There are 58 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 |
-- This plan not offered in 2021 --
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H9295 -001 -0 | | | | | |
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2022 Exemplar Health Freedom 1 (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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-- This plan not offered in 2021 --
|
H9295 -002 -0 | | | | | |
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2022 Exemplar Health Freedom 2 (MSA)
| $0.00 |
n/a |
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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H9295 -003 -0 | | | | | |
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2022 Exemplar Health Freedom 3 (MSA)
| $0.00 |
n/a |
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 |
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. | |
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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. | |
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2021 AARP Medicare Advantage (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4527 -013 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
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2022 AARP Medicare Advantage (HMO)
| $0.00 |
$3,400 |
$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 AARP Medicare Advantage Choice (PPO)
| $18.00 |
$5,900 |
$255 | No additional gap coverage, only the Donut Hole Discount |
H1278 -010 -0 | $0.00 | $14.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
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|
|
|
2022 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$5,900 |
$255 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
2021 AARP Medicare Advantage Patriot (HMO-POS)
| $0.00 |
$5,500 |
No Rx Coverage |
H4527 -024 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 AARP Medicare Advantage Patriot (HMO-POS)
| $0.00 |
$5,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 Aetna Medicare Choice Plan (PPO)
| $0.00 |
$6,000 |
$250 | Yes, some additional gap coverage. |
H3288 -009 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
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2022 Aetna Medicare Choice Plan (PPO)
| $0.00 |
$6,000 |
$200 | 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 Plus Plan (PPO)
| $0.00 |
$7,550 |
$300 | Yes, some additional gap coverage. |
H3288 -012 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,659
2021 Formulary |
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2022 Aetna Medicare Plus Plan (PPO)
| $0.00 |
$7,550 |
$300 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
2021 Blue Cross Medicare Advantage Basic (HMO)
| $0.00 |
$3,400 |
$445 | Yes, some additional gap coverage. |
H8133 -005 -0 | $0.00 | $8.00 | $39.00 | $39.00 | 3,563
2021 Formulary |
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|
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2022 Blue Cross Medicare Advantage Basic (HMO)
| $0.00 |
$3,400 |
$480 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
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-- This plan not offered in 2021 --
|
H4801 -006 -0 | | | | | |
new |
new |
new |
|
2022 Blue Cross Medicare Advantage Classic (PPO)
| $0.00 |
$5,900 |
$350 | 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 |
2021 Blue Cross Medicare Advantage Value (HMO)
| $0.00 |
$4,000 |
$195 | Yes, some additional gap coverage. |
H8554 -001 -0 | $0.00 | $8.00 | $39.00 | $39.00 | 3,563
2021 Formulary |
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-- |
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2022 Blue Cross Medicare Advantage Value (HMO)
| $0.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
|
2021 Cigna CarePlan MMP (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H8423 -001 -0 | | | | | 3,446
2021 Formulary |
-- |
-- |
-- |
|
2022 Cigna CarePlan MMP (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,459 2022 Formulary |
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2021 Cigna Fundamental Medicare (HMO)
| $0.00 |
$3,900 |
No Rx Coverage |
H4513 -009 -0 | This plan does NOT include Prescription Drug coverage. | |
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2022 Cigna Fundamental Medicare (HMO)
| $0.00 |
$4,300 |
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 |
2021 Cigna Preferred Medicare (HMO)
| $0.00 |
$3,750 |
$190 | Yes, some additional gap coverage. |
H4513 -061 -2 | $0.00 | $4.00 | $42.00 | $42.00 | 3,446
2021 Formulary |
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|
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2022 Cigna Preferred Medicare (HMO)
| $0.00 |
$3,400 |
$190 | Yes, some additional gap coverage. | $0.00 | $4.00 | $42.00 | $42.00 | 3,459 2022 Formulary |
|
2021 Cigna True Choice Medicare (PPO)
| $0.00 |
$6,850 |
$190 | Yes, some additional gap coverage. |
H7849 -039 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,446
2021 Formulary |
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|
|
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2022 Cigna True Choice Medicare (PPO)
| $0.00 |
$6,700 |
$190 | Yes, some additional gap coverage. | $0.00 | $4.00 | $42.00 | $42.00 | 3,459 2022 Formulary |
|
2021 Humana Gold Plus H0028-046 (HMO)
| $0.00 |
$3,400 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H0028 -046 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
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|
|
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2022 Humana Gold Plus H0028-046 (HMO)
| $0.00 |
$3,450 |
$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 Honor (PPO)
| $0.00 |
$5,400 |
No Rx Coverage |
H5216 -128 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
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2022 Humana Honor (PPO)
| $0.00 |
$5,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 HumanaChoice R4182-001 (Regional PPO)
| $0.00 |
$5,700 |
No Rx Coverage |
R4182 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
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2022 HumanaChoice R4182-001 (Regional PPO)
| $0.00 |
$5,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2021 --
|
H8197 -002 -0 | | | | | |
-- |
-- |
-- |
|
2022 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,269 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 --
|
H7678 -004 -0 | | | | | |
|
-- |
|
|
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 |
|
-- This plan not offered in 2021 --
|
H7678 -005 -0 | | | | | |
|
-- |
|
|
2022 Molina Medicare Choice Care Select (HMO)
| $0.00 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $20.00 | $47.00 | $47.00 | 3,218 2022 Formulary |
|
2021 Prominence Plus (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. |
H7680 -002 -0 | $0.00 | $12.00 | $35.00 | $35.00 | 3,207
2021 Formulary |
|
|
|
|
2022 Prominence Plus (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $35.00 | $35.00 | 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 Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H6870 -001 -0 | | | | | 3,473
2021 Formulary |
-- |
-- |
-- |
|
2022 Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands | | | | | 3,382 2022 Formulary |
|
2021 UnitedHealthcare Chronic Complete (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H4527 -042 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Chronic Complete (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands | $0.00 | $0.00 | $47.00 | $47.00 | 3,654 2022 Formulary |
|
2021 Allwell Medicare Boost (HMO)
| $0.00 |
$7,550 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H5294 -012 -0 | $2.00 | $12.00 | $37.00 | $37.00 | 3,370
2021 Formulary |
|
-- |
|
|
2022 Wellcare Giveback (HMO)
| $0.00 |
$7,550 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $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 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5294 -011 -0 | $2.00 | $12.00 | $37.00 | $37.00 | 3,370
2021 Formulary |
|
-- |
|
|
2022 Wellcare No Premium (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
2021 Allwell Medicare (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0062 -003 -0 | $2.00 | $12.00 | $37.00 | $37.00 | 3,370
2021 Formulary |
|
-- |
|
|
2022 Wellcare No Premium Medicare (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $37.00 | $37.00 | 3,375 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H7323 -007 -0 | | | | | |
|
new |
|
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$6,700 |
$200 | Yes, some additional gap coverage. | $0.00 | $3.00 | $25.00 | $25.00 | 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 Rx Plus (PPO)
| $0.00 |
$6,000 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H7323 -006 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,348
2021 Formulary |
|
new |
|
|
2022 Wellcare No Premium Rx Plus Open (PPO)
| $0.00 |
$6,000 |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $35.00 | $35.00 | 3,375 2022 Formulary |
|
2021 Allwell Medicare Simple (HMO)
| $0.00 |
$3,450 |
No Rx Coverage |
H5294 -014 -0 | This plan does NOT include Prescription Drug coverage. | |
|
-- |
|
|
2022 Wellcare Patriot No Premium (HMO)
| $0.00 |
$3,450 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2021 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $4.90 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
R6801 -008 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $3.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,663 2022 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2021 Cigna TotalCare (HMO D-SNP)
| $7.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H4513 -060 -2 | | | | | 3,446
2021 Formulary |
|
|
|
|
2022 Cigna TotalCare (HMO D-SNP)
| $5.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,459 2022 Formulary |
|
2021 UnitedHealthcare Dual Complete Plan 2 (HMO D-SNP)
| $2.10 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5322 -026 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Dual Complete Plan 2 (HMO D-SNP)
| $5.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
2021 HumanaChoice H5216-043 (PPO)
| $10.00 |
$6,700 |
$295 | No additional gap coverage, only the Donut Hole Discount |
H5216 -043 -1 | $3.00 | $10.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice H5216-043 (PPO)
| $10.00 |
$6,700 |
$250 | Yes, some additional gap coverage. | $3.00 | $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 UnitedHealthcare Dual Complete Plan 1 (HMO D-SNP)
| $11.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H4527 -015 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Dual Complete Plan 1 (HMO D-SNP)
| $10.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,654 2022 Formulary |
|
2021 Allwell Medicare Complement (HMO)
| $14.00 |
$3,450 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5294 -013 -0 | $2.00 | $19.00 | $46.00 | $46.00 | 3,352
2021 Formulary |
|
-- |
|
|
2022 Wellcare Complement Assist (HMO)
| $14.50 |
$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 Aetna Medicare Dual Complete Plan (HMO D-SNP)
| $20.60 |
n/a |
$220 | No additional gap coverage, only the Donut Hole Discount |
H8597 -001 -0 | $0.00 | $0.00 | 25% | 25% | 3,659
2021 Formulary |
|
|
|
|
2022 Aetna Medicare Dual Complete Plan (HMO D-SNP)
| $18.00 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,672 2022 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2021 Blue Cross Medicare Advantage Choice Plus (PPO)
| $20.00 |
$7,550 |
$350 | Yes, some additional gap coverage. |
H1666 -010 -0 | $0.00 | $13.00 | $40.00 | $40.00 | 3,563
2021 Formulary |
|
|
|
|
2022 Blue Cross Medicare Advantage Choice Plus (PPO)
| $20.00 |
$7,550 |
$350 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,616 2022 Formulary |
|
2021 Humana Gold Plus SNP-DE H0028-045 (HMO D-SNP)
| $22.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H0028 -045 -0 | $3.00 | $15.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
|
|
|
2022 Humana Gold Plus SNP-DE H0028-045 (HMO D-SNP)
| $22.50 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $19.00 | $47.00 | $47.00 | 3,408 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H0783 -002 -0 | | | | | |
|
new |
new |
|
2022 Humana Gold Plus H0783-002 (HMO)
| $24.50 |
$3,450 |
$480 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $19.00 | $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 Molina Medicare Complete Care (HMO D-SNP)
| $22.50 |
n/a |
$445 | Yes, some additional gap coverage. |
H7678 -001 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 3,245
2021 Formulary |
|
-- |
|
|
2022 Molina Medicare Complete Care (HMO D-SNP)
| $25.10 |
n/a |
$480 | Some Generics | $0.00 | $5.00 | $42.00 | $42.00 | 3,263 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H7680 -007 -0 | | | | | |
|
|
|
|
2022 Prominence Dual (HMO D-SNP)
| $25.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | 25% | 25% | 3,133 2022 Formulary |
|
2021 Texas Independence Health Plan, Inc. (HMO I-SNP)
| $22.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5015 -001 -0 | | | | | 3,578
2021 Formulary |
|
new |
|
|
2022 Texas Independence Health Plan, Inc. (HMO I-SNP)
| $25.10 |
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 Dual Complete Choice (Regional PPO D-SNP)
| $22.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
R6801 -011 -0 | | | | | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP)
| $25.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,663 2022 Formulary |
|
2021 Allwell Dual Medicare Harmony (HMO D-SNP)
| $20.30 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5294 -015 -0 | $1.00 | $10.00 | $47.00 | $47.00 | 3,352
2021 Formulary |
|
-- |
|
|
2022 Wellcare Dual Access Harmony (HMO D-SNP)
| $25.10 |
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 Imperial (PPO D-SNP)
| $22.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H7323 -005 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,348
2021 Formulary |
|
new |
|
|
2022 Wellcare Dual Access Open (PPO D-SNP)
| $25.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,375 2022 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2021 Allwell Medicare Nurture (HMO D-SNP)
| $22.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5294 -010 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,352
2021 Formulary |
|
-- |
|
|
2022 Wellcare Dual Liberty Nurture (HMO D-SNP)
| $25.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,375 2022 Formulary |
|
2021 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $29.00 |
n/a |
$295 | No additional gap coverage, only the Donut Hole Discount |
R6801 -009 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $29.00 |
n/a |
$295 | Some Generics | $4.00 | $12.00 | $47.00 | $47.00 | tbd |
|
2021 Humana Gold Choice H8145-126 (PFFS)
| $30.00 |
n/a |
No Rx Coverage |
H8145 -126 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2022 Humana Gold Choice H8145-126 (PFFS)
| $30.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2021 UnitedHealthcare Medicare Advantage Choice (Regional PPO)
| $49.00 |
$7,550 |
$395 | No additional gap coverage, only the Donut Hole Discount |
R6801 -012 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,604
2021 Formulary |
|
|
|
|
2022 UnitedHealthcare Medicare Advantage Choice (Regional PPO)
| $49.00 |
$7,550 |
$395 | Yes, some additional gap coverage. | $4.00 | $12.00 | $47.00 | $47.00 | tbd |
|
2021 HumanaChoice R4182-004 (Regional PPO)
| $55.00 |
$7,200 |
$175 | No additional gap coverage, only the Donut Hole Discount |
R4182 -004 -0 | $6.00 | $13.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice R4182-004 (Regional PPO)
| $54.00 |
$7,200 |
$175 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $13.00 | $47.00 | $47.00 | 3,421 2022 Formulary |
|
2021 HumanaChoice R4182-003 (Regional PPO)
| $93.00 |
$7,200 |
$175 | No additional gap coverage, only the Donut Hole Discount |
R4182 -003 -0 | $7.00 | $12.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 HumanaChoice R4182-003 (Regional PPO)
| $92.00 |
$7,200 |
$175 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $12.00 | $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 Choice H8145-084 (PFFS)
| $96.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount |
H8145 -084 -0 | $6.00 | $12.00 | $47.00 | $47.00 | 3,386
2021 Formulary |
|
|
|
|
2022 Humana Gold Choice H8145-084 (PFFS)
| $97.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $12.00 | $47.00 | $47.00 | 3,413 2022 Formulary |
|
-- This plan not offered in 2021 --
|
H4801 -014 -0 | | | | | |
new |
new |
new |
|
2022 Blue Cross Medicare Advantage Flex (PPO)
| $215.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $44.00 | $44.00 | 3,002 2022 Formulary |
|
2021 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H8197 -001 -0 | | | | | 3,242
2021 Formulary |
-- |
-- |
-- |
|
-- Members will be assigned to Molina Dual Options (Medicare-Medicaid Plan) H8197-002 --
| | | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2021 Humana Gold Plus SNP-DE H0783-001 (HMO D-SNP)
| $22.50 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H0783 -001 -0 | $3.00 | $20.00 | $47.00 | $47.00 | 3,382
2021 Formulary |
|
new |
new |
|
-- This plan not offered in 2022 --
|
| | | | |
|