There are 72 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. | |
|
|
|
|
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. | |
|
|
|
|
2022 Lasso Healthcare Growth Plus (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$5,900 |
No Rx Coverage |
H8768 -019 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2022 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$5,900 |
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 AARP Medicare Advantage Walgreens (PPO)
| $0.00 |
$5,900 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H8768 -010 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 AARP Medicare Advantage Walgreens (PPO)
| $0.00 |
$5,900 |
$250 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
2021 Aetna Better Health Premier Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H2506 -001 -0 | | | | | 3,242
2021 Formulary |
-- |
-- |
-- |
|
2022 Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,260 2022 Formulary |
|
2021 Aetna Medicare DMG Prime (PPO)
| $0.00 |
$3,950 |
$0 | Yes, some additional gap coverage. |
H5521 -314 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Aetna Medicare DMG Prime (PPO)
| $0.00 |
$3,950 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $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 |
2021 Aetna Medicare Eagle (PPO)
| $0.00 |
$5,900 |
No Rx Coverage |
H5521 -286 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2022 Aetna Medicare Eagle (PPO)
| $0.00 |
$5,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Aetna Medicare Prime (HMO)
| $0.00 |
$3,950 |
$0 | Yes, some additional gap coverage. |
H3192 -001 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Aetna Medicare Prime (HMO-POS)
| $0.00 |
$3,950 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
2021 Aetna Medicare Value (PPO)
| $0.00 |
$3,950 |
$0 | Yes, some additional gap coverage. |
H5521 -086 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Aetna Medicare Value (PPO)
| $0.00 |
$3,950 |
$0 | Yes, some additional gap coverage. | $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 |
2021 Ascension Complete AMITA Health Reward (HMO)
| $0.00 |
$7,550 |
$430 | No additional gap coverage, only the Donut Hole Discount |
H7399 -001 -0 | $2.00 | $20.00 | $47.00 | $47.00 | 3,370
2021 Formulary |
|
new |
|
|
2022 Ascension Complete AMITA Health Reward (HMO)
| $0.00 |
$2,900 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 Ascension Complete AMITA Health Secure (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7399 -002 -0 | $2.00 | $10.00 | $47.00 | $47.00 | 3,370
2021 Formulary |
|
new |
|
|
2022 Ascension Complete AMITA Health Secure (HMO)
| $0.00 |
$2,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $1.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 Blue Cross Community MMAI (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H0927 -001 -0 | | | | | 2,800
2021 Formulary |
-- |
-- |
-- |
|
2022 Blue Cross Community MMAI (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 2,840 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 Blue Cross Medicare Advantage Basic (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3822 -001 -0 | $0.00 | $8.00 | $39.00 | $39.00 | 3,563
2021 Formulary |
|
|
|
|
2022 Blue Cross Medicare Advantage Basic (HMO)
| $0.00 |
$2,950 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
|
2021 Blue Cross Medicare Advantage Basic Plus (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H3822 -007 -0 | $0.00 | $8.00 | $39.00 | $39.00 | 3,563
2021 Formulary |
|
|
|
|
2022 Blue Cross Medicare Advantage Basic Plus (HMO-POS)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
|
2021 Blue Cross Medicare Advantage Classic (PPO)
| $0.00 |
$7,550 |
$445 | Yes, some additional gap coverage. |
H8634 -008 -0 | $0.00 | $13.00 | $40.00 | $40.00 | 3,563
2021 Formulary |
|
|
|
|
2022 Blue Cross Medicare Advantage Classic (PPO)
| $0.00 |
$6,900 |
$250 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 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 --
|
H8634 -016 -0 | | | | | |
|
|
|
|
2022 Blue Cross Medicare Advantage Elite (PPO)
| $0.00 |
$3,900 |
$250 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
|
2021 Blue Medicare Advocate Health (HMO)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H8547 -001 -0 | $0.00 | $8.00 | $39.00 | $39.00 | 3,563
2021 Formulary |
|
new |
new |
|
2022 Blue Medicare Advocate Health (HMO)
| $0.00 |
$2,950 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
|
2021 Bright Advantage (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H6121 -008 -0 | $0.00 | $8.00 | $39.00 | $39.00 | 3,364
2021 Formulary |
|
new |
new |
|
2022 Bright Advantage Classic Care Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $39.00 | $39.00 | 3,133 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 Fundamental Medicare (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H1415 -013 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2022 Cigna Fundamental Medicare (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Cigna Preferred Medicare (HMO)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1415 -024 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,446
2021 Formulary |
|
|
|
|
2022 Cigna Preferred Medicare (HMO)
| $0.00 |
$3,150 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $42.00 | $42.00 | 3,459 2022 Formulary |
|
2021 Cigna Premier Medicare (HMO-POS)
| $0.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1415 -021 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,446
2021 Formulary |
|
|
|
|
2022 Cigna Premier Medicare (HMO-POS)
| $0.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $42.00 | $42.00 | 3,459 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 True Choice Medicare (PPO)
| $0.00 |
$4,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7849 -002 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,446
2021 Formulary |
|
|
|
|
2022 Cigna True Choice Medicare (PPO)
| $0.00 |
$4,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $42.00 | $42.00 | 3,459 2022 Formulary |
|
2021 Clear Spring Health Community Advantage Plan (HMO)
| $0.00 |
$3,950 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3071 -002 -0 | $0.00 | $12.00 | $42.00 | $42.00 | 3,260
2021 Formulary |
|
-- |
|
|
2022 Clear Spring Health Community Advantage Plan (HMO)
| $0.00 |
$3,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $42.00 | $42.00 | 3,232 2022 Formulary |
|
2021 Clear Spring Health Essential (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5454 -002 -0 | $3.00 | $12.00 | $42.00 | $42.00 | 3,260
2021 Formulary |
|
-- |
-- |
|
2022 Clear Spring Health Essential (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $42.00 | $42.00 | 3,232 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 --
|
H7151 -001 -0 | | | | | |
new |
new |
new |
|
2022 Devoted Health Core (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,349 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H7151 -003 -0 | | | | | |
new |
new |
new |
|
2022 Devoted Health Essentials (HMO)
| $0.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $47.00 | $47.00 | 3,349 2022 Formulary |
|
2021 Humana Community HMO Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1468 -017 -0 | $1.00 | $5.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
2022 Humana Community HMO Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $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 |
2021 Humana Gold Plus H1468-013 (HMO)
| $0.00 |
$2,650 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1468 -013 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
2022 Humana Gold Plus H1468-013 (HMO)
| $0.00 |
$2,600 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H0336 -001 -0 | | | | | 3,119
2021 Formulary |
-- |
-- |
-- |
|
2022 Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,160 2022 Formulary |
|
2021 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5216 -258 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2022 Humana Honor (PPO)
| $0.00 |
$5,900 |
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 H5216-251 (PPO)
| $0.00 |
$5,500 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H5216 -251 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-251 (PPO)
| $0.00 |
$5,500 |
$200 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 HumanaChoice R5361-001 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R5361 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
-- |
|
|
2022 HumanaChoice R5361-001 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 MeridianComplete (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H6080 -001 -0 | | | | | 3,370
2021 Formulary |
-- |
-- |
-- |
|
2022 MeridianComplete (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,382 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 --
|
H8046 -001 -0 | | | | | |
-- |
-- |
-- |
|
2022 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,260 2022 Formulary |
|
2021 WellCare Absolute (PPO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H6713 -002 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
new |
new |
|
2022 Wellcare Giveback Open (PPO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 WellCare Value (HMO-POS)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1416 -009 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
-- |
|
|
2022 Wellcare No Premium (HMO-POS)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $37.00 | $37.00 | 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 Essential (HMO)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5779 -005 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
-- |
|
|
2022 Wellcare No Premium Essential (HMO)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H5779 -007 -0 | | | | | |
|
-- |
|
|
2022 Wellcare No Premium Exclusive (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 WellCare Premier (PPO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H6713 -001 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
new |
new |
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $37.00 | $37.00 | 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 |
$3,450 |
No Rx Coverage |
H1416 -053 -0 | This plan does NOT include Prescription Drug coverage. | |
|
-- |
|
|
2022 Wellcare Patriot No Premium (HMO-POS)
| $0.00 |
$3,450 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Zing Choice IL (HMO)
| $0.00 |
$2,950 |
$0 | Yes, some additional gap coverage. |
H4624 -001 -0 | $2.00 | $10.00 | $35.00 | $35.00 | 3,960
2021 Formulary |
|
new |
new |
|
2022 Zing Choice IL (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,911 2022 Formulary |
|
2021 Zing Essential Wellness IL (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H4624 -010 -0 | $2.00 | $10.00 | $35.00 | $35.00 | 3,960
2021 Formulary |
|
new |
new |
|
2022 Zing Essential Wellness IL (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands | $0.00 | $5.00 | $47.00 | $47.00 | 3,911 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 --
|
H5779 -008 -0 | | | | | |
|
-- |
|
|
2022 Wellcare Assist (HMO)
| $12.30 |
$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 WellCare Edge (HMO)
| $27.40 |
$3,450 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5779 -006 -0 | $0.00 | $18.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
-- |
|
|
2022 Wellcare Edge Plus (HMO)
| $18.70 |
$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 Clear Spring Health Community Flex Plan (HMO-POS)
| $19.00 |
$3,950 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3071 -003 -0 | $0.00 | $12.00 | $42.00 | $42.00 | 3,260
2021 Formulary |
|
-- |
|
|
2022 Clear Spring Health Community Flex Plan (HMO-POS)
| $19.00 |
$2,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $42.00 | $42.00 | 3,232 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 Compass (HMO)
| $12.60 |
$3,450 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1416 -023 -0 | $0.00 | $20.00 | $45.00 | $45.00 | 3,348
2021 Formulary |
|
-- |
|
|
2022 Wellcare Assist Compass (HMO)
| $19.00 |
$3,450 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,375 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H1468 -020 -0 | | | | | |
|
|
|
|
2022 Humana Together in Health IE-SNP (HMO I-SNP)
| $23.70 |
n/a |
$460 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $47.00 | $47.00 | 3,413 2022 Formulary |
|
2021 Humana Together in Health (HMO I-SNP)
| $25.30 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1468 -019 -0 | | | | | 3,386
2021 Formulary |
|
|
|
|
2022 Humana Together in Health I-SNP (HMO I-SNP)
| $23.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $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 Zing Open Access IL (HMO-POS)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H4624 -002 -0 | $2.00 | $10.00 | $35.00 | $35.00 | 3,960
2021 Formulary |
|
new |
new |
|
2022 Zing Open Access IL (HMO-POS)
| $25.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,911 2022 Formulary |
|
2021 AARP Medicare Advantage Plan 1 (HMO)
| $26.00 |
$3,900 |
$195 | No additional gap coverage, only the Donut Hole Discount |
H2802 -025 -0 | $3.00 | $10.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 AARP Medicare Advantage (HMO)
| $26.00 |
$3,900 |
$195 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
2021 WellCare Plus (HMO)
| $16.60 |
$3,450 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1416 -048 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
-- |
|
|
2022 Wellcare Plus (HMO)
| $26.60 |
$3,450 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $43.00 | $43.00 | 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 |
-- This plan not offered in 2021 --
|
H0271 -027 -0 | | | | | |
|
|
|
|
2022 UnitedHealthcare Chronic Complete Assure (PPO C-SNP)
| $26.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
2021 Bright Advantage Assist (HMO)
| $27.40 |
$6,700 |
$445 | Yes, some additional gap coverage. |
H6121 -003 -0 | $0.00 | 25% | 25% | 25% | 3,364
2021 Formulary |
|
new |
new |
|
2022 Bright Advantage Classic Choice Plan (HMO)
| $29.10 |
$6,700 |
$480 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 3,133 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H7151 -002 -0 | | | | | |
new |
new |
new |
|
2022 Devoted Health Prime (HMO)
| $29.10 |
$2,900 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | 25% | 25% | 3,349 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 --
|
H9590 -001 -0 | | | | | |
|
-- |
|
|
2022 Longevity Health Plan (HMO I-SNP)
| $29.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,678 2022 Formulary |
|
2021 Provider Partners Illinois Advantage Plan (HMO I-SNP)
| $27.40 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H3800 -001 -0 | | | | | 3,578
2021 Formulary |
|
new |
|
|
2022 Provider Partners Illinois Advantage Plan (HMO I-SNP)
| $29.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,497 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H3800 -002 -0 | | | | | |
|
new |
|
|
2022 Provider Partners Illinois Community Plan (HMO I-SNP)
| $29.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,497 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 Assure (PPO)
| $25.40 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H0271 -004 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Medicare Advantage Assure (PPO)
| $29.10 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
2021 UnitedHealthcare Nursing Home Plan 1 (HMO-POS I-SNP)
| $22.20 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H2802 -027 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Nursing Home Plan 1 (HMO-POS I-SNP)
| $29.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
2021 UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP)
| $27.40 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H0710 -039 -0 | | | | | 3,604
2021 Formulary |
|
-- |
|
|
2022 UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP)
| $29.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 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 -283 -0 | | | | | |
|
|
|
|
2022 HumanaChoice H5216-283 (PPO)
| $35.00 |
$3,750 |
$150 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 AARP Medicare Advantage Choice (PPO)
| $38.00 |
$3,900 |
$195 | No additional gap coverage, only the Donut Hole Discount |
H8768 -005 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 3,604
2021 Formulary |
|
|
|
|
2022 AARP Medicare Advantage Choice (PPO)
| $38.00 |
$3,900 |
$195 | Yes, some additional gap coverage. | $3.00 | $10.00 | $45.00 | $45.00 | 3,654 2022 Formulary |
|
2021 Aetna Medicare Premier Plus (PPO)
| $59.00 |
$3,475 |
$0 | Yes, some additional gap coverage. |
H5521 -016 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Aetna Medicare Premier Plus (PPO)
| $39.00 |
$3,475 |
$0 | Yes, some additional gap coverage. | $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 |
2021 Blue Cross Medicare Advantage Choice Plus (PPO)
| $79.00 |
$6,700 |
$445 | Yes, some additional gap coverage. |
H8634 -003 -0 | $0.00 | $13.00 | $40.00 | $40.00 | 3,563
2021 Formulary |
|
|
|
|
2022 Blue Cross Medicare Advantage Choice Plus (PPO)
| $79.00 |
$4,900 |
$250 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
|
2021 Blue Cross Medicare Advantage Premier Plus (HMO-POS)
| $83.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H3822 -008 -0 | $0.00 | $8.00 | $39.00 | $39.00 | 3,563
2021 Formulary |
|
|
|
|
2022 Blue Cross Medicare Advantage Premier Plus (HMO-POS)
| $83.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
|
2021 HumanaChoice H5216-013 (PPO)
| $88.00 |
$3,750 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -013 -0 | $6.00 | $15.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-013 (PPO)
| $88.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $15.00 | $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 |
2021 HumanaChoice R5361-002 (Regional PPO)
| $120.00 |
$6,700 |
$420 | No additional gap coverage, only the Donut Hole Discount |
R5361 -002 -0 | $3.00 | $9.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
-- |
|
|
2022 HumanaChoice R5361-002 (Regional PPO)
| $120.00 |
$6,700 |
$480 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $12.00 | $47.00 | $47.00 | 3,421 2022 Formulary |
|
2021 Blue Cross Medicare Advantage Choice Premier (PPO)
| $142.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H8634 -004 -0 | $0.00 | $13.00 | $40.00 | $40.00 | 3,563
2021 Formulary |
|
|
|
|
2022 Blue Cross Medicare Advantage Choice Premier (PPO)
| $142.00 |
$3,460 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H8634 -014 -0 | | | | | |
|
|
|
|
2022 Blue Cross Medicare Advantage Flex (PPO)
| $189.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $44.00 | $44.00 | 3,002 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 Plan 2 (HMO)
| $76.00 |
$3,900 |
$60 | No additional gap coverage, only the Donut Hole Discount |
H2802 -026 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 3,604
2021 Formulary |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage (HMO) H2802-025 --
| | | | | |
|
2021 Bright Advantage Choice Plus (PPO)
| $49.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3725 -001 -0 | $0.00 | $8.00 | $39.00 | $39.00 | 3,364
2021 Formulary |
|
|
|
|
-- This plan not offered in 2022 --
|
| | | | |
|
2021 Bright Advantage Choice (PPO)
| $0.00 |
$4,000 |
$400 | Yes, some additional gap coverage. |
H3725 -004 -0 | $0.00 | $8.00 | $39.00 | $39.00 | 3,364
2021 Formulary |
|
|
|
|
-- This plan not offered in 2022 --
|
| | | | |
|