There are 99 Medicare Advantage plans meeting your criteria.
2020 / 2021 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 2020 --
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H1924 -001 -0 | | | | | |
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2021 Lasso Healthcare Growth (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2020 --
|
H1924 -004 -0 | | | | | |
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|
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2021 Lasso Healthcare Growth Plus (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2020 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$3,400 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H2406 -018 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
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2021 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 | 3,604 2021 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 |
2020 AARP Medicare Advantage Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$395 | No additional gap coverage, only the Donut Hole Discount |
R0759 -001 -0 | $3.00 | $14.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
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|
|
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2021 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 | 3,604 2021 Formulary |
|
2020 AARP Medicare Advantage Choice Essential (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R0759 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
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2021 AARP Medicare Advantage Patriot (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2020 Aetna Medicare Choice (HMO-POS)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. |
H1609 -028 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,763
2020 Formulary |
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|
|
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2021 Aetna Medicare Choice (HMO-POS)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,659 2021 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 2020 --
|
H1609 -053 -0 | | | | | |
|
|
|
|
2021 Aetna Medicare Credit (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,659 2021 Formulary |
|
2020 Aetna Medicare Premier (PPO)
| $0.00 |
$6,700 |
$300 | Yes, some additional gap coverage. |
H5521 -033 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,763
2020 Formulary |
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|
|
|
2021 Aetna Medicare Premier (PPO)
| $0.00 |
$6,700 |
$300 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,659 2021 Formulary |
|
2020 Aetna Medicare Premier Plus (PPO)
| $0.00 |
$4,900 |
$150 | Yes, some additional gap coverage. |
H5521 -273 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,763
2020 Formulary |
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|
|
|
2021 Aetna Medicare Premier Plus (PPO)
| $0.00 |
$4,900 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,659 2021 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 |
2020 Aetna Medicare Summit Select (HMO)
| $0.00 |
$2,850 |
$0 | Yes, some additional gap coverage. |
H1609 -018 -0 | $0.00 | $0.00 | $3.00 | $3.00 | 3,880
2020 Formulary |
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|
|
|
2021 Aetna Medicare Select (HMO)
| $0.00 |
$2,850 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $3.00 | $3.00 | 3,682 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H1016 -026 -0 | | | | | |
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|
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2021 AvMed Medicare Access (HMO-POS)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,339 2021 Formulary |
|
2020 AvMed Medicare Choice (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1016 -021 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,270
2020 Formulary |
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|
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2021 AvMed Medicare Choice (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,339 2021 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 |
2020 AvMed Medicare Circle (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1016 -024 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 3,270
2020 Formulary |
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|
|
|
2021 AvMed Medicare Circle (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $20.00 | $20.00 | 3,339 2021 Formulary |
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-- This plan not offered in 2020 --
|
H1016 -028 -0 | | | | | |
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|
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2021 AvMed Medicare Premium Saver (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 3,339 2021 Formulary |
|
2020 BlueMedicare Classic (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H1035 -019 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,308
2020 Formulary |
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2021 BlueMedicare Classic (HMO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $40.00 | $40.00 | 3,450 2021 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 |
2020 BlueMedicare Premier (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H1035 -025 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 4,205
2020 Formulary |
|
|
|
|
2021 BlueMedicare Premier (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $20.00 | $20.00 | 4,319 2021 Formulary |
|
2020 BlueMedicare Saver (HMO)
| $0.00 |
$6,700 |
$50 | Yes, some additional gap coverage. |
H1035 -035 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 2,665
2020 Formulary |
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|
|
|
2021 BlueMedicare Saver (HMO)
| $0.00 |
$6,700 |
$50 | Yes, some additional gap coverage. | $3.00 | $12.00 | $47.00 | $47.00 | 2,744 2021 Formulary |
|
2020 BlueMedicare Value (PPO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H5434 -026 -0 | $2.00 | $10.00 | $47.00 | $47.00 | 2,665
2020 Formulary |
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|
|
|
2021 BlueMedicare Value (PPO)
| $0.00 |
$3,900 |
$150 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 2,744 2021 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 2020 --
|
H4709 -011 -0 | | | | | |
new |
new |
new |
|
2021 Bright Advantage Health Dollars (HMO)
| $0.00 |
$2,950 |
$0 | Yes, some additional gap coverage. | $0.00 | $4.00 | $47.00 | $47.00 | 3,364 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H3281 -007 -0 | | | | | |
new |
new |
new |
|
2021 Bright Advantage Part B Savings (PPO)
| $0.00 |
$5,500 |
$400 | Yes, some additional gap coverage. | $0.00 | $20.00 | $47.00 | $47.00 | 3,364 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H1019 -106 -0 | | | | | |
|
|
|
|
2021 CareComplete (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,382 2021 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 |
2020 CareFree (HMO)
| $0.00 |
$3,400 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H1019 -065 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 CareFree (HMO)
| $0.00 |
$3,400 |
$100 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,382 2021 Formulary |
|
2020 CareOne (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. |
H1019 -001 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 3,369
2020 Formulary |
|
|
|
|
2021 CareOne (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $5.00 | $5.00 | 3,382 2021 Formulary |
|
2020 Devoted Health Broward (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H1290 -002 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 3,275
2020 Formulary |
|
new |
|
|
2021 Devoted Health Core Broward (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $20.00 | $20.00 | 3,173 2021 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 |
2020 Devoted Health Essentials Broward (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1290 -014 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,275
2020 Formulary |
|
new |
|
|
2021 Devoted Health Essentials Broward (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $45.00 | $45.00 | 3,173 2021 Formulary |
|
2020 Freedom VIP Savings (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5427 -082 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 3,302
2020 Formulary |
|
|
|
|
2021 Freedom VIP Savings (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | $85.00 | $85.00 | 3,327 2021 Formulary |
|
2020 Freedom VIP Savings COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5427 -083 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 3,302
2020 Formulary |
|
|
|
|
2021 Freedom VIP Savings COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | 3,322 2021 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 |
2020 HealthSun HealthAdvantage Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5431 -012 -0 | $0.00 | $0.00 | $15.00 | $15.00 | 3,579
2020 Formulary |
|
-- |
|
|
2021 HealthSun HealthAdvantage Plan (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $15.00 | $15.00 | 3,581 2021 Formulary |
|
2020 Humana Gold Plus - Diabetes (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H1036 -121 -0 | $0.00 | $3.00 | $40.00 | $40.00 | 3,369
2020 Formulary |
|
|
|
|
2021 Humana Gold Plus - Diabetes (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $3.00 | $40.00 | $40.00 | 3,382 2021 Formulary |
|
2020 Humana Gold Plus H1036-065C (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H1036 -065 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 3,369
2020 Formulary |
|
|
|
|
2021 Humana Gold Plus H1036-065C (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $5.00 | $5.00 | 3,382 2021 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 |
2020 Humana Gold Plus H1036-237 (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1036 -237 -1 | $0.00 | $0.00 | $40.00 | $40.00 | 3,369
2020 Formulary |
|
|
|
|
2021 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 | 3,382 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H1036 -279 -0 | | | | | |
|
|
|
|
2021 Humana Honor (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2020 HumanaChoice Florida H5216-068 (PPO)
| $0.00 |
$5,500 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H5216 -068 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 HumanaChoice Florida H5216-068 (PPO)
| $0.00 |
$4,500 |
$150 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,386 2021 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 |
2020 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5826 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2021 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2020 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 | 3,369
2020 Formulary |
|
|
|
|
2021 HumanaChoice R5826-074 (Regional PPO)
| $0.00 |
$7,550 |
$395 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $20.00 | $47.00 | $47.00 | 3,386 2021 Formulary |
|
2020 Medica HealthCare Plans MedicareMax (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5420 -003 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
|
|
|
|
2021 Medica HealthCare Plans MedicareMax (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,604 2021 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 |
2020 MMM PLUS (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3293 -005 -0 | $0.00 | $0.00 | $5.00 | $5.00 | 3,270
2020 Formulary |
|
new |
|
|
2021 MMM ELITE (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $5.00 | $5.00 | 3,340 2021 Formulary |
|
2020 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 | 3,270
2020 Formulary |
|
new |
|
|
2021 MMM EXTRA (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,340 2021 Formulary |
|
2020 Optimum Gold Rewards Plan (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H5594 -001 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 3,302
2020 Formulary |
|
|
|
|
2021 Optimum Gold Rewards Plan (HMO)
| $0.00 |
$1,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | $85.00 | $85.00 | 3,322 2021 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 |
2020 Optimum Platinum Plan (HMO)
| $0.00 |
$1,500 |
$0 | Yes, some additional gap coverage. |
H5594 -002 -0 | $0.00 | $10.00 | $65.00 | $65.00 | 3,302
2020 Formulary |
|
|
|
|
2021 Optimum Platinum Plan (HMO)
| $0.00 |
$1,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $65.00 | $65.00 | 3,322 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H8961 -001 -0 | | | | | |
new |
new |
new |
|
2021 Oscar + Holy Cross + Memorial Health (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,339 2021 Formulary |
|
2020 PHP (HMO C-SNP)
| $0.00 |
n/a |
$435 | Yes, some additional gap coverage. |
H3132 -001 -0 | 20% | 15% | 25% | 25% | 3,181
2020 Formulary |
|
|
|
|
2021 PHP (HMO C-SNP)
| $0.00 |
n/a |
$445 | Yes, some additional gap coverage. | 15% | 15% | 25% | 25% | 3,207 2021 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 |
2020 Preferred Choice Broward (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1045 -005 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
|
|
|
|
2021 Preferred Choice Broward (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,604 2021 Formulary |
|
2020 Simply Comfort (HMO I-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. |
H5471 -081 -0 | $0.00 | $5.00 | 25% | 25% | 3,911
2020 Formulary |
|
|
|
|
2021 Simply Comfort (HMO I-SNP)
| $0.00 |
n/a |
$445 | Yes, some additional gap coverage. | $0.00 | $5.00 | 25% | 25% | 3,912 2021 Formulary |
|
2020 Simply Extra (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5471 -104 -0 | $5.00 | $20.00 | $47.00 | $47.00 | 3,911
2020 Formulary |
|
|
|
|
2021 Simply Extra (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $5.00 | $20.00 | $47.00 | $47.00 | 3,912 2021 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 |
2020 Simply Level (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5471 -080 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,911
2020 Formulary |
|
|
|
|
2021 Simply Level (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,912 2021 Formulary |
|
2020 Simply More (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5471 -077 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,911
2020 Formulary |
|
|
|
|
2021 Simply More (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 3,912 2021 Formulary |
|
2020 SOLIS SPF 007 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0982 -007 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 5,059
2020 Formulary |
new |
new |
|
|
2021 SOLIS SPF 007 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $20.00 | $20.00 | 3,920 2021 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 |
2020 WellCare Champion (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H1032 -228 -0 | $0.00 | $0.00 | $10.00 | $10.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Champion (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $10.00 | $10.00 | 3,348 2021 Formulary |
|
2020 WellCare Dividend Prime (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1032 -195 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Dividend Prime (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,348 2021 Formulary |
|
2020 WellCare Elite (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H1032 -196 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Elite (HMO)
| $0.00 |
$1,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,348 2021 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 |
2020 WellCare Guardian (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H1032 -226 -0 | $0.00 | $0.00 | $10.00 | $10.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Guardian (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $10.00 | $10.00 | 3,348 2021 Formulary |
|
2020 WellCare Premier (PPO)
| $0.00 |
$3,400 |
$100 | Yes, some additional gap coverage. |
H5199 -012 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
new |
new |
|
|
2021 WellCare Premier (PPO)
| $0.00 |
$3,400 |
$100 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,348 2021 Formulary |
|
2020 CareNeeds PLUS (HMO D-SNP)
| $13.60 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1019 -023 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 CareNeeds PLUS (HMO D-SNP)
| $16.30 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,382 2021 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 |
2020 Humana Fully Integrated H1036-282 (HMO D-SNP)
| $18.30 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1036 -282 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 Humana Fully Integrated H1036-282 (HMO D-SNP)
| $19.90 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,382 2021 Formulary |
|
2020 Simply Complete (HMO D-SNP)
| $26.60 |
n/a |
$435 | Yes, some additional gap coverage. |
H5471 -076 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,911
2020 Formulary |
|
|
|
|
2021 Simply Complete (HMO D-SNP)
| $24.80 |
n/a |
$445 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,912 2021 Formulary |
|
2020 WellCare Reserve (HMO D-SNP)
| $22.80 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1032 -197 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Reserve (HMO D-SNP)
| $26.40 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,348 2021 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 |
2020 Preferred Medicare Assist (HMO D-SNP)
| $20.00 |
n/a |
$435 | Yes, some additional gap coverage. |
H1045 -012 -0 | $0.00 | $0.00 | 25% | 25% | 3,601
2020 Formulary |
|
|
|
|
2021 Preferred Medicare Assist Plan 1 (HMO D-SNP)
| $27.10 |
n/a |
$445 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 3,604 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H1045 -053 -0 | | | | | |
|
|
|
|
2021 Preferred Medicare Assist Plan 2 (HMO D-SNP)
| $27.20 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,604 2021 Formulary |
|
2020 WellCare Access (HMO D-SNP)
| $24.20 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1032 -124 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Access (HMO D-SNP)
| $28.10 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,348 2021 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 |
2020 Humana Gold Plus SNP-DE H1036-103A (HMO D-SNP)
| $24.90 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1036 -103 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 Humana Gold Plus SNP-DE H1036-103A (HMO D-SNP)
| $28.90 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,382 2021 Formulary |
|
2020 Allwell Dual Medicare (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. |
H5190 -003 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,451
2020 Formulary |
|
-- |
|
|
2021 Allwell Dual Medicare (HMO D-SNP)
| $29.10 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $47.00 | $47.00 | 3,352 2021 Formulary |
|
2020 Aetna Medicare Assure Plus (HMO D-SNP)
| $27.80 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount |
H1609 -043 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,880
2020 Formulary |
|
|
|
|
2021 Aetna Medicare Assure Plus (HMO D-SNP)
| $29.50 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,682 2021 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 2020 --
|
H5431 -015 -0 | | | | | |
|
-- |
|
|
2021 HealthSun MediSun Plus (HMO D-SNP)
| $29.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,581 2021 Formulary |
|
2020 WellCare Liberty (HMO D-SNP)
| $26.60 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1032 -175 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Liberty (HMO D-SNP)
| $30.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,348 2021 Formulary |
|
2020 Aetna Medicare Assure (HMO D-SNP)
| $27.80 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount |
H1609 -017 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,880
2020 Formulary |
|
|
|
|
2021 Aetna Medicare Assure (HMO D-SNP)
| $30.80 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,682 2021 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 2020 --
|
H5190 -005 -0 | | | | | |
|
-- |
|
|
2021 Allwell Medicare Nurture (HMO D-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $20.00 | $47.00 | $47.00 | 3,352 2021 Formulary |
|
2020 BlueMedicare Complete (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. |
H1035 -028 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 4,205
2020 Formulary |
|
|
|
|
2021 BlueMedicare Complete (HMO D-SNP)
| $30.80 |
n/a |
$445 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 4,319 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H1290 -020 -0 | | | | | |
|
new |
|
|
2021 Devoted Health Dual Broward (HMO D-SNP)
| $30.80 |
n/a |
$445 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 3,173 2021 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 |
2020 Devoted Health Prime Broward (HMO)
| $28.50 |
$3,400 |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1290 -007 -0 | $0.00 | $0.00 | 25% | 25% | 3,275
2020 Formulary |
|
new |
|
|
2021 Devoted Health Prime Broward (HMO)
| $30.80 |
$3,400 |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | 25% | 25% | 3,173 2021 Formulary |
|
2020 Freedom Medi-Medi Full (HMO D-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5427 -087 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 3,302
2020 Formulary |
|
|
|
|
2021 Freedom Medi-Medi Full (HMO D-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $45.00 | $95.00 | $95.00 | 3,322 2021 Formulary |
|
2020 Freedom Medi-Medi Partial (HMO D-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5427 -078 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 3,302
2020 Formulary |
|
|
|
|
2021 Freedom Medi-Medi Partial (HMO D-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $45.00 | $95.00 | $95.00 | 3,322 2021 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 |
2020 HealthSun MediMax (HMO)
| $28.50 |
$3,400 |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5431 -006 -0 | 25% | 25% | 25% | 25% | 3,579
2020 Formulary |
|
-- |
|
|
2021 HealthSun MediMax (HMO)
| $30.80 |
$3,450 |
$445 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,581 2021 Formulary |
|
2020 Longevity Health Plan (HMO I-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1644 -001 -0 | 25% | | | | 3,717
2020 Formulary |
new |
new |
new |
|
2021 Longevity Health Plan (HMO I-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,764 2021 Formulary |
|
2020 Medica HealthCare Plans MedicareMax Plus (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. |
H5420 -006 -0 | $0.00 | $0.00 | 25% | 25% | 3,601
2020 Formulary |
|
|
|
|
2021 Medica HealthCare Plans MedicareMax Plus (HMO D-SNP)
| $30.80 |
n/a |
$445 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 3,604 2021 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 |
2020 MMM PLATINUM (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. |
H3293 -004 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,173
2020 Formulary |
|
new |
|
|
2021 MMM PLATINUM (HMO D-SNP)
| $30.80 |
n/a |
$445 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 3,234 2021 Formulary |
|
2020 Molina Medicare Complete Care (HMO D-SNP)
| $28.50 |
n/a |
$435 | Yes, some additional gap coverage. |
H8130 -001 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,185
2020 Formulary |
|
|
|
|
2021 Molina Medicare Complete Care (HMO D-SNP)
| $30.80 |
n/a |
$445 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,245 2021 Formulary |
|
2020 Optimum Emerald Full (HMO D-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5594 -017 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 3,302
2020 Formulary |
|
|
|
|
2021 Optimum Emerald Full (HMO D-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $45.00 | $95.00 | $95.00 | 3,322 2021 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 |
2020 Optimum Emerald Partial (HMO D-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5594 -016 -0 | $0.00 | $45.00 | $95.00 | $95.00 | 3,302
2020 Formulary |
|
|
|
|
2021 Optimum Emerald Partial (HMO D-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $45.00 | $95.00 | $95.00 | 3,322 2021 Formulary |
|
2020 Simply Care (HMO I-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5471 -079 -0 | $4.00 | $5.00 | 25% | 25% | 3,911
2020 Formulary |
|
|
|
|
2021 Simply Care (HMO I-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $5.00 | 25% | 25% | 3,912 2021 Formulary |
|
2020 Simply Select (HMO)
| $24.10 |
$3,400 |
$435 | Yes, some additional gap coverage. |
H5471 -100 -0 | $0.00 | $0.00 | 25% | 25% | 3,911
2020 Formulary |
|
|
|
|
2021 Simply Select (HMO)
| $30.80 |
$3,450 |
$445 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 3,912 2021 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 2020 --
|
H0982 -012 -0 | | | | | |
new |
new |
|
|
2021 SOLIS SPF 012 (HMO D-SNP)
| $30.80 |
n/a |
$0 | Yes, some additional gap coverage. | 0% | 0% | 0% | 0% | 3,920 2021 Formulary |
|
2020 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $16.30 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount |
H0710 -012 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
|
-- |
|
|
2021 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $30.80 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,604 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H1889 -002 -2 | | | | | |
new |
new |
new |
|
2021 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,604 2021 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 |
2020 UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
| $28.10 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
R0759 -003 -0 | 15% | 15% | 15% | 15% | 3,601
2020 Formulary |
|
|
|
|
2021 UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,604 2021 Formulary |
|
2020 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H0710 -010 -0 | 25% | 25% | 25% | 25% | 3,601
2020 Formulary |
|
-- |
|
|
2021 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $30.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,604 2021 Formulary |
|
2020 BlueMedicare Choice (Regional PPO)
| $47.90 |
$6,500 |
$250 | Yes, some additional gap coverage. |
R3332 -001 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,308
2020 Formulary |
|
|
|
|
2021 BlueMedicare Choice (Regional PPO)
| $47.90 |
$6,500 |
$250 | Yes, some additional gap coverage. | $0.00 | $10.00 | $40.00 | $40.00 | 3,450 2021 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 |
2020 HumanaChoice H5216-065 (PPO)
| $56.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H5216 -065 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 HumanaChoice H5216-065 (PPO)
| $52.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $47.00 | $47.00 | 3,386 2021 Formulary |
|
2020 WellCare Prime (PPO)
| $75.00 |
$2,000 |
$0 | Yes, some additional gap coverage. |
H5199 -010 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
new |
new |
|
|
2021 WellCare Prime (PPO)
| $75.00 |
$1,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,348 2021 Formulary |
|
2020 Humana Gold Choice H8145-061 (PFFS)
| $116.00 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount |
H8145 -061 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
-- |
|
|
2021 Humana Gold Choice H8145-061 (PFFS)
| $101.00 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,386 2021 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 |
2020 HumanaChoice R5826-005 (Regional PPO)
| $101.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount |
R5826 -005 -0 | $5.00 | $15.00 | $45.00 | $45.00 | 3,369
2020 Formulary |
|
|
|
|
2021 HumanaChoice R5826-005 (Regional PPO)
| $105.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $45.00 | $45.00 | 3,386 2021 Formulary |
|
2020 BlueMedicare Select (PPO)
| $145.50 |
$5,900 |
$305 | Yes, some additional gap coverage. |
H5434 -002 -0 | $3.00 | $10.00 | $40.00 | $40.00 | 4,205
2020 Formulary |
|
|
|
|
2021 BlueMedicare Select (PPO)
| $146.80 |
$5,900 |
$305 | Yes, some additional gap coverage. | $3.00 | $10.00 | $40.00 | $40.00 | 4,319 2021 Formulary |
|
2020 CareNeeds (HMO D-SNP)
| $14.20 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1019 -081 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
-- Members will be assigned to CareNeeds PLUS (HMO D-SNP) H1019-023-0 --
| | | | | |
|
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 |
2020 Humana Gold Plus SNP-DE H1036-255 (HMO D-SNP)
| $26.90 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1036 -255 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus SNP-DE H1036-103A (HMO D-SNP) H1036-103-0 --
| | | | | |
|
2020 MMM ELITE (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3293 -002 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 3,270
2020 Formulary |
|
new |
|
|
-- Members will be assigned to MMM ELITE (HMO) H3293-005-0 --
| | | | | |
|
2020 MMM MORE (HMO D-SNP)
| $28.50 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H3293 -006 -0 | 25% | 25% | 25% | 25% | 3,173
2020 Formulary |
|
new |
|
|
-- Members will be assigned to MMM PLATINUM (HMO D-SNP) H3293-004-0 --
| | | | | |
|
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 |
2020 WellCare Select (HMO D-SNP)
| $23.70 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1032 -061 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
-- This plan not offered in 2021 --
|
| | | | |
|
2020 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1032 -223 -3 | $0.00 | $0.00 | $35.00 | $35.00 | 3,274
2020 Formulary |
|
|
|
|
-- This plan not offered in 2021 --
|
| | | | |
|
2020 Allwell Medicare (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H9276 -012 -0 | $0.00 | $0.00 | $42.00 | $42.00 | 3,959
2020 Formulary |
|
-- |
|
|
-- This plan not offered in 2021 --
|
| | | | |
|