There are 67 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 Choice (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H2577 -013 -0 | $0.00 | $14.00 | $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 | $14.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H2577 -015 -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-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H5253 -111 -2 | $0.00 | $14.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Plan 1 (HMO-POS)
| $0.00 |
$4,900 |
$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 |
-- This plan not offered in 2022 --
|
H5253 -119 -0 | | | | | |
|
|
|
|
2023 AARP Medicare Advantage Rebate (HMO-POS)
| $0.00 |
$8,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 Aetna Medicare Premier Plan (PPO)
| $0.00 |
$7,550 |
$0 | Yes, some additional gap coverage. |
H5521 -345 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Premier Plan (PPO)
| $0.00 |
$7,550 |
$150 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Aetna Medicare Select Plan (HMO-POS)
| $0.00 |
$6,400 |
$0 | Yes, some additional gap coverage. |
H3931 -098 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Select Plan (HMO-POS)
| $0.00 |
$6,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2022 Align Connect (HMO C-SNP)
| $0.00 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1277 -002 -0 | $2.00 | $15.00 | $45.00 | $45.00 | 3,860
2022 Formulary |
|
-- |
-- |
|
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 |
|
2022 Align Thrive (HMO I-SNP)
| $0.00 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1277 -001 -0 | $2.00 | $15.00 | $45.00 | $45.00 | 3,860
2022 Formulary |
|
-- |
-- |
|
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 Anthem MediBlue + Kroger (HMO)
| $0.00 |
$4,900 |
$150 | Yes, some additional gap coverage. |
H3447 -039 -0 | $4.00 | $10.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue + Kroger (HMO)
| $0.00 |
$4,900 |
$150 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 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 Anthem MediBlue + Kroger Access (PPO)
| $0.00 |
$7,550 |
$95 | Yes, some additional gap coverage. |
H4909 -026 -0 | $4.00 | $13.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue + Kroger Access (PPO)
| $0.00 |
$7,550 |
$95 | Yes, some additional gap coverage. | $0.00 | $13.00 | $42.00 | $42.00 | 3,603 2023 Formulary |
|
2022 Anthem MediBlue Access (PPO)
| $0.00 |
$7,550 |
$95 | Yes, some additional gap coverage. |
H4909 -014 -0 | $4.00 | $13.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Access (PPO)
| $0.00 |
$7,550 |
$95 | Yes, some additional gap coverage. | $4.00 | $13.00 | $42.00 | $42.00 | 3,603 2023 Formulary |
|
2022 Anthem MediBlue Care on Site (HMO I-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H3447 -010 -0 | $0.00 | $7.50 | $40.00 | $40.00 | 3,117
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Care on Site (HMO I-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $40.00 | $40.00 | 3,157 2023 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2022 Anthem MediBlue COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H3447 -003 -0 | $0.00 | $9.50 | $40.00 | $40.00 | 3,117
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.50 | $40.00 | $40.00 | 3,157 2023 Formulary |
|
2022 Anthem MediBlue Diabetes and Heart Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Many Generics, Some Brands |
H3447 -004 -0 | $0.00 | $7.50 | $35.00 | $35.00 | 3,117
2022 Formulary |
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|
|
|
2023 Anthem MediBlue Diabetes and Heart Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $7.50 | $35.00 | $35.00 | 3,157 2023 Formulary |
|
2022 Anthem MediBlue ESRD Care (HMO C-SNP)
| $0.00 |
n/a |
$325 | Few Generics |
H3447 -033 -0 | $4.00 | $10.00 | $42.00 | $42.00 | 3,603
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue ESRD Care (HMO C-SNP)
| $0.00 |
n/a |
$325 | Yes, some additional gap coverage. | $4.00 | $10.00 | $42.00 | $42.00 | 3,579 2023 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2022 Anthem MediBlue Local (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H3447 -001 -0 | $0.00 | $9.50 | $40.00 | $40.00 | 3,117
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Local (HMO)
| $0.00 |
$3,650 |
$0 | Yes, some additional gap coverage. | $0.00 | $9.50 | $40.00 | $40.00 | 3,157 2023 Formulary |
|
2022 Anthem MediBlue Service (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H4909 -020 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Anthem MediBlue Service (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Anthem MediBlue Smart Fit (HMO)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H3447 -005 -0 | $5.00 | $12.50 | $40.00 | $40.00 | 3,117
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Smart Fit (HMO)
| $0.00 |
$3,650 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $12.50 | $40.00 | $40.00 | 3,157 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 --
|
H9725 -010 -0 | | | | | |
|
|
|
|
2023 Cigna Preferred Medicare (HMO)
| $0.00 |
$3,150 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $42.00 | $42.00 | 3,524 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7849 -070 -0 | | | | | |
|
|
|
|
2023 Cigna True Choice Medicare (PPO)
| $0.00 |
$6,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,524 2023 Formulary |
|
2022 Clear Spring Health Essential (HMO)
| $0.00 |
$3,250 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H8293 -001 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 3,232
2022 Formulary |
|
-- |
|
|
2023 Clear Spring Health Essential (HMO)
| $0.00 |
$3,250 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $5.00 | $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 |
-- This plan not offered in 2022 --
|
H8014 -002 -0 | | | | | |
new |
new |
new |
|
2023 Clear Spring Health Essential (PPO)
| $0.00 |
$4,950 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $5.00 | $42.00 | $42.00 | 3,255 2023 Formulary |
|
2022 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$150 | No additional gap coverage, only the Donut Hole Discount |
H5619 -046 -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 |
$150 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Humana Gold Plus H5619-139 (HMO)
| $0.00 |
$6,300 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5619 -139 -2 | $4.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus H5619-139 (HMO)
| $0.00 |
$6,300 |
$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 Humana Gold Plus H6622-004 (HMO)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6622 -004 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus H6622-004 (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5216 -310 -0 | | | | | |
|
|
|
|
2023 Humana Honor (PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Humana Honor R1390-003 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage |
R1390 -003 -0 | This plan does NOT include Prescription Drug coverage. | |
|
-- |
|
|
2023 Humana Honor (Regional PPO)
| $0.00 |
$7,550 |
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 H5216-152 (PPO)
| $0.00 |
$3,400 |
No Rx Coverage |
H5216 -152 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 HumanaChoice H5216-152 (PPO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 HumanaChoice H5216-266 (PPO)
| $0.00 |
$5,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -266 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-266 (PPO)
| $0.00 |
$5,400 |
$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 --
|
H5216 -308 -0 | | | | | |
|
|
|
|
2023 HumanaChoice H5216-308 (PPO)
| $0.00 |
$8,300 |
$485 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2022 --
|
H5216 -312 -0 | | | | | |
|
|
|
|
2023 HumanaChoice H5216-312 (PPO)
| $0.00 |
$3,650 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $45.00 | $45.00 | 3,404 2023 Formulary |
|
2022 HumanaChoice R1390-001 (Regional PPO)
| $0.00 |
$6,950 |
No Rx Coverage |
R1390 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
-- |
|
|
2023 HumanaChoice R1390-001 (Regional PPO)
| $0.00 |
$6,950 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
H7559 -003 -0 | | | | | |
|
-- |
|
|
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 |
|
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 Optima Medicare Salute (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H2563 -014 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Optima Medicare Salute (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Optima Medicare Value (HMO)
| $0.00 |
$4,000 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H2563 -009 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,416
2022 Formulary |
|
|
|
|
2023 Optima Medicare Value (HMO)
| $0.00 |
$4,000 |
$150 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,560 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5619 -145 -0 | | | | | |
|
|
|
|
2023 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $4.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $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 Humana Gold Plus H6622-074 (HMO)
| $17.00 |
$7,550 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H6622 -074 -2 | $2.00 | $8.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus H6622-074 (HMO)
| $15.00 |
$7,550 |
$250 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $8.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Aetna Medicare Assure Value (HMO D-SNP)
| $27.80 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H1610 -003 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Assure Value (HMO D-SNP)
| $19.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,597 2023 Formulary |
|
2022 Aetna Medicare Assure Premier (HMO D-SNP)
| $27.00 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H1610 -002 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Assure Premier (HMO D-SNP)
| $20.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,597 2023 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2022 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $35.10 |
n/a |
$390 | No additional gap coverage, only the Donut Hole Discount |
H3447 -030 -0 | $5.00 | $15.00 | $40.00 | $40.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $22.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $47.00 | $47.00 | 3,603 2023 Formulary |
|
2022 AARP Medicare Advantage Plan 2 (HMO-POS)
| $23.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H5253 -112 -2 | $0.00 | $12.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Plan 2 (HMO-POS)
| $23.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 Virginia Premier Advantage Elite (HMO D-SNP)
| $35.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H9877 -001 -0 | | | | | 3,394
2022 Formulary |
|
|
|
|
2023 Virginia Premier Advantage Elite (HMO D-SNP)
| $23.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,560 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 Optima Community Complete (HMO D-SNP)
| $35.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2563 -004 -0 | | | | | 3,416
2022 Formulary |
|
|
|
|
2023 Optima Community Complete (HMO D-SNP)
| $25.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,560 2023 Formulary |
|
2022 Anthem MediBlue Extra (HMO)
| $35.10 |
$5,900 |
$480 | Yes, some additional gap coverage. |
H3447 -027 -0 | $0.00 | $16.00 | $47.00 | $47.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Extra (HMO)
| $25.90 |
$3,400 |
$505 | Yes, some additional gap coverage. | $0.00 | $16.00 | $47.00 | $47.00 | 3,603 2023 Formulary |
|
2022 Aetna Better Health of Virginia (HMO D-SNP)
| $29.70 |
n/a |
$400 | No additional gap coverage, only the Donut Hole Discount |
H1610 -001 -0 | $0.00 | $0.00 | $46.00 | $46.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Better Health of Virginia (HMO D-SNP)
| $27.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 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 Humana Gold Choice H8145-042 (PFFS)
| $32.00 |
n/a |
No Rx Coverage |
H8145 -042 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Humana Gold Choice H8145-042 (PFFS)
| $28.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
H9725 -011 -0 | | | | | |
|
|
|
|
2023 Cigna Preferred Plus Medicare (HMO)
| $29.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $42.00 | $42.00 | 3,524 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H7849 -071 -0 | | | | | |
|
|
|
|
2023 Cigna True Choice Plus Medicare (PPO)
| $29.00 |
$6,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 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 Anthem MediBlue Dual Access (PPO D-SNP)
| $35.10 |
n/a |
$390 | No additional gap coverage, only the Donut Hole Discount |
H4909 -018 -0 | $5.00 | $15.00 | $40.00 | $40.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Dual Access (PPO D-SNP)
| $29.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $47.00 | $47.00 | 3,603 2023 Formulary |
|
2022 UnitedHealthcare Dual Complete ONE (HMO D-SNP)
| $35.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H7464 -005 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete ONE (HMO-POS D-SNP)
| $29.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H0710 -059 -0 | | | | | |
|
-- |
|
|
2023 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $29.80 |
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 ONE Plus (HMO D-SNP)
| $29.00 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H7464 -007 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete ONE Plus (HMO-POS D-SNP)
| $29.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 UnitedHealthcare Dual Complete (HMO D-SNP)
| $31.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H7464 -001 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP)
| $33.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1277 -004 -0 | | | | | |
|
-- |
-- |
|
2023 Align Kidney Care (HMO C-SNP)
| $34.50 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $15.00 | $45.00 | $45.00 | 3,838 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 Plan 2 (HMO D-SNP)
| $35.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H7464 -006 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete Balance (HMO-POS D-SNP)
| $34.50 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 Anthem MediBlue Full Dual Advantage (HMO D-SNP)
| $33.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H3447 -011 -0 | $5.00 | $15.00 | $40.00 | $40.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Anthem MediBlue Full Dual Advantage (HMO D-SNP)
| $34.60 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $40.00 | $40.00 | 3,603 2023 Formulary |
|
2022 Molina Medicare Complete Care (HMO D-SNP)
| $35.10 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H7559 -001 -0 | | | | | 3,263
2022 Formulary |
|
-- |
|
|
2023 Molina Medicare Complete Care (HMO D-SNP)
| $34.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,270 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 --
|
H7559 -002 -0 | | | | | |
|
-- |
|
|
2023 Molina Medicare Complete Care Select (HMO D-SNP)
| $34.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $29.00 | $29.00 | 3,270 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H1889 -006 -0 | | | | | |
|
|
|
|
2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $34.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP)
| $36.30 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0710 -032 -0 | | | | | 3,654
2022 Formulary |
|
-- |
|
|
2023 UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP)
| $37.50 |
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 HumanaChoice H5216-144 (PPO)
| $50.00 |
$7,550 |
$265 | No additional gap coverage, only the Donut Hole Discount |
H5216 -144 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 HumanaChoice H5216-144 (PPO)
| $39.00 |
$7,550 |
$265 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Humana Gold Choice H8145-004 (PFFS)
| $87.00 |
n/a |
$160 | No additional gap coverage, only the Donut Hole Discount |
H8145 -004 -0 | $5.00 | $15.00 | $47.00 | $47.00 | 3,413
2022 Formulary |
|
|
|
|
2023 Humana Gold Choice H8145-004 (PFFS)
| $68.00 |
n/a |
$160 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $47.00 | $47.00 | 3,409 2023 Formulary |
|
2022 Aetna Medicare Essential Plan (PPO)
| $70.00 |
$6,700 |
$300 | Yes, some additional gap coverage. |
H5521 -082 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Essential Plan (PPO)
| $77.00 |
$6,700 |
$300 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2022 HumanaChoice R1390-002 (Regional PPO)
| $98.80 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount |
R1390 -002 -0 | $8.00 | $18.00 | $47.00 | $47.00 | 3,416
2022 Formulary |
|
-- |
|
|
2023 HumanaChoice R1390-002 (Regional PPO)
| $98.00 |
$7,550 |
$480 | No additional gap coverage, only the Donut Hole Discount | $8.00 | $18.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Optima Medicare Prime (HMO)
| $57.00 |
$4,500 |
$130 | No additional gap coverage, only the Donut Hole Discount |
H2563 -013 -0 | $0.00 | $8.00 | $40.00 | $40.00 | 3,416
2022 Formulary |
|
|
|
|
-- Members will be assigned to Optima Medicare Value (HMO) H2563-009 --
| | | | | |
|
2022 UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
| $35.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
R1548 -001 -0 | | | | | 3,663
2022 Formulary |
|
|
|
|
-- Members will be assigned to UnitedHealthcare Dual Complete Choice (PPO D-SNP) H1889-005 --
| | | | | |
|
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 Essential (PPO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H2020 -002 -0 | $2.00 | $5.00 | $42.00 | $42.00 | 3,232
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|