There are 73 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 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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|
|
2023 Lasso Healthcare Growth (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 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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|
|
|
2023 Lasso Healthcare Growth Plus (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$4,900 |
$175 | Yes, some additional gap coverage. |
H2406 -015 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
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2023 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 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 Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$395 | Yes, some additional gap coverage. |
R0759 -001 -0 | $3.00 | $14.00 | $47.00 | $47.00 | n/a |
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|
|
2023 AARP Medicare Advantage Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 AARP Medicare Advantage Patriot (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R0759 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
2023 AARP Medicare Advantage Patriot (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 AARP Medicare Advantage (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H1045 -043 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
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|
|
|
2023 AARP Medicare Advantage Premier (HMO-POS)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $45.00 | $45.00 | 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 Advantage Care by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H2962 -021 -0 | $0.00 | $25.00 | $60.00 | $60.00 | 4,020
2022 Formulary |
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|
|
|
2023 Advantage Care by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $20.00 | $60.00 | $60.00 | 3,806 2023 Formulary |
|
2022 Advantage Care CHF by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H2962 -022 -0 | $0.00 | $25.00 | $60.00 | $60.00 | 4,020
2022 Formulary |
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|
|
|
2023 Advantage Care CHF by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $20.00 | $60.00 | $60.00 | 3,806 2023 Formulary |
|
2022 Advantage Care COPD by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H2962 -023 -0 | $0.00 | $25.00 | $60.00 | $60.00 | 4,020
2022 Formulary |
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2023 Advantage Care COPD by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $20.00 | $60.00 | $60.00 | 3,806 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 Premier (PPO)
| $0.00 |
$6,700 |
$300 | Yes, some additional gap coverage. |
H5521 -033 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Premier (PPO)
| $0.00 |
$6,700 |
$300 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5521 -377 -0 | | | | | |
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2023 Aetna Medicare Premier Plus (PPO)
| $0.00 |
$5,000 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Aetna Medicare Select (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H1609 -038 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,698
2022 Formulary |
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|
|
|
2023 Aetna Medicare Select (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,622 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 BlueMedicare Classic (HMO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H1035 -019 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,479
2022 Formulary |
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|
|
|
2023 BlueMedicare Classic (HMO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $40.00 | $40.00 | 3,534 2023 Formulary |
|
2022 BlueMedicare Classic Plus (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H1035 -046 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,479
2022 Formulary |
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|
|
|
2023 BlueMedicare Classic Plus (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,534 2023 Formulary |
|
2022 BlueMedicare Value (PPO)
| $0.00 |
$4,500 |
$150 | Yes, some additional gap coverage. |
H5434 -039 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 2,713
2022 Formulary |
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|
|
2023 BlueMedicare Value (PPO)
| $0.00 |
$4,500 |
$150 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 2,939 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 Freedom Platinum Plan Rx (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. |
H5427 -093 -0 | $0.00 | $30.00 | $70.00 | $70.00 | 3,313
2022 Formulary |
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|
|
|
2023 Freedom Platinum Plan Rx (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $70.00 | $70.00 | 3,308 2023 Formulary |
|
2022 Freedom Savings Plan (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H5427 -052 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
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2023 Freedom Savings Plan (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Freedom VIP Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Some Brands |
H5427 -070 -0 | $0.00 | $20.00 | $60.00 | $60.00 | 3,313
2022 Formulary |
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|
|
|
2023 Freedom VIP Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $55.00 | $55.00 | 3,308 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 Freedom VIP Rewards (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H5427 -099 -0 | $0.00 | $30.00 | $60.00 | $60.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Freedom VIP Rewards (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $60.00 | $60.00 | 3,308 2023 Formulary |
|
2022 Freedom VIP Savings (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Some Brands |
H5427 -072 -0 | $0.00 | $25.00 | $70.00 | $70.00 | 3,313
2022 Formulary |
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|
|
|
2023 Freedom VIP Savings (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $25.00 | $65.00 | $65.00 | 3,308 2023 Formulary |
|
2022 Freedom VIP Savings COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H5427 -077 -0 | $0.00 | $20.00 | $60.00 | $60.00 | 3,313
2022 Formulary |
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|
|
|
2023 Freedom VIP Savings COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $20.00 | $60.00 | $60.00 | 3,308 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 - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H1036 -160 -0 | $0.00 | $0.00 | $5.00 | $5.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $5.00 | $5.00 | 3,404 2023 Formulary |
|
2022 Humana Gold Plus H1036-140 (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H1036 -140 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus H1036-140 (HMO)
| $0.00 |
$2,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 3,404 2023 Formulary |
|
2022 Humana Gold Plus H1036-266 (HMO)
| $0.00 |
$4,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1036 -266 -0 | $0.00 | $3.00 | $45.00 | $45.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus H1036-266 (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $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 Honor (HMO)
| $0.00 |
$4,500 |
No Rx Coverage |
H1036 -119 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Humana Honor (HMO)
| $0.00 |
$3,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
H5216 -257 -0 | | | | | |
|
|
|
|
2023 Humana Honor (PPO)
| $0.00 |
$5,100 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 HumanaChoice Florida H5216-072 (PPO)
| $0.00 |
$5,000 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H5216 -072 -0 | $2.00 | $10.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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|
|
|
2023 HumanaChoice Florida H5216-072 (PPO)
| $0.00 |
$4,900 |
$150 | Yes, some additional gap coverage. | $2.00 | $10.00 | $47.00 | $47.00 | 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 |
-- This plan not offered in 2022 --
|
H5216 -304 -0 | | | | | |
|
|
|
|
2023 HumanaChoice Florida H5216-304 (PPO)
| $0.00 |
$4,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage |
R5826 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
H5594 -028 -0 | | | | | |
|
|
|
|
2023 Optimum Diamond Rewards (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $55.00 | $55.00 | 3,308 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 --
|
H5594 -029 -0 | | | | | |
|
|
|
|
2023 Optimum Diamond Rewards COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $55.00 | $55.00 | 3,308 2023 Formulary |
|
2022 Optimum Diamond Rewards (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H5594 -030 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Optimum Diamond Savings (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | 3,308 2023 Formulary |
|
2022 Optimum Diamond Rewards COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H5594 -031 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Optimum Diamond Savings COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | 3,308 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 Optimum Platinum Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5594 -019 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Optimum Gold Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $35.00 | $85.00 | $85.00 | 3,308 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5594 -032 -0 | | | | | |
|
|
|
|
2023 Optimum Gold Plus Plan (HMO)
| $0.00 |
$1,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $20.00 | $60.00 | $60.00 | 3,308 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5594 -001 -0 | | | | | |
|
|
|
|
2023 Optimum Gold Rewards Plan (HMO)
| $0.00 |
$1,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $70.00 | $70.00 | 3,308 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 --
|
H5594 -002 -0 | | | | | |
|
|
|
|
2023 Optimum Platinum Plan (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $50.00 | $50.00 | 3,308 2023 Formulary |
|
2022 Premier by Ultimate (HMO)
| $0.00 |
$2,800 |
$0 | Yes, some additional gap coverage. |
H2962 -013 -4 | $0.00 | $35.00 | $60.00 | $60.00 | 4,020
2022 Formulary |
|
|
|
|
2023 Premier by Ultimate (HMO)
| $0.00 |
$1,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $60.00 | $60.00 | 3,806 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H2962 -032 -0 | | | | | |
|
|
|
|
2023 Premier Plus by Ultimate (HMO)
| $0.00 |
$1,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,806 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 --
|
H9469 -008 -0 | | | | | |
new |
new |
new |
|
2023 Simply Freedom (PPO)
| $0.00 |
$5,000 |
$150 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,927 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H9469 -005 -0 | | | | | |
new |
new |
new |
|
2023 Simply Freedom Extra (PPO)
| $0.00 |
$6,100 |
$150 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,927 2023 Formulary |
|
2022 UnitedHealthcare Medicare Advantage Walgreens (HMO C-SNP)
| $0.00 |
n/a |
$150 | Some Generics |
H1045 -048 -3 | $0.00 | $0.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Medicare Advantage Walgreens (HMO-POS C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $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 Wellcare Giveback (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H1032 -200 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Giveback (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 3,393 2023 Formulary |
|
2022 Wellcare No Premium (HMO)
| $0.00 |
$1,200 |
$0 | Yes, some additional gap coverage. |
H1032 -201 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare No Premium (HMO)
| $0.00 |
$1,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,393 2023 Formulary |
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$3,400 |
$100 | Yes, some additional gap coverage. |
H5199 -012 -0 | $0.00 | $0.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare No Premium Open (PPO)
| $0.00 |
$3,400 |
$100 | Yes, some additional gap coverage. | $0.00 | $0.00 | $37.00 | $37.00 | 3,393 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 Wellcare Specialty Giveback (HMO C-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H1032 -203 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,373
2022 Formulary |
|
|
|
|
2023 Wellcare Specialty Giveback (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,393 2023 Formulary |
|
2022 Wellcare Specialty No Premium (HMO C-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H1032 -184 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,373
2022 Formulary |
|
|
|
|
2023 Wellcare Specialty No Premium (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,393 2023 Formulary |
|
2022 HumanaChoice R5826-074 (Regional PPO)
| $8.00 |
$7,550 |
$395 | No additional gap coverage, only the Donut Hole Discount |
R5826 -074 -0 | $6.00 | $20.00 | $47.00 | $47.00 | 3,421
2022 Formulary |
|
|
|
|
2023 HumanaChoice R5826-074 (Regional PPO)
| $4.00 |
$7,550 |
$395 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $20.00 | $47.00 | $47.00 | 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 |
-- This plan not offered in 2022 --
|
H5199 -016 -0 | | | | | |
|
|
|
|
2023 Wellcare Dual Access Open (PPO D-SNP)
| $18.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1609 -061 -0 | | | | | |
|
|
|
|
2023 Aetna Medicare Assure Plus (HMO D-SNP)
| $24.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $15.00 | 25% | 25% | 3,622 2023 Formulary |
|
2022 Humana Gold Plus SNP-DE H1036-102 (HMO D-SNP)
| $24.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1036 -102 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus SNP-DE H1036-102 (HMO D-SNP)
| $25.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $6.00 | $47.00 | $47.00 | 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 |
-- This plan not offered in 2022 --
|
H1036 -280 -0 | | | | | |
|
|
|
|
2023 Humana Fully Integrated H1036-280 (HMO D-SNP)
| $28.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $16.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Wellcare Dual Reserve (HMO D-SNP)
| $31.60 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1032 -202 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Dual Reserve (HMO D-SNP)
| $33.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
2022 Advantage Plus by Ultimate (Full) (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2962 -035 -0 | | | | | 4,020
2022 Formulary |
|
|
|
|
2023 Advantage Plus by Ultimate (Full) (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,806 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 Advantage Plus by Ultimate (Partial) (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2962 -036 -0 | | | | | 4,020
2022 Formulary |
|
|
|
|
2023 Advantage Plus by Ultimate (Partial) (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,806 2023 Formulary |
|
2022 Freedom Medi-Medi Full (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5427 -087 -0 | $10.00 | $45.00 | $95.00 | $95.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Freedom Medi-Medi Full (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $45.00 | $95.00 | $95.00 | 3,308 2023 Formulary |
|
2022 Freedom Medi-Medi Partial (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5427 -078 -0 | $10.00 | $45.00 | $95.00 | $95.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Freedom Medi-Medi Partial (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $45.00 | $95.00 | $95.00 | 3,308 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)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1644 -001 -0 | | | | | 3,678
2022 Formulary |
|
-- |
|
|
2023 Longevity Health Plan (HMO I-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,970 2023 Formulary |
|
2022 Optimum Emerald Full (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5594 -017 -0 | $10.00 | $45.00 | $95.00 | $95.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Optimum Emerald Full (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $45.00 | $95.00 | $95.00 | 3,308 2023 Formulary |
|
2022 Optimum Emerald Partial (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5594 -016 -0 | $10.00 | $45.00 | $95.00 | $95.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Optimum Emerald Partial (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $45.00 | $95.00 | $95.00 | 3,308 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 --
|
H0710 -012 -0 | | | | | |
|
-- |
|
|
2023 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $35.90 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1889 -002 -1 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H2509 -001 -0 | | | | | |
new |
new |
new |
|
2023 UnitedHealthcare Dual Complete ONE (HMO-POS D-SNP)
| $35.90 |
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 Dual Complete RP (Regional PPO D-SNP)
| $31.50 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
R0759 -003 -0 | | | | | 3,663
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H0710 -010 -0 | | | | | |
|
-- |
|
|
2023 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 Wellcare Dual Access (HMO D-SNP)
| $32.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1032 -124 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Dual Access (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 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 Wellcare Dual Liberty (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1032 -175 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Dual Liberty (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
2022 BlueMedicare Choice (Regional PPO)
| $51.90 |
$6,500 |
$250 | Yes, some additional gap coverage. |
R3332 -001 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,486
2022 Formulary |
|
|
|
|
2023 BlueMedicare Choice (Regional PPO)
| $49.90 |
$6,500 |
$250 | Yes, some additional gap coverage. | $0.00 | $10.00 | $40.00 | $40.00 | 3,534 2023 Formulary |
|
2022 Wellcare Premium Enhanced Open (PPO)
| $85.00 |
$1,700 |
$0 | Yes, some additional gap coverage. |
H5199 -010 -0 | $0.00 | $0.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Premium Enhanced Open (PPO)
| $99.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $37.00 | $37.00 | 3,393 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 HumanaChoice R5826-005 (Regional PPO)
| $114.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount |
R5826 -005 -0 | $5.00 | $15.00 | $45.00 | $45.00 | 3,416
2022 Formulary |
|
|
|
|
2023 HumanaChoice R5826-005 (Regional PPO)
| $111.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
2022 Humana Fully Integrated H1036-283 (HMO D-SNP)
| $15.60 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1036 -283 -0 | $0.00 | $3.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
-- Members will be assigned to Humana Fully Integrated H1036-280 (HMO D-SNP) H1036-280 --
| | | | | |
|
2022 Premier Plus by Ultimate (HMO)
| $0.00 |
$1,500 |
$0 | Yes, some additional gap coverage. |
H2962 -014 -2 | $0.00 | $25.00 | $50.00 | $50.00 | 4,020
2022 Formulary |
|
|
|
|
-- Members will be assigned to Premier Plus by Ultimate (HMO) H2962-032 --
| | | | | |
|
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 Choice H8145-061 (PFFS)
| $102.00 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount |
H8145 -061 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|