There are 96 Medicare Advantage plans meeting your criteria.
2019 / 2020 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 |
2019 AARP MedicareComplete Choice (PPO)
| $0.00 |
$6,700 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H2406 -018 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,516
2019 Formulary |
|
|
|
|
2020 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$3,400 |
$150 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $47.00 | $47.00 | 3,601 2020 Formulary |
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-- This plan not offered in 2019 --
|
R0759 -002 -0 | | | | | |
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|
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2020 AARP Medicare Advantage Choice Essential (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2019 --
|
R0759 -001 -0 | | | | | |
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|
|
|
2020 AARP Medicare Advantage Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$395 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $14.00 | $47.00 | $47.00 | 3,601 2020 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 |
2019 Aetna Medicare Choice Plan (HMO-POS)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. |
H1609 -028 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,744
2019 Formulary |
|
|
|
|
2020 Aetna Medicare Choice (HMO-POS)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,763 2020 Formulary |
|
2019 Aetna Medicare Premier Plan (PPO)
| $0.00 |
$6,700 |
$295 | Yes, some additional gap coverage. |
H5521 -033 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,744
2019 Formulary |
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|
|
|
2020 Aetna Medicare Premier (PPO)
| $0.00 |
$6,700 |
$300 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,763 2020 Formulary |
|
2019 Coventry Medicare Summit Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1609 -016 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,864
2019 Formulary |
|
|
|
|
2020 Aetna Medicare Summit Select (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,880 2020 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 |
2019 Allwell Medicare (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H9276 -004 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,811
2019 Formulary |
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-- |
|
|
2020 Allwell Medicare (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,959 2020 Formulary |
|
2019 AvMed Medicare Choice (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1016 -001 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,078
2019 Formulary |
|
|
|
|
2020 AvMed Medicare Choice (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 3,270 2020 Formulary |
|
2019 AvMed Medicare Circle (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1016 -023 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,078
2019 Formulary |
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|
|
|
2020 AvMed Medicare Circle (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $15.00 | $15.00 | 3,270 2020 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 |
2019 BlueMedicare Classic (HMO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H1035 -017 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 4,088
2019 Formulary |
|
|
|
|
2020 BlueMedicare Classic (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 4,205 2020 Formulary |
|
2019 BlueMedicare Premier (HMO)
| $0.00 |
$3,200 |
$0 | Yes, some additional gap coverage. |
H1035 -024 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 4,088
2019 Formulary |
|
|
|
|
2020 BlueMedicare Premier (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 4,205 2020 Formulary |
|
-- This plan not offered in 2019 --
|
H1035 -039 -0 | | | | | |
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|
|
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2020 BlueMedicare Saver (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 2,665 2020 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 2019 --
|
H5434 -032 -0 | | | | | |
|
|
|
|
2020 BlueMedicare Value (PPO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $2.00 | $10.00 | $47.00 | $47.00 | 2,665 2020 Formulary |
|
2019 CareFree PLUS (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1019 -076 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,368
2019 Formulary |
|
|
|
|
2020 CareFree PLUS (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,369 2020 Formulary |
|
2019 CareOne PLUS (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. |
H1019 -006 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,368
2019 Formulary |
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|
|
|
2020 CareOne PLUS (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,369 2020 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 2019 --
|
H1290 -013 -0 | | | | | |
new |
new |
|
|
2020 Devoted Health Essentials Miami-Dade (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $30.00 | $30.00 | 3,275 2020 Formulary |
|
2019 Devoted Health Miami-Dade (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1290 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,250
2019 Formulary |
new |
new |
|
|
2020 Devoted Health Miami-Dade (HMO)
| $0.00 |
$1,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,275 2020 Formulary |
|
2019 DrCare (HMO-POS SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H4140 -003 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 3,826
2019 Formulary |
new |
new |
|
|
2020 DrCare (HMO-POS C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $10.00 | $10.00 | 3,987 2020 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 |
2019 DrExtra (HMO-POS SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H4140 -004 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 3,826
2019 Formulary |
new |
new |
|
|
2020 DrExtra (HMO-POS C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $10.00 | $10.00 | 3,987 2020 Formulary |
|
2019 DrMax (HMO-POS)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4140 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,826
2019 Formulary |
new |
new |
|
|
2020 DrMax (HMO-POS)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,987 2020 Formulary |
|
-- This plan not offered in 2019 --
|
H4140 -005 -0 | | | | | |
new |
new |
|
|
2020 DrValue (HMO-POS)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,987 2020 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 |
2019 HealthSun SunPlus Advantage Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5431 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,453
2019 Formulary |
|
-- |
|
|
2020 HealthSun SunPlus Advantage Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,579 2020 Formulary |
|
2019 Humana Gold Plus H1036-054C (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. |
H1036 -054 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,368
2019 Formulary |
|
|
|
|
2020 Humana Gold Plus H1036-054C (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,369 2020 Formulary |
|
2019 Humana Gold Plus H1036-237 (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1036 -237 -2 | $0.00 | $0.00 | $40.00 | $40.00 | 3,368
2019 Formulary |
|
|
|
|
2020 Humana Gold Plus H1036-237 (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $40.00 | $40.00 | 3,369 2020 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 |
2019 HumanaChoice Florida H5216-068 (PPO)
| $0.00 |
$3,400 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H5216 -068 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,368
2019 Formulary |
|
|
|
|
2020 HumanaChoice Florida H5216-068 (PPO)
| $0.00 |
$5,500 |
$150 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,369 2020 Formulary |
|
2019 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5826 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2020 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2019 HumanaChoice R5826-074 (Regional PPO)
| $0.00 |
$6,700 |
$395 | No additional gap coverage, only the Donut Hole Discount |
R5826 -074 -0 | $6.00 | $20.00 | $47.00 | $47.00 | n/a |
|
|
|
|
2020 HumanaChoice R5826-074 (Regional PPO)
| $0.00 |
$6,700 |
$395 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $20.00 | $47.00 | $47.00 | 3,369 2020 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 |
2019 Leon Medical Centers Health Plans - Leon Cares (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5410 -001 -0 | $0.00 | $0.00 | 33% | | 4,200
2019 Formulary |
|
|
|
|
2020 Leon Medical Centers Health Plans - Leon Cares (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 4,217 2020 Formulary |
|
2019 Medica HealthCare Plans MedicareMax (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5420 -001 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,516
2019 Formulary |
|
|
|
|
2020 Medica HealthCare Plans MedicareMax (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,601 2020 Formulary |
|
2019 MMM - ELITE DADE (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3293 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,250
2019 Formulary |
new |
new |
|
|
2020 MMM ELITE DADE (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,270 2020 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 |
2019 MMM - EXTRA (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3293 -003 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,250
2019 Formulary |
new |
new |
|
|
2020 MMM EXTRA (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,270 2020 Formulary |
|
-- This plan not offered in 2019 --
|
H3293 -005 -0 | | | | | |
new |
new |
|
|
2020 MMM PLUS (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $5.00 | $5.00 | 3,270 2020 Formulary |
|
2019 PHP (HMO SNP)
| $0.00 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H3132 -001 -0 | 25% | 25% | 25% | 25% | 3,154
2019 Formulary |
|
|
|
|
2020 PHP (HMO C-SNP)
| $0.00 |
n/a |
$435 | Yes, some additional gap coverage. | 20% | 15% | 25% | 25% | 3,181 2020 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 |
2019 Preferred Choice Dade (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1045 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,516
2019 Formulary |
|
|
|
|
2020 Preferred Choice Dade (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,601 2020 Formulary |
|
2019 Preferred Special Care Miami-Dade (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H1045 -018 -0 | $0.00 | $0.00 | $15.00 | $15.00 | 3,516
2019 Formulary |
|
|
|
|
2020 Preferred Special Care Miami-Dade (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $15.00 | $15.00 | 3,601 2020 Formulary |
|
-- This plan not offered in 2019 --
|
H5471 -103 -0 | | | | | |
|
|
|
|
2020 Simply Extra (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,911 2020 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 |
2019 Simply Level (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5471 -069 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,848
2019 Formulary |
|
|
|
|
2020 Simply Level (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,911 2020 Formulary |
|
2019 Simply More (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5471 -065 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,848
2019 Formulary |
|
|
|
|
2020 Simply More (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,911 2020 Formulary |
|
2019 Solis Health Plans (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0982 -001 -0 | $0.00 | $0.00 | $10.00 | $10.00 | 5,065
2019 Formulary |
new |
new |
|
|
2020 SOLIS SPF 001 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 5,059 2020 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 |
2019 WellCare Dividend (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. |
H1032 -040 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,254
2019 Formulary |
|
|
|
|
2020 WellCare Dividend (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 3,274 2020 Formulary |
|
2019 WellCare Guardian (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H1032 -186 -0 | $0.00 | $0.00 | $15.00 | $15.00 | 3,254
2019 Formulary |
|
|
|
|
2020 WellCare Guardian (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $10.00 | $10.00 | 3,274 2020 Formulary |
|
2019 CareNeeds PLUS (HMO SNP)
| $6.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1019 -024 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,368
2019 Formulary |
|
|
|
|
2020 CareNeeds PLUS (HMO D-SNP)
| $7.20 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,369 2020 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 |
2019 CareNeeds (HMO SNP)
| $17.70 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1019 -083 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,368
2019 Formulary |
|
|
|
|
2020 CareNeeds (HMO D-SNP)
| $9.80 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,369 2020 Formulary |
|
2019 CareExtra (HMO)
| $12.00 |
$1,500 |
$415 | Yes, some additional gap coverage. |
H1019 -089 -0 | $0.00 | $0.00 | 24% | 24% | 3,368
2019 Formulary |
|
|
|
|
2020 CareExtra (HMO)
| $11.80 |
$1,500 |
$435 | Yes, some additional gap coverage. | $0.00 | $0.00 | 24% | 24% | 3,369 2020 Formulary |
|
2019 UnitedHealthcare Assisted Living Plan (PPO SNP)
| $27.70 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount |
H0710 -012 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,516
2019 Formulary |
|
-- |
|
|
2020 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $16.30 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,601 2020 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 2019 --
|
H1036 -280 -0 | | | | | |
|
|
|
|
2020 Humana Fully Integrated H1036-280 (HMO D-SNP)
| $17.00 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,369 2020 Formulary |
|
2019 Humana Gold Plus SNP-DE H1036-077A (HMO SNP)
| $20.60 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1036 -077 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,368
2019 Formulary |
|
|
|
|
2020 Humana Gold Plus SNP-DE H1036-077A (HMO D-SNP)
| $18.70 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,369 2020 Formulary |
|
2019 Preferred Medicare Assist (HMO SNP)
| $27.00 |
n/a |
$415 | Yes, some additional gap coverage. |
H1045 -012 -0 | $0.00 | $0.00 | 25% | 25% | 3,516
2019 Formulary |
|
|
|
|
2020 Preferred Medicare Assist (HMO D-SNP)
| $20.00 |
n/a |
$435 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 3,601 2020 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 |
2019 Humana Value Plus H1036-264 (HMO)
| $20.20 |
$3,400 |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1036 -264 -0 | $0.00 | 24% | 24% | 24% | 3,368
2019 Formulary |
|
|
|
|
2020 Humana Value Plus H1036-264 (HMO)
| $21.60 |
$3,400 |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | 24% | 24% | 24% | 3,369 2020 Formulary |
|
2019 Humana Gold Plus SNP-DE H1036-257 (HMO SNP)
| $20.50 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1036 -257 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,368
2019 Formulary |
|
|
|
|
2020 Humana Gold Plus SNP-DE H1036-257 (HMO D-SNP)
| $23.60 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,369 2020 Formulary |
|
2019 WellCare Select (HMO SNP)
| $26.80 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1032 -061 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,254
2019 Formulary |
|
|
|
|
2020 WellCare Select (HMO D-SNP)
| $23.70 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,274 2020 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 |
2019 WellCare Access (HMO SNP)
| $28.10 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1032 -170 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,254
2019 Formulary |
|
|
|
|
2020 WellCare Access (HMO D-SNP)
| $24.80 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,274 2020 Formulary |
|
2019 WellCare Reserve (HMO SNP)
| $28.20 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1032 -206 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,254
2019 Formulary |
|
|
|
|
2020 WellCare Reserve (HMO D-SNP)
| $24.80 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,274 2020 Formulary |
|
2019 Preferred Complete Care (HMO)
| $30.30 |
$3,400 |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1045 -046 -0 | 25% | 25% | 25% | 25% | 3,516
2019 Formulary |
|
|
|
|
2020 Preferred Complete Care (HMO)
| $26.40 |
$2,900 |
$435 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,601 2020 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 |
2019 WellCare Liberty (HMO SNP)
| $30.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H1032 -176 -0 | $0.00 | $11.00 | $47.00 | $47.00 | 3,254
2019 Formulary |
|
|
|
|
2020 WellCare Liberty (HMO D-SNP)
| $27.20 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,274 2020 Formulary |
|
2019 Coventry Medicare Summit Plan (HMO SNP)
| $25.50 |
n/a |
$415 | Yes, some additional gap coverage. |
H1609 -017 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,864
2019 Formulary |
|
|
|
|
2020 Aetna Medicare Assure (HMO D-SNP)
| $27.80 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,880 2020 Formulary |
|
-- This plan not offered in 2019 --
|
H1609 -043 -0 | | | | | |
|
|
|
|
2020 Aetna Medicare Assure Plus (HMO D-SNP)
| $27.80 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,880 2020 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 2019 --
|
R0759 -003 -0 | | | | | |
|
|
|
|
2020 UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
| $28.10 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | 15% | 15% | 15% | 15% | 3,601 2020 Formulary |
|
-- This plan not offered in 2019 --
|
H1609 -050 -0 | | | | | |
|
|
|
|
2020 Aetna Medicare Assure Value (HMO D-SNP)
| $28.50 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,880 2020 Formulary |
|
2019 Allwell Dual Medicare (HMO SNP)
| $30.30 |
n/a |
$415 | Yes, some additional gap coverage. |
H5190 -004 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,297
2019 Formulary |
|
-- |
|
|
2020 Allwell Dual Medicare (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,451 2020 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 |
2019 BlueMedicare Complete (HMO SNP)
| $30.30 |
n/a |
$415 | Yes, some additional gap coverage. |
H1035 -027 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 4,088
2019 Formulary |
|
|
|
|
2020 BlueMedicare Complete (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 4,205 2020 Formulary |
|
2019 Devoted Health Prime Miami-Dade (HMO)
| $30.30 |
$3,400 |
$415 | Yes, some additional gap coverage. |
H1290 -006 -0 | $0.00 | $0.00 | 25% | 25% | 3,250
2019 Formulary |
new |
new |
|
|
2020 Devoted Health Prime Miami-Dade (HMO)
| $28.50 |
$3,400 |
$435 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 3,275 2020 Formulary |
|
2019 DrPlus (HMO-POS SNP)
| $30.30 |
n/a |
$0 | Yes, some additional gap coverage. |
H4140 -002 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,826
2019 Formulary |
new |
new |
|
|
2020 DrPlus (HMO-POS D-SNP)
| $28.50 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,987 2020 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 |
2019 HealthSun MediMax (HMO)
| $30.30 |
$3,400 |
$415 | No additional gap coverage, only the Donut Hole Discount |
H5431 -006 -0 | 25% | 25% | 25% | 25% | 3,453
2019 Formulary |
|
-- |
|
|
2020 HealthSun MediMax (HMO)
| $28.50 |
$3,400 |
$435 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,579 2020 Formulary |
|
-- This plan not offered in 2019 --
|
H1644 -001 -0 | | | | | |
new |
new |
|
|
2020 Longevity Health Plan (HMO I-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | 25% | | | | 3,717 2020 Formulary |
|
2019 Medica HealthCare Plans MedicareMax Plus (HMO SNP)
| $30.30 |
n/a |
$415 | Yes, some additional gap coverage. |
H5420 -006 -0 | $0.00 | $0.00 | 25% | 25% | 3,516
2019 Formulary |
|
|
|
|
2020 Medica HealthCare Plans MedicareMax Plus (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 3,601 2020 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 2019 --
|
H3293 -006 -0 | | | | | |
new |
new |
|
|
2020 MMM MORE (HMO D-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,173 2020 Formulary |
|
2019 MMM - PLATINUM (HMO SNP)
| $30.30 |
n/a |
$415 | Yes, some additional gap coverage. |
H3293 -004 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,151
2019 Formulary |
new |
new |
|
|
2020 MMM PLATINUM (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. | $0.00 | $0.00 | $45.00 | $45.00 | 3,173 2020 Formulary |
|
2019 Molina Medicare Options Plus (HMO SNP)
| $30.20 |
n/a |
$415 | Yes, some additional gap coverage. |
H8130 -001 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,163
2019 Formulary |
|
|
|
|
2020 Molina Medicare Complete Care (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,185 2020 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 |
2019 Simply Care (HMO SNP)
| $30.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H5471 -067 -0 | $5.00 | $10.00 | 25% | 25% | 3,848
2019 Formulary |
|
|
|
|
2020 Simply Care (HMO I-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $5.00 | 25% | 25% | 3,911 2020 Formulary |
|
2019 Simply Comfort (HMO SNP)
| $30.30 |
n/a |
$415 | Yes, some additional gap coverage. |
H5471 -068 -0 | $0.00 | $5.00 | 25% | 25% | 3,848
2019 Formulary |
|
|
|
|
2020 Simply Comfort (HMO I-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. | $0.00 | $5.00 | 25% | 25% | 3,911 2020 Formulary |
|
2019 Simply Complete (HMO SNP)
| $30.30 |
n/a |
$415 | Yes, some additional gap coverage. |
H5471 -064 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,848
2019 Formulary |
|
|
|
|
2020 Simply Complete (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,911 2020 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 |
2019 Solis Health Plans (HMO SNP)
| $30.30 |
n/a |
$0 | Yes, some additional gap coverage. |
H0982 -002 -0 | 0% | 0% | 25% | 25% | 5,065
2019 Formulary |
new |
new |
|
|
2020 SOLIS SPF 002 (HMO D-SNP)
| $28.50 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 25% | 25% | 5,059 2020 Formulary |
|
2019 UnitedHealthcare Nursing Home Plan (PPO SNP)
| $30.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H0710 -010 -0 | 25% | 25% | 25% | 25% | 3,516
2019 Formulary |
|
-- |
|
|
2020 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,601 2020 Formulary |
|
2019 UnitedHealthcare Nursing Home Plan (HMO SNP)
| $36.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H5322 -003 -0 | 25% | 25% | 25% | 25% | 3,516
2019 Formulary |
|
|
|
|
2020 UnitedHealthcare Nursing Home Plan (HMO I-SNP)
| $34.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,601 2020 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 |
2019 BlueMedicare Choice (Regional PPO)
| $42.00 |
$6,700 |
$250 | Yes, some additional gap coverage. |
R3332 -001 -0 | $0.00 | $10.00 | $47.00 | $47.00 | n/a |
|
|
|
|
2020 BlueMedicare Choice (Regional PPO)
| $47.90 |
$6,500 |
$250 | Yes, some additional gap coverage. | $0.00 | $10.00 | $40.00 | $40.00 | 3,308 2020 Formulary |
|
2019 HumanaChoice H5216-065 (PPO)
| $57.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H5216 -065 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,368
2019 Formulary |
|
|
|
|
2020 HumanaChoice H5216-065 (PPO)
| $56.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $47.00 | $47.00 | 3,369 2020 Formulary |
|
2019 HumanaChoice R5826-005 (Regional PPO)
| $96.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount |
R5826 -005 -0 | $5.00 | $15.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2020 HumanaChoice R5826-005 (Regional PPO)
| $101.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $45.00 | $45.00 | 3,369 2020 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 |
2019 Humana Gold Choice H8145-061 (PFFS)
| $117.00 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount |
H8145 -061 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,368
2019 Formulary |
|
-- |
|
|
2020 Humana Gold Choice H8145-061 (PFFS)
| $116.00 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,369 2020 Formulary |
|
2019 AARP MedicareComplete Choice Essential (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R7444 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage Choice Essential (Regional PPO) R0759-002-0 --
| | | | | |
|
2019 AARP MedicareComplete Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$395 | No additional gap coverage, only the Donut Hole Discount |
R7444 -003 -0 | | | | | n/a |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage Choice Plan 2 (Regional PPO) R0759-001-0 --
| | | | | |
|
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 |
2019 Coventry Medicare Vista Plan (HMO SNP)
| $25.40 |
n/a |
$415 | Yes, some additional gap coverage. |
H1609 -015 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,864
2019 Formulary |
|
|
|
|
-- Members will be assigned to Aetna Medicare Assure (HMO D-SNP) H1609-017-0 --
| | | | | |
|
2019 Coventry Medicare Vista Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1609 -014 -0 | $0.00 | $0.00 | $3.00 | $3.00 | 3,864
2019 Formulary |
|
|
|
|
-- Members will be assigned to Aetna Medicare Summit Select (HMO) H1609-016-0 --
| | | | | |
|
2019 UnitedHealthcare Dual Complete RP (Regional PPO SNP)
| $25.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
R7444 -012 -0 | | | | | n/a |
|
|
|
|
-- Members will be assigned to UnitedHealthcare Dual Complete RP (Regional PPO D-SNP) R0759-003-0 --
| | | | | |
|
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 |
2019 Freedom Savings Plan (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H5427 -052 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
2019 Freedom Medicare Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5427 -060 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
2019 Freedom VIP Care (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5427 -070 -0 | $0.00 | $20.00 | $60.00 | $60.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
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 |
2019 Freedom VIP Savings (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5427 -072 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
2019 Freedom VIP Savings COPD (HMO SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5427 -077 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
2019 Freedom Medi-Medi Partial (HMO SNP)
| $30.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H5427 -078 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
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 |
2019 Freedom Medi-Medi Full (HMO SNP)
| $30.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H5427 -087 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
2019 Optimum Gold Rewards Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5594 -001 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
2019 Optimum Platinum Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5594 -002 -0 | $0.00 | $10.00 | $65.00 | $65.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
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 |
2019 Optimum Emerald Partial (HMO SNP)
| $30.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H5594 -016 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
2019 Optimum Emerald Full (HMO SNP)
| $30.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
H5594 -017 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 3,176
2019 Formulary |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|
2019 UnitedHealthcare Dual Complete RP ONE (Regional PPO SNP)
| $25.30 |
n/a |
$415 | No additional gap coverage, only the Donut Hole Discount |
R7444 -013 -0 | | | | | n/a |
|
|
|
|
-- This plan not offered in 2020 --
|
| | | | |
|