There are 62 Medicare Advantage plans meeting your criteria.
2021 / 2022 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 |
2021 Lasso Healthcare Growth (MSA)
| $0.00 |
n/a |
No Rx Coverage |
H1924 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 Lasso Healthcare Growth (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Lasso Healthcare Growth Plus (MSA)
| $0.00 |
n/a |
No Rx Coverage |
H1924 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 Lasso Healthcare Growth Plus (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2021 --
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H6528 -031 -0 | | | | | |
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2022 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$5,900 |
$250 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
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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 |
2021 AARP Medicare Advantage Patriot (HMO)
| $0.00 |
$4,500 |
No Rx Coverage |
H3464 -007 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 AARP Medicare Advantage Patriot (HMO)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2021 --
|
H3464 -001 -0 | | | | | |
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2022 AARP Medicare Advantage Plan 1 (HMO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
2021 Aetna Medicare Elite (PPO)
| $0.00 |
$6,000 |
$0 | Yes, some additional gap coverage. |
H1608 -054 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
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2022 Aetna Medicare Elite (PPO)
| $0.00 |
$6,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
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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 2021 --
|
H2663 -039 -0 | | | | | |
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2022 Aetna Medicare Premier (HMO)
| $0.00 |
$5,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
2021 Aetna Medicare Premier Plus (PPO)
| $0.00 |
$7,550 |
$0 | Yes, some additional gap coverage. |
H1608 -021 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
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2022 Aetna Medicare Premier Plus (PPO)
| $0.00 |
$5,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
2021 BlueMedicare Premier (HMO)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. |
H6158 -001 -0 | $3.00 | $7.00 | $47.00 | $47.00 | 3,450
2021 Formulary |
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new |
new |
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2022 BlueMedicare Premier (HMO)
| $0.00 |
$5,500 |
$195 | Yes, some additional gap coverage. | $3.00 | $8.00 | $47.00 | $47.00 | 3,495 2022 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 |
2021 Cigna Preferred Medicare (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H4513 -050 -0 | $3.00 | $15.00 | $42.00 | $42.00 | 3,446
2021 Formulary |
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2022 Cigna Preferred Medicare (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $42.00 | $42.00 | 3,459 2022 Formulary |
|
2021 Health Advantage Blue Classic (HMO)
| $0.00 |
$6,000 |
$250 | Yes, some additional gap coverage. |
H9699 -004 -2 | $3.00 | $13.00 | $40.00 | $40.00 | 3,450
2021 Formulary |
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2022 Health Advantage Blue Classic (HMO)
| $0.00 |
$6,000 |
$250 | Yes, some additional gap coverage. | $3.00 | $13.00 | $40.00 | $40.00 | 3,495 2022 Formulary |
|
2021 Health Advantage Blue Premier (HMO)
| $0.00 |
$6,500 |
$250 | Yes, some additional gap coverage. |
H9699 -006 -0 | $3.00 | $10.00 | $47.00 | $47.00 | 3,450
2021 Formulary |
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2022 Health Advantage Blue Premier (HMO)
| $0.00 |
$6,500 |
$250 | Yes, some additional gap coverage. | $3.00 | $10.00 | $47.00 | $47.00 | 3,495 2022 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 2021 --
|
H5619 -111 -0 | | | | | |
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2022 Humana Gold Plus H5619-111 (HMO)
| $0.00 |
$4,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
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2021 Humana Honor (PPO)
| $0.00 |
$4,500 |
No Rx Coverage |
H5216 -140 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 Humana Honor (PPO)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2021 --
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H5216 -231 -0 | | | | | |
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2022 HumanaChoice H5216-231 (PPO)
| $0.00 |
$4,200 |
$0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $12.00 | $47.00 | $47.00 | 3,413 2022 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 2021 --
|
H5216 -270 -1 | | | | | |
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2022 HumanaChoice H5216-270 (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $47.00 | $47.00 | 3,217 2022 Formulary |
|
2021 HumanaChoice R1532-001 (Regional PPO)
| $0.00 |
$3,900 |
No Rx Coverage |
R1532 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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-- |
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2022 HumanaChoice R1532-001 (Regional PPO)
| $0.00 |
$3,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2021 --
|
H2722 -002 -0 | | | | | |
|
new |
|
|
2022 Vantage BASIC (HMO-POS)
| $0.00 |
$5,900 |
$480 | Yes, some additional gap coverage. | $0.00 | $16.00 | $47.00 | $47.00 | 3,883 2022 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 |
2021 Allwell Medicare Boost (HMO)
| $0.00 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H9630 -008 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,370
2021 Formulary |
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2022 Wellcare Giveback (HMO)
| $0.00 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,375 2022 Formulary |
|
2021 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1416 -064 -0 | $1.00 | $10.00 | $40.00 | $40.00 | 3,348
2021 Formulary |
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-- |
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2022 Wellcare Giveback Dividend (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $10.00 | $40.00 | $40.00 | 3,375 2022 Formulary |
|
2021 Allwell Medicare (HMO)
| $0.00 |
$7,100 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H9630 -002 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,370
2021 Formulary |
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2022 Wellcare No Premium (HMO)
| $0.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,375 2022 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 |
2021 Allwell Medicare (HMO)
| $0.00 |
$7,300 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H9630 -004 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,370
2021 Formulary |
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|
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2022 Wellcare No Premium Medicare (HMO)
| $0.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,375 2022 Formulary |
|
2021 WellCare Premier (PPO)
| $0.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0270 -001 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
-- |
-- |
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $47.00 | $47.00 | 3,375 2022 Formulary |
|
2021 WellCare Preferred (HMO)
| $0.00 |
$6,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1416 -055 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
-- |
|
|
2022 Wellcare No Premium Preferred (HMO)
| $0.00 |
$6,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,375 2022 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 |
2021 WellCare Patriot (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage |
H1416 -058 -0 | This plan does NOT include Prescription Drug coverage. | |
|
-- |
|
|
2022 Wellcare Patriot Giveback (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Allwell Medicare Simple (HMO)
| $0.00 |
$4,900 |
No Rx Coverage |
H9630 -009 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
2022 Wellcare Patriot No Premium (HMO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $4.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
R3444 -008 -0 | | | | | 3,604
2021 Formulary |
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|
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2022 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $4.60 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,663 2022 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 |
2021 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $23.00 |
n/a |
$295 | No additional gap coverage, only the Donut Hole Discount |
R3444 -009 -0 | $4.00 | $15.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
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2022 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $17.00 |
n/a |
$295 | Some Generics | $4.00 | $15.00 | $47.00 | $47.00 | tbd |
|
2021 Tribute Advantage (HMO-POS D-SNP)
| $25.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1587 -001 -0 | | | | | 3,578
2021 Formulary |
|
-- |
|
|
2022 Tribute Advantage (HMO-POS D-SNP)
| $18.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,497 2022 Formulary |
|
2021 UnitedHealthcare Medicare Advantage Choice Plan 3 (Regional PPO)
| $19.00 |
$6,700 |
$245 | No additional gap coverage, only the Donut Hole Discount |
R3444 -023 -0 | $4.00 | $15.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
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|
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2022 UnitedHealthcare Medicare Advantage Choice Plan 3 (Regional PPO)
| $19.00 |
$6,700 |
$245 | Yes, some additional gap coverage. | $4.00 | $15.00 | $47.00 | $47.00 | tbd |
|
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 |
2021 Humana Gold Plus SNP-DE H5619-123 (HMO D-SNP)
| $26.80 |
n/a |
$300 | No additional gap coverage, only the Donut Hole Discount |
H5619 -123 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
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|
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2022 Humana Gold Plus SNP-DE H5619-123 (HMO D-SNP)
| $20.50 |
n/a |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 HumanaChoice H9070-005 (PPO)
| $20.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H9070 -005 -0 | $7.00 | $12.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H9070-005 (PPO)
| $21.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $12.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 Humana Value Plus H5619-109 (HMO)
| $26.80 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5619 -109 -0 | $1.00 | $17.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
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2022 Humana Value Plus H5619-109 (HMO)
| $21.30 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $17.00 | $47.00 | $47.00 | 3,408 2022 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 2021 --
|
H9630 -010 -0 | | | | | |
|
|
|
|
2022 Wellcare Dual Access (HMO D-SNP)
| $22.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $47.00 | $47.00 | 3,375 2022 Formulary |
|
2021 WellCare Compass (HMO)
| $15.20 |
$3,450 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1416 -041 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
-- |
|
|
2022 Wellcare Assist Compass (HMO)
| $22.60 |
$3,450 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $11.00 | $42.00 | $42.00 | 3,375 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H9630 -011 -0 | | | | | |
|
|
|
|
2022 Wellcare Dual Liberty (HMO D-SNP)
| $22.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $47.00 | $47.00 | 3,375 2022 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 |
2021 Allwell Medicare Premier (HMO)
| $21.50 |
$7,100 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H9630 -005 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,370
2021 Formulary |
|
|
|
|
2022 Wellcare Assist (HMO)
| $25.00 |
$3,450 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,375 2022 Formulary |
|
2021 Tribute Select (HMO-POS I-SNP)
| $24.90 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1587 -003 -0 | | | | | 3,578
2021 Formulary |
|
-- |
|
|
2022 Tribute Select (HMO-POS I-SNP)
| $25.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,497 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H5325 -007 -0 | | | | | |
|
|
|
|
2022 Aetna Medicare Assure (HMO D-SNP)
| $26.50 |
n/a |
$450 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,672 2022 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 2021 --
|
H0271 -023 -0 | | | | | |
|
|
|
|
2022 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $26.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H0271 -024 -0 | | | | | |
|
|
|
|
2022 UnitedHealthcare Dual Complete Choice Select (PPO D-SNP)
| $26.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H2722 -003 -0 | | | | | |
|
new |
|
|
2022 Vantage DUAL PLUS (HMO-POS D-SNP)
| $26.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | 25% | 25% | 3,883 2022 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 2021 --
|
H2722 -004 -0 | | | | | |
|
new |
|
|
2022 Vantage STANDARD (HMO-POS)
| $26.70 |
$4,900 |
$480 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,883 2022 Formulary |
|
2021 WellCare Access (HMO-POS D-SNP)
| $26.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1416 -033 -0 | $0.00 | $10.00 | $46.00 | $46.00 | 3,348
2021 Formulary |
|
-- |
|
|
2022 Wellcare Dual Access (HMO-POS D-SNP)
| $26.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $30.00 | $30.00 | 3,375 2022 Formulary |
|
2021 WellCare Imperial (PPO D-SNP)
| $26.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H0270 -002 -0 | $0.00 | $8.00 | $46.00 | $46.00 | 3,348
2021 Formulary |
|
-- |
-- |
|
2022 Wellcare Dual Access Open (PPO D-SNP)
| $26.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $40.00 | $40.00 | 3,375 2022 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 |
2021 WellCare Liberty (HMO-POS D-SNP)
| $26.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1416 -043 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,348
2021 Formulary |
|
-- |
|
|
2022 Wellcare Dual Liberty (HMO-POS D-SNP)
| $26.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $36.00 | $36.00 | 3,375 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H3464 -002 -0 | | | | | |
|
|
|
|
2022 AARP Medicare Advantage Plan 2 (HMO)
| $27.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
2021 Humana Gold Choice H8145-120 (PFFS)
| $36.00 |
n/a |
No Rx Coverage |
H8145 -120 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2022 Humana Gold Choice H8145-120 (PFFS)
| $31.00 |
n/a |
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 |
2021 Humana Gold Plus H5619-122 (HMO)
| $36.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5619 -122 -0 | $6.00 | $11.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
2022 Humana Gold Plus H5619-122 (HMO)
| $37.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $11.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 HumanaChoice H5216-163 (PPO)
| $45.00 |
$7,550 |
$195 | No additional gap coverage, only the Donut Hole Discount |
H5216 -163 -0 | $8.00 | $15.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-163 (PPO)
| $46.00 |
$7,550 |
$195 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $15.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 BlueMedicare Premier Choice (PPO)
| $49.00 |
$6,500 |
$195 | Yes, some additional gap coverage. |
H3554 -007 -0 | $3.00 | $10.00 | $47.00 | $47.00 | 3,450
2021 Formulary |
|
new |
new |
|
2022 BlueMedicare Premier Choice (PPO)
| $49.00 |
$5,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $47.00 | $47.00 | 3,495 2022 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 |
2021 UnitedHealthcare Medicare Advantage Choice Plan 2 (Regional PPO)
| $55.00 |
$6,700 |
$295 | No additional gap coverage, only the Donut Hole Discount |
R3444 -012 -0 | $4.00 | $15.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Medicare Advantage Choice Plan 2 (Regional PPO)
| $54.00 |
$6,700 |
$295 | Yes, some additional gap coverage. | $4.00 | $15.00 | $47.00 | $47.00 | tbd |
|
2021 HumanaChoice R1532-002 (Regional PPO)
| $50.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount |
R1532 -002 -0 | $5.00 | $13.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
-- |
|
|
2022 HumanaChoice R1532-002 (Regional PPO)
| $63.00 |
$6,700 |
$480 | No additional gap coverage, only the Donut Hole Discount | $14.00 | $19.00 | $47.00 | $47.00 | 3,421 2022 Formulary |
|
2021 BlueMedicare Value (PFFS)
| $69.00 |
n/a |
No Rx Coverage |
H4213 -016 -4 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2022 BlueMedicare Value (PFFS)
| $69.00 |
n/a |
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 |
2021 HumanaChoice H5216-083 (PPO)
| $76.00 |
$6,700 |
$195 | No additional gap coverage, only the Donut Hole Discount |
H5216 -083 -0 | $8.00 | $15.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-083 (PPO)
| $77.00 |
$6,700 |
$195 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $15.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 BlueMedicare Preferred (PFFS)
| $99.00 |
n/a |
$420 | No additional gap coverage, only the Donut Hole Discount |
H4213 -017 -6 | $3.00 | $13.00 | $40.00 | $40.00 | 3,450
2021 Formulary |
|
|
|
|
2022 BlueMedicare Preferred (PFFS)
| $100.00 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $20.00 | $47.00 | $47.00 | 3,495 2022 Formulary |
|
2021 Humana Gold Choice H8145-122 (PFFS)
| $131.00 |
n/a |
$195 | No additional gap coverage, only the Donut Hole Discount |
H8145 -122 -0 | $8.00 | $15.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 Humana Gold Choice H8145-122 (PFFS)
| $132.00 |
n/a |
$195 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $15.00 | $47.00 | $47.00 | 3,413 2022 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 |
2021 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$5,900 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H6528 -032 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage Choice (PPO) H6528-031 --
| | | | | |
|
2021 AARP Medicare Advantage Plan 1 (HMO)
| $0.00 |
$5,900 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H3464 -003 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage Plan 1 (HMO) H3464-001 --
| | | | | |
|
2021 AARP Medicare Advantage Plan 2 (HMO)
| $52.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3464 -004 -0 | $3.00 | $10.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage Plan 2 (HMO) H3464-002 --
| | | | | |
|
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 |
2021 HumanaChoice H5216-139 (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -139 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,172
2021 Formulary |
|
|
|
|
-- Members will be assigned to HumanaChoice (PPO) H5216-270 --
| | | | | |
|
2021 UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP)
| $28.20 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
R3444 -011 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
-- Members will be assigned to UnitedHealthcare Dual Complete Choice (PPO D-SNP) H0271-023 --
| | | | | |
|