There are 66 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 Patriot (HMO-POS)
| $0.00 |
$3,700 |
No Rx Coverage |
H2802 -050 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 AARP Medicare Advantage Patriot (HMO-POS)
| $0.00 |
$3,700 |
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 |
2021 AARP Medicare Advantage (HMO-POS)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2802 -028 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
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|
|
|
2022 AARP Medicare Advantage Plan 1 (HMO-POS)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H2802 -052 -0 | | | | | |
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|
|
|
2022 AARP Medicare Advantage Plan 2 (HMO-POS)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
2021 AARP Medicare Advantage Walgreens (PPO)
| $0.00 |
$3,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2228 -083 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
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|
|
|
2022 AARP Medicare Advantage Walgreens (PPO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $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 Aetna Medicare Eagle (PPO)
| $0.00 |
$5,000 |
No Rx Coverage |
H1608 -060 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
|
2022 Aetna Medicare Eagle (PPO)
| $0.00 |
$5,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Aetna Medicare Elite (PPO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H1608 -050 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
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|
|
2022 Aetna Medicare Elite (PPO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
2021 Aetna Medicare Gold Advantage Prime (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H2663 -005 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
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|
|
|
2022 Aetna Medicare Gold Advantage Prime (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,698 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 Anthem MediBlue Access Basic (PPO)
| $0.00 |
$4,900 |
$95 | Yes, some additional gap coverage. |
H4909 -016 -0 | $4.00 | $13.00 | $42.00 | $42.00 | 3,639
2021 Formulary |
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|
|
|
2022 Anthem MediBlue Access Basic (PPO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $4.00 | $13.00 | $42.00 | $42.00 | 3,626 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H3447 -038 -2 | | | | | |
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|
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2022 Anthem MediBlue Plus (HMO)
| $0.00 |
$2,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $42.00 | $42.00 | 3,626 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H4909 -021 -0 | | | | | |
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2022 Anthem MediBlue Service (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 2021 --
|
H7389 -003 -0 | | | | | |
new |
new |
new |
|
2022 Cigna Preferred Medicare (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $4.00 | $42.00 | $42.00 | 3,459 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H7849 -057 -0 | | | | | |
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2022 Cigna True Choice Medicare (PPO)
| $0.00 |
$4,100 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $42.00 | $42.00 | 3,459 2022 Formulary |
|
2021 Essence Advantage (HMO)
| $0.00 |
$1,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2610 -005 -0 | $0.00 | $0.00 | $39.00 | $39.00 | 3,579
2021 Formulary |
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2022 Essence Advantage (HMO)
| $0.00 |
$1,750 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $39.00 | $39.00 | 3,528 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 Essence Advantage Select (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2610 -016 -0 | $0.00 | $0.00 | $39.00 | $39.00 | 3,579
2021 Formulary |
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|
|
|
2022 Essence Advantage Select (HMO)
| $0.00 |
$2,800 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $39.00 | $39.00 | 3,528 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H0028 -051 -0 | | | | | |
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|
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2022 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $11.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 Humana Gold Plus H0028-014 (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0028 -014 -0 | $5.00 | $10.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
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|
|
|
2022 Humana Gold Plus H0028-014 (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $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 Honor (PPO)
| $0.00 |
$4,500 |
No Rx Coverage |
H5216 -140 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2022 Humana Honor (PPO)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 HumanaChoice H5216-033 (PPO)
| $0.00 |
$3,600 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -033 -2 | $7.00 | $14.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
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|
2022 HumanaChoice H5216-033 (PPO)
| $0.00 |
$3,600 |
$0 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $14.00 | $47.00 | $47.00 | 3,408 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. | |
|
-- |
|
|
2022 HumanaChoice R1532-001 (Regional PPO)
| $0.00 |
$3,900 |
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 SSM Health Plan Harmony (HMO-POS)
| $0.00 |
$2,500 |
No Rx Coverage |
H8019 -003 -0 | This plan does NOT include Prescription Drug coverage. | |
|
new |
new |
|
2022 SSM Health Plan Harmony (HMO-POS)
| $0.00 |
$2,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 SSM Health Plan Integrity (HMO-POS)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H8019 -002 -0 | $0.00 | $5.00 | $40.00 | $40.00 | 3,923
2021 Formulary |
|
new |
new |
|
2022 SSM Health Plan Integrity (HMO-POS)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,438 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H1664 -006 -0 | | | | | |
|
|
|
|
2022 Wellcare Giveback (HMO)
| $0.00 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $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 Allwell Medicare (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H1664 -004 -0 | $0.00 | $5.00 | $37.00 | $37.00 | 3,370
2021 Formulary |
|
|
|
|
2022 Wellcare No Premium (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H7518 -001 -0 | | | | | |
|
new |
new |
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$3,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H7518 -002 -0 | | | | | |
|
new |
new |
|
2022 Wellcare Patriot Giveback Open (PPO)
| $0.00 |
$4,000 |
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 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 |
|
|
|
|
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 |
|
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 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 |
|
|
|
|
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 H0028-015 (HMO D-SNP)
| $20.70 |
n/a |
$300 | No additional gap coverage, only the Donut Hole Discount |
H0028 -015 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
2022 Humana Gold Plus SNP-DE H0028-015 (HMO D-SNP)
| $21.10 |
n/a |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H7518 -004 -0 | | | | | |
|
new |
new |
|
2022 Wellcare Low Premium Open (PPO)
| $25.00 |
$3,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 AARP Medicare Advantage Choice Plan 1 (PPO)
| $29.00 |
$4,400 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H2228 -030 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,604
2021 Formulary |
|
|
|
|
2022 AARP Medicare Advantage Choice (PPO)
| $29.00 |
$4,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 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 |
-- This plan not offered in 2021 --
|
H7518 -003 -0 | | | | | |
|
new |
new |
|
2022 Wellcare Dual Access Open (PPO D-SNP)
| $30.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $42.00 | $42.00 | 3,375 2022 Formulary |
|
2021 UnitedHealthcare Dual Complete (HMO D-SNP)
| $30.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H0169 -002 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Dual Complete (HMO D-SNP)
| $30.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
2021 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $29.30 |
n/a |
$445 | Yes, some additional gap coverage. |
H3447 -018 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,639
2021 Formulary |
|
|
|
|
2022 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $30.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $40.00 | $40.00 | 3,626 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 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. | |
|
-- This plan not offered in 2021 --
|
H1664 -007 -0 | | | | | |
|
|
|
|
2022 Wellcare Assist (HMO)
| $31.90 |
$3,400 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,375 2022 Formulary |
|
2021 NHC Advantage (HMO I-SNP)
| $30.20 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H4172 -001 -0 | | | | | 3,764
2021 Formulary |
|
-- |
|
|
2022 NHC Advantage (HMO I-SNP)
| $32.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,712 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 Assure Gold Prime (HMO D-SNP)
| $30.50 |
n/a |
$220 | No additional gap coverage, only the Donut Hole Discount |
H5325 -005 -0 | $0.00 | $0.00 | 25% | 25% | 3,659
2021 Formulary |
|
|
|
|
2022 Aetna Medicare Assure Gold Prime (HMO D-SNP)
| $33.40 |
n/a |
$375 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
2021 American Health Advantage of Missouri (HMO I-SNP)
| $30.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H4490 -001 -0 | | | | | 3,568
2021 Formulary |
|
-- |
-- |
|
2022 American Health Advantage of Missouri (HMO I-SNP)
| $33.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,502 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H4490 -003 -0 | | | | | |
|
-- |
-- |
|
2022 American Health Advantage of Missouri Choice (HMO I-SNP)
| $33.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,502 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 --
|
H2610 -017 -0 | | | | | |
|
|
|
|
2022 Essence Dual Advantage (HMO D-SNP)
| $33.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $42.00 | $42.00 | 3,528 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H9191 -001 -0 | | | | | |
|
new |
new |
|
2022 Provider Partners Missouri Advantage Plan (HMO I-SNP)
| $33.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,497 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H0271 -029 -0 | | | | | |
|
|
|
|
2022 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $33.40 |
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 |
2021 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $30.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H0710 -016 -0 | | | | | 3,604
2021 Formulary |
|
-- |
|
|
2022 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $33.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H7518 -005 -0 | | | | | |
|
new |
new |
|
2022 Wellcare Community Assist (PPO)
| $33.40 |
$5,000 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 Allwell Dual Medicare (HMO D-SNP)
| $25.80 |
n/a |
$250 | Yes, some additional gap coverage. |
H1664 -005 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,352
2021 Formulary |
|
|
|
|
2022 Wellcare Dual Access (HMO D-SNP)
| $33.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $41.00 | $41.00 | 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 Aetna Medicare Advantra 1 (HMO-POS)
| $33.00 |
$7,550 |
$0 | Yes, some additional gap coverage. |
H2663 -006 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Aetna Medicare Option 1 (HMO-POS)
| $34.00 |
$6,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
2021 Anthem MediBlue Access (PPO)
| $39.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H4909 -015 -0 | $4.00 | $13.00 | $42.00 | $42.00 | 3,639
2021 Formulary |
|
|
|
|
2022 Anthem MediBlue Access (PPO)
| $39.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $4.00 | $13.00 | $42.00 | $42.00 | 3,626 2022 Formulary |
|
2021 Aetna Medicare Premier Advantra (PPO)
| $51.00 |
$7,550 |
$200 | Yes, some additional gap coverage. |
H1608 -013 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Aetna Medicare Premier (PPO)
| $52.00 |
$7,550 |
$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 Humana Gold Choice H8145-125 (PFFS)
| $53.00 |
n/a |
$195 | No additional gap coverage, only the Donut Hole Discount |
H8145 -125 -0 | $8.00 | $15.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 Humana Gold Choice H8145-125 (PFFS)
| $54.00 |
n/a |
$195 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $15.00 | $47.00 | $47.00 | 3,413 2022 Formulary |
|
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 |
|
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 Advantra 2 (HMO)
| $70.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H2663 -002 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,679
2021 Formulary |
|
|
|
|
2022 Aetna Medicare Option 2 (HMO)
| $66.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,698 2022 Formulary |
|
2021 Essence Advantage Plus (HMO)
| $73.00 |
$1,700 |
$0 | Yes, some additional gap coverage. |
H2610 -006 -0 | $0.00 | $0.00 | $34.00 | $34.00 | 3,579
2021 Formulary |
|
|
|
|
2022 Essence Advantage Plus (HMO)
| $66.00 |
$1,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $34.00 | $34.00 | 3,528 2022 Formulary |
|
2021 HumanaChoice H5216-032 (PPO)
| $78.00 |
$6,700 |
$195 | No additional gap coverage, only the Donut Hole Discount |
H5216 -032 -0 | $8.00 | $15.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-032 (PPO)
| $79.00 |
$6,700 |
$195 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $15.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
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 American Health Advantage Plus of Missouri (HMO I-SNP)
| $115.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4490 -002 -0 | $0.00 | $15.00 | $45.00 | $45.00 | 3,568
2021 Formulary |
|
-- |
-- |
|
2022 American Health Advantage of Missouri Premier (HMO I-SNP)
| $115.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $45.00 | $45.00 | 3,502 2022 Formulary |
|
2021 Aetna Medicare Prime (HMO-POS)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H2663 -015 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,679
2021 Formulary |
|
|
|
|
-- Members will be assigned to Aetna Medicare Gold Advantage Prime (HMO) H2663-005 --
| | | | | |
|
2021 Anthem MediBlue Plus (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3447 -019 -0 | $0.00 | $15.00 | $42.00 | $42.00 | 3,639
2021 Formulary |
|
|
|
|
-- Members will be assigned to Anthem MediBlue Plus (HMO) H3447-038 --
| | | | | |
|
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 SSM Health Plan Unity (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H8019 -001 -0 | $0.00 | $5.00 | $40.00 | $40.00 | 3,923
2021 Formulary |
|
new |
new |
|
-- Members will be assigned to SSM Health Plan Integrity (HMO-POS) H8019-002 --
| | | | | |
|
2021 SSM Health Plan Companion (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H8019 -004 -0 | $0.00 | $5.00 | $40.00 | $40.00 | 3,923
2021 Formulary |
|
new |
new |
|
-- Members will be assigned to SSM Health Plan Integrity (HMO-POS) H8019-002 --
| | | | | |
|
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 --
| | | | | |
|
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 Complement (HMO)
| $23.10 |
$3,000 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1664 -011 -0 | $2.00 | $8.00 | $44.00 | $44.00 | 3,352
2021 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Assist (HMO) H1664-007 --
| | | | | |
|
2021 Allwell Medicare Boost (HMO)
| $0.00 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1664 -010 -0 | $0.00 | $9.00 | $37.00 | $37.00 | 3,370
2021 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Giveback (HMO) H1664-006 --
| | | | | |
|
2021 NHC Advantage Gold (HMO I-SNP)
| $176.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4172 -002 -0 | $4.00 | $15.00 | $45.00 | $45.00 | 3,941
2021 Formulary |
|
-- |
|
|
-- This plan not offered in 2022 --
|
| | | | |
|