There are 61 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 Choice (PPO)
| $0.00 |
$5,900 |
$95 | No additional gap coverage, only the Donut Hole Discount |
H2577 -006 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
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2022 AARP Medicare Advantage Choice Plan 1 (PPO)
| $0.00 |
$5,900 |
$95 | Yes, some additional gap coverage. | $0.00 | $14.00 | $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-POS)
| $0.00 |
$4,500 |
No Rx Coverage |
H8748 -019 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
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2022 AARP Medicare Advantage Patriot (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 AARP Medicare Advantage Plan 1 (HMO-POS)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H8748 -002 -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 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
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-- This plan not offered in 2021 --
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H5521 -279 -0 | | | | | |
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2022 Aetna Medicare Eagle Plan (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 |
2021 Aetna Medicare Premier Plan (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5521 -247 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
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2022 Aetna Medicare Premier Plan (PPO)
| $0.00 |
$6,100 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
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-- This plan not offered in 2021 --
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H8003 -007 -0 | | | | | |
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|
|
2022 BlueCross Blue Basic (PPO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2021 --
|
H8003 -006 -0 | | | | | |
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2022 BlueCross Total Value (PPO)
| $0.00 |
$6,900 |
$75 | Yes, some additional gap coverage. | $0.00 | $15.00 | $40.00 | $40.00 | 3,240 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 --
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H7020 -008 -0 | | | | | |
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2022 Cigna Preferred Medicare (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,459 2022 Formulary |
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-- This plan not offered in 2021 --
|
H7849 -045 -0 | | | | | |
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2022 Cigna True Choice Medicare (PPO)
| $0.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,459 2022 Formulary |
|
2021 Clover Health Choice (PPO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5141 -036 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,358
2021 Formulary |
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|
2022 Clover Health LiveHealthy (PPO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $37.00 | $37.00 | 3,358 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 First Choice VIP Care Plus (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H8213 -001 -0 | | | | | 3,407
2021 Formulary |
-- |
-- |
-- |
|
2022 First Choice VIP Care Plus (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,477 2022 Formulary |
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-- This plan not offered in 2021 --
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H5619 -144 -2 | | | | | |
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2022 Humana Gold Plus H5619-144 (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
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2021 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5216 -217 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2021 --
|
H5216 -286 -0 | | | | | |
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2022 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 HumanaChoice - Diabetes (PPO C-SNP)
| $0.00 |
n/a |
$145 | No additional gap coverage, only the Donut Hole Discount |
H5216 -244 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
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2022 HumanaChoice - Diabetes and Heart (PPO C-SNP)
| $0.00 |
n/a |
$145 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 HumanaChoice H5216-154 (PPO)
| $0.00 |
$7,550 |
$400 | No additional gap coverage, only the Donut Hole Discount |
H5216 -154 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,172
2021 Formulary |
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2022 HumanaChoice H5216-154 (PPO)
| $0.00 |
$7,550 |
$400 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $47.00 | $47.00 | 3,408 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 H5216-157 (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5216 -157 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 HumanaChoice H5216-157 (PPO)
| $0.00 |
$6,100 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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-- This plan not offered in 2021 --
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H5216 -279 -0 | | | | | |
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2022 HumanaChoice H5216-279 (PPO)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,413 2022 Formulary |
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-- This plan not offered in 2021 --
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H5216 -282 -2 | | | | | |
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2022 HumanaChoice H5216-282 (PPO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $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 R3392-001 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R3392 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 HumanaChoice R3392-001 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H2533 -001 -0 | | | | | 3,242
2021 Formulary |
-- |
-- |
-- |
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2022 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,260 2022 Formulary |
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-- This plan not offered in 2021 --
|
H8176 -003 -0 | | | | | |
|
new |
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|
2022 Molina Medicare Choice Care (HMO)
| $0.00 |
$7,550 |
$125 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $47.00 | $47.00 | 3,218 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 Patriot (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R2604 -005 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2022 UnitedHealthcare Medicare Advantage Patriot (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 WellCare Absolute (PPO)
| $0.00 |
$6,700 |
$90 | Yes, some additional gap coverage. |
H7326 -003 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
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|
|
2022 Wellcare Giveback Open (PPO)
| $0.00 |
$6,700 |
$90 | Yes, some additional gap coverage. | $0.00 | $10.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 WellCare Elite (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4847 -002 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
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|
|
|
2022 Wellcare No Premium (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $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 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1436 -002 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,370
2021 Formulary |
|
-- |
|
|
2022 Wellcare No Premium Medicare (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 WellCare Premier (PPO)
| $0.00 |
$5,500 |
$100 | Yes, some additional gap coverage. |
H7326 -001 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
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|
|
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$100 | Yes, some additional gap coverage. | $0.00 | $0.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 WellCare Patriot (HMO-POS)
| $0.00 |
$3,450 |
No Rx Coverage |
H4847 -006 -0 | This plan does NOT include Prescription Drug coverage. | |
|
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|
|
2022 Wellcare Patriot Giveback (HMO-POS)
| $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 |
2021 Absolute Total Care (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H1723 -001 -0 | | | | | 3,473
2021 Formulary |
-- |
-- |
-- |
|
2022 Wellcare Prime by Absolute Total Care (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,382 2022 Formulary |
|
2021 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $9.70 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
R2604 -002 -0 | | | | | 3,604
2021 Formulary |
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|
2022 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $9.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,663 2022 Formulary |
|
2021 Aetna Medicare Value Plan (PPO)
| $16.00 |
$6,700 |
$150 | Yes, some additional gap coverage. |
H5521 -251 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
|
|
|
|
2022 Aetna Medicare Value Plan (PPO)
| $16.00 |
$6,700 |
$150 | 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 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $19.00 |
n/a |
$210 | No additional gap coverage, only the Donut Hole Discount |
R2604 -003 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
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|
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|
2022 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $19.00 |
n/a |
$210 | Some Generics | $4.00 | $12.00 | $47.00 | $47.00 | tbd |
|
2021 AARP Medicare Advantage Plan 2 (HMO-POS)
| $24.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H8748 -025 -0 | $2.00 | $8.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 AARP Medicare Advantage Plan 2 (HMO-POS)
| $24.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H5216 -243 -0 | | | | | |
|
|
|
|
2022 Humana Together in Health (PPO I-SNP)
| $24.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $11.00 | $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 BlueCross Total (PPO)
| $29.00 |
$6,900 |
$100 | Yes, some additional gap coverage. |
H8003 -003 -0 | $5.00 | $15.00 | $37.00 | $37.00 | 4,063
2021 Formulary |
|
|
|
|
2022 BlueCross Total (PPO)
| $25.00 |
$6,500 |
$50 | Yes, some additional gap coverage. | $0.00 | $15.00 | $37.00 | $37.00 | 3,416 2022 Formulary |
|
2021 Humana Gold Plus H5619-083 (HMO)
| $29.00 |
$6,700 |
$245 | No additional gap coverage, only the Donut Hole Discount |
H5619 -083 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
2022 Humana Gold Plus H5619-083 (HMO)
| $25.00 |
$6,700 |
$245 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H5216 -277 -0 | | | | | |
|
|
|
|
2022 HumanaChoice SNP-DE H5216-277 (PPO D-SNP)
| $25.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $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 SNP-DE H5619-082 (HMO D-SNP)
| $25.70 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5619 -082 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
2022 Humana Gold Plus SNP-DE H5619-082 (HMO D-SNP)
| $26.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
2021 WellCare Compass (HMO)
| $13.30 |
$3,450 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H4847 -005 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
|
|
|
2022 Wellcare Assist (HMO)
| $28.20 |
$3,400 |
$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 --
|
H2577 -026 -0 | | | | | |
|
|
|
|
2022 AARP Medicare Advantage Choice Plan 2 (PPO)
| $29.00 |
$6,900 |
$395 | 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 Clover Health Choice Value (PPO)
| $27.60 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5141 -037 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,358
2021 Formulary |
|
|
|
|
2022 Clover Health LiveHealthy Value (PPO)
| $31.10 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $37.00 | $37.00 | 3,358 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H4739 -001 -0 | | | | | |
new |
new |
new |
|
2022 First Choice VIP Care (HMO D-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $5.00 | 25% | | | 3,477 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H5216 -280 -2 | | | | | |
|
|
|
|
2022 HumanaChoice H5216-280 (PPO)
| $31.10 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $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 Molina Medicare Complete Care (HMO D-SNP)
| $27.60 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H8176 -001 -0 | $0.00 | $4.00 | $45.00 | $45.00 | 3,245
2021 Formulary |
|
new |
|
|
2022 Molina Medicare Complete Care (HMO D-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $45.00 | $45.00 | 3,263 2022 Formulary |
|
2021 PruittHealth Premier (HMO I-SNP)
| $27.60 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H6345 -002 -0 | | | | | 3,764
2021 Formulary |
|
-- |
|
|
2022 PruittHealth Premier (HMO I-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,712 2022 Formulary |
|
2021 UnitedHealthcare Dual Complete (PPO D-SNP)
| $27.60 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H0271 -016 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Dual Complete (PPO D-SNP)
| $31.10 |
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 |
2021 Allwell Dual Medicare (HMO D-SNP)
| $27.60 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H1436 -005 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,352
2021 Formulary |
|
-- |
|
|
2022 Wellcare Dual Access (HMO D-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,375 2022 Formulary |
|
2021 WellCare Access (HMO D-SNP)
| $21.70 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H4847 -004 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
|
|
|
2022 Wellcare Dual Liberty (HMO D-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $43.00 | $43.00 | 3,375 2022 Formulary |
|
2021 WellCare Prime (PPO)
| $30.00 |
$6,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7326 -002 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
|
|
|
2022 Wellcare Low Premium Open (PPO)
| $44.00 |
$6,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $2.00 | $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 UnitedHealthcare Medicare Advantage Choice (Regional PPO)
| $49.00 |
$6,700 |
$295 | No additional gap coverage, only the Donut Hole Discount |
R2604 -001 -0 | $4.00 | $14.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Medicare Advantage Choice (Regional PPO)
| $49.00 |
$6,700 |
$295 | Yes, some additional gap coverage. | $4.00 | $14.00 | $47.00 | $47.00 | tbd |
|
2021 HumanaChoice H5216-075 (PPO)
| $70.00 |
$7,550 |
$340 | No additional gap coverage, only the Donut Hole Discount |
H5216 -075 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-075 (PPO)
| $66.00 |
$7,550 |
$340 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,413 2022 Formulary |
|
2021 HumanaChoice R3392-002 (Regional PPO)
| $87.00 |
$6,700 |
$340 | No additional gap coverage, only the Donut Hole Discount |
R3392 -002 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice R3392-002 (Regional PPO)
| $103.00 |
$6,700 |
$340 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $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 Humana Gold Plus H5619-132 (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5619 -132 -2 | $4.00 | $12.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus (HMO) H5619-144 --
| | | | | |
|
2021 HumanaChoice H5216-241 (PPO)
| $28.70 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5216 -241 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
-- Members will be assigned to HumanaChoice (PPO) H5216-280 --
| | | | | |
|
2021 HumanaChoice H5216-238 (PPO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -238 -2 | $4.00 | $12.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
-- Members will be assigned to HumanaChoice (PPO) H5216-282 --
| | | | | |
|
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 Dual Complete Choice (Regional PPO D-SNP)
| $28.80 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
R2604 -004 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
-- Members will be assigned to UnitedHealthcare Dual Complete (PPO D-SNP) H0271-016 --
| | | | | |
|
2021 WellCare Plus (HMO)
| $21.70 |
$3,000 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H4847 -003 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,348
2021 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Assist (HMO) H4847-005 --
| | | | | |
|
2021 WellCare Flex Complete (PPO)
| $90.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H7326 -004 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Giveback Open (PPO) H7326-003 --
| | | | | |
|
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 - Diabetes and Heart (PPO C-SNP)
| $5.20 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5216 -245 -0 | $0.00 | $17.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
-- This plan not offered in 2022 --
|
| | | | |
|