There are 58 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. | |
|
|
|
|
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. | |
|
|
|
|
2023 Lasso Healthcare Growth Plus (MSA)
| $0.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 UnitedHealthcare Connected® for One Care (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H9239 -001 -0 | | | | | 3,528
2022 Formulary |
new |
new |
new |
|
2023 UnitedHealthcare Connected(r) for One Care (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | | | | | 3,538 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 Walgreens (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H3442 -004 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H3442 -005 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 AARP Medicare Advantage Plan 1 (HMO)
| $0.00 |
$5,700 |
$250 | Yes, some additional gap coverage. |
H1944 -005 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
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|
|
|
2023 AARP Medicare Advantage Plan 1 (HMO-POS)
| $0.00 |
$5,700 |
$195 | Yes, some additional gap coverage. | $0.00 | $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 Aetna Medicare Eagle Plan (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5521 -296 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Aetna Medicare Eagle Plan (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Aetna Medicare Explorer Plan (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5521 -160 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
|
|
2023 Aetna Medicare Explorer Plan (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Aetna Medicare Value Plan (HMO)
| $0.00 |
$6,700 |
$250 | Yes, some additional gap coverage. |
H5793 -014 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
|
|
2023 Aetna Medicare Value Plan (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 |
-- This plan not offered in 2022 --
|
H1277 -002 -0 | | | | | |
|
-- |
-- |
|
2023 Align Connect (HMO C-SNP)
| $0.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $45.00 | $45.00 | 3,833 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1277 -001 -0 | | | | | |
|
-- |
-- |
|
2023 Align Thrive (HMO I-SNP)
| $0.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $45.00 | $45.00 | 3,833 2023 Formulary |
|
2022 CCA Medicare Preferred (PPO)
| $0.00 |
$6,500 |
$195 | No additional gap coverage, only the Donut Hole Discount |
H9414 -001 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,894
2022 Formulary |
|
new |
new |
|
2023 CCA Medicare Preferred (PPO)
| $0.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,861 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 CCA One Care (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H0137 -001 -0 | | | | | 3,672
2022 Formulary |
-- |
-- |
-- |
|
2023 CCA One Care (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | | | | | 3,705 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H9001 -038 -0 | | | | | |
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|
|
2023 Fallon Medicare Plus Orange HMO (HMO)
| $0.00 |
$7,550 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $37.00 | $37.00 | 3,724 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H8578 -018 -0 | | | | | |
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|
|
|
2023 Health New England Baystate Health Preferred (HMO)
| $0.00 |
$6,500 |
$270 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $40.00 | $40.00 | 3,372 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 New England Medicare Basic No Rx (HMO)
| $0.00 |
$4,900 |
No Rx Coverage |
H8578 -009 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Health New England Medicare Basic No Rx (HMO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Health New England Medicare Compass (PPO)
| $0.00 |
$6,700 |
$380 | No additional gap coverage, only the Donut Hole Discount |
H2737 -001 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,297
2022 Formulary |
|
new |
new |
|
2023 Health New England Medicare Compass (PPO)
| $0.00 |
$6,700 |
$380 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $40.00 | $40.00 | 3,372 2023 Formulary |
|
2022 Health New England Medicare Value (HMO)
| $0.00 |
$6,700 |
$380 | No additional gap coverage, only the Donut Hole Discount |
H8578 -012 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,297
2022 Formulary |
|
|
|
|
2023 Health New England Medicare Value (HMO)
| $0.00 |
$6,700 |
$380 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $40.00 | $40.00 | 3,372 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 Medicare HMO Blue SaverRx (HMO)
| $0.00 |
$7,550 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H2261 -024 -0 | $0.00 | $8.00 | $42.00 | $42.00 | 3,916
2022 Formulary |
|
|
|
|
2023 Medicare HMO Blue SaverRx (HMO)
| $0.00 |
$5,600 |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $42.00 | $42.00 | 3,361 2023 Formulary |
|
2022 Medicare PPO Blue SaverRx (PPO)
| $0.00 |
$6,700 |
$175 | No additional gap coverage, only the Donut Hole Discount |
H2230 -017 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,916
2022 Formulary |
|
|
|
|
2023 Medicare PPO Blue SaverRx (PPO)
| $0.00 |
$5,600 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,361 2023 Formulary |
|
2022 Tufts Medicare Preferred HMO Saver Rx (HMO)
| $0.00 |
$7,550 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H2256 -028 -0 | $0.00 | $4.00 | $47.00 | $47.00 | 4,156
2022 Formulary |
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|
|
|
2023 Tufts Medicare Preferred HMO Saver Rx (HMO)
| $0.00 |
$7,550 |
$250 | Yes, some additional gap coverage. | $0.00 | $4.00 | $47.00 | $47.00 | 4,175 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 Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
| $0.00 |
$5,900 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H2256 -046 -0 | $0.00 | $4.00 | $47.00 | $47.00 | 4,156
2022 Formulary |
|
|
|
|
2023 Tufts Medicare Preferred HMO Smart Saver Rx (HMO)
| $0.00 |
$5,900 |
$100 | Yes, some additional gap coverage. | $0.00 | $2.00 | $47.00 | $47.00 | 4,175 2023 Formulary |
|
2022 Wellcare Giveback Open (PPO)
| $0.00 |
$7,550 |
$350 | Yes, some additional gap coverage. |
H9761 -002 -0 | $0.00 | $10.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
new |
new |
|
2023 Wellcare Giveback Open (PPO)
| $0.00 |
$7,550 |
$350 | Yes, some additional gap coverage. | $0.00 | $10.00 | $37.00 | $37.00 | 3,392 2023 Formulary |
|
2022 Wellcare No Premium (HMO)
| $0.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6193 -001 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,375
2022 Formulary |
|
new |
new |
|
2023 Wellcare No Premium (HMO)
| $0.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $35.00 | $35.00 | 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 Open (PPO)
| $0.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H9761 -001 -0 | $0.00 | $3.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
new |
new |
|
2023 Wellcare No Premium Open (PPO)
| $0.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $3.00 | $37.00 | $37.00 | 3,392 2023 Formulary |
|
2022 UnitedHealthcare Senior Care Options NHC (HMO D-SNP)
| $30.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2226 -003 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Senior Care Options NHC (HMO D-SNP)
| $17.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 CCA Medicare Value (PPO)
| $36.30 |
$6,500 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H9414 -002 -0 | $6.50 | $20.00 | $47.00 | $47.00 | 3,894
2022 Formulary |
|
new |
new |
|
2023 CCA Medicare Value (PPO)
| $20.00 |
$5,000 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,861 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 Senior Care Options (HMO D-SNP)
| $28.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2226 -001 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Senior Care Options (HMO D-SNP)
| $20.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H9001 -039 -0 | | | | | |
|
|
|
|
2023 Fallon Medicare Plus Saver No Rx HMO (HMO)
| $35.00 |
$7,550 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Medicare HMO Blue ValueRx (HMO)
| $36.00 |
$3,450 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H2261 -022 -1 | $0.00 | $6.00 | $42.00 | $42.00 | 3,916
2022 Formulary |
|
|
|
|
2023 Medicare HMO Blue ValueRx (HMO)
| $35.00 |
$3,450 |
$320 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $42.00 | $42.00 | 3,361 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 --
|
H1277 -003 -0 | | | | | |
|
-- |
-- |
|
2023 Align Premier (HMO I-SNP)
| $36.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,683 2023 Formulary |
|
2022 CCA Senior Care Options (HMO D-SNP)
| $36.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2225 -001 -0 | 25% | 25% | 25% | 25% | 3,672
2022 Formulary |
|
|
|
|
2023 CCA Senior Care Options (HMO D-SNP)
| $36.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,704 2023 Formulary |
|
2022 NaviCare (HMO D-SNP)
| $36.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H8928 -001 -0 | | | | | 3,613
2022 Formulary |
|
new |
new |
|
2023 NaviCare (HMO D-SNP)
| $36.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,724 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 Tufts Health Plan Senior Care Options (HMO D-SNP)
| $36.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H8330 -001 -0 | | | | | 4,156
2022 Formulary |
|
new |
new |
|
2023 Tufts Health Plan Senior Care Options (HMO D-SNP)
| $36.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 4,175 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H8330 -002 -0 | | | | | |
|
new |
new |
|
2023 Tufts Health Plan Senior Care Options CW (HMO D-SNP)
| $36.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 4,175 2023 Formulary |
|
2022 Health New England Medicare Choice (HMO)
| $46.00 |
$5,900 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H8578 -017 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,297
2022 Formulary |
|
|
|
|
2023 Health New England Medicare Choice (HMO)
| $46.00 |
$5,900 |
$350 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $40.00 | $40.00 | 3,372 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 Plan 2 (HMO)
| $49.00 |
$4,900 |
$225 | Yes, some additional gap coverage. |
H1944 -006 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Plan 2 (HMO-POS)
| $47.00 |
$4,900 |
$175 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 Tufts Medicare Preferred HMO Basic Rx (HMO)
| $45.00 |
$3,450 |
$225 | No additional gap coverage, only the Donut Hole Discount |
H2256 -026 -3 | $0.00 | $4.00 | $47.00 | $47.00 | 4,156
2022 Formulary |
|
|
|
|
2023 Tufts Medicare Preferred HMO Basic Rx (HMO)
| $48.00 |
$3,650 |
$225 | Yes, some additional gap coverage. | $0.00 | $4.00 | $47.00 | $47.00 | 4,175 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H9001 -040 -0 | | | | | |
|
|
|
|
2023 Fallon Medicare Plus Super Saver HMO (HMO)
| $52.00 |
$7,550 |
$505 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $9.00 | $42.00 | $42.00 | 3,724 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 (Regional PPO)
| $55.00 |
$7,550 |
$295 | Yes, some additional gap coverage. |
R7444 -001 -0 | $3.00 | $12.00 | $47.00 | $47.00 | n/a |
|
|
|
|
2023 AARP Medicare Advantage Choice (Regional PPO)
| $53.00 |
$7,550 |
$295 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 Wellcare Premium Enhanced Open (PPO)
| $60.00 |
$4,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H9761 -004 -0 | $0.00 | $1.00 | $35.00 | $35.00 | 3,375
2022 Formulary |
|
new |
new |
|
2023 Wellcare Premium Enhanced Open (PPO)
| $60.00 |
$4,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $1.00 | $35.00 | $35.00 | 3,392 2023 Formulary |
|
2022 Fallon Medicare Plus Green HMO (HMO)
| $68.00 |
$5,200 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H9001 -030 -16 | $0.00 | $7.00 | $37.00 | $37.00 | 3,613
2022 Formulary |
|
|
|
|
2023 Fallon Medicare Plus Green HMO (HMO)
| $66.00 |
$5,200 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $37.00 | $37.00 | 3,724 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 Medicare PPO Blue ValueRx (PPO)
| $76.00 |
$4,900 |
$290 | No additional gap coverage, only the Donut Hole Discount |
H2230 -018 -1 | $0.00 | $6.00 | $42.00 | $42.00 | 3,916
2022 Formulary |
|
|
|
|
2023 Medicare PPO Blue ValueRx (PPO)
| $75.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $6.00 | $42.00 | $42.00 | 3,361 2023 Formulary |
|
2022 Health New England Medicare Premium No Rx (HMO)
| $79.00 |
$4,400 |
No Rx Coverage |
H8578 -003 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Health New England Medicare Premium No Rx (HMO)
| $79.00 |
$4,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Medicare HMO Blue FlexRx (HMO-POS)
| $96.00 |
$3,900 |
$260 | No additional gap coverage, only the Donut Hole Discount |
H2261 -023 -1 | $0.00 | $5.00 | $42.00 | $42.00 | 3,916
2022 Formulary |
|
|
|
|
2023 Medicare HMO Blue FlexRx (HMO-POS)
| $95.00 |
$3,900 |
$260 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $42.00 | $42.00 | 3,361 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 Tufts Medicare Preferred HMO Value Rx (HMO)
| $89.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2256 -018 -8 | $0.00 | $4.00 | $47.00 | $47.00 | 4,156
2022 Formulary |
|
|
|
|
2023 Tufts Medicare Preferred HMO Value Rx (HMO)
| $97.00 |
$3,650 |
$0 | Yes, some additional gap coverage. | $0.00 | $4.00 | $47.00 | $47.00 | 4,175 2023 Formulary |
|
2022 Health New England Medicare Compass Premier (PPO)
| $99.00 |
$4,900 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H2737 -002 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,297
2022 Formulary |
|
new |
new |
|
2023 Health New England Medicare Compass Premier (PPO)
| $99.00 |
$4,900 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $40.00 | $40.00 | 3,372 2023 Formulary |
|
2022 Health New England Medicare Plus (HMO)
| $113.00 |
$4,900 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H8578 -004 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,297
2022 Formulary |
|
|
|
|
2023 Health New England Medicare Plus (HMO)
| $113.00 |
$4,900 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $40.00 | $40.00 | 3,372 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 Fallon Medicare Plus Blue HMO (HMO)
| $117.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H9001 -031 -16 | $0.00 | $7.00 | $37.00 | $37.00 | 3,613
2022 Formulary |
|
|
|
|
2023 Fallon Medicare Plus Blue HMO (HMO)
| $115.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $37.00 | $37.00 | 3,724 2023 Formulary |
|
2022 Tufts Medicare Preferred HMO Prime Rx (HMO)
| $109.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H2256 -015 -6 | $4.00 | $8.00 | $45.00 | $45.00 | 4,156
2022 Formulary |
|
|
|
|
2023 Tufts Medicare Preferred HMO Prime Rx (HMO)
| $117.00 |
$3,650 |
$0 | Yes, some additional gap coverage. | $4.00 | $8.00 | $45.00 | $45.00 | 4,175 2023 Formulary |
|
2022 Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
| $129.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H2256 -001 -6 | $2.00 | $4.00 | $30.00 | $30.00 | 4,156
2022 Formulary |
|
|
|
|
2023 Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
| $137.00 |
$3,650 |
$0 | Yes, some additional gap coverage. | $2.00 | $4.00 | $30.00 | $30.00 | 4,175 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 New England Medicare Premium (HMO)
| $170.00 |
$4,400 |
$250 | Yes, some additional gap coverage. |
H8578 -001 -0 | $4.00 | $10.00 | $45.00 | $45.00 | 3,297
2022 Formulary |
|
|
|
|
2023 Health New England Medicare Premium (HMO)
| $168.00 |
$4,400 |
$250 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,372 2023 Formulary |
|
2022 Medicare PPO Blue PlusRx (PPO)
| $264.00 |
$3,400 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H2230 -002 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 3,916
2022 Formulary |
|
|
|
|
2023 Medicare PPO Blue PlusRx (PPO)
| $254.00 |
$3,400 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $42.00 | $42.00 | 3,361 2023 Formulary |
|
2022 Medicare HMO Blue PlusRx (HMO)
| $268.00 |
$3,400 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H2261 -005 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 3,916
2022 Formulary |
|
|
|
|
2023 Medicare HMO Blue PlusRx (HMO)
| $258.00 |
$3,400 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $42.00 | $42.00 | 3,361 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 Fallon Medicare Plus Orange HMO (HMO)
| $0.00 |
$7,550 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H9001 -034 -16 | $0.00 | $7.00 | $37.00 | $37.00 | 3,613
2022 Formulary |
|
|
|
|
-- Members will be assigned to Fallon Medicare Plus Orange HMO (HMO) H9001-038 --
| | | | | |
|
2022 Fallon Medicare Plus Saver No Rx HMO (HMO)
| $13.00 |
$7,550 |
No Rx Coverage |
H9001 -029 -16 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to Fallon Medicare Plus Saver No Rx HMO (HMO) H9001-039 --
| | | | | |
|
2022 Fallon Medicare Plus Super Saver HMO (HMO)
| $42.00 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H9001 -032 -16 | $0.00 | $9.00 | $42.00 | $42.00 | 3,613
2022 Formulary |
|
|
|
|
-- Members will be assigned to Fallon Medicare Plus Super Saver HMO (HMO) H9001-040 --
| | | | | |
|
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 Assist Open (PPO)
| $22.10 |
$5,500 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H9761 -003 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare No Premium Open (PPO) H9761-001 --
| | | | | |
|