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 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 (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H2802 -010 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
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|
|
|
2023 AARP Medicare Advantage (HMO-POS)
| $0.00 |
$3,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $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 AARP Medicare Advantage Choice Plan 2 (PPO)
| $0.00 |
$5,500 |
$185 | Yes, some additional gap coverage. |
H2228 -081 -0 | $3.00 | $10.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
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|
|
|
2023 AARP Medicare Advantage Choice Plan 2 (PPO)
| $0.00 |
$4,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
|
2022 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$5,500 |
No Rx Coverage |
H2228 -091 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
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2023 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$5,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Aetna Medicare Eagle (PPO)
| $0.00 |
$5,500 |
No Rx Coverage |
H5521 -286 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
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2023 Aetna Medicare Eagle (PPO)
| $0.00 |
$4,390 |
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 Aetna Medicare Prime (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H3192 -006 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Prime (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Aetna Medicare Value (PPO)
| $0.00 |
$5,950 |
$0 | Yes, some additional gap coverage. |
H5521 -231 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
|
|
2023 Aetna Medicare Value (PPO)
| $0.00 |
$4,950 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Anthem MediBlue Access (PPO)
| $0.00 |
$4,900 |
$175 | Yes, some additional gap coverage. |
H7093 -002 -0 | $5.00 | $15.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
|
new |
new |
|
2023 Anthem MediBlue Access (PPO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $5.00 | $15.00 | $42.00 | $42.00 | 3,603 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 --
|
H3447 -042 -4 | | | | | |
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|
|
2023 Anthem MediBlue Plus (HMO)
| $0.00 |
$4,250 |
$0 | Yes, some additional gap coverage. | $2.00 | $9.00 | $42.00 | $42.00 | 3,603 2023 Formulary |
|
2022 Anthem MediBlue Service (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H7093 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
new |
new |
|
2023 Anthem MediBlue Service (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Health Alliance Medicare HMO Basic (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H1463 -008 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
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2023 Health Alliance Medicare HMO Basic (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 --
|
H1463 -043 -0 | | | | | |
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2023 Health Alliance Medicare HMO Classic Rx (HMO)
| $0.00 |
$8,300 |
$100 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5619 -055 -0 | | | | | |
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2023 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5619 -049 -0 | | | | | |
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2023 Humana Gold Plus H5619-049 (HMO-POS)
| $0.00 |
$3,900 |
$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 Humana Honor (PPO)
| $0.00 |
$5,900 |
No Rx Coverage |
H5216 -218 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Humana Honor (PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
H5216 -307 -0 | | | | | |
|
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|
|
2023 Humana USAA Honor with Rx (PPO)
| $0.00 |
$6,550 |
$350 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice H5216-192 (PPO)
| $0.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H5216 -192 -0 | $0.00 | $17.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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|
|
|
2023 HumanaChoice H5216-192 (PPO)
| $0.00 |
$6,700 |
$250 | Yes, some additional gap coverage. | $0.00 | $5.00 | $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 H5216-229 (PPO)
| $0.00 |
$4,900 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H5216 -229 -0 | $2.00 | $8.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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|
|
|
2023 HumanaChoice H5216-229 (PPO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5216 -309 -0 | | | | | |
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|
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2023 HumanaChoice H5216-309 (PPO)
| $0.00 |
$6,500 |
$350 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice R0865-001 (Regional PPO)
| $0.00 |
$5,700 |
No Rx Coverage |
R0865 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 HumanaChoice R0865-001 (Regional PPO)
| $0.00 |
$3,900 |
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 --
|
H7220 -011 -0 | | | | | |
|
|
|
|
2023 IU Health Plans Medicare Flex Network (HMO-POS)
| $0.00 |
$3,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $37.00 | $37.00 | 3,375 2023 Formulary |
|
2022 MDwise Medicare Inspire (HMO)
| $0.00 |
$5,200 |
$100 | Yes, some additional gap coverage. |
H7746 -001 -0 | $3.50 | $12.50 | $47.00 | $47.00 | 3,133
2022 Formulary |
|
new |
new |
|
2023 MDwise Medicare Inspire (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,288 2023 Formulary |
|
2022 Simplete 1 (HMO)
| $0.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H1463 -023 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,830
2022 Formulary |
|
|
|
|
2023 Simplete 1 (HMO)
| $0.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 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 |
$7,550 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H3499 -007 -0 | $0.00 | $5.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
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|
|
|
2023 Wellcare Giveback (HMO)
| $0.00 |
$8,300 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $37.00 | $37.00 | 3,392 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H3499 -002 -0 | | | | | |
|
|
|
|
2023 Wellcare No Premium (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $37.00 | $37.00 | 3,392 2023 Formulary |
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$4,300 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6348 -002 -0 | $0.00 | $5.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
-- |
|
|
2023 Wellcare No Premium Open (PPO)
| $0.00 |
$4,300 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $37.00 | $37.00 | 3,392 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 Patriot Giveback Open (PPO)
| $0.00 |
$5,500 |
No Rx Coverage |
H6348 -005 -0 | This plan does NOT include Prescription Drug coverage. | |
|
-- |
|
|
2023 Wellcare Patriot Giveback Open (PPO)
| $0.00 |
$5,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Wellcare Assist (HMO)
| $24.50 |
$5,500 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H3499 -008 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Assist (HMO)
| $12.00 |
$5,500 |
$505 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,392 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H6348 -007 -0 | | | | | |
|
-- |
|
|
2023 Wellcare Low Premium Open (PPO)
| $15.00 |
$4,300 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $37.00 | $37.00 | 3,392 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 Access Preferred (PPO)
| $19.00 |
$3,900 |
$100 | Yes, some additional gap coverage. |
H1607 -015 -0 | $4.00 | $13.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Access Preferred (PPO)
| $19.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $4.00 | $13.00 | $42.00 | $42.00 | 3,603 2023 Formulary |
|
2022 Anthem MediBlue Extra (HMO)
| $25.80 |
$6,700 |
$480 | Yes, some additional gap coverage. |
H3447 -024 -0 | $0.00 | $9.00 | $37.00 | $37.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Extra (HMO)
| $21.10 |
$6,700 |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $37.00 | $37.00 | 3,603 2023 Formulary |
|
2022 AARP Medicare Advantage Choice Plan 1 (PPO)
| $22.00 |
$4,900 |
$150 | Yes, some additional gap coverage. |
H2228 -021 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Choice Plan 1 (PPO)
| $22.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $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 Health Alliance Medicare POS Basic (HMO-POS)
| $23.00 |
$6,700 |
No Rx Coverage |
H1463 -014 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Health Alliance Medicare POS Basic (HMO-POS)
| $23.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
H3192 -009 -0 | | | | | |
|
|
|
|
2023 Aetna Medicare Assure Premier (HMO D-SNP)
| $23.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,597 2023 Formulary |
|
2022 Aetna Medicare Premier (PPO)
| $26.00 |
$5,300 |
$0 | Yes, some additional gap coverage. |
H5521 -302 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Premier (PPO)
| $24.00 |
$4,300 |
$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 |
-- This plan not offered in 2022 --
|
H0271 -054 -0 | | | | | |
|
|
|
|
2023 UnitedHealthcare Dual Complete Choice Select (PPO D-SNP)
| $24.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 MDwise Medicare Inspire Plus (HMO)
| $25.00 |
$4,300 |
$0 | Yes, some additional gap coverage. |
H7746 -002 -0 | $3.50 | $12.50 | $47.00 | $47.00 | 3,133
2022 Formulary |
|
new |
new |
|
2023 MDwise Medicare Inspire Plus (HMO)
| $25.00 |
$4,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,288 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H6348 -006 -0 | | | | | |
|
-- |
|
|
2023 Wellcare Dual Access Open (PPO D-SNP)
| $26.70 |
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 Simplete 2 (HMO)
| $28.00 |
$4,950 |
$0 | Yes, some additional gap coverage. |
H1463 -024 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,830
2022 Formulary |
|
|
|
|
2023 Simplete 2 (HMO)
| $28.00 |
$4,950 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 2023 Formulary |
|
2022 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $29.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H3447 -020 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $28.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $20.00 | $47.00 | $47.00 | 3,603 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7076 -015 -0 | | | | | |
|
new |
new |
|
2023 CareSource Dual Advantage (HMO D-SNP)
| $28.10 |
n/a |
$505 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 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 |
-- This plan not offered in 2022 --
|
H5619 -054 -0 | | | | | |
|
|
|
|
2023 Humana Gold Plus SNP-DE H5619-054 (HMO D-SNP)
| $28.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,404 2023 Formulary |
|
2022 Humana Value Plus H5216-193 (PPO)
| $26.30 |
$7,550 |
$260 | No additional gap coverage, only the Donut Hole Discount |
H5216 -193 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Value Plus H5216-193 (PPO)
| $28.10 |
$7,550 |
$260 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice SNP-DE H5525-048 (PPO D-SNP)
| $24.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5525 -048 -0 | $0.00 | $16.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice SNP-DE H5525-048 (PPO D-SNP)
| $28.10 |
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 MDwise Medicare Inspire Duals (HMO D-SNP)
| $29.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H7746 -004 -0 | | | | | 3,133
2022 Formulary |
|
new |
new |
|
2023 MDwise Medicare Inspire Duals (HMO D-SNP)
| $28.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,288 2023 Formulary |
|
2022 UnitedHealthcare Dual Complete (PPO D-SNP)
| $29.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0271 -005 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete (PPO D-SNP)
| $28.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 Wellcare Dual Access (HMO D-SNP)
| $29.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H3499 -005 -0 | $0.00 | $11.00 | $42.00 | $42.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Dual Access (HMO D-SNP)
| $28.10 |
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 Health Alliance Medicare HMO Basic Rx (HMO)
| $33.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1463 -009 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,830
2022 Formulary |
|
|
|
|
2023 Health Alliance Medicare HMO Basic Rx (HMO)
| $33.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 2023 Formulary |
|
2022 HumanaChoice R0865-003 (Regional PPO)
| $72.00 |
$7,550 |
$195 | No additional gap coverage, only the Donut Hole Discount |
R0865 -003 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,416
2022 Formulary |
|
|
|
|
2023 HumanaChoice R0865-003 (Regional PPO)
| $33.00 |
$7,550 |
$195 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 IU Health Plans Medicare Select Plus (HMO)
| $46.00 |
$5,150 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H7220 -009 -1 | $3.00 | $12.00 | $47.00 | $47.00 | 3,359
2022 Formulary |
|
|
|
|
2023 IU Health Plans Medicare Select Plus (HMO)
| $46.00 |
$5,150 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $37.00 | $37.00 | 3,375 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 Simplete 3 (HMO-POS)
| $48.00 |
$4,950 |
$0 | Yes, some additional gap coverage. |
H1463 -025 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,830
2022 Formulary |
|
|
|
|
2023 Simplete 3 (HMO-POS)
| $48.00 |
$4,950 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 2023 Formulary |
|
2022 MDwise Medicare Inspire Flex (HMO-POS)
| $49.00 |
$4,300 |
$0 | Yes, some additional gap coverage. |
H7746 -003 -0 | $3.50 | $12.50 | $47.00 | $47.00 | 3,133
2022 Formulary |
|
new |
new |
|
2023 MDwise Medicare Inspire Flex (HMO-POS)
| $49.00 |
$4,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,288 2023 Formulary |
|
2022 Health Alliance Medicare POS Basic Rx (HMO-POS)
| $53.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1463 -015 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,830
2022 Formulary |
|
|
|
|
2023 Health Alliance Medicare POS Basic Rx (HMO-POS)
| $53.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 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 Access Plus (PPO)
| $54.00 |
$6,400 |
$60 | Yes, some additional gap coverage. |
H1607 -012 -0 | $4.00 | $12.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Access Plus (PPO)
| $54.00 |
$6,400 |
$60 | Yes, some additional gap coverage. | $4.00 | $12.00 | $42.00 | $42.00 | 3,603 2023 Formulary |
|
2022 Health Alliance Medicare HMO 40 Rx (HMO)
| $75.00 |
$4,700 |
$0 | Yes, some additional gap coverage. |
H1463 -010 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,830
2022 Formulary |
|
|
|
|
2023 Health Alliance Medicare HMO 40 Rx (HMO)
| $75.00 |
$4,700 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 2023 Formulary |
|
2022 HumanaChoice H5525-008 (PPO)
| $76.00 |
$6,200 |
$220 | No additional gap coverage, only the Donut Hole Discount |
H5525 -008 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5525-008 (PPO)
| $75.00 |
$6,200 |
$220 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $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 Anthem MediBlue Access Basic (Regional PPO)
| $80.00 |
$6,400 |
$100 | Yes, some additional gap coverage. |
R4487 -001 -0 | $6.00 | $15.00 | $37.00 | $37.00 | 3,635
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Access Basic (Regional PPO)
| $81.00 |
$6,400 |
$0 | Yes, some additional gap coverage. | $6.00 | $15.00 | $37.00 | $37.00 | 3,603 2023 Formulary |
|
2022 Humana Gold Choice H8145-032 (PFFS)
| $83.00 |
n/a |
$225 | No additional gap coverage, only the Donut Hole Discount |
H8145 -032 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 Humana Gold Choice H8145-032 (PFFS)
| $82.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,409 2023 Formulary |
|
2022 Health Alliance Medicare POS 30 Rx (HMO-POS)
| $105.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H1463 -017 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,830
2022 Formulary |
|
|
|
|
2023 Health Alliance Medicare POS 30 Rx (HMO-POS)
| $105.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 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 Health Alliance Medicare HMO 20 Rx (HMO)
| $125.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H1463 -003 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,830
2022 Formulary |
|
|
|
|
2023 Health Alliance Medicare HMO 20 Rx (HMO)
| $125.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 2023 Formulary |
|
2022 Health Alliance Medicare POS 10 Rx (HMO-POS)
| $165.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H1463 -019 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,830
2022 Formulary |
|
|
|
|
2023 Health Alliance Medicare POS 10 Rx (HMO-POS)
| $165.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,864 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H3192 -015 -0 | | | | | |
|
|
|
|
2023 Aetna Medicare Premier Plus (HMO-POS)
| $187.00 |
$4,250 |
$350 | 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 Anthem MediBlue Plus (HMO)
| $0.00 |
$4,250 |
$0 | Yes, some additional gap coverage. |
H3447 -036 -1 | $2.00 | $9.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
|
|
|
|
-- Members will be assigned to Anthem MediBlue Plus (HMO) H3447-042 --
| | | | | |
|
2022 HumanaChoice H5216-111 (PPO)
| $15.00 |
$4,900 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H5216 -111 -0 | $2.00 | $8.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
-- Members will be assigned to HumanaChoice H5216-229 (PPO) H5216-229 --
| | | | | |
|