There are 84 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 AARP Medicare Advantage Choice Plan 1 (PPO)
| $0.00 |
$5,900 |
$95 | Yes, some additional gap coverage. |
H2577 -006 -0 | $0.00 | $14.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Choice Plan 1 (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $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 Walgreens (PPO)
| $0.00 |
$6,700 |
$95 | Yes, some additional gap coverage. |
H2577 -005 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Choice Rebate (PPO)
| $0.00 |
$6,700 |
$95 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 AARP Medicare Advantage Patriot (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage |
H8748 -019 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 AARP Medicare Advantage Patriot (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 AARP Medicare Advantage Plan 1 (HMO-POS)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H8748 -002 -0 | $0.00 | $14.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Plan 1 (HMO-POS)
| $0.00 |
$5,900 |
$0 | 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 -279 -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 Premier Plan (PPO)
| $0.00 |
$6,700 |
$150 | Yes, some additional gap coverage. |
H5521 -140 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Premier Plan (PPO)
| $0.00 |
$6,700 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Aetna Medicare Premier Plus Plan (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5521 -319 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Premier Plus Plan (PPO)
| $0.00 |
$5,950 |
$0 | 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 Prime Plan (HMO-POS)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H3146 -014 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Prime Plan (HMO-POS)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 BlueCross Blue Basic (PPO)
| $0.00 |
$4,900 |
No Rx Coverage |
H8003 -007 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 BlueCross Blue Basic (PPO)
| $0.00 |
$6,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 BlueCross Secure (HMO)
| $0.00 |
$6,500 |
$70 | Yes, some additional gap coverage. |
H7165 -001 -0 | $5.00 | $15.00 | $37.00 | $37.00 | 3,416
2022 Formulary |
|
-- |
-- |
|
2023 BlueCross Secure (HMO)
| $0.00 |
$6,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,399 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 BlueCross Total Value (PPO)
| $0.00 |
$6,900 |
$75 | Yes, some additional gap coverage. |
H8003 -004 -0 | $0.00 | $15.00 | $40.00 | $40.00 | 3,240
2022 Formulary |
|
|
|
|
2023 BlueCross Total Value (PPO)
| $0.00 |
$6,900 |
$25 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,276 2023 Formulary |
|
2022 Cigna Fundamental Medicare (HMO)
| $0.00 |
$5,900 |
No Rx Coverage |
H7020 -005 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Cigna Courage Medicare (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Cigna Preferred Medicare (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7020 -004 -0 | $0.00 | $8.00 | $47.00 | $47.00 | 3,459
2022 Formulary |
|
|
|
|
2023 Cigna Preferred Medicare (HMO)
| $0.00 |
$5,100 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 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 True Choice Medicare (PPO)
| $0.00 |
$6,800 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7849 -018 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,459
2022 Formulary |
|
|
|
|
2023 Cigna True Choice Medicare (PPO)
| $0.00 |
$6,300 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,524 2023 Formulary |
|
2022 Clear Spring Health Gold Plus (PPO)
| $19.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H2334 -005 -0 | $0.00 | $12.00 | $42.00 | $42.00 | 3,232
2022 Formulary |
|
-- |
-- |
|
2023 Clear Spring Health Gold Plus (PPO)
| $0.00 |
$6,500 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $42.00 | $42.00 | 3,255 2023 Formulary |
|
2022 Clear Spring Health Select Plan (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H9403 -004 -0 | $3.00 | $12.00 | $42.00 | $42.00 | 3,232
2022 Formulary |
|
-- |
-- |
|
2023 Clear Spring Health Select Plan (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $42.00 | $42.00 | 3,255 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 Clear Spring Health Silver Plan (HMO C-SNP)
| $0.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount |
H9403 -003 -0 | $0.00 | $15.00 | $42.00 | $42.00 | 3,232
2022 Formulary |
|
-- |
-- |
|
2023 Clear Spring Health Silver Plan (HMO C-SNP)
| $0.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $42.00 | $42.00 | 3,255 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7028 -002 -0 | | | | | |
new |
new |
new |
|
2023 Devoted CHOICE GIVEBACK Upstate (PPO)
| $0.00 |
$6,700 |
$395 | Yes, some additional gap coverage. | $0.00 | $2.00 | $47.00 | $47.00 | 3,364 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7028 -001 -0 | | | | | |
new |
new |
new |
|
2023 Devoted CHOICE Upstate (PPO)
| $0.00 |
$5,900 |
$0 | 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 |
-- This plan not offered in 2022 --
|
H3041 -001 -0 | | | | | |
new |
new |
new |
|
2023 Devoted CORE Upstate (HMO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,364 2023 Formulary |
|
2022 First Choice VIP Care Plus (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H8213 -001 -0 | | | | | 3,477
2022 Formulary |
-- |
-- |
-- |
|
2023 First Choice VIP Care Plus (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | | | | | 3,501 2023 Formulary |
|
2022 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$195 | No additional gap coverage, only the Donut Hole Discount |
H5619 -087 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$195 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2022 --
|
H5619 -152 -0 | | | | | |
|
|
|
|
2023 Humana Gold Plus H5619-152 (HMO)
| $0.00 |
$7,550 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5216 -217 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Humana Honor (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5216 -286 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Humana Honor (PPO)
| $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 |
2022 HumanaChoice - Diabetes and Heart (PPO C-SNP)
| $0.00 |
n/a |
$145 | No additional gap coverage, only the Donut Hole Discount |
H5216 -244 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice - Diabetes and Heart (PPO C-SNP)
| $0.00 |
n/a |
$145 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice H5216-154 (PPO)
| $0.00 |
$7,550 |
$400 | No additional gap coverage, only the Donut Hole Discount |
H5216 -154 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-154 (PPO)
| $0.00 |
$7,550 |
$400 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice H5216-157 (PPO)
| $0.00 |
$6,100 |
No Rx Coverage |
H5216 -157 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 HumanaChoice H5216-157 (PPO)
| $0.00 |
$6,100 |
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 HumanaChoice H5216-279 (PPO)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -279 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-279 (PPO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5216 -345 -0 | | | | | |
|
|
|
|
2023 HumanaChoice H5216-345 (PPO)
| $0.00 |
$7,550 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5216 -347 -0 | | | | | |
|
|
|
|
2023 HumanaChoice H5216-347 (PPO)
| $0.00 |
$5,900 |
$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 HumanaChoice R3392-001 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage |
R3392 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 HumanaChoice R3392-001 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
R3392 -004 -0 | | | | | |
|
|
|
|
2023 HumanaChoice R3392-004 (Regional PPO)
| $0.00 |
$7,550 |
$195 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H2533 -001 -0 | | | | | 3,260
2022 Formulary |
-- |
-- |
-- |
|
2023 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | | | | | 3,267 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 Choice Care (HMO)
| $0.00 |
$7,550 |
$125 | No additional gap coverage, only the Donut Hole Discount |
H8176 -003 -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 UnitedHealthcare Medicare Advantage Patriot (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R2604 -005 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 UnitedHealthcare Medicare Advantage Patriot (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Wellcare Giveback Open (PPO)
| $0.00 |
$6,700 |
$90 | Yes, some additional gap coverage. |
H7326 -003 -0 | $0.00 | $10.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Giveback Open (PPO)
| $0.00 |
$6,700 |
$90 | Yes, some additional gap coverage. | $0.00 | $10.00 | $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 No Premium (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4847 -001 -0 | $0.00 | $5.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare No Premium (HMO)
| $0.00 |
$5,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $37.00 | $37.00 | 3,393 2023 Formulary |
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$100 | Yes, some additional gap coverage. |
H7326 -001 -0 | $0.00 | $0.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$100 | Yes, some additional gap coverage. | $0.00 | $0.00 | $37.00 | $37.00 | 3,393 2023 Formulary |
|
2022 Wellcare No Premium Value (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1416 -056 -0 | $0.00 | $15.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare No Premium Value (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $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 Patriot Giveback (HMO-POS)
| $0.00 |
$6,700 |
No Rx Coverage |
H4847 -006 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Wellcare Patriot Giveback (HMO-POS)
| $0.00 |
$7,550 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Wellcare Patriot No Premium (HMO-POS)
| $0.00 |
$3,450 |
No Rx Coverage |
H1416 -059 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Wellcare Patriot No Premium (HMO-POS)
| $0.00 |
$3,450 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Wellcare Prime by Absolute Total Care (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | All Generics, All Brands |
H1723 -001 -0 | | | | | 3,382
2022 Formulary |
-- |
-- |
-- |
|
2023 Wellcare Prime by Absolute Total Care (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | | | | | 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 Humana Gold Choice H8145-069 (PFFS)
| $44.00 |
n/a |
$340 | No additional gap coverage, only the Donut Hole Discount |
H8145 -069 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 Humana Gold Choice H8145-069 (PFFS)
| $9.00 |
n/a |
$340 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,409 2023 Formulary |
|
2022 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $9.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
R2604 -002 -0 | | | | | 3,663
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $9.50 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 Wellcare Assist (HMO)
| $28.20 |
$3,400 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H4847 -005 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Assist (HMO)
| $14.90 |
$6,500 |
$505 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 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 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $19.00 |
n/a |
$210 | Some Generics |
R2604 -003 -0 | $4.00 | $12.00 | $47.00 | $47.00 | n/a |
|
|
|
|
2023 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $15.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7326 -007 -0 | | | | | |
|
|
|
|
2023 Wellcare Assist Open (PPO)
| $15.70 |
$6,000 |
$505 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,392 2023 Formulary |
|
2022 BlueCross Total (PPO)
| $19.00 |
$6,500 |
$50 | Yes, some additional gap coverage. |
H8003 -001 -0 | $0.00 | $15.00 | $37.00 | $37.00 | 3,416
2022 Formulary |
|
|
|
|
2023 BlueCross Total (PPO)
| $19.00 |
$6,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,399 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 --
|
H3146 -016 -0 | | | | | |
|
|
|
|
2023 Aetna Medicare Assure Plan (HMO D-SNP)
| $21.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,597 2023 Formulary |
|
2022 Aetna Medicare Value Plus Plan (HMO)
| $24.00 |
$6,900 |
$95 | Yes, some additional gap coverage. |
H3146 -011 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Value Plus Plan (HMO)
| $22.00 |
$6,900 |
$95 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Cigna Preferred Plus Medicare (HMO)
| $24.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7020 -006 -0 | $0.00 | $4.00 | $47.00 | $47.00 | 3,459
2022 Formulary |
|
|
|
|
2023 Cigna Preferred Plus Medicare (HMO)
| $22.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $47.00 | $47.00 | 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 |
-- This plan not offered in 2022 --
|
H7326 -006 -0 | | | | | |
|
|
|
|
2023 Wellcare Dual Liberty Open (PPO D-SNP)
| $23.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
2022 AARP Medicare Advantage Plan 2 (HMO-POS)
| $24.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H8748 -025 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Plan 2 (HMO-POS)
| $24.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 AARP Medicare Advantage Choice Plan 2 (PPO)
| $29.00 |
$6,900 |
$395 | Yes, some additional gap coverage. |
H2577 -026 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Choice Plan 2 (PPO)
| $29.00 |
$6,900 |
$295 | 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 Wellcare Dual Liberty (HMO D-SNP)
| $30.00 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1416 -036 -0 | $0.00 | $5.00 | $34.00 | $34.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Dual Access (HMO D-SNP)
| $30.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5216 -346 -0 | | | | | |
|
|
|
|
2023 HumanaChoice H5216-346 (PPO)
| $32.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Humana Together in Health (PPO I-SNP)
| $24.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5216 -243 -0 | $2.00 | $11.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 Humana Together in Health (PPO I-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $11.00 | $47.00 | $47.00 | 3,409 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 NHC Advantage (HMO I-SNP)
| $32.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H4172 -001 -0 | | | | | 3,712
2022 Formulary |
|
-- |
|
|
2023 NHC Advantage (HMO I-SNP)
| $35.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,683 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5619 -153 -0 | | | | | |
|
|
|
|
2023 Humana Gold Plus SNP-DE H5619-153 (HMO D-SNP)
| $36.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,404 2023 Formulary |
|
2022 HumanaChoice H5216-280 (PPO)
| $31.10 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5216 -280 -2 | $0.00 | $20.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-280 (PPO)
| $36.70 |
$7,550 |
$505 | Yes, some additional gap coverage. | $0.00 | $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 Clear Spring Health Deluxe Plan (HMO D-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H9403 -001 -0 | | | | | 3,232
2022 Formulary |
|
-- |
-- |
|
2023 Clear Spring Health Deluxe Plan (HMO D-SNP)
| $37.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,255 2023 Formulary |
|
2022 First Choice VIP Care (HMO D-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H4739 -001 -0 | $5.00 | 25% | | | 3,477
2022 Formulary |
|
new |
new |
|
2023 First Choice VIP Care (HMO D-SNP)
| $37.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $7.00 | 25% | | | 3,501 2023 Formulary |
|
2022 Humana Gold Plus SNP-DE H5619-082 (HMO D-SNP)
| $26.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5619 -082 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus SNP-DE H5619-082 (HMO D-SNP)
| $37.80 |
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 HumanaChoice SNP-DE H5216-277 (PPO D-SNP)
| $25.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5216 -277 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice SNP-DE H5216-277 (PPO D-SNP)
| $37.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,404 2023 Formulary |
|
2022 Molina Medicare Complete Care (HMO D-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H8176 -001 -0 | $0.00 | $4.00 | $45.00 | $45.00 | 3,263
2022 Formulary |
|
|
|
|
2023 Molina Medicare Complete Care (HMO D-SNP)
| $37.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $45.00 | $45.00 | 3,270 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H0710 -068 -0 | | | | | |
|
-- |
|
|
2023 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $37.80 |
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 (PPO D-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0271 -016 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $37.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H0271 -056 -0 | | | | | |
|
|
|
|
2023 UnitedHealthcare Dual Complete Select (PPO D-SNP)
| $37.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0710 -053 -0 | | | | | 3,654
2022 Formulary |
|
-- |
|
|
2023 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $37.80 |
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 --
|
H4847 -004 -0 | | | | | |
|
|
|
|
2023 Wellcare Dual Liberty (HMO D-SNP)
| $37.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
2022 UnitedHealthcare Medicare Advantage Choice (Regional PPO)
| $49.00 |
$6,700 |
$295 | Yes, some additional gap coverage. |
R2604 -001 -0 | $4.00 | $14.00 | $47.00 | $47.00 | n/a |
|
|
|
|
2023 UnitedHealthcare Medicare Advantage Choice (Regional PPO)
| $49.00 |
$6,700 |
$295 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 HumanaChoice R3392-002 (Regional PPO)
| $103.00 |
$6,700 |
$340 | No additional gap coverage, only the Donut Hole Discount |
R3392 -002 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,421
2022 Formulary |
|
|
|
|
2023 HumanaChoice R3392-002 (Regional PPO)
| $103.00 |
$6,700 |
$340 | 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 Humana Gold Plus H5178-001 (HMO)
| $126.00 |
$6,700 |
$390 | No additional gap coverage, only the Donut Hole Discount |
H5178 -001 -0 | $8.00 | $12.00 | 25% | 25% | 3,413
2022 Formulary |
|
-- |
-- |
|
2023 Humana Gold Plus H5178-001 (HMO)
| $110.00 |
$6,700 |
$420 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $12.00 | 25% | 25% | 3,409 2023 Formulary |
|
2022 Clear Spring Health Choice Plan (PPO)
| $0.00 |
$7,550 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H2334 -003 -0 | $0.00 | $12.00 | $42.00 | $42.00 | 3,232
2022 Formulary |
|
|
|
|
-- Members will be assigned to Clear Spring Health Gold Plus (PPO) H2334-005 --
| | | | | |
|
2022 Humana Gold Plus H5619-144 (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5619 -144 -1 | $4.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H5619-152 (HMO) H5619-152 --
| | | | | |
|
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 H5216-237 (PPO)
| $42.00 |
$6,700 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H5216 -237 -1 | $5.00 | $12.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
-- Members will be assigned to HumanaChoice H5216-346 (PPO) H5216-346 --
| | | | | |
|
2022 HumanaChoice H5216-282 (PPO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -282 -1 | $4.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
-- Members will be assigned to HumanaChoice H5216-347 (PPO) H5216-347 --
| | | | | |
|
2022 Wellcare Dual Access (HMO D-SNP)
| $31.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1436 -005 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,375
2022 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Dual Liberty (HMO D-SNP) H4847-004 --
| | | | | |
|
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 Medicare (HMO)
| $0.00 |
$7,550 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1436 -004 -0 | $0.00 | $3.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare No Premium (HMO) H4847-001 --
| | | | | |
|
2022 Wellcare Low Premium Open (PPO)
| $44.00 |
$6,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7326 -002 -0 | $0.00 | $2.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|
2022 HumanaChoice H7617-001 (PPO)
| $111.00 |
$6,700 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H7617 -001 -0 | $0.00 | $5.00 | 25% | 25% | 3,413
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|