There are 113 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. | |
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2022 AARP Medicare Advantage (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H1045 -030 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
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2023 AARP Medicare Advantage (HMO-POS)
| $0.00 |
$2,900 |
$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 (PPO)
| $0.00 |
$5,900 |
$150 | Yes, some additional gap coverage. |
H2406 -010 -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 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
|
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. | |
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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 |
-- This plan not offered in 2022 --
|
H2962 -050 -0 | | | | | |
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2023 Advantage Care by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $25.00 | $60.00 | $60.00 | 3,806 2023 Formulary |
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-- This plan not offered in 2022 --
|
H2962 -034 -0 | | | | | |
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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 |
|
2022 Aetna Medicare Choice (HMO-POS)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. |
H1609 -028 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
|
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2023 Aetna Medicare Choice (HMO-POS)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. | $0.00 | $0.00 | $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 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 |
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|
|
|
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 |
|
2022 Aetna Medicare Premier Plus (PPO)
| $0.00 |
$5,900 |
$150 | Yes, some additional gap coverage. |
H5521 -268 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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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 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H1609 -042 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,701
2022 Formulary |
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2023 Aetna Medicare Select (HMO)
| $0.00 |
$2,750 |
$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 |
-- This plan not offered in 2022 --
|
H1016 -030 -0 | | | | | |
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2023 AvMed Medicare Circle (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,361 2023 Formulary |
|
2022 BlueMedicare Classic (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H1035 -020 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,479
2022 Formulary |
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2023 BlueMedicare Classic (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $40.00 | $40.00 | 3,534 2023 Formulary |
|
2022 BlueMedicare Premier (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1035 -026 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,479
2022 Formulary |
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2023 BlueMedicare Premier (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,534 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 Saver (HMO)
| $0.00 |
$6,700 |
$50 | Yes, some additional gap coverage. |
H1035 -038 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 2,713
2022 Formulary |
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|
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2023 BlueMedicare Saver (HMO)
| $0.00 |
$6,700 |
$50 | Yes, some additional gap coverage. | $3.00 | $12.00 | $47.00 | $47.00 | 2,939 2023 Formulary |
|
2022 BlueMedicare Value (PPO)
| $0.00 |
$4,500 |
$150 | Yes, some additional gap coverage. |
H5434 -033 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 2,713
2022 Formulary |
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|
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2023 BlueMedicare Value (PPO)
| $0.00 |
$4,500 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 2,939 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H4709 -011 -0 | | | | | |
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-- |
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2023 Bright Advantage Health Dollars Plan (HMO)
| $0.00 |
$1,199 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 3,467 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 Bright Advantage Part B Savings Plan (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H4709 -029 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,133
2022 Formulary |
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-- |
|
|
2023 Bright Advantage Part B Savings Plan (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $47.00 | $47.00 | 3,467 2023 Formulary |
|
2022 Bright Advantage Part B Savings Plan (PPO)
| $0.00 |
$4,400 |
$110 | Yes, some additional gap coverage. |
H3281 -010 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,133
2022 Formulary |
|
-- |
|
|
2023 Bright Advantage Part B Savings Plan (PPO)
| $0.00 |
$4,900 |
$110 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,467 2023 Formulary |
|
2022 CareBreeze (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H1019 -116 -0 | $0.00 | $5.00 | $35.00 | $35.00 | 3,408
2022 Formulary |
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|
|
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2023 CareBreeze (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 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 --
|
H1019 -125 -0 | | | | | |
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|
|
2023 CareBreeze Platinum (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,404 2023 Formulary |
|
2022 CareComplete (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H1019 -107 -0 | $0.00 | $5.00 | $35.00 | $35.00 | 3,408
2022 Formulary |
|
|
|
|
2023 CareComplete (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1019 -122 -0 | | | | | |
|
|
|
|
2023 CareComplete Platinum (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 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 CareFree (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1019 -120 -2 | $0.00 | $5.00 | $35.00 | $35.00 | 3,408
2022 Formulary |
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|
|
|
2023 CareFree (HMO)
| $0.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1019 -138 -0 | | | | | |
|
|
|
|
2023 CareFree Platinum (HMO)
| $0.00 |
$3,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
2022 CareOne PLATINUM (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1019 -112 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,408
2022 Formulary |
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|
|
|
2023 CareOne Platinum (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 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 CareOne PLUS (HMO-POS)
| $0.00 |
$2,750 |
$0 | Yes, some additional gap coverage. |
H1019 -057 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,408
2022 Formulary |
|
|
|
|
2023 CareOne Plus (HMO-POS)
| $0.00 |
$2,750 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1019 -133 -0 | | | | | |
|
|
|
|
2023 CareSalute (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Cigna Preferred Medicare (HMO)
| $0.00 |
$3,750 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5410 -024 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,459
2022 Formulary |
|
-- |
|
|
2023 Cigna Preferred Medicare (HMO)
| $0.00 |
$2,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 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 Cigna Preferred Savings Medicare (HMO)
| $0.00 |
$3,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5410 -026 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,459
2022 Formulary |
|
-- |
|
|
2023 Cigna Preferred Savings Medicare (HMO)
| $0.00 |
$3,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,524 2023 Formulary |
|
2022 Cigna True Choice Medicare (PPO)
| $0.00 |
$5,850 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7849 -017 -0 | $2.00 | $4.00 | $40.00 | $40.00 | 3,459
2022 Formulary |
|
|
|
|
2023 Cigna True Choice Medicare (PPO)
| $0.00 |
$4,950 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $40.00 | $40.00 | 3,524 2023 Formulary |
|
2022 Devoted Health Latitude Greater Orlando (PPO)
| $0.00 |
$4,900 |
$150 | Yes, some additional gap coverage. |
H9884 -003 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,349
2022 Formulary |
|
new |
new |
|
2023 Devoted CHOICE Orlando (PPO)
| $0.00 |
$4,900 |
$150 | 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 |
2022 Devoted Health Core Greater Orlando (HMO)
| $0.00 |
$2,750 |
$0 | Yes, some additional gap coverage. |
H1290 -005 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,349
2022 Formulary |
|
|
|
|
2023 Devoted CORE Orlando (HMO)
| $0.00 |
$2,750 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 3,364 2023 Formulary |
|
2022 Devoted Health Essentials Greater Orlando (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1290 -018 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,349
2022 Formulary |
|
|
|
|
2023 Devoted ESSENTIALS Orlando (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,364 2023 Formulary |
|
2022 Freedom Platinum Plan Rx (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. |
H5427 -089 -0 | $0.00 | $30.00 | $70.00 | $70.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Freedom Platinum Plan Rx (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $25.00 | $65.00 | $65.00 | 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 Platinum Rewards Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5427 -102 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Freedom Platinum Rewards Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $35.00 | $85.00 | $85.00 | 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. | |
|
|
|
|
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 |
|
|
|
|
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 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 |
|
|
|
|
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 |
|
|
|
|
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 |
|
-- This plan not offered in 2022 --
|
H1036 -300 -0 | | | | | |
|
|
|
|
2023 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$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 Gold Plus H1036-146 (HMO)
| $0.00 |
$2,750 |
$0 | Yes, some additional gap coverage. |
H1036 -146 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus H1036-146 (HMO)
| $0.00 |
$2,600 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,404 2023 Formulary |
|
2022 Humana Gold Plus H1036-269 (HMO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H1036 -269 -0 | $0.00 | $15.00 | $45.00 | $45.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus H1036-269 (HMO)
| $0.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,404 2023 Formulary |
|
2022 Humana Honor (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H1036 -290 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Humana Honor (HMO)
| $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 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 |
|
|
|
|
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 |
|
-- 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 |
|
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 R5826-018 (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. | |
|
2022 Molina Medicare Choice Care (HMO)
| $0.00 |
$7,550 |
$125 | No additional gap coverage, only the Donut Hole Discount |
H8130 -010 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,218
2022 Formulary |
|
-- |
|
|
2023 Molina Medicare Choice Care (HMO)
| $0.00 |
$8,300 |
$125 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $47.00 | $47.00 | 3,221 2023 Formulary |
|
2022 Molina Medicare Choice Care Select (HMO)
| $0.00 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H8130 -011 -0 | $15.00 | $20.00 | $47.00 | $47.00 | 3,218
2022 Formulary |
|
-- |
|
|
2023 Molina Medicare Choice Care Select (HMO)
| $0.00 |
$8,300 |
$450 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $20.00 | $47.00 | $47.00 | 3,221 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 Molina Medicare Connect Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H8130 -008 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,263
2022 Formulary |
|
-- |
|
|
2023 Molina Medicare Connect Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $45.00 | $45.00 | 3,270 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 Gold Rewards Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5594 -022 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 3,313
2022 Formulary |
|
|
|
|
2023 Optimum Gold Rewards 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 --
|
H2962 -046 -0 | | | | | |
|
|
|
|
2023 Premier by Ultimate (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $60.00 | $60.00 | 3,806 2023 Formulary |
|
2022 Simply Care (HMO I-SNP)
| $0.00 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5471 -092 -0 | $4.00 | $5.00 | 25% | 25% | 3,948
2022 Formulary |
|
|
|
|
2023 Simply Care (HMO I-SNP)
| $0.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $5.00 | 25% | 25% | 3,927 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 Simply Comfort (HMO I-SNP)
| $0.00 |
n/a |
$480 | Some Generics, Few Brands |
H5471 -093 -0 | $0.00 | $5.00 | 25% | 25% | 3,948
2022 Formulary |
|
|
|
|
2023 Simply Comfort (HMO I-SNP)
| $0.00 |
n/a |
$505 | Yes, some additional gap coverage. | $0.00 | $5.00 | 25% | 25% | 3,927 2023 Formulary |
|
2022 Simply Extra (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H5471 -107 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,948
2022 Formulary |
|
|
|
|
2023 Simply Extra (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,927 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H9469 -006 -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 |
|
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 Simply Level (HMO C-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H5471 -073 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,948
2022 Formulary |
|
|
|
|
2023 Simply Level (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 3,927 2023 Formulary |
|
2022 Simply More (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H5471 -074 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,948
2022 Formulary |
|
|
|
|
2023 Simply More (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 3,927 2023 Formulary |
|
2022 UnitedHealthcare Medicare Advantage Walgreens (HMO C-SNP)
| $0.00 |
n/a |
$150 | Some Generics |
H1045 -048 -1 | $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 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1032 -212 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Giveback (HMO)
| $0.00 |
$3,400 |
$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 |
$1,700 |
$0 | Yes, some additional gap coverage. |
H1032 -213 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare No Premium (HMO)
| $0.00 |
$1,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 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 -227 -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 -224 -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 |
2022 CareNeeds PLUS (HMO D-SNP)
| $14.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1019 -026 -0 | $0.00 | $4.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 CareNeeds Plus (HMO D-SNP)
| $14.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $15.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Cigna Primary Medicare (HMO)
| $23.60 |
$3,500 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5410 -033 -0 | $1.00 | $12.00 | 18% | 18% | 3,459
2022 Formulary |
|
-- |
|
|
2023 Cigna Primary Medicare (HMO)
| $17.20 |
$3,500 |
$505 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $18.00 | 20% | 20% | 3,524 2023 Formulary |
|
-- 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 |
|
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 --
|
H5410 -046 -0 | | | | | |
|
-- |
|
|
2023 Cigna TotalCare (HMO D-SNP)
| $19.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,524 2023 Formulary |
|
2022 Cigna TotalCare Plus (HMO D-SNP)
| $20.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5410 -025 -0 | $2.00 | $13.00 | 18% | 18% | 3,459
2022 Formulary |
|
-- |
|
|
2023 Cigna TotalCare Plus (HMO D-SNP)
| $20.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,524 2023 Formulary |
|
2022 Aetna Medicare Assure Plus (HMO D-SNP)
| $30.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1609 -046 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,701
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Assure Plus (HMO D-SNP)
| $22.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $15.00 | 25% | 25% | 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 Humana Gold Plus SNP-DE H1036-213 (HMO D-SNP)
| $22.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1036 -213 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus SNP-DE H1036-213 (HMO D-SNP)
| $27.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $12.00 | $18.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
-- 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 Devoted Health Dual Greater Orlando (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1290 -022 -0 | 25% | 25% | 25% | 25% | 3,349
2022 Formulary |
|
|
|
|
2023 Devoted DUAL Orlando (HMO D-SNP)
| $30.90 |
n/a |
$505 | Yes, some additional gap coverage. | 25% | 25% | 25% | 25% | 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 --
|
H1290 -037 -4 | | | | | |
|
|
|
|
2023 Devoted PRIME (HMO)
| $32.00 |
$3,400 |
$505 | Yes, some additional gap coverage. | $0.00 | $0.00 | 25% | 25% | 3,364 2023 Formulary |
|
2022 Molina Medicare Complete Care Select (HMO D-SNP)
| $34.30 |
n/a |
$480 | Some Generics, Few Brands |
H8130 -009 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,263
2022 Formulary |
|
-- |
|
|
2023 Molina Medicare Complete Care Select (HMO D-SNP)
| $35.20 |
n/a |
$505 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,270 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H2962 -035 -0 | | | | | |
|
|
|
|
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 |
-- This plan not offered in 2022 --
|
H2962 -036 -0 | | | | | |
|
|
|
|
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 BlueMedicare Complete (HMO D-SNP)
| $34.30 |
n/a |
$480 | Some Generics, Few Brands |
H1035 -029 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 3,479
2022 Formulary |
|
|
|
|
2023 BlueMedicare Complete (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,534 2023 Formulary |
|
2022 Florida Complete Care (HMO I-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H9986 -001 -0 | | | | | 3,251
2022 Formulary |
|
new |
new |
|
2023 Florida Complete Care (HMO I-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,258 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 Florida Complete Care- In The Community (HMO I-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H9986 -002 -0 | | | | | 3,251
2022 Formulary |
|
new |
new |
|
2023 Florida Complete Care- In The Community (HMO I-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,258 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 |
-- This plan not offered in 2022 --
|
H1644 -001 -0 | | | | | |
|
-- |
|
|
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 Molina Medicare Complete Care (HMO D-SNP)
| $34.30 |
n/a |
$480 | Some Generics, Few Brands |
H8130 -001 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,263
2022 Formulary |
|
-- |
|
|
2023 Molina Medicare Complete Care (HMO D-SNP)
| $35.90 |
n/a |
$505 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,270 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 |
|
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 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 |
|
2022 Simply Complete (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5471 -072 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,948
2022 Formulary |
|
|
|
|
2023 Simply Complete (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $20.00 | $47.00 | $47.00 | 3,927 2023 Formulary |
|
-- 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 |
|
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 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 |
|
2022 UnitedHealthcare Dual Complete LP (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1045 -039 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete LP (HMO-POS D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
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 |
|
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)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0710 -010 -0 | | | | | 3,654
2022 Formulary |
|
-- |
|
|
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 |
|
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 |
|
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 Reserve (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1032 -214 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Dual Reserve (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 BlueMedicare Select (PPO)
| $147.90 |
$5,900 |
$305 | Yes, some additional gap coverage. |
H5434 -002 -0 | $3.00 | $10.00 | $40.00 | $40.00 | 3,479
2022 Formulary |
|
|
|
|
2023 BlueMedicare Select (PPO)
| $108.70 |
$5,900 |
$305 | Yes, some additional gap coverage. | $3.00 | $10.00 | $40.00 | $40.00 | 3,534 2023 Formulary |
|
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 Aetna Medicare Assure (HMO D-SNP)
| $25.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1609 -023 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,701
2022 Formulary |
|
|
|
|
-- Members will be assigned to Aetna Medicare Assure Plus (HMO D-SNP) H1609-046 --
| | | | | |
|
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 Health Dollars Plan (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H4709 -001 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 3,133
2022 Formulary |
|
|
|
|
-- Members will be assigned to Bright Advantage Health Dollars Plan (HMO) H4709-011 --
| | | | | |
|
2022 Bright Advantage Health Dollars Plan (PPO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. |
H3281 -001 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,133
2022 Formulary |
|
|
|
|
-- Members will be assigned to Bright Advantage Part B Savings Plan (PPO) H3281-010 --
| | | | | |
|
2022 Devoted Health Prime (HMO)
| $34.30 |
$3,400 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1290 -038 -1 | $0.00 | $0.00 | 25% | 25% | 3,349
2022 Formulary |
|
|
|
|
-- Members will be assigned to Devoted PRIME (HMO) H1290-037 --
| | | | | |
|
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 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 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$0 | Some Generics, Few Brands |
H1036 -294 -0 | $0.00 | $7.00 | $35.00 | $35.00 | 3,408
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 Wellcare Dual Medicare (HMO D-SNP)
| $33.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5190 -002 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,375
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 Wellcare Dual Nurture (HMO D-SNP)
| $34.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5190 -005 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
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 --
|
| | | | |
|