There are 71 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 --
|
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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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 Walgreens Plan 1 (HMO)
| $0.00 |
$6,700 |
$275 | No additional gap coverage, only the Donut Hole Discount |
H1111 -009 -2 | $0.00 | $5.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
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|
2021 AARP Medicare Advantage Walgreens (HMO)
| $0.00 |
$6,700 |
$275 | No additional gap coverage, only the Donut Hole Discount | $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 Aetna Medicare Basics Plan (PPO)
| $0.00 |
$5,900 |
No Rx Coverage |
H3288 -034 -0 | This plan does NOT include Prescription Drug coverage. | |
new |
new |
new |
|
2021 Aetna Medicare Eagle Plan (PPO)
| $0.00 |
$6,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2020 Aetna Medicare Essential Plan (PPO)
| $0.00 |
$5,900 |
$200 | Yes, some additional gap coverage. |
H5521 -091 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,763
2020 Formulary |
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|
|
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2021 Aetna Medicare Essential Plan (PPO)
| $0.00 |
$6,900 |
$195 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,659 2021 Formulary |
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-- This plan not offered in 2020 --
|
H5422 -014 -0 | | | | | |
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2021 Anthem MediBlue Core (HMO)
| $0.00 |
$7,550 |
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 |
2020 Anthem MediBlue Plus (HMO)
| $0.00 |
$6,700 |
$150 | Yes, some additional gap coverage. |
H5422 -011 -0 | $4.00 | $11.00 | $42.00 | $42.00 | 3,780
2020 Formulary |
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|
|
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2021 Anthem MediBlue Plus (HMO)
| $0.00 |
$6,700 |
$150 | Yes, some additional gap coverage. | $4.00 | $11.00 | $42.00 | $42.00 | 3,639 2021 Formulary |
|
2020 Cigna-HealthSpring Preferred (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0439 -007 -0 | $3.00 | $12.00 | $42.00 | $42.00 | 3,383
2020 Formulary |
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|
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2021 Cigna Preferred Medicare (HMO)
| $0.00 |
$6,200 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $42.00 | $42.00 | 3,446 2021 Formulary |
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-- This plan not offered in 2020 --
|
H7849 -003 -0 | | | | | |
new |
new |
new |
|
2021 Cigna True Choice Medicare (PPO)
| $0.00 |
$6,950 |
$95 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $42.00 | $42.00 | 3,446 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 EON CHOICE (PPO)
| $0.00 |
$6,700 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H9589 -003 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 4,225
2020 Formulary |
-- |
-- |
-- |
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2021 Clear Spring Health Choice Plan (PPO)
| $0.00 |
$7,550 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $42.00 | $42.00 | 3,260 2021 Formulary |
|
2020 EON SELECT (HMO)
| $0.00 |
$6,700 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H6672 -004 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 4,225
2020 Formulary |
-- |
-- |
|
|
2021 Clear Spring Health Select (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $42.00 | $42.00 | 3,260 2021 Formulary |
|
2020 EON SILVER (HMO C-SNP)
| $0.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount |
H6672 -003 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 4,225
2020 Formulary |
-- |
-- |
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2021 Clear Spring Health Silver Plan (HMO C-SNP)
| $0.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $42.00 | $42.00 | 3,260 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 --
|
H5141 -046 -0 | | | | | |
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2021 Clover Health Choice (PPO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $40.00 | $40.00 | 3,358 2021 Formulary |
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2020 Humana Gold Plus H4141-017 (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4141 -017 -3 | $4.00 | $12.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
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2021 Humana Gold Plus H4141-017 (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,382 2021 Formulary |
|
2020 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5216 -217 -0 | This plan does NOT include Prescription Drug coverage. | |
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2021 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2020 --
|
H5216 -246 -0 | | | | | |
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2021 HumanaChoice - Diabetes (PPO C-SNP)
| $0.00 |
n/a |
$145 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,386 2021 Formulary |
|
2020 HumanaChoice H5216-154 (PPO)
| $0.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount |
H5216 -154 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,117
2020 Formulary |
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2021 HumanaChoice H5216-154 (PPO)
| $0.00 |
$7,550 |
$400 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $47.00 | $47.00 | 3,172 2021 Formulary |
|
2020 HumanaChoice H5216-157 (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5216 -157 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
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2021 HumanaChoice H5216-157 (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2020 HumanaChoice H5216-203 (PPO)
| $0.00 |
$6,700 |
$75 | No additional gap coverage, only the Donut Hole Discount |
H5216 -203 -1 | $4.00 | $12.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
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2021 HumanaChoice H5216-203 (PPO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,386 2021 Formulary |
|
2020 HumanaChoice R3392-001 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R3392 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2021 HumanaChoice R3392-001 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2020 Kaiser Permanente Senior Advantage Basic (HMO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H1170 -009 -0 | $0.00 | $6.00 | $47.00 | $47.00 | 4,833
2020 Formulary |
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|
2021 Kaiser Permanente Senior Advantage Basic (HMO)
| $0.00 |
$6,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $6.00 | $47.00 | $47.00 | 4,700 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 Medicare Advantage Choice Plan 1 (PPO)
| $49.00 |
$6,700 |
$275 | No additional gap coverage, only the Donut Hole Discount |
H6528 -006 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
|
|
|
|
2021 UnitedHealthcare Medicare Advantage Choice Plan 1 (PPO)
| $0.00 |
$6,700 |
$275 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,604 2021 Formulary |
|
2020 UnitedHealthcare Medicare Advantage Essential (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R2604 -005 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2021 UnitedHealthcare Medicare Advantage Patriot (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2020 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H1112 -042 -0 | $4.00 | $15.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $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 |
-- This plan not offered in 2020 --
|
H0111 -005 -0 | | | | | |
|
|
|
|
2021 WellCare Endurance (PPO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,348 2021 Formulary |
|
2020 WellCare Advance (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage |
H1112 -034 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2021 WellCare Patriot (HMO-POS)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2020 WellCare Premier (PPO)
| $0.00 |
$5,500 |
$75 | Yes, some additional gap coverage. |
H0111 -001 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Premier (PPO)
| $0.00 |
$4,900 |
$75 | Yes, some additional gap coverage. | $0.00 | $5.00 | $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 WellCare Value (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1112 -038 -0 | $0.00 | $10.00 | $44.00 | $44.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Value (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $44.00 | $44.00 | 3,348 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H8390 -014 -0 | | | | | |
new |
new |
new |
|
2021 CareSource Advantage Zero Premium (HMO)
| $0.10 |
$7,550 |
$150 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $45.00 | $45.00 | 3,622 2021 Formulary |
|
2020 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $2.80 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
R2604 -002 -0 | 25% | 25% | 25% | 25% | 3,601
2020 Formulary |
|
|
|
|
2021 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $9.70 |
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 |
-- This plan not offered in 2020 --
|
H6672 -005 -0 | | | | | |
-- |
-- |
|
|
2021 Clear Spring Health Select Plus (HMO)
| $19.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $42.00 | $42.00 | 3,260 2021 Formulary |
|
2020 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $13.00 |
n/a |
$210 | No additional gap coverage, only the Donut Hole Discount |
R2604 -003 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
|
|
|
|
2021 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $19.00 |
n/a |
$210 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,604 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H5521 -328 -0 | | | | | |
|
|
|
|
2021 Aetna Medicare Value Plus Plan (PPO)
| $20.00 |
$7,550 |
$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 |
2020 Cigna-HealthSpring Preferred GA (HMO)
| $20.00 |
$6,700 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H0439 -003 -2 | $3.00 | $12.00 | $42.00 | $42.00 | 3,383
2020 Formulary |
|
|
|
|
2021 Cigna Preferred GA Medicare (HMO)
| $20.00 |
$7,400 |
$300 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $42.00 | $42.00 | 3,446 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H8390 -012 -0 | | | | | |
new |
new |
new |
|
2021 CareSource Advantage (HMO)
| $22.10 |
$5,600 |
$75 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $45.00 | $45.00 | 3,622 2021 Formulary |
|
2020 Aetna Medicare Dual Preferred Plan (HMO D-SNP)
| $18.50 |
n/a |
$275 | No additional gap coverage, only the Donut Hole Discount |
H5302 -012 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,763
2020 Formulary |
-- |
-- |
|
|
2021 Aetna Medicare Dual Preferred Plan (HMO D-SNP)
| $22.20 |
n/a |
$220 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | 25% | 25% | 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 --
|
H7728 -006 -0 | | | | | |
|
|
|
|
2021 Anthem MediBlue Access Basic (PPO)
| $25.00 |
$6,700 |
$150 | Yes, some additional gap coverage. | $4.00 | $13.00 | $42.00 | $42.00 | 3,639 2021 Formulary |
|
2020 Senior Advantage Medicare Medicaid Plan (HMO D-SNP)
| $24.80 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1170 -008 -0 | $12.00 | $18.00 | $47.00 | $47.00 | 4,833
2020 Formulary |
|
|
|
|
2021 Senior Advantage Medicare Medicaid Plan (HMO D-SNP)
| $25.40 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $12.00 | $20.00 | $47.00 | $47.00 | 4,700 2021 Formulary |
|
2020 Cigna-HealthSpring TotalCare (HMO D-SNP)
| $23.90 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H0439 -002 -0 | 15% | 15% | 15% | 15% | 3,383
2020 Formulary |
|
|
|
|
2021 Cigna TotalCare (HMO D-SNP)
| $26.20 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,446 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 Compass (HMO)
| $20.40 |
$3,400 |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1112 -043 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Compass (HMO)
| $26.90 |
$3,450 |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $42.00 | $42.00 | 3,348 2021 Formulary |
|
2020 HumanaChoice SNP-DE H5216-205 (PPO D-SNP)
| $25.00 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5216 -205 -0 | $0.00 | $17.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 HumanaChoice SNP-DE H5216-205 (PPO D-SNP)
| $27.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $18.00 | $47.00 | $47.00 | 3,382 2021 Formulary |
|
2020 HumanaChoice SNP-DE H5216-206 (PPO D-SNP)
| $23.60 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5216 -206 -0 | $0.00 | $19.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 HumanaChoice SNP-DE H5216-206 (PPO D-SNP)
| $27.70 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $19.00 | $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 |
-- This plan not offered in 2020 --
|
H5216 -241 -0 | | | | | |
|
|
|
|
2021 HumanaChoice H5216-241 (PPO)
| $28.70 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,386 2021 Formulary |
|
2020 UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP)
| $24.70 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
R2604 -004 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,601
2020 Formulary |
|
|
|
|
2021 UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP)
| $28.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,604 2021 Formulary |
|
2020 Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP)
| $22.00 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H4141 -003 -0 | $0.00 | $19.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP)
| $29.70 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $19.00 | $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 Allwell Dual Medicare (HMO D-SNP)
| $25.30 |
n/a |
$345 | No additional gap coverage, only the Donut Hole Discount |
H7173 -001 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,451
2020 Formulary |
|
|
|
|
2021 Allwell Dual Medicare (HMO D-SNP)
| $29.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $47.00 | $47.00 | 3,352 2021 Formulary |
|
2020 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $25.30 |
n/a |
$435 | Yes, some additional gap coverage. |
H5422 -007 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,780
2020 Formulary |
|
|
|
|
2021 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $29.80 |
n/a |
$445 | Yes, some additional gap coverage. | $0.00 | $4.00 | $42.00 | $42.00 | 3,639 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H5422 -013 -0 | | | | | |
|
|
|
|
2021 Anthem MediBlue Extra (HMO)
| $29.80 |
$5,900 |
$445 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,639 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 --
|
H8390 -016 -0 | | | | | |
new |
new |
new |
|
2021 CareSource Dual Advantage (HMO D-SNP)
| $29.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,622 2021 Formulary |
|
2020 EON DELUXE (HMO D-SNP)
| $25.30 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H6672 -001 -0 | 25% | 25% | 25% | 25% | 4,225
2020 Formulary |
-- |
-- |
|
|
2021 Clear Spring Health Deluxe Plan (HMO D-SNP)
| $29.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,260 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H5141 -047 -0 | | | | | |
|
|
|
|
2021 Clover Health Choice Value (PPO)
| $29.80 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | 22% | 22% | 22% | 3,358 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 --
|
H3291 -002 -0 | | | | | |
|
-- |
|
|
2021 PruittHealth Premier D-SNP (HMO D-SNP)
| $29.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,764 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H3256 -001 -0 | | | | | |
new |
new |
new |
|
2021 UnitedHealthcare Dual Complete Choice LP (PPO D-SNP)
| $29.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,604 2021 Formulary |
|
2020 UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP)
| $25.30 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5322 -004 -0 | 25% | 25% | 25% | 25% | 3,601
2020 Formulary |
-- |
|
|
|
2021 UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP)
| $29.80 |
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 Nursing Home Plan 2 (PPO I-SNP)
| $25.30 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H0710 -033 -0 | 25% | 25% | 25% | 25% | 3,601
2020 Formulary |
|
-- |
|
|
2021 UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP)
| $29.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,604 2021 Formulary |
|
2020 WellCare Access (HMO D-SNP)
| $25.30 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1112 -006 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Access (HMO D-SNP)
| $29.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,348 2021 Formulary |
|
-- This plan not offered in 2020 --
|
H0111 -004 -0 | | | | | |
|
|
|
|
2021 WellCare Imperial (PPO D-SNP)
| $29.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $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 WellCare Liberty (HMO D-SNP)
| $25.30 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H1112 -033 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Liberty (HMO D-SNP)
| $29.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $14.00 | $47.00 | $47.00 | 3,348 2021 Formulary |
|
2020 Anthem MediBlue Essential (HMO)
| $46.00 |
$5,800 |
$95 | Yes, some additional gap coverage. |
H5422 -008 -0 | $5.00 | $15.00 | $42.00 | $42.00 | 3,780
2020 Formulary |
|
|
|
|
2021 Anthem MediBlue Essential (HMO)
| $38.00 |
$3,450 |
$95 | Yes, some additional gap coverage. | $5.00 | $15.00 | $37.00 | $37.00 | 3,639 2021 Formulary |
|
2020 WellCare Prime (PPO)
| $45.00 |
$5,100 |
$0 | Yes, some additional gap coverage. |
H0111 -002 -0 | $0.00 | $7.00 | $45.00 | $45.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Prime (PPO)
| $45.00 |
$5,100 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 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 HumanaChoice H5216-073 (PPO)
| $52.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount |
H5216 -073 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 HumanaChoice H5216-073 (PPO)
| $48.00 |
$6,700 |
$360 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,386 2021 Formulary |
|
2020 UnitedHealthcare Medicare Advantage Choice (Regional PPO)
| $45.00 |
$6,700 |
$195 | No additional gap coverage, only the Donut Hole Discount |
R2604 -001 -0 | $4.00 | $14.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
|
|
|
|
2021 UnitedHealthcare Medicare Advantage Choice (Regional PPO)
| $49.00 |
$6,700 |
$295 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $14.00 | $47.00 | $47.00 | 3,604 2021 Formulary |
|
2020 Humana Gold Choice H8145-069 (PFFS)
| $92.00 |
n/a |
$340 | No additional gap coverage, only the Donut Hole Discount |
H8145 -069 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
-- |
|
|
2021 Humana Gold Choice H8145-069 (PFFS)
| $53.00 |
n/a |
$340 | 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 Anthem MediBlue Access (PPO)
| $58.00 |
$5,900 |
$95 | Yes, some additional gap coverage. |
H7728 -005 -0 | $4.00 | $13.00 | $42.00 | $42.00 | 3,780
2020 Formulary |
|
|
|
|
2021 Anthem MediBlue Access (PPO)
| $59.00 |
$5,900 |
$95 | Yes, some additional gap coverage. | $4.00 | $13.00 | $42.00 | $42.00 | 3,639 2021 Formulary |
|
2020 Kaiser Permanente Senior Advantage Enhanced (HMO)
| $71.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H1170 -002 -0 | $0.00 | $6.00 | $47.00 | $47.00 | 4,833
2020 Formulary |
|
|
|
|
2021 Kaiser Permanente Senior Advantage Enhanced (HMO)
| $71.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $6.00 | $47.00 | $47.00 | 4,700 2021 Formulary |
|
2020 HumanaChoice R3392-002 (Regional PPO)
| $76.00 |
$6,700 |
$340 | No additional gap coverage, only the Donut Hole Discount |
R3392 -002 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
2021 HumanaChoice R3392-002 (Regional PPO)
| $87.00 |
$6,700 |
$340 | 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 WellCare Flex Complete (PPO)
| $90.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H0111 -003 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,274
2020 Formulary |
|
|
|
|
2021 WellCare Flex Complete (PPO)
| $90.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,348 2021 Formulary |
|
2020 AARP Medicare Advantage Walgreens Plan 2 (HMO)
| $56.00 |
$5,500 |
$175 | No additional gap coverage, only the Donut Hole Discount |
H1111 -010 -2 | $0.00 | $5.00 | $47.00 | $47.00 | 3,601
2020 Formulary |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage Walgreens (HMO) H1111-009-2 --
| | | | | |
|
2020 HumanaChoice H5216-145 (PPO)
| $34.00 |
$6,700 |
$75 | No additional gap coverage, only the Donut Hole Discount |
H5216 -145 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,369
2020 Formulary |
|
|
|
|
-- Members will be assigned to HumanaChoice H5216-203 (PPO) H5216-203-1 --
| | | | | |
|
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 Lasso Healthcare (MSA)
| $0.00 |
n/a |
No Rx Coverage |
H1924 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to Lasso Healthcare Growth (MSA) H1924-001-0 --
| | | | | |
|
2020 EON GOLD (PPO C-SNP)
| $15.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount |
H9589 -001 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 4,225
2020 Formulary |
-- |
-- |
-- |
|
-- This plan not offered in 2021 --
|
| | | | |
|