There are 65 Medicare Advantage plans meeting your criteria.
2022 / 2023 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 |
2022 AARP Medicare Advantage Patriot (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H0609 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
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2023 AARP Medicare Advantage Patriot (HMO-POS)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 AARP Medicare Advantage Plan 1 (HMO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. |
H0609 -048 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
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2023 AARP Medicare Advantage Plan 1 (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 AARP Medicare Advantage SecureHorizons Plan 2 (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H0609 -012 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
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2023 AARP Medicare Advantage SecureHorizons Plan 2 (HMO-POS)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,682 2023 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 |
2022 AARP Medicare Advantage Walgreens (PPO)
| $0.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H2577 -002 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
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|
|
2023 AARP Medicare Advantage Walgreens (PPO)
| $0.00 |
$5,100 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 Aetna Medicare Eagle Prime (HMO-POS)
| $0.00 |
$5,000 |
No Rx Coverage |
H4711 -010 -0 | This plan does NOT include Prescription Drug coverage. | |
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2023 Aetna Medicare Eagle (HMO-POS)
| $0.00 |
$5,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
H5521 -378 -0 | | | | | |
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2023 Aetna Medicare Eagle 1 (PPO)
| $0.00 |
$5,500 |
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 |
2022 Aetna Medicare Elite Prime (HMO-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H4711 -006 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
|
|
2023 Aetna Medicare Elite 1 (HMO-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H3931 -153 -0 | | | | | |
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2023 Aetna Medicare Premier 1 (HMO-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Aetna Medicare Prime 1 (HMO-POS)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H4711 -008 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
|
|
2023 Aetna Medicare Premier 1 (HMO-POS)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 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 |
2022 Aetna Medicare Prime 1 (PPO)
| $0.00 |
$5,300 |
$0 | Yes, some additional gap coverage. |
H5521 -250 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
|
|
2023 Aetna Medicare Premier Plus 1 (PPO)
| $0.00 |
$5,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Anthem MediBlue Access (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H4909 -022 -0 | $5.00 | $12.00 | $37.00 | $37.00 | 3,626
2022 Formulary |
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|
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2023 Anthem MediBlue Access (PPO)
| $0.00 |
$6,050 |
$0 | Yes, some additional gap coverage. | $5.00 | $12.00 | $37.00 | $37.00 | 3,603 2023 Formulary |
|
2022 Anthem MediBlue ESRD Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Few Generics |
H4346 -029 -0 | $5.00 | $8.00 | $42.00 | $42.00 | 3,603
2022 Formulary |
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|
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2023 Anthem MediBlue ESRD Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $5.00 | $8.00 | $42.00 | $42.00 | 3,579 2023 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 |
2022 Anthem MediBlue Plus (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H4346 -012 -0 | $5.00 | $8.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
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|
|
2023 Anthem MediBlue Plus (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $5.00 | $8.00 | $42.00 | $42.00 | 3,603 2023 Formulary |
|
2022 Cigna Preferred Medicare (HMO)
| $0.00 |
$4,200 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0672 -001 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,459
2022 Formulary |
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2023 Cigna Preferred Savings Medicare (HMO)
| $0.00 |
$3,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $42.00 | $42.00 | 3,524 2023 Formulary |
|
2022 Cigna True Choice Medicare (PPO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7849 -001 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,459
2022 Formulary |
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2023 Cigna True Choice Savings Medicare (PPO)
| $0.00 |
$5,200 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $42.00 | $42.00 | 3,524 2023 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 |
2022 Clear Spring Health Essential (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6379 -001 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 3,232
2022 Formulary |
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-- |
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|
2023 Clear Spring Health Essential (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $42.00 | $42.00 | 3,255 2023 Formulary |
|
-- This plan not offered in 2022 --
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H8014 -001 -0 | | | | | |
new |
new |
new |
|
2023 Clear Spring Health Essential (PPO)
| $0.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $42.00 | $42.00 | 3,255 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H4808 -002 -0 | | | | | |
new |
new |
new |
|
2023 Devoted CHOICE Colorado (PPO)
| $0.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,364 2023 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 2022 --
|
H7147 -004 -0 | | | | | |
new |
new |
new |
|
2023 Devoted CORE Colorado (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,364 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7147 -005 -0 | | | | | |
new |
new |
new |
|
2023 Devoted GIVEBACK Colorado (HMO)
| $0.00 |
$5,900 |
$150 | Yes, some additional gap coverage. | $0.00 | $9.00 | $47.00 | $47.00 | 3,364 2023 Formulary |
|
2022 Elevate Medicare Select (HMO)
| $39.80 |
$4,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5608 -002 -0 | $3.00 | $9.00 | 25% | 25% | 3,133
2022 Formulary |
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|
|
2023 Elevate Medicare Select (HMO)
| $0.00 |
$4,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $47.00 | $47.00 | 3,288 2023 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 |
2022 Humana Gold Plus H0028-025 (HMO)
| $0.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0028 -025 -1 | $2.00 | $7.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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|
|
|
2023 Humana Gold Plus H0028-025 (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
2022 Humana Honor (PPO)
| $0.00 |
$4,400 |
No Rx Coverage |
H5216 -213 -0 | This plan does NOT include Prescription Drug coverage. | |
|
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|
|
2023 Humana Honor (PPO)
| $0.00 |
$4,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 HumanaChoice H5216-077 (PPO)
| $0.00 |
$4,000 |
No Rx Coverage |
H5216 -077 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 HumanaChoice H5216-077 (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 |
2022 HumanaChoice H5216-137 (PPO)
| $0.00 |
$7,550 |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5216 -137 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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|
|
|
2023 HumanaChoice H5216-137 (PPO)
| $0.00 |
$7,350 |
$445 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice H5216-261 (PPO)
| $0.00 |
$6,700 |
$195 | No additional gap coverage, only the Donut Hole Discount |
H5216 -261 -0 | $2.00 | $7.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-261 (PPO)
| $0.00 |
$5,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H0630 -025 -0 | | | | | |
|
|
|
|
2023 Kaiser Permanente Senior Advantage Bronze DM (HMO-POS)
| $0.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $40.00 | $40.00 | 3,388 2023 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 |
2022 Kaiser Permanente Senior Advantage Core (HMO)
| $0.00 |
$4,200 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0630 -013 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 4,211
2022 Formulary |
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|
|
|
2023 Kaiser Permanente Senior Advantage Core DM (HMO)
| $0.00 |
$4,200 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $40.00 | $40.00 | 3,388 2023 Formulary |
|
2022 UnitedHealthcare Chronic Complete (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics |
H0609 -047 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Chronic Complete (HMO-POS C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 Cigna TotalCare (HMO D-SNP)
| $16.00 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0672 -009 -0 | | | | | 3,459
2022 Formulary |
|
|
|
|
2023 Cigna TotalCare (HMO D-SNP)
| $18.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,524 2023 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 2022 --
|
H0672 -010 -0 | | | | | |
|
|
|
|
2023 Cigna TotalCare Plus (HMO D-SNP)
| $18.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,524 2023 Formulary |
|
2022 Aetna Medicare Assure Premier Prime (HMO D-SNP)
| $22.00 |
n/a |
$450 | No additional gap coverage, only the Donut Hole Discount |
H4711 -012 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Assure Premier (HMO D-SNP)
| $19.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,597 2023 Formulary |
|
2022 HumanaChoice H5216-223 (PPO)
| $28.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -223 -0 | $2.00 | $5.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-223 (PPO)
| $28.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,404 2023 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 |
2022 Humana Gold Plus H0028-047 (HMO)
| $35.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0028 -047 -0 | $5.00 | $10.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus H0028-047 (HMO)
| $34.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7147 -003 -0 | | | | | |
new |
new |
new |
|
2023 Devoted DUAL Colorado - 1 (HMO D-SNP)
| $34.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,364 2023 Formulary |
|
2022 Senior Advantage Medicare Medicaid (HMO D-SNP)
| $33.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0630 -014 -0 | | | | | 4,211
2022 Formulary |
|
|
|
|
2023 Senior Advantage Medicare Medicaid (HMO D-SNP)
| $36.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,388 2023 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 |
2022 AARP Medicare Advantage SecureHorizons Plan 1 (HMO)
| $44.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H0609 -007 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage SecureHorizons Plan 1 (HMO-POS)
| $39.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 Kaiser Permanente Senior Advantage Silver (HMO)
| $38.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0630 -015 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 4,211
2022 Formulary |
|
|
|
|
2023 Kaiser Permanente Senior Advantage Silver DM (HMO-POS)
| $39.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $40.00 | $40.00 | 3,388 2023 Formulary |
|
2022 HumanaChoice SNP-DE H5216-267 (PPO D-SNP)
| $24.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5216 -267 -0 | $8.00 | $20.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice SNP-DE H5216-267 (PPO D-SNP)
| $39.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,404 2023 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 |
2022 Longevity Health Plan (HMO I-SNP)
| $39.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0363 -001 -0 | | | | | 3,678
2022 Formulary |
|
new |
new |
|
2023 Longevity Health Plan (HMO I-SNP)
| $39.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,970 2023 Formulary |
|
2022 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $39.80 |
n/a |
$480 | Some Generics |
H4346 -014 -0 | $0.00 | $4.00 | $36.00 | $36.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $41.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $47.00 | $47.00 | 3,603 2023 Formulary |
|
2022 Elevate Medicare Choice (HMO D-SNP)
| $39.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5608 -001 -0 | | | | | 3,133
2022 Formulary |
|
|
|
|
2023 Elevate Medicare Choice (HMO D-SNP)
| $41.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,288 2023 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 |
2022 Humana Value Plus H5216-195 (PPO)
| $33.90 |
$7,550 |
$435 | No additional gap coverage, only the Donut Hole Discount |
H5216 -195 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Value Plus H5216-195 (PPO)
| $41.60 |
$7,550 |
$500 | No additional gap coverage, only the Donut Hole Discount | $12.00 | $19.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H0363 -003 -0 | | | | | |
|
new |
new |
|
2023 Longevity Health Plan Assisted Living (HMO I-SNP)
| $41.60 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,970 2023 Formulary |
|
2022 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $39.80 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount |
H0710 -008 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
-- |
|
|
2023 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $41.60 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,682 2023 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 |
2022 UnitedHealthcare Dual Complete (HMO D-SNP)
| $39.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0624 -001 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP)
| $41.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H0271 -046 -0 | | | | | |
|
|
|
|
2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $41.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H0271 -045 -0 | | | | | |
|
|
|
|
2023 UnitedHealthcare Dual Complete Choice Select (PPO D-SNP)
| $41.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 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 |
2022 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $39.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0710 -007 -0 | | | | | 3,654
2022 Formulary |
|
-- |
|
|
2023 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $41.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 HumanaChoice H5216-078 (PPO)
| $57.00 |
$6,700 |
$195 | No additional gap coverage, only the Donut Hole Discount |
H5216 -078 -1 | $2.00 | $8.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-078 (PPO)
| $46.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
2022 Humana Gold Choice H8145-123 (PFFS)
| $90.00 |
n/a |
$300 | No additional gap coverage, only the Donut Hole Discount |
H8145 -123 -0 | $7.00 | $15.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 Humana Gold Choice H8145-123 (PFFS)
| $61.00 |
n/a |
$300 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $15.00 | $45.00 | $45.00 | 3,409 2023 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 2022 --
|
H5216 -333 -0 | | | | | |
|
|
|
|
2023 HumanaChoice H5216-333 (PPO)
| $96.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $2.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
2022 Kaiser Permanente Senior Advantage Gold (HMO)
| $186.00 |
$3,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0630 -016 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 4,211
2022 Formulary |
|
|
|
|
2023 Kaiser Permanente Senior Advantage Gold (HMO-POS)
| $186.00 |
$3,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $40.00 | $40.00 | 3,388 2023 Formulary |
|
2022 Aetna Medicare Prime (PPO)
| $47.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H5521 -057 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
-- Members will be assigned to Aetna Medicare Premier Plus 1 (PPO) H5521-250 --
| | | | | |
|
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 |
2022 Clear Spring Health Essential (PPO)
| $0.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H2020 -001 -0 | $0.00 | $7.00 | $42.00 | $42.00 | 3,232
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 Aetna Medicare Prime (HMO)
| $0.00 |
$6,800 |
$0 | Yes, some additional gap coverage. |
H3931 -093 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 Anthem MediBlue Diabetes Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H4346 -022 -0 | $0.00 | $7.50 | $35.00 | $35.00 | 3,117
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
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 |
2022 Anthem MediBlue Care On Site (HMO I-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H4346 -023 -0 | $0.00 | $7.50 | $40.00 | $40.00 | 3,117
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 Bright Advantage Classic Care Plan (HMO)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H7853 -001 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,133
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 Bright Advantage Classic Plus Plan (HMO)
| $30.00 |
$3,250 |
$0 | Yes, some additional gap coverage. |
H7853 -002 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,133
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
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 |
2022 Bright Advantage Part B Savings Plan (HMO)
| $0.00 |
$5,400 |
$125 | Yes, some additional gap coverage. |
H7853 -010 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,133
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 Bright Advantage Dual Access Plan (HMO D-SNP)
| $38.80 |
n/a |
$480 | Some Generics |
H7853 -011 -0 | $0.00 | 25% | 25% | 25% | 3,133
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 Bright Advantage Embrace Care Plan (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics |
H7853 -012 -0 | $0.00 | $5.00 | $40.00 | $40.00 | 3,133
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
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 |
2022 Bright Advantage Embrace Choice Plan (HMO C-SNP)
| $39.80 |
n/a |
$480 | Some Generics |
H7853 -013 -0 | $0.00 | 25% | 25% | 25% | 3,133
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 Bright Advantage Embrace Assist Plan (HMO C-SNP)
| $39.80 |
n/a |
$480 | Some Generics |
H7853 -015 -0 | $0.00 | 25% | 25% | 25% | 3,133
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|