There are 62 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 Aetna Medicare Advantra Plan (HMO)
| $0.00 |
$5,900 |
$150 | Yes, some additional gap coverage. |
H3928 -001 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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2023 Aetna Medicare Advantra Plan (HMO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 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 Aetna Medicare Eagle Plan (PPO)
| $0.00 |
$6,400 |
No Rx Coverage |
H5521 -235 -0 | This plan does NOT include Prescription Drug coverage. | |
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2023 Aetna Medicare Eagle Plan (PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Aetna Medicare Freedom Plan (PPO)
| $0.00 |
$7,550 |
$150 | Yes, some additional gap coverage. |
H5521 -178 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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2023 Aetna Medicare Freedom Plan (PPO)
| $0.00 |
$5,900 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
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-- This plan not offered in 2022 --
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H5521 -366 -0 | | | | | |
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2023 Aetna Medicare Signature Plan (PPO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 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 Blue Advantage (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H6453 -007 -1 | $3.00 | $12.00 | $45.00 | $45.00 | 3,490
2022 Formulary |
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2023 Blue Advantage (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $3.00 | $12.00 | $45.00 | $45.00 | 3,467 2023 Formulary |
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-- This plan not offered in 2022 --
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H6453 -011 -0 | | | | | |
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2023 Blue Advantage (HMO)
| $0.00 |
$7,550 |
$195 | Yes, some additional gap coverage. | $3.00 | $12.00 | $45.00 | $45.00 | 3,467 2023 Formulary |
|
2022 Blue Advantage (PPO)
| $0.00 |
$7,550 |
$195 | Yes, some additional gap coverage. |
H1248 -007 -0 | $3.00 | $12.00 | $45.00 | $45.00 | 3,490
2022 Formulary |
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2023 Blue Advantage (PPO)
| $0.00 |
$7,550 |
$195 | Yes, some additional gap coverage. | $3.00 | $12.00 | $45.00 | $45.00 | 3,467 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 Humana BR Clinic-BR Gen H1951-055 (HMO)
| $0.00 |
$3,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1951 -055 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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2023 Humana BR Clinic-BR Gen H1951-055 (HMO)
| $0.00 |
$3,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
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2022 Humana FMOL Baton Rouge H1951-053 (HMO)
| $0.00 |
$3,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1951 -053 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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2023 Humana FMOL Baton Rouge H1951-053 (HMO)
| $0.00 |
$3,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
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2022 Humana Gold Plus H1951-048 (HMO)
| $0.00 |
$3,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1951 -048 -1 | $3.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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2023 Humana Gold Plus H1951-048 (HMO)
| $0.00 |
$3,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 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 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5216 -201 -0 | This plan does NOT include Prescription Drug coverage. | |
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2023 Humana Honor (PPO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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-- This plan not offered in 2022 --
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H5216 -325 -0 | | | | | |
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2023 HumanaChoice H5216-325 (PPO)
| $0.00 |
$3,600 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
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2022 HumanaChoice R0110-001 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage |
R0110 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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2023 HumanaChoice R0110-001 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2022 Ochsner Health Plan Freedom (HMO-POS)
| $0.00 |
$3,700 |
$0 | Yes, some additional gap coverage. |
H9763 -002 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,133
2022 Formulary |
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new |
new |
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2023 Ochsner Health Plan Freedom (HMO-POS)
| $0.00 |
$3,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,288 2023 Formulary |
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-- This plan not offered in 2022 --
|
H9763 -003 -1 | | | | | |
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new |
new |
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2023 Ochsner Health Plan Premier (HMO)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,288 2023 Formulary |
|
2022 Peoples Health Choices (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H4544 -001 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
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2023 Peoples Health Choices (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $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 Peoples Health Choices 65 (HMO)
| $0.00 |
$3,600 |
$0 | Yes, some additional gap coverage. |
H1961 -014 -1 | $0.00 | $10.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
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2023 Peoples Health Choices 65 (HMO-POS)
| $0.00 |
$3,600 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
|
2022 Peoples Health Patriot (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H4544 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
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2023 Peoples Health Patriot (PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2022 Vantage BASIC (HMO-POS)
| $0.00 |
$5,900 |
$480 | Yes, some additional gap coverage. |
H5576 -020 -2 | $0.00 | $16.00 | $47.00 | $47.00 | 3,883
2022 Formulary |
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2023 Vantage BASIC (HMO-POS)
| $0.00 |
$5,900 |
$505 | Yes, some additional gap coverage. | $0.00 | $16.00 | $47.00 | $47.00 | 3,826 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 |
-- This plan not offered in 2022 --
|
H5576 -023 -0 | | | | | |
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2023 Vantage Giveback (HMO-POS)
| $0.00 |
$5,900 |
$505 | Yes, some additional gap coverage. | $0.00 | $20.00 | $47.00 | $47.00 | 3,826 2023 Formulary |
|
2022 Wellcare Endurance (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H2491 -016 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,375
2022 Formulary |
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-- |
|
|
2023 Wellcare Endurance (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,393 2023 Formulary |
|
2022 Wellcare Giveback Open (PPO)
| $0.00 |
$7,550 |
$195 | Yes, some additional gap coverage. |
H3047 -002 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
new |
|
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2023 Wellcare Giveback Open (PPO)
| $0.00 |
$7,550 |
$195 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 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 No Premium (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H2491 -007 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
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-- |
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2023 Wellcare No Premium (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,392 2023 Formulary |
|
2022 Wellcare No Premium Medicare (HMO)
| $0.00 |
$7,550 |
$0 | Yes, some additional gap coverage. |
H5117 -003 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
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-- |
|
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2023 Wellcare No Premium Medicare (HMO)
| $0.00 |
$8,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,392 2023 Formulary |
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$5,000 |
$75 | Yes, some additional gap coverage. |
H3047 -001 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
new |
|
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2023 Wellcare No Premium Open (PPO)
| $0.00 |
$5,000 |
$75 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 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 No Premium (HMO)
| $0.00 |
$5,500 |
No Rx Coverage |
H2491 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
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-- |
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2023 Wellcare Patriot No Premium (HMO)
| $0.00 |
$5,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Wellcare Assist (HMO)
| $21.20 |
$3,400 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2491 -010 -0 | $0.00 | $17.00 | $42.00 | $42.00 | 3,375
2022 Formulary |
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-- |
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2023 Wellcare Assist (HMO)
| $12.70 |
$3,400 |
$385 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,392 2023 Formulary |
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-- This plan not offered in 2022 --
|
H1947 -003 -0 | | | | | |
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2023 Healthy Blue Enhanced Care (HMO D-SNP)
| $16.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $47.00 | $47.00 | 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 |
2022 Aetna Medicare Value Plus Plan (PPO)
| $21.00 |
$7,550 |
$150 | Yes, some additional gap coverage. |
H5521 -326 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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2023 Aetna Medicare Value Plus Plan (PPO)
| $17.00 |
$6,000 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H3239 -011 -0 | | | | | |
|
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2023 Aetna Medicare Dual Select Plan (HMO D-SNP)
| $17.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,597 2023 Formulary |
|
2022 Wellcare Dual Access Medicare (HMO D-SNP)
| $36.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5117 -004 -0 | $0.00 | $9.00 | $42.00 | $42.00 | 3,375
2022 Formulary |
|
-- |
|
|
2023 Wellcare Dual Access Medicare (HMO D-SNP)
| $26.10 |
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 |
-- This plan not offered in 2022 --
|
H3239 -001 -0 | | | | | |
|
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|
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2023 Aetna Medicare Dual Preferred Plan (HMO D-SNP)
| $30.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,597 2023 Formulary |
|
2022 Wellcare Community Assist (PPO)
| $36.40 |
$6,000 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H3047 -004 -0 | $0.00 | $0.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
new |
|
|
2023 Wellcare Community Assist (PPO)
| $30.80 |
$6,000 |
$305 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $37.00 | $37.00 | 3,392 2023 Formulary |
|
2022 Wellcare Dual Freedom (HMO D-SNP)
| $29.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2491 -011 -0 | $0.00 | $20.00 | $42.00 | $42.00 | 3,375
2022 Formulary |
|
-- |
|
|
2023 Wellcare Dual Freedom Access (HMO D-SNP)
| $31.50 |
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 Pinnacle (HMO D-SNP)
| $33.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2491 -012 -0 | $0.00 | $6.00 | $42.00 | $42.00 | 3,375
2022 Formulary |
|
-- |
|
|
2023 Wellcare Dual Pinnacle Liberty (HMO D-SNP)
| $31.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
2022 Healthy Blue Dual Advantage (HMO D-SNP)
| $32.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1947 -001 -0 | $5.00 | $15.00 | $40.00 | $40.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Healthy Blue Dual Advantage (HMO D-SNP)
| $33.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $40.00 | $40.00 | 3,603 2023 Formulary |
|
2022 Peoples Health Secure Complete (HMO D-SNP)
| $34.00 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1961 -019 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 Peoples Health Secure Complete (HMO-POS D-SNP)
| $37.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2022 Dignity Health Plan (HMO I-SNP)
| $34.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H8492 -001 -0 | | | | | 3,497
2022 Formulary |
|
-- |
-- |
|
2023 Dignity Health Plan (HMO I-SNP)
| $38.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,445 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1951 -057 -0 | | | | | |
|
|
|
|
2023 Humana Gold Plus SNP-DE H1951-057 (HMO D-SNP)
| $38.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,404 2023 Formulary |
|
2022 Humana Gold Plus SNP-DE H1951-032 (HMO D-SNP)
| $36.40 |
n/a |
$475 | No additional gap coverage, only the Donut Hole Discount |
H1951 -032 -0 | $1.00 | $14.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus SNP-DE H1951-032 (HMO D-SNP)
| $38.40 |
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 Humana Gold Plus SNP-DE H1951-056 (HMO D-SNP)
| $28.50 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1951 -056 -0 | $15.00 | $20.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus SNP-DE H1951-056 (HMO D-SNP)
| $38.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5216 -332 -0 | | | | | |
|
|
|
|
2023 HumanaChoice SNP-DE H5216-332 (PPO D-SNP)
| $38.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,404 2023 Formulary |
|
2022 Peoples Health Secure Health (HMO D-SNP)
| $36.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1961 -003 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 Peoples Health Secure Health (HMO-POS D-SNP)
| $38.40 |
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 |
-- This plan not offered in 2022 --
|
H5008 -010 -0 | | | | | |
|
|
|
|
2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP)
| $38.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1889 -010 -0 | | | | | |
|
|
|
|
2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $38.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 Vantage DUAL PLUS (HMO-POS D-SNP)
| $36.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5576 -019 -0 | $0.00 | $10.00 | 25% | 25% | 3,883
2022 Formulary |
|
|
|
|
2023 Vantage DUAL PLUS (HMO-POS D-SNP)
| $38.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,826 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 Vantage STANDARD (HMO-POS)
| $36.40 |
$4,900 |
$480 | Yes, some additional gap coverage. |
H5576 -017 -2 | $0.00 | $14.00 | $47.00 | $47.00 | 3,883
2022 Formulary |
|
|
|
|
2023 Vantage STANDARD (HMO-POS)
| $38.40 |
$4,900 |
$505 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,826 2023 Formulary |
|
2022 HumanaChoice H5216-064 (PPO)
| $45.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -064 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-064 (PPO)
| $44.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1248 -004 -0 | | | | | |
|
|
|
|
2023 Blue Advantage (PPO)
| $100.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $3.00 | $12.00 | $45.00 | $45.00 | 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 HumanaChoice R0110-003 (Regional PPO)
| $110.00 |
$7,550 |
$400 | No additional gap coverage, only the Donut Hole Discount |
R0110 -003 -0 | $6.00 | $15.00 | $47.00 | $47.00 | 3,416
2022 Formulary |
|
|
|
|
2023 HumanaChoice R0110-003 (Regional PPO)
| $109.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Vantage PREMIUM (HMO-POS)
| $171.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H5576 -018 -2 | $0.00 | $14.00 | $47.00 | $47.00 | 3,883
2022 Formulary |
|
|
|
|
2023 Vantage PREMIUM (HMO-POS)
| $171.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,826 2023 Formulary |
|
2022 Vantage 100 (HMO-POS)
| $222.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5576 -022 -0 | $0.00 | $14.00 | $47.00 | $47.00 | 3,883
2022 Formulary |
|
|
|
|
2023 Vantage 100 (HMO-POS)
| $220.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,826 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 Blue Advantage (PPO)
| $100.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H1248 -001 -0 | $3.00 | $12.00 | $45.00 | $45.00 | 3,490
2022 Formulary |
|
|
|
|
-- Members will be assigned to Blue Advantage (PPO) H1248-004 --
| | | | | |
|
2022 HumanaChoice H5216-202 (PPO)
| $79.00 |
$6,700 |
$400 | No additional gap coverage, only the Donut Hole Discount |
H5216 -202 -0 | $6.00 | $15.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
-- Members will be assigned to HumanaChoice H5216-064 (PPO) H5216-064 --
| | | | | |
|
2022 Ochsner Health Plan Premier (HMO)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H9763 -001 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,133
2022 Formulary |
|
|
|
|
-- Members will be assigned to Ochsner Health Plan Premier (HMO) H9763-003 --
| | | | | |
|
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 Access (HMO D-SNP)
| $29.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2491 -006 -0 | $0.00 | $11.00 | $42.00 | $42.00 | 3,375
2022 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Dual Freedom Access (HMO D-SNP) H2491-011 --
| | | | | |
|
2022 Wellcare Dual Liberty (HMO D-SNP)
| $33.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2491 -008 -0 | $0.00 | $5.00 | $36.00 | $36.00 | 3,375
2022 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Dual Pinnacle Liberty (HMO D-SNP) H2491-012 --
| | | | | |
|
2022 Wellcare No Premium Baton Rouge General (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H2491 -014 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 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 ATRIO Choice Rx (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7006 -008 -0 | $5.00 | $20.00 | $45.00 | $45.00 | 3,510
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 ATRIO Select Rx (PPO)
| $20.00 |
$3,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7006 -009 -0 | $5.00 | $20.00 | $45.00 | $45.00 | 3,510
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|