulary |
|
2018 Advantra Silver Plus (PPO)
| $86.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5522 -013 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 5,215
2018 Formulary |
|
|
|
|
2019 Advantra Silver Plus (PPO)
| $29.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,864 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 Choice H8145-055 (PFFS)
| $29.00 |
n/a |
No Rx Coverage |
H8145 -055 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2019 Humana Gold Choice H8145-055 (PFFS)
| $29.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2018 --
|
H3954 -156 -17 | | | | | |
|
|
|
|
2019 Geisinger Gold Classic Advantage (HMO)
| $30.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2018 Humana Gold Plus SNP-DE H6622-038 (HMO SNP)
| $25.00 |
n/a |
$230 | No additional gap coverage, only the Donut Hole Discount |
H6622 -038 -0 | $0.00 | $19.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
|
|
|
|
2019 Humana Gold Plus SNP-DE H6622-038 (HMO SNP)
| $31.40 |
n/a |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $19.00 | $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 Advantra Cares (HMO SNP)
| $31.10 |
n/a |
$130 | No additional gap coverage, only the Donut Hole Discount |
H3959 -036 -0 | $3.00 | $7.00 | $47.00 | $47.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Advantra Cares (HMO SNP)
| $36.40 |
n/a |
$150 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $5.00 | $47.00 | $47.00 | 3,744 2019 Formulary |
|
2018 AmeriHealth Caritas VIP Care (HMO SNP)
| $37.20 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H4227 -002 -0 | $19.00 | $20.00 | $47.00 | $47.00 | 3,363
2018 Formulary |
|
|
|
|
2019 AmeriHealth Caritas VIP Care (HMO SNP)
| $37.00 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | $6.00 | 25% | | | 3,335 2019 Formulary |
|
2018 Gateway Health Medicare Assured Diamond (HMO SNP)
| $37.20 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H5932 -001 -0 | | | | | 3,150
2018 Formulary |
|
|
|
|
2019 Gateway Health Medicare Assured Diamond (HMO SNP)
| $37.00 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,113 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 Ruby (HMO SNP)
| $37.20 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H5932 -009 -0 | | | | | 3,150
2018 Formulary |
|
|
|
|
2019 Gateway Health Medicare Assured Ruby (HMO SNP)
| $37.00 |
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 Geisinger Gold Secure Rx (HMO SNP)
| $37.20 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H3954 -097 -0 | | | | | 3,788
2018 Formulary |
|
|
|
|
2019 Geisinger Gold Secure Rx (HMO SNP)
| $37.00 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | 15% | | | | 3,667 2019 Formulary |
|
2018 UnitedHealthcare Nursing Home Plan 2 (PPO SNP)
| $32.70 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H0710 -017 -0 | | | | | 3,779
2018 Formulary |
|
-- |
|
|
2019 UnitedHealthcare Nursing Home Plan 2 (PPO SNP)
| $37.00 |
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 UPMC for Life Dual (HMO SNP)
| $37.10 |
n/a |
$405 | No additional gap coverage, only the Donut Hole Discount |
H4279 -001 -0 | $7.00 | $10.00 | $14.00 | $14.00 | 3,762
2018 Formulary |
|
|
|
|
2019 UPMC for Life Dual (HMO SNP)
| $37.00 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $6.00 | $10.00 | $10.00 | 3,360 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3954 -158 -17 | | | | | |
|
|
|
|
2019 Geisinger Gold Classic Complete Rx (HMO)
| $38.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,667 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3924 -062 -17 | | | | | |
|
|
|
|
2019 Geisinger Gold Preferred Enhanced Rx (PPO)
| $45.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,667 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 Silver Plan (HMO)
| $56.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3931 -070 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Aetna Medicare Silver Plan (HMO)
| $47.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,864 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3962 -020 -0 | | | | | |
|
|
|
|
2019 BlueJourney Alliance Assisted Care (HMO SNP)
| $50.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $42.00 | $42.00 | 4,086 2019 Formulary |
|
2018 BlueJourney Value (HMO)
| $48.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3962 -004 -0 | $4.00 | $12.00 | $42.00 | $42.00 | 4,198
2018 Formulary |
|
|
|
|
2019 BlueJourney Value (HMO)
| $50.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $42.00 | $42.00 | 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 |
-- This plan not offered in 2018 --
|
H2228 -036 -0 | | | | | |
|
|
|
|
2019 AARP MedicareComplete Choice Plan 2 (PPO)
| $58.00 |
$5,400 |
$75 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,516 2019 Formulary |
|
2018 Humana Gold Choice H8145-052 (PFFS)
| $63.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H8145 -052 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
|
|
|
|
2019 Humana Gold Choice H8145-052 (PFFS)
| $58.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,368 2019 Formulary |
|
2018 UPMC for Life PPO Rx Enhanced (PPO)
| $135.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5533 -007 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,762
2018 Formulary |
|
|
|
|
2019 UPMC for Life PPO Rx Enhanced (PPO)
| $60.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,417 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 Vibra Health Plan Enhanced Coverage (PPO)
| $55.00 |
$4,800 |
$0 | Yes, some additional gap coverage. |
H9408 -002 -0 | $0.00 | $10.00 | $35.00 | $35.00 | 3,301
2018 Formulary |
|
|
|
|
2019 Vibra Health Plan Enhanced (PPO)
| $60.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $35.00 | $35.00 | 3,238 2019 Formulary |
|
2018 BlueJourney Classic (PPO)
| $62.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3923 -013 -0 | $3.00 | $15.00 | $42.00 | $42.00 | 4,198
2018 Formulary |
|
|
|
|
2019 BlueJourney Classic (PPO)
| $65.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $42.00 | $42.00 | 4,086 2019 Formulary |
|
2018 Freedom Blue PPO ValueRx (PPO)
| $73.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3916 -018 -0 | $0.00 | $15.00 | $42.00 | $42.00 | 4,214
2018 Formulary |
|
|
|
|
2019 Freedom Blue PPO ValueRx (PPO)
| $71.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $42.00 | $42.00 | 3,491 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 R0923-002 (Regional PPO)
| $95.00 |
$6,700 |
$315 | No additional gap coverage, only the Donut Hole Discount |
R0923 -002 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
|
|
|
|
2019 HumanaChoice R0923-002 (Regional PPO)
| $75.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $20.00 | $47.00 | $47.00 | tbd |
|
2018 UPMC for Life HMO Rx (HMO)
| $81.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3907 -047 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,762
2018 Formulary |
|
|
|
|
2019 UPMC for Life HMO Rx (HMO)
| $81.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,417 2019 Formulary |
|
2018 Aetna Medicare Premier Plan (PPO)
| $126.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5521 -012 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Aetna Medicare Premier Plan (PPO)
| $85.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,864 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 --
|
H3924 -059 -17 | | | | | |
|
|
|
|
2019 Geisinger Gold Preferred Advantage Rx (PPO)
| $87.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,667 2019 Formulary |
|
2018 Freedom Blue PPO Basic (PPO)
| $93.00 |
$6,700 |
No Rx Coverage |
H3916 -012 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2019 Freedom Blue PPO Basic (PPO)
| $93.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2018 HumanaChoice H5216-120 (PPO)
| $117.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -120 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,666
2018 Formulary |
|
|
|
|
2019 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 | 3,368 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 Aetna Medicare Gold Plan (PPO)
| $156.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H5521 -122 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 5,223
2018 Formulary |
|
|
|
|
2019 Aetna Medicare Gold Plan (PPO)
| $147.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,864 2019 Formulary |
|
2018 BlueJourney Premier (HMO)
| $148.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3962 -001 -0 | $3.00 | $10.00 | $42.00 | $42.00 | 4,198
2018 Formulary |
|
|
|
|
2019 BlueJourney Premier (HMO)
| $148.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $42.00 | $42.00 | 4,086 2019 Formulary |
|
-- This plan not offered in 2018 --
|
H3954 -157 -17 | | | | | |
|
|
|
|
2019 Geisinger Gold Classic Advantage Rx (HMO)
| $149.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $20.00 | $47.00 | $47.00 | 3,667 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 BlueJourney Prime (PPO)
| $169.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3923 -017 -0 | $3.00 | $15.00 | $42.00 | $42.00 | 4,198
2018 Formulary |
|
|
|
|
2019 BlueJourney Prime (PPO)
| $170.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $42.00 | $42.00 | 4,086 2019 Formulary |
|
2018 Freedom Blue PPO Standard (PPO)
| $188.50 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3916 -015 -0 | $0.00 | $15.00 | $42.00 | $42.00 | 4,357
2018 Formulary |
|
|
|
|
2019 Freedom Blue PPO Standard (PPO)
| $186.50 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $42.00 | $42.00 | 4,160 2019 Formulary |
|
2018 Freedom Blue PPO Deluxe (PPO)
| $291.50 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3916 -005 -0 | $0.00 | $15.00 | $42.00 | $42.00 | 4,357
2018 Formulary |
|
|
|
|
2019 Freedom Blue PPO Deluxe (PPO)
| $289.50 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $42.00 | $42.00 | 4,160 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 Geisinger Gold Preferred Advantage Rx (PPO)
| $77.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H3924 -059 -4 | $3.00 | $20.00 | $47.00 | $47.00 | 3,788
2018 Formulary |
|
|
|
|
-- This plan not offered in 2019 --
|
| | | | |
|
2018 Geisinger Gold Preferred Complete Rx (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3924 -060 -4 | $3.00 | $20.00 | $47.00 | $47.00 | 3,788
2018 Formulary |
|
|
|
|
-- This plan not offered in 2019 --
|
| | | | |
|
2018 Geisinger Gold Classic Advantage (HMO)
| $30.00 |
$3,400 |
No Rx Coverage |
H3954 -156 -4 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2019 --
|
| | | | |
|
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 Geisinger Gold Classic Advantage Rx (HMO)
| $149.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3954 -157 -4 | $3.00 | $20.00 | $47.00 | $47.00 | 3,788
2018 Formulary |
|
|
|
|
-- This plan not offered in 2019 --
|
| | | | |
|
2018 Geisinger Gold Classic Complete Rx (HMO)
| $38.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H3954 -158 -4 | $3.00 | $20.00 | $47.00 | $47.00 | 3,788
2018 Formulary |
|
|
|
|
-- This plan not offered in 2019 --
|
| | | | |
|
2018 UnitedHealthcare Assisted Living Plan (PPO SNP)
| $29.30 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount |
H0710 -018 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,779
2018 Formulary |
|
|
|
|
-- This plan not offered in 2019 --
|
| | | | |
|
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 Geisinger Gold Essential Rx (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3954 -159 -4 | $3.00 | $20.00 | $47.00 | $47.00 | 3,788
2018 Formulary |
|
|
|
|
-- This plan not offered in 2019 --
|
| | | | |
|