There are 57 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. | |
|
2021 AARP Medicare Advantage Headwaters (PPO)
| $0.00 |
$5,900 |
$395 | No additional gap coverage, only the Donut Hole Discount |
H7404 -001 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
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2022 AARP Medicare Advantage Headwaters (PPO)
| $0.00 |
$5,900 |
$395 | 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 (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H7404 -015 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Allina Health Aetna Medicare Discover Value (PPO)
| $0.00 |
$5,900 |
No Rx Coverage |
H3219 -005 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 Allina Health Aetna Medicare Eagle (PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Allina Health Aetna Medicare Discover Plus (PPO)
| $0.00 |
$5,900 |
$250 | Yes, some additional gap coverage. |
H3219 -001 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
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2022 Allina Health Aetna Medicare Plus (PPO)
| $0.00 |
$5,900 |
$250 | Yes, some additional gap coverage. | $0.00 | $0.00 | $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 |
2021 Blue Cross Medicare Advantage Choice MA Only (PPO)
| $14.00 |
$4,900 |
No Rx Coverage |
H5959 -007 -1 | This plan does NOT include Prescription Drug coverage. | |
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2022 Blue Cross Medicare Advantage Choice MA Only (PPO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Blue Cross Medicare Advantage Core (PPO)
| $0.00 |
$5,900 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5959 -013 -1 | $0.00 | $13.00 | 21% | 21% | 3,450
2021 Formulary |
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2022 Blue Cross Medicare Advantage Core (PPO)
| $0.00 |
$5,500 |
$350 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $13.00 | 21% | 21% | 3,479 2022 Formulary |
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-- This plan not offered in 2021 --
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H0422 -003 -0 | | | | | |
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-- |
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2022 Care Wise: M Health Fairview & North Memorial (HMO-POS)
| $0.00 |
$5,800 |
$480 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | 17% | 17% | 3,436 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 HealthPartners Journey Pace (PPO)
| $0.00 |
$6,100 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H4882 -002 -0 | $8.00 | $14.00 | $47.00 | $47.00 | 3,263
2021 Formulary |
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2022 HealthPartners Journey Pace (PPO)
| $0.00 |
$5,500 |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $14.00 | $47.00 | $47.00 | 3,265 2022 Formulary |
|
2021 Humana Gold Plus H6622-073 (HMO-POS)
| $0.00 |
$5,500 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H6622 -073 -0 | $5.00 | $10.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
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2022 Humana Gold Plus H6622-073 (HMO-POS)
| $0.00 |
$5,100 |
$350 | 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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-- This plan not offered in 2021 --
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H5216 -278 -1 | | | | | |
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2022 Humana Honor (PPO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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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 --
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H5216 -275 -0 | | | | | |
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2022 HumanaChoice H5216-275 (PPO)
| $0.00 |
$4,400 |
$325 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $17.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
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2021 Medica Advantage Solution H6154-001 (HMO-POS)
| $0.00 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H6154 -001 -0 | $5.00 | $14.00 | $47.00 | $47.00 | 3,622
2021 Formulary |
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2022 Medica Advantage Solution H6154-001 (HMO-POS)
| $0.00 |
$5,500 |
$350 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $14.00 | $47.00 | $47.00 | 3,468 2022 Formulary |
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-- This plan not offered in 2021 --
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H8889 -009 -0 | | | | | |
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2022 Medica Advantage Solution H8889-009 (PPO)
| $0.00 |
$5,500 |
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 Medica Advantage Solution PartnerCare Focus (HMO I-SNP)
| $16.00 |
n/a |
$140 | No additional gap coverage, only the Donut Hole Discount |
H6154 -004 -0 | $5.00 | $12.00 | $42.00 | $42.00 | 3,622
2021 Formulary |
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2022 Medica Advantage Solution PartnerCare Focus (HMO I-SNP)
| $0.00 |
n/a |
$140 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $42.00 | $42.00 | 3,468 2022 Formulary |
|
2021 UCare Prime (HMO-POS)
| $0.00 |
$5,500 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H2459 -020 -0 | $3.00 | $10.00 | 17% | 17% | 3,496
2021 Formulary |
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2022 UCare Prime (HMO-POS)
| $0.00 |
$6,000 |
$480 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | 17% | 17% | 3,436 2022 Formulary |
|
2021 UCare Value Plus (HMO-POS)
| $0.00 |
$5,500 |
No Rx Coverage |
H2459 -030 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 UCare Value Plus (HMO-POS)
| $0.00 |
$5,500 |
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 UCare Advocate Choice (HMO I-SNP)
| $10.00 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H2459 -031 -0 | $5.00 | $13.00 | $47.00 | $47.00 | 3,496
2021 Formulary |
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2022 UCare Advocate Choice (HMO I-SNP)
| $12.00 |
n/a |
$395 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $13.00 | $47.00 | $47.00 | 3,436 2022 Formulary |
|
2021 UCare Aware (HMO-POS)
| $26.00 |
$5,000 |
$395 | No additional gap coverage, only the Donut Hole Discount |
H2459 -029 -0 | $2.00 | $10.00 | 17% | 17% | 3,496
2021 Formulary |
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|
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2022 UCare Aware (HMO-POS)
| $26.00 |
$5,400 |
$395 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | 17% | 17% | 3,436 2022 Formulary |
|
2021 UCare Value (HMO-POS)
| $29.00 |
$3,400 |
No Rx Coverage |
H2459 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 UCare Value (HMO-POS)
| $29.00 |
$3,400 |
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 Value Plus H5216-176 (PPO)
| $28.60 |
$6,700 |
$230 | No additional gap coverage, only the Donut Hole Discount |
H5216 -176 -0 | $7.00 | $12.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
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2022 Humana Value Plus H5216-176 (PPO)
| $33.50 |
$6,700 |
$315 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $12.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 AARP Medicare Advantage Premier (PPO)
| $35.90 |
$4,900 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H7404 -004 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
2022 AARP Medicare Advantage Premier (PPO)
| $34.90 |
$4,900 |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H0710 -047 -0 | | | | | |
|
-- |
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|
2022 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $36.20 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 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 |
2021 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $31.30 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H0710 -041 -0 | | | | | 3,604
2021 Formulary |
|
-- |
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|
2022 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $36.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
2021 HumanaChoice H5216-092 (PPO)
| $38.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H5216 -092 -0 | $4.00 | $15.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
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|
|
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2022 HumanaChoice H5216-092 (PPO)
| $38.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $15.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 UCare Advocate Plus (HMO I-SNP)
| $38.00 |
n/a |
$435 | No additional gap coverage, only the Donut Hole Discount |
H2459 -032 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 3,496
2021 Formulary |
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|
|
|
2022 UCare Advocate Plus (HMO I-SNP)
| $38.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $45.00 | $45.00 | 3,436 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 HealthPartners Minnesota Senior Health Options (HMO D-SNP)
| $38.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H2422 -002 -0 | | | | | 3,263
2021 Formulary |
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|
2022 HealthPartners Minnesota Senior Health Options (HMO D-SNP)
| $38.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,265 2022 Formulary |
|
2021 Medica AccessAbility Solution Enhanced (HMO D-SNP)
| $38.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H9952 -001 -0 | | | | | 3,622
2021 Formulary |
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|
|
|
2022 Medica AccessAbility Solution Enhanced (HMO D-SNP)
| $38.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,490 2022 Formulary |
|
2021 Medica DUAL Solution (HMO D-SNP)
| $38.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H2458 -002 -0 | | | | | 3,622
2021 Formulary |
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|
|
|
2022 Medica DUAL Solution (HMO D-SNP)
| $38.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,490 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 SecureBlue (HMO D-SNP)
| $38.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H2425 -001 -0 | | | | | 3,440
2021 Formulary |
|
|
|
|
2022 SecureBlue (HMO D-SNP)
| $38.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,426 2022 Formulary |
|
2021 UCare Connect + Medicare (HMO D-SNP)
| $38.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5937 -001 -0 | | | | | 3,493
2021 Formulary |
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|
|
|
2022 UCare Connect + Medicare (HMO D-SNP)
| $38.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,432 2022 Formulary |
|
2021 UCare's Minnesota Senior Health Options (HMO D-SNP)
| $38.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H2456 -002 -0 | | | | | 3,493
2021 Formulary |
|
|
|
|
2022 UCare's Minnesota Senior Health Options (HMO D-SNP)
| $38.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,432 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 Care Core: M Health Fairview & North Memorial (HMO-POS)
| $44.00 |
$5,000 |
$400 | No additional gap coverage, only the Donut Hole Discount |
H0422 -001 -0 | $3.00 | $15.00 | $47.00 | $47.00 | 3,496
2021 Formulary |
|
-- |
|
|
2022 Care Core: M Health Fairview & North Memorial (HMO-POS)
| $44.00 |
$5,500 |
$395 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $47.00 | $47.00 | 3,436 2022 Formulary |
|
2021 Medica Advantage Solution H8889-005 (PPO)
| $49.00 |
$7,550 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H8889 -005 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,622
2021 Formulary |
|
|
|
|
2022 Medica Advantage Solution H8889-005 (PPO)
| $45.00 |
$4,000 |
$275 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,468 2022 Formulary |
|
2021 Allina Health Aetna Medicare Discover Premier (PPO)
| $46.00 |
$5,000 |
$150 | Yes, some additional gap coverage. |
H3219 -002 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Allina Health Aetna Medicare Premier (PPO)
| $47.00 |
$3,800 |
$150 | 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 AARP Medicare Advantage Lakeshore (PPO)
| $49.00 |
$4,000 |
$295 | No additional gap coverage, only the Donut Hole Discount |
H7404 -002 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 AARP Medicare Advantage Lakeshore (PPO)
| $49.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
2021 HealthPartners Journey Stride (PPO)
| $51.00 |
$4,100 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H4882 -001 -0 | $6.00 | $12.00 | $47.00 | $47.00 | 3,263
2021 Formulary |
|
|
|
|
2022 HealthPartners Journey Stride (PPO)
| $51.00 |
$3,900 |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $47.00 | $47.00 | 3,265 2022 Formulary |
|
2021 HumanaChoice H5216-080 (PPO)
| $59.00 |
$5,900 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H5216 -080 -1 | $4.00 | $15.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-080 (PPO)
| $55.00 |
$5,900 |
$350 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $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 UCare Essentials Rx (HMO-POS)
| $56.00 |
$3,800 |
$395 | No additional gap coverage, only the Donut Hole Discount |
H2459 -023 -1 | $2.00 | $10.00 | $47.00 | $47.00 | 3,496
2021 Formulary |
|
|
|
|
2022 UCare Essentials Rx (HMO-POS)
| $59.00 |
$3,800 |
$395 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $47.00 | $47.00 | 3,436 2022 Formulary |
|
2021 Medica Advantage Solution PartnerCare Premier (HMO I-SNP)
| $66.00 |
n/a |
$140 | No additional gap coverage, only the Donut Hole Discount |
H6154 -003 -0 | $5.00 | $12.00 | $42.00 | $42.00 | 3,622
2021 Formulary |
|
|
|
|
2022 Medica Advantage Solution PartnerCare Premier (HMO I-SNP)
| $67.00 |
n/a |
$140 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $42.00 | $42.00 | 3,468 2022 Formulary |
|
2021 HumanaChoice H5216-167 (PPO)
| $89.00 |
$4,500 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H5216 -167 -0 | $0.00 | $6.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-167 (PPO)
| $78.00 |
$4,000 |
$350 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $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 Blue Cross Medicare Advantage Choice (PPO)
| $79.20 |
$3,100 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H5959 -014 -1 | $0.00 | $10.00 | $37.00 | $37.00 | 3,450
2021 Formulary |
|
|
|
|
2022 Blue Cross Medicare Advantage Choice (PPO)
| $78.70 |
$3,000 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,479 2022 Formulary |
|
2021 Medica Advantage Solution H8889-001 (PPO)
| $105.00 |
$3,450 |
$275 | No additional gap coverage, only the Donut Hole Discount |
H8889 -001 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,622
2021 Formulary |
|
|
|
|
2022 Medica Advantage Solution H8889-001 (PPO)
| $85.00 |
$3,000 |
$245 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,468 2022 Formulary |
|
2021 HealthPartners Journey Dash (PPO)
| $91.00 |
$3,600 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H4882 -006 -0 | $5.00 | $10.00 | $47.00 | $47.00 | 3,263
2021 Formulary |
|
|
|
|
2022 HealthPartners Journey Dash (PPO)
| $89.00 |
$3,200 |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,265 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 Allina Health Aetna Medicare Discover Grand (PPO)
| $96.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H3219 -003 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Allina Health Aetna Medicare Grand (PPO)
| $96.00 |
$3,100 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
2021 HumanaChoice H5216-063 (PPO)
| $106.00 |
$3,200 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H5216 -063 -0 | $0.00 | $6.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-063 (PPO)
| $98.00 |
$3,200 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 AARP Medicare Advantage Riverbank (PPO)
| $99.00 |
$3,000 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H7404 -014 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 AARP Medicare Advantage Riverbank (PPO)
| $99.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 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 |
2021 UCare Complete (HMO-POS)
| $99.00 |
$3,000 |
$235 | No additional gap coverage, only the Donut Hole Discount |
H2459 -026 -1 | $0.00 | $10.00 | $47.00 | $47.00 | 3,496
2021 Formulary |
|
|
|
|
2022 UCare Complete (HMO-POS)
| $99.00 |
$3,200 |
$235 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,436 2022 Formulary |
|
2021 Humana Gold Plus H6622-062 (HMO-POS)
| $127.00 |
$3,000 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H6622 -062 -0 | $0.00 | $6.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
2022 Humana Gold Plus H6622-062 (HMO-POS)
| $128.00 |
$3,000 |
$100 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 HealthPartners Journey Steady (PPO)
| $136.00 |
$3,300 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H4882 -003 -0 | $4.00 | $10.00 | $47.00 | $47.00 | 3,263
2021 Formulary |
|
|
|
|
2022 HealthPartners Journey Steady (PPO)
| $136.00 |
$3,000 |
$300 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $10.00 | $47.00 | $47.00 | 3,265 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 Allina Health Aetna Medicare Discover Elite (PPO)
| $146.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H3219 -004 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Allina Health Aetna Medicare Elite (PPO)
| $152.00 |
$2,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
2021 Blue Cross Medicare Advantage Complete (PPO)
| $157.20 |
$2,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5959 -010 -1 | $0.00 | $9.00 | $37.00 | $37.00 | 3,450
2021 Formulary |
|
|
|
|
2022 Blue Cross Medicare Advantage Complete (PPO)
| $161.90 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $47.00 | $47.00 | 3,479 2022 Formulary |
|
2021 UCare Classic (HMO-POS)
| $185.00 |
$3,000 |
$225 | Yes, some additional gap coverage. |
H2459 -021 -1 | $0.00 | $7.00 | $35.00 | $35.00 | 3,496
2021 Formulary |
|
|
|
|
2022 UCare Classic (HMO-POS)
| $185.00 |
$3,000 |
$200 | Yes, some additional gap coverage. | $0.00 | $7.00 | $35.00 | $35.00 | 3,436 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 Medica Advantage Solution H8889-003 (PPO)
| $199.00 |
$3,450 |
$225 | No additional gap coverage, only the Donut Hole Discount |
H8889 -003 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,622
2021 Formulary |
|
|
|
|
2022 Medica Advantage Solution H8889-003 (PPO)
| $196.00 |
$3,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,468 2022 Formulary |
|
2021 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5216 -086 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to Humana Honor (PPO) H5216-278 --
| | | | | |
|
2021 Care Advantage: M Health Fairview & North Memorial (HMO-POS)
| $139.00 |
$3,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0422 -002 -0 | $3.00 | $15.00 | $47.00 | $47.00 | 3,496
2021 Formulary |
|
-- |
|
|
-- This plan not offered in 2022 --
|
| | | | |
|