There are 65 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 Plan 1 (PPO)
| $0.00 |
$6,500 |
$225 | Yes, some additional gap coverage. |
H1821 -002 -0 | $0.00 | $12.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
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|
|
|
2023 AARP Medicare Advantage Choice Plan 1 (PPO)
| $0.00 |
$6,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
|
2022 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$5,500 |
No Rx Coverage |
H1821 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
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2023 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$5,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2022 --
|
H3805 -017 -0 | | | | | |
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2023 AARP Medicare Advantage Plan 2 (HMO-POS)
| $0.00 |
$6,700 |
$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 AARP Medicare Advantage Walgreens (HMO-POS)
| $0.00 |
$6,500 |
$0 | Yes, some additional gap coverage. |
H3805 -032 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Walgreens (HMO-POS)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,682 2023 Formulary |
|
2022 Aetna Medicare Eagle Plan (PPO)
| $0.00 |
$5,500 |
No Rx Coverage |
H5521 -330 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
2023 Aetna Medicare Eagle Plan (PPO)
| $0.00 |
$5,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Aetna Medicare Elite Plan (HMO-POS)
| $0.00 |
$5,700 |
$0 | Yes, some additional gap coverage. |
H3748 -009 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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2023 Aetna Medicare Elite Plan (HMO-POS)
| $0.00 |
$5,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $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 --
|
H5521 -380 -0 | | | | | |
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|
|
2023 Aetna Medicare Preferred Plan (PPO)
| $0.00 |
$6,900 |
$200 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Aetna Medicare Value Plan (HMO-POS)
| $0.00 |
$7,550 |
$0 | Yes, some additional gap coverage. |
H3931 -126 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
|
2023 Aetna Medicare Value Plan (HMO-POS)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Aetna Medicare Value Plus Plan (HMO-POS)
| $0.00 |
$6,500 |
$0 | Yes, some additional gap coverage. |
H3748 -003 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
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|
|
|
2023 Aetna Medicare Value Plus Plan (HMO-POS)
| $0.00 |
$6,500 |
$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 Amerivantage Classic (HMO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H1894 -001 -0 | $5.00 | $15.00 | $42.00 | $42.00 | 3,626
2022 Formulary |
|
|
|
|
2023 Amerivantage Classic (HMO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $5.00 | $15.00 | $42.00 | $42.00 | 3,603 2023 Formulary |
|
2022 Amerivantage ESRD Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Few Generics |
H1894 -008 -0 | $5.00 | $15.00 | $42.00 | $42.00 | 3,603
2022 Formulary |
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|
|
2023 Amerivantage ESRD Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $5.00 | $15.00 | $42.00 | $42.00 | 3,579 2023 Formulary |
|
2022 Community Health Plan of WA MA No Rx Plan (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5826 -006 -0 | This plan does NOT include Prescription Drug coverage. | |
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2023 Community Health Plan of WA MA Freedom Plan (HMO)
| $0.00 |
$7,900 |
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 Community Health Plan of WA MA Plan 1 (HMO)
| $0.00 |
$6,700 |
$230 | No additional gap coverage, only the Donut Hole Discount |
H5826 -016 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,224
2022 Formulary |
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2023 Community Health Plan of WA MA Plan 1 (HMO)
| $0.00 |
$7,900 |
$230 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,178 2023 Formulary |
|
2022 Humana Gold Plus H5619-064 (HMO)
| $0.00 |
$6,500 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H5619 -064 -0 | $4.00 | $15.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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2023 Humana Gold Plus H5619-064 (HMO)
| $0.00 |
$6,000 |
$200 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Humana Honor (PPO)
| $0.00 |
$5,000 |
No Rx Coverage |
H5216 -301 -4 | This plan does NOT include Prescription Drug coverage. | |
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2023 Humana Honor (PPO)
| $0.00 |
$5,000 |
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 --
|
H5216 -315 -0 | | | | | |
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2023 Humana Honor (PPO)
| $0.00 |
$8,300 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 HumanaChoice H5216-247 (PPO)
| $0.00 |
$7,550 |
$400 | No additional gap coverage, only the Donut Hole Discount |
H5216 -247 -0 | $4.00 | $15.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
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|
|
|
2023 HumanaChoice H5216-247 (PPO)
| $0.00 |
$6,500 |
$175 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Kaiser Permanente Medicare Advantage Key (HMO)
| $0.00 |
$6,600 |
$100 | Yes, some additional gap coverage. |
H5050 -022 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 4,211
2022 Formulary |
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|
|
|
2023 Kaiser Permanente Medicare Advantage Key (HMO)
| $0.00 |
$6,600 |
$100 | Yes, some additional gap coverage. | $3.00 | $10.00 | $47.00 | $47.00 | 3,388 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 |
H5823 -011 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,218
2022 Formulary |
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|
|
|
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 Premera Blue Cross Medicare Advantage (HMO)
| $0.00 |
$6,500 |
$160 | No additional gap coverage, only the Donut Hole Discount |
H7245 -001 -0 | $4.00 | $12.00 | $42.00 | $42.00 | 4,207
2022 Formulary |
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|
|
2023 Premera Blue Cross Medicare Advantage (HMO)
| $0.00 |
$6,500 |
$160 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $12.00 | $42.00 | $42.00 | 4,230 2023 Formulary |
|
2022 Premera Blue Cross Medicare Advantage Peak + Rx (HMO)
| $0.00 |
$6,700 |
$160 | No additional gap coverage, only the Donut Hole Discount |
H9302 -011 -0 | $3.00 | $12.00 | $42.00 | $42.00 | 4,207
2022 Formulary |
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|
|
|
2023 Premera Blue Cross Medicare Advantage Peak + Rx (HMO)
| $0.00 |
$6,700 |
$160 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $42.00 | $42.00 | 4,230 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 Regence Valiance (PPO)
| $0.00 |
$6,200 |
No Rx Coverage |
H5009 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Regence Valiance (PPO)
| $0.00 |
$6,200 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Wellcare Giveback (HMO)
| $0.00 |
$7,550 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H1353 -006 -0 | $0.00 | $10.00 | $35.00 | $35.00 | 3,375
2022 Formulary |
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-- |
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|
2023 Wellcare Giveback (HMO)
| $0.00 |
$7,550 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $35.00 | $35.00 | 3,392 2023 Formulary |
|
2022 Wellcare No Premium (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1353 -005 -0 | $0.00 | $4.00 | $35.00 | $35.00 | 3,375
2022 Formulary |
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-- |
|
|
2023 Wellcare No Premium (HMO)
| $0.00 |
$6,300 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $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 |
-- This plan not offered in 2022 --
|
H5965 -002 -0 | | | | | |
|
-- |
-- |
|
2023 Wellcare No Premium Open (PPO)
| $0.00 |
$6,700 |
$250 | 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 --
|
H5965 -003 -0 | | | | | |
|
-- |
-- |
|
2023 Wellcare Patriot Giveback Open (PPO)
| $0.00 |
$4,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2022 Wellcare Assist (HMO)
| $29.10 |
$5,900 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1353 -007 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,375
2022 Formulary |
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-- |
|
|
2023 Wellcare Assist (HMO)
| $12.00 |
$5,900 |
$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 Amerivantage Dual Coordination (HMO D-SNP)
| $24.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount |
H1894 -002 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,626
2022 Formulary |
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|
|
|
2023 Amerivantage Dual Coordination (HMO D-SNP)
| $19.40 |
n/a |
$410 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $47.00 | $47.00 | 3,603 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5965 -004 -0 | | | | | |
|
-- |
-- |
|
2023 Wellcare Dual Access Open (PPO D-SNP)
| $21.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
2022 Wellcare Dual Liberty (HMO D-SNP)
| $38.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1353 -004 -0 | $0.00 | $12.00 | $42.00 | $42.00 | 3,375
2022 Formulary |
|
-- |
|
|
2023 Wellcare Dual Liberty (HMO D-SNP)
| $22.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2022 Wellcare Dual Access (HMO D-SNP)
| $40.50 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H1353 -002 -0 | $0.00 | $8.00 | $40.00 | $40.00 | 3,375
2022 Formulary |
|
-- |
|
|
2023 Wellcare Dual Access (HMO D-SNP)
| $23.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,394 2023 Formulary |
|
2022 Humana Gold Plus SNP-DE H5619-136 (HMO D-SNP)
| $21.70 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5619 -136 -4 | $0.00 | $20.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Gold Plus SNP-DE H5619-136 (HMO D-SNP)
| $23.90 |
n/a |
$450 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $19.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Premera Blue Cross Medicare Advantage Alpine (HMO)
| $24.00 |
$6,500 |
No Rx Coverage |
H9302 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Premera Blue Cross Medicare Advantage Alpine (HMO)
| $24.00 |
$6,500 |
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 Regence MedAdvantage + Rx Primary (PPO)
| $29.00 |
$6,700 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H5009 -009 -0 | $0.00 | $13.00 | $40.00 | $40.00 | 3,428
2022 Formulary |
|
|
|
|
2023 Regence MedAdvantage + Rx Primary (PPO)
| $28.00 |
$6,700 |
$325 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $13.00 | $40.00 | $40.00 | 3,450 2023 Formulary |
|
2022 Kaiser Permanente Medicare Advantage Vital (HMO)
| $29.00 |
$5,800 |
$0 | Yes, some additional gap coverage. |
H5050 -013 -0 | $3.00 | $7.00 | $47.00 | $47.00 | 4,211
2022 Formulary |
|
|
|
|
2023 Kaiser Permanente Medicare Advantage Vital (HMO)
| $29.00 |
$5,600 |
$0 | Yes, some additional gap coverage. | $3.00 | $7.00 | $47.00 | $47.00 | 3,388 2023 Formulary |
|
2022 Humana Value Plus H5619-134 (HMO)
| $26.00 |
$6,700 |
$440 | No additional gap coverage, only the Donut Hole Discount |
H5619 -134 -0 | $1.00 | $15.00 | 25% | 25% | 3,408
2022 Formulary |
|
|
|
|
2023 Humana Value Plus H5619-134 (HMO)
| $31.00 |
$6,700 |
$450 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $15.00 | 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 AARP Medicare Advantage Choice Plan 2 (PPO)
| $36.00 |
$6,000 |
$225 | Yes, some additional gap coverage. |
H1821 -005 -0 | $0.00 | $12.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Choice Plan 2 (PPO)
| $34.00 |
$6,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
|
2022 Premera Blue Cross Medicare Advantage Sound + Rx (HMO)
| $35.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H9302 -007 -0 | $2.00 | $12.00 | $42.00 | $42.00 | 4,207
2022 Formulary |
|
|
|
|
2023 Premera Blue Cross Medicare Advantage Sound + Rx (HMO)
| $34.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $42.00 | $42.00 | 4,230 2023 Formulary |
|
2022 Kaiser Permanente Medicare Advantage Basic (HMO)
| $40.00 |
$4,200 |
No Rx Coverage |
H5050 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2023 Kaiser Permanente Medicare Advantage Basic (HMO)
| $40.00 |
$4,200 |
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 UnitedHealthcare Dual Complete (HMO D-SNP)
| $40.50 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5008 -002 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP)
| $40.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 Community Health Plan of WA Dual Plan (HMO D-SNP)
| $40.40 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5826 -014 -0 | | | | | 3,224
2022 Formulary |
|
|
|
|
2023 Community Health Plan of WA Dual Plan (HMO D-SNP)
| $41.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,178 2023 Formulary |
|
2022 Community Health Plan of WA MA Plan 2 (HMO)
| $40.50 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5826 -010 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,224
2022 Formulary |
|
|
|
|
2023 Community Health Plan of WA MA Plan 2 (HMO)
| $41.00 |
$7,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,178 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 Complete Care (HMO D-SNP)
| $40.50 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount |
H5823 -006 -0 | $0.00 | $0.00 | $29.00 | $29.00 | 3,263
2022 Formulary |
|
|
|
|
2023 Molina Medicare Complete Care (HMO D-SNP)
| $41.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $29.00 | $29.00 | 3,270 2023 Formulary |
|
2022 Molina Medicare Complete Care Select (HMO D-SNP)
| $40.50 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount |
H5823 -010 -0 | $0.00 | $0.00 | $29.00 | $29.00 | 3,263
2022 Formulary |
|
|
|
|
2023 Molina Medicare Complete Care Select (HMO D-SNP)
| $41.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $29.00 | $29.00 | 3,270 2023 Formulary |
|
2022 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $36.80 |
n/a |
$200 | No additional gap coverage, only the Donut Hole Discount |
H0710 -030 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
-- |
|
|
2023 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $41.00 |
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 |
-- This plan not offered in 2022 --
|
H0271 -044 -0 | | | | | |
|
|
|
|
2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $41.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 UnitedHealthcare Dual Complete Select (HMO D-SNP)
| $40.50 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H5008 -015 -0 | | | | | 3,654
2022 Formulary |
|
|
|
|
2023 UnitedHealthcare Dual Complete Select (HMO-POS D-SNP)
| $41.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,682 2023 Formulary |
|
2022 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $40.50 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H0710 -031 -0 | | | | | 3,654
2022 Formulary |
|
-- |
|
|
2023 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $41.00 |
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 AARP Medicare Advantage Plan 3 (HMO)
| $45.00 |
$5,900 |
$225 | Yes, some additional gap coverage. |
H3805 -015 -0 | $0.00 | $12.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Plan 3 (HMO-POS)
| $43.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
|
2022 Aetna Medicare Choice Plan (PPO)
| $49.00 |
$6,200 |
$0 | Yes, some additional gap coverage. |
H5521 -127 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Choice Plan (PPO)
| $49.00 |
$6,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,597 2023 Formulary |
|
2022 Aetna Medicare Platinum Plus Plan (HMO-POS)
| $43.00 |
$6,500 |
$0 | Yes, some additional gap coverage. |
H3748 -004 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Platinum Plus Plan (HMO-POS)
| $53.00 |
$7,550 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $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 Premera Blue Cross Medicare Advantage Classic (HMO)
| $55.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7245 -002 -0 | $2.00 | $10.00 | $40.00 | $40.00 | 4,207
2022 Formulary |
|
|
|
|
2023 Premera Blue Cross Medicare Advantage Classic (HMO)
| $54.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $10.00 | $40.00 | $40.00 | 4,230 2023 Formulary |
|
-- This plan not offered in 2022 --
|
H5619 -061 -0 | | | | | |
|
|
|
|
2023 Humana Gold Plus H5619-061 (HMO)
| $57.00 |
$5,900 |
$50 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,404 2023 Formulary |
|
2022 Community Health Plan of WA MA Plan 3 (HMO)
| $68.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5826 -008 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,224
2022 Formulary |
|
|
|
|
2023 Community Health Plan of WA MA Plan 3 (HMO)
| $70.00 |
$7,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,178 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 Regence MedAdvantage + Rx Classic (PPO)
| $78.00 |
$6,200 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H5009 -008 -0 | $0.00 | $13.00 | $40.00 | $40.00 | 3,428
2022 Formulary |
|
|
|
|
2023 Regence MedAdvantage + Rx Classic (PPO)
| $77.00 |
$6,200 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $13.00 | $40.00 | $40.00 | 3,450 2023 Formulary |
|
2022 AARP Medicare Advantage Plan 1 (HMO)
| $88.00 |
$4,200 |
$185 | Yes, some additional gap coverage. |
H3805 -037 -0 | $0.00 | $12.00 | $45.00 | $45.00 | 3,654
2022 Formulary |
|
|
|
|
2023 AARP Medicare Advantage Plan 1 (HMO-POS)
| $86.00 |
$4,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $45.00 | $45.00 | 3,682 2023 Formulary |
|
2022 Aetna Medicare Select Plan (PPO)
| $99.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H5521 -128 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,672
2022 Formulary |
|
|
|
|
2023 Aetna Medicare Select Plan (PPO)
| $99.00 |
$6,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $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 Kaiser Permanente Medicare Advantage Essential (HMO)
| $99.00 |
$4,800 |
$0 | Yes, some additional gap coverage. |
H5050 -009 -0 | $3.00 | $7.00 | $45.00 | $45.00 | 4,211
2022 Formulary |
|
|
|
|
2023 Kaiser Permanente Medicare Advantage Essential (HMO)
| $99.00 |
$4,100 |
$0 | Yes, some additional gap coverage. | $3.00 | $7.00 | $45.00 | $45.00 | 3,388 2023 Formulary |
|
2022 Regence MedAdvantage + Rx Enhanced (PPO)
| $158.00 |
$5,400 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H5009 -002 -0 | $0.00 | $8.00 | $40.00 | $40.00 | 3,428
2022 Formulary |
|
|
|
|
2023 Regence MedAdvantage + Rx Enhanced (PPO)
| $153.00 |
$5,400 |
$250 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $40.00 | $40.00 | 3,450 2023 Formulary |
|
2022 Kaiser Permanente Medicare Advantage Optimal (HMO)
| $296.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H5050 -004 -0 | $3.00 | $7.00 | $45.00 | $45.00 | 4,211
2022 Formulary |
|
|
|
|
2023 Kaiser Permanente Medicare Advantage Optimal (HMO)
| $296.00 |
$3,150 |
$0 | Yes, some additional gap coverage. | $3.00 | $7.00 | $45.00 | $45.00 | 3,388 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)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. |
H3805 -025 -2 | $0.00 | $12.00 | $47.00 | $47.00 | 3,654
2022 Formulary |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage Plan 2 (HMO-POS) H3805-017 --
| | | | | |
|
2022 Humana Gold Plus H5619-062 (HMO)
| $49.00 |
$5,000 |
$160 | No additional gap coverage, only the Donut Hole Discount |
H5619 -062 -0 | $4.00 | $15.00 | $47.00 | $47.00 | 3,408
2022 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H5619-061 (HMO) H5619-061 --
| | | | | |
|
2022 Premera Blue Cross Medicare Advantage Classic Plus (HMO)
| $170.00 |
$5,000 |
$180 | No additional gap coverage, only the Donut Hole Discount |
H7245 -003 -0 | $4.00 | $12.00 | $42.00 | $42.00 | 4,207
2022 Formulary |
|
|
|
|
-- Members will be assigned to Premera Blue Cross Medicare Advantage Classic (HMO) H7245-002 --
| | | | | |
|
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 Premera Blue Cross Medicare Advantage Charter + Rx (HMO)
| $110.00 |
$4,900 |
$160 | No additional gap coverage, only the Donut Hole Discount |
H9302 -003 -0 | $2.00 | $12.00 | $42.00 | $42.00 | 4,207
2022 Formulary |
|
|
|
|
-- Members will be assigned to Premera Blue Cross Medicare Advantage Sound + Rx (HMO) H9302-007 --
| | | | | |
|
2022 HumanaChoice H5216-048 (PPO)
| $200.00 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H5216 -048 -0 | $16.00 | $18.00 | 25% | 25% | 3,413
2022 Formulary |
|
|
|
|
-- This plan not offered in 2023 --
|
| | | | |
|