There are 63 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 AARP Medicare Advantage Patriot (HMO)
| $0.00 |
$3,200 |
No Rx Coverage |
H5253 -113 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
2023 AARP Medicare Advantage Patriot (HMO-POS)
| $0.00 |
$3,200 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 AARP Medicare Advantage Plan 1 (HMO)
| $0.00 |
$3,700 |
$0 | Yes, some additional gap coverage. |
H5253 -047 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
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2023 AARP Medicare Advantage Plan 1 (HMO-POS)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
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-- This plan not offered in 2022 --
|
H5253 -121 -0 | | | | | |
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2023 AARP Medicare Advantage Rebate (HMO-POS)
| $0.00 |
$5,900 |
$395 | Yes, some additional gap coverage. | $0.00 | $14.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
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Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2022 --
|
H5521 -355 -0 | | | | | |
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|
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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 |
$0 | Yes, some additional gap coverage. |
H5521 -254 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
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2023 Aetna Medicare Premier Plan (PPO)
| $0.00 |
$6,700 |
$0 | 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 --
|
H8343 -010 -0 | | | | | |
|
new |
|
|
2023 Amerivantage Choice (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $2.00 | $10.00 | $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 |
2022 Amerivantage Classic Plus (HMO-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H5828 -005 -0 | $2.00 | $8.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
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|
|
2023 Amerivantage Classic Plus (HMO-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $2.00 | $8.00 | $42.00 | $42.00 | 3,603 2023 Formulary |
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-- This plan not offered in 2022 --
|
H8343 -011 -0 | | | | | |
|
new |
|
|
2023 Amerivantage Courage (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
H8121 -002 -0 | | | | | |
|
new |
new |
|
2023 Ascension Complete Saint Thomas Access (PPO)
| $0.00 |
$2,900 |
$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 |
-- This plan not offered in 2022 --
|
H8121 -001 -0 | | | | | |
|
new |
new |
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2023 Ascension Complete Saint Thomas Access Plus (PPO)
| $0.00 |
$3,450 |
$0 | 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 --
|
H2853 -001 -0 | | | | | |
|
new |
|
|
2023 Ascension Complete Saint Thomas Reward (HMO)
| $0.00 |
$3,450 |
$480 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $37.00 | $37.00 | 3,392 2023 Formulary |
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-- This plan not offered in 2022 --
|
H2853 -002 -0 | | | | | |
|
new |
|
|
2023 Ascension Complete Saint Thomas Secure (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $1.00 | $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 BlueAdvantage Freedom (PPO)
| $0.00 |
$4,900 |
No Rx Coverage |
H7917 -039 -0 | This plan does NOT include Prescription Drug coverage. | |
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2023 BlueAdvantage Freedom (PPO)
| $0.00 |
$3,200 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 BlueAdvantage Sapphire (PPO)
| $0.00 |
$5,700 |
$0 | Yes, some additional gap coverage. |
H7917 -030 -0 | $1.00 | $10.00 | $42.00 | $42.00 | 3,638
2022 Formulary |
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2023 BlueAdvantage Sapphire (PPO)
| $0.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,588 2023 Formulary |
|
2022 Cigna Fundamental Medicare (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H4513 -033 -0 | This plan does NOT include Prescription Drug coverage. | |
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2023 Cigna Courage Medicare (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 --
|
H4513 -049 -2 | | | | | |
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2023 Cigna Preferred Medicare (HMO)
| $0.00 |
$5,600 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $42.00 | $42.00 | 3,524 2023 Formulary |
|
2022 Cigna True Choice Medicare (PPO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7849 -010 -0 | $0.00 | $4.00 | $40.00 | $40.00 | 3,459
2022 Formulary |
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2023 Cigna True Choice Medicare (PPO)
| $0.00 |
$5,100 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $2.00 | $40.00 | $40.00 | 3,524 2023 Formulary |
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-- This plan not offered in 2022 --
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H9231 -001 -0 | | | | | |
new |
new |
new |
|
2023 Devoted CHOICE Tennessee (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $2.00 | $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 --
|
H7605 -007 -0 | | | | | |
new |
new |
new |
|
2023 Devoted CORE Tennessee (HMO)
| $0.00 |
$5,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $45.00 | $45.00 | 3,364 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7605 -008 -0 | | | | | |
new |
new |
new |
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2023 Devoted GIVEBACK Tennessee (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.00 | $47.00 | $47.00 | 3,364 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H4863 -001 -0 | | | | | |
new |
new |
new |
|
2023 Farm Bureau Advantage (HMO)
| $0.00 |
$5,300 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $47.00 | $47.00 | 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 Humana Gold Plus H4461-029 (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4461 -029 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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2023 Humana Gold Plus H4461-029 (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H4461 -039 -0 | | | | | |
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2023 Humana Gold Plus H4461-039 (HMO)
| $0.00 |
$7,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Humana Honor (HMO)
| $0.00 |
$3,200 |
No Rx Coverage |
H4461 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
|
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2023 Humana Honor (HMO)
| $0.00 |
$3,200 |
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 Humana Honor (PPO)
| $0.00 |
$3,400 |
No Rx Coverage |
H5216 -235 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Humana Honor (PPO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 HumanaChoice H5216-180 (PPO)
| $29.30 |
$6,700 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5216 -180 -0 | $7.00 | $15.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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2023 HumanaChoice H5216-180 (PPO)
| $0.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice H5216-274 (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -274 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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|
|
|
2023 HumanaChoice H5216-274 (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $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 R7315-001 (Regional PPO)
| $0.00 |
$3,400 |
No Rx Coverage |
R7315 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 HumanaChoice R7315-001 (Regional PPO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 UnitedHealthcare Medicare Advantage Choice (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H2577 -020 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Medicare Advantage Choice (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1416 -080 -0 | | | | | |
|
|
|
|
2023 Wellcare Giveback (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $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 Giveback Open (PPO)
| $0.00 |
$6,700 |
$90 | Yes, some additional gap coverage. |
H9428 -002 -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 | 3,392 2023 Formulary |
|
2022 Wellcare No Premium (HMO-POS)
| $0.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1416 -077 -0 | $0.00 | $5.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
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|
|
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2023 Wellcare No Premium (HMO-POS)
| $0.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $37.00 | $37.00 | 3,392 2023 Formulary |
|
2022 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$75 | Yes, some additional gap coverage. |
H9428 -001 -0 | $0.00 | $10.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
-- |
|
|
2023 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$75 | Yes, some additional gap coverage. | $0.00 | $10.00 | $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 (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage |
H1416 -061 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Wellcare Patriot Giveback (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Amerivantage Balance Plus (HMO)
| $23.30 |
$4,900 |
$480 | Yes, some additional gap coverage. |
H5828 -008 -0 | $0.00 | $9.00 | $37.00 | $37.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Amerivantage Balance Plus (HMO)
| $9.30 |
$4,900 |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $37.00 | $37.00 | 3,603 2023 Formulary |
|
2022 Amerivantage Classic (HMO)
| $15.00 |
$6,500 |
$0 | Yes, some additional gap coverage. |
H2593 -022 -0 | $2.00 | $8.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
|
-- |
|
|
2023 Amerivantage Classic (HMO)
| $15.00 |
$6,100 |
$0 | Yes, some additional gap coverage. | $2.00 | $8.00 | $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 |
2022 Wellcare Assist (HMO)
| $22.00 |
$4,900 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1416 -042 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Assist (HMO)
| $17.10 |
$4,900 |
$485 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,392 2023 Formulary |
|
2022 Aetna Medicare Value Plus Plan (HMO)
| $24.00 |
$6,700 |
$95 | Yes, some additional gap coverage. |
H3146 -012 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Value Plus Plan (HMO)
| $18.00 |
$6,700 |
$95 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Amerivantage Dual Premier (HMO D-SNP)
| $32.70 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H5828 -002 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Amerivantage Dual Premier (HMO D-SNP)
| $22.20 |
n/a |
$490 | 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 Cigna TotalCare Plus (HMO D-SNP)
| $23.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H4513 -034 -0 | | | | | 3,459
2022 Formulary |
|
|
|
|
2023 Cigna TotalCare Plus (HMO D-SNP)
| $22.50 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,524 2023 Formulary |
|
2022 AARP Medicare Advantage Plan 2 (HMO)
| $33.00 |
$3,200 |
$0 | Yes, some additional gap coverage. |
H5253 -048 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Plan 2 (HMO-POS)
| $28.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
|
2022 Amerivantage Dual Coordination (HMO D-SNP)
| $32.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2593 -021 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,626
2022 Formulary |
|
-- |
|
|
2023 Amerivantage Dual Coordination (HMO D-SNP)
| $28.70 |
n/a |
$450 | 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 Amerivantage Full Dual Coordination (HMO D-SNP)
| $32.70 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H5828 -001 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Amerivantage Full Dual Coordination (HMO D-SNP)
| $35.20 |
n/a |
$380 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $47.00 | $47.00 | 3,603 2023 Formulary |
|
2022 BlueCare Plus (HMO D-SNP)
| $32.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H3259 -001 -0 | | | | | 3,638
2022 Formulary |
|
|
|
|
2023 BlueCare Plus (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,588 2023 Formulary |
|
2022 BlueCare Plus Choice (HMO D-SNP)
| $27.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H3259 -002 -0 | | | | | 3,638
2022 Formulary |
|
|
|
|
2023 BlueCare Plus Choice (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,588 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 --
|
H3259 -003 -0 | | | | | |
|
|
|
|
2023 BlueCare Plus Select (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,588 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7605 -006 -0 | | | | | |
new |
new |
new |
|
2023 Devoted RESTORE PLUS Tennessee - D (HMO C-SNP)
| $35.20 |
n/a |
$505 | Yes, some additional gap coverage. | 25% | 25% | 25% | 25% | 3,364 2023 Formulary |
|
2022 Humana Gold Plus SNP-DE H4461-022 (HMO D-SNP)
| $27.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H4461 -022 -0 | $3.00 | $10.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus SNP-DE H4461-022 (HMO D-SNP)
| $35.20 |
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 H4461-038 (HMO D-SNP)
| $27.80 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H4461 -038 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus SNP-DE H4461-038 (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,404 2023 Formulary |
|
2022 UnitedHealthcare Dual Complete (HMO D-SNP)
| $32.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0251 -002 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 UnitedHealthcare Dual Complete ONE (HMO D-SNP)
| $32.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0251 -004 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete ONE (HMO-POS D-SNP)
| $35.20 |
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 Wellcare Dual Access (HMO D-SNP)
| $30.20 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1416 -035 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,375
2022 Formulary |
|
|
|
|
2023 Wellcare Dual Access (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
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 |
|
2022 BlueAdvantage Emerald (PPO)
| $36.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H7917 -036 -0 | $1.00 | $5.00 | $35.00 | $35.00 | 3,638
2022 Formulary |
|
|
|
|
2023 BlueAdvantage Emerald (PPO)
| $36.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 3,588 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 Premier Medicare (HMO-POS)
| $57.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H4513 -036 -0 | $3.00 | $12.00 | $42.00 | $42.00 | 3,459
2022 Formulary |
|
|
|
|
2023 Cigna Premier Medicare (HMO-POS)
| $55.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $42.00 | $42.00 | 3,524 2023 Formulary |
|
2022 HumanaChoice H5216-097 (PPO)
| $68.00 |
$6,700 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H5216 -097 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-097 (PPO)
| $58.00 |
$6,700 |
$150 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice R7315-002 (Regional PPO)
| $84.00 |
$6,700 |
$380 | No additional gap coverage, only the Donut Hole Discount |
R7315 -002 -0 | $5.00 | $12.00 | 25% | 25% | 3,421
2022 Formulary |
|
|
|
|
2023 HumanaChoice R7315-002 (Regional PPO)
| $59.00 |
$6,700 |
$405 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.00 | 25% | 25% | 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 BlueAdvantage Ruby (PPO)
| $92.00 |
$4,300 |
$0 | Yes, some additional gap coverage. |
H7917 -014 -0 | $1.00 | $5.00 | $28.00 | $28.00 | 3,638
2022 Formulary |
|
|
|
|
2023 BlueAdvantage Ruby (PPO)
| $92.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $28.00 | $28.00 | 3,588 2023 Formulary |
|
2022 BlueAdvantage Diamond (PPO)
| $217.00 |
$3,700 |
$0 | Yes, some additional gap coverage. |
H7917 -010 -0 | $1.00 | $5.00 | $28.00 | $28.00 | 3,638
2022 Formulary |
|
|
|
|
2023 BlueAdvantage Diamond (PPO)
| $167.00 |
$3,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $28.00 | $28.00 | 3,588 2023 Formulary |
|
2022 Amerivantage Balance (HMO)
| $30.80 |
$6,700 |
$480 | Yes, some additional gap coverage. |
H2593 -025 -0 | $0.00 | $9.00 | $37.00 | $37.00 | 3,626
2022 Formulary |
|
|
|
|
-- Members will be assigned to Amerivantage Classic (HMO) H2593-022 --
| | | | | |
|
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 ONE Plus (HMO D-SNP)
| $32.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0251 -005 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
-- Members will be assigned to UnitedHealthcare Dual Complete (HMO-POS D-SNP) H0251-002 --
| | | | | |
|
2022 Wellcare Giveback (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1416 -073 -3 | $0.00 | $7.00 | $37.00 | $37.00 | 3,375
2022 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Giveback (HMO) H1416-078 --
| | | | | |
|
2022 Cigna Preferred Medicare (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4513 -049 -1 | $0.00 | $5.00 | $42.00 | $42.00 | 3,459
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|