There are 84 Medicare Advantage plans meeting your criteria.
Click on the plan name or details button below to access plan details and contact information.
2023 / 2024 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 |
2023 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$4,500 |
No Rx Coverage |
H8768 -021 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 AARP Medicare Advantage Patriot No Rx OH-MA01 (PPO)
| $0.00 |
$4,500 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Anthem MediBlue Service (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H4036 -022 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Anthem Veteran (PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Anthem MediBlue Access Core (Regional PPO)
| $0.00 |
$4,900 |
No Rx Coverage |
R5941 -013 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Anthem Veteran (Regional PPO)
| $0.00 |
$3,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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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 |
2023 Humana Honor (PPO)
| $0.00 |
$5,900 |
No Rx Coverage |
H5216 -218 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Humana USAA Honor (PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 HumanaChoice R5495-001 (Regional PPO)
| $0.00 |
$6,500 |
No Rx Coverage |
R5495 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 HumanaChoice R5495-001 (Regional PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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-- This plan not offered in 2023 --
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H3668 -013 -0 | | | | | |
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2024 Mount Carmel MediGold Cash Back No Premium MA Only (HMO)
| $0.00 |
$3,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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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 |
2023 The Health Plan SecureCare - Option I, MA Only (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H3672 -021 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 The Health Plan SecureCare Integrity Plan 1 (HMO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 AARP Medicare Advantage Plan 5 (HMO-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H5253 -062 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC OH-0002 (HMO-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
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-- This plan not offered in 2023 --
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H5253 -132 -0 | | | | | |
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2024 AARP Medicare Advantage from UHC OH-0011 (HMO-POS)
| $0.00 |
$6,300 |
$350 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,634 2024 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 2023 --
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H8768 -038 -1 | | | | | |
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2024 AARP Medicare Advantage from UHC OH-0016 (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
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-- This plan not offered in 2023 --
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H5253 -135 -0 | | | | | |
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2024 AARP Medicare Advantage from UHC OH-0017 (HMO-POS)
| $0.00 |
$6,500 |
$395 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
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2023 Aetna Medicare Premier (HMO-POS)
| $0.00 |
$5,200 |
$0 | Yes, some additional gap coverage. |
H0628 -017 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,622
2023 Formulary |
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2024 Aetna Medicare Premier (HMO-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,658 2024 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 2023 --
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H5521 -441 -0 | | | | | |
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2024 Aetna Medicare SmartFit (PPO)
| $0.00 |
$3,850 |
$400 | Yes, some additional gap coverage. | $0.00 | $10.00 | 20% | 20% | 3,619 2024 Formulary |
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2023 Aetna Medicare Value Plan (PPO)
| $0.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H5521 -089 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
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2024 Aetna Medicare Value Plan (PPO)
| $0.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
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2023 Anthem MediBlue Preferred (HMO)
| $0.00 |
$4,200 |
$0 | Yes, some additional gap coverage. |
H3655 -045 -1 | $4.00 | $10.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
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2024 Anthem Medicare Advantage (HMO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,581 2024 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 2023 --
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H5216 -307 -0 | | | | | |
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2024 Humana USAA Honor with Rx (PPO)
| $0.00 |
$8,850 |
$350 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
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2023 HumanaChoice H5216-285 (PPO)
| $0.00 |
$5,300 |
$200 | Yes, some additional gap coverage. |
H5216 -285 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
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2024 HumanaChoice H5216-285 (PPO)
| $0.00 |
$5,300 |
$200 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
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2023 HumanaChoice H5216-309 (PPO)
| $0.00 |
$6,500 |
$350 | Yes, some additional gap coverage. |
H5216 -309 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
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2024 HumanaChoice H5216-309 (PPO)
| $0.00 |
$7,550 |
$545 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 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 2023 --
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H4497 -005 -4 | | | | | |
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2024 MedMutual Advantage Access (PPO)
| $0.00 |
$6,400 |
$0 | Yes, some additional gap coverage. | $4.00 | $8.00 | $42.00 | $42.00 | 3,202 2024 Formulary |
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2023 MedMutual Advantage Classic (HMO)
| $0.00 |
$4,900 |
$95 | Yes, some additional gap coverage. |
H6723 -001 -3 | $0.00 | $5.00 | $42.00 | $42.00 | 3,467
2023 Formulary |
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2024 MedMutual Advantage Classic (HMO)
| $0.00 |
$4,900 |
$95 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,490 2024 Formulary |
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-- This plan not offered in 2023 --
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H6723 -006 -7 | | | | | |
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2024 MedMutual Advantage Signature (HMO)
| $0.00 |
$3,900 |
$100 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,202 2024 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 |
2023 Molina Medicare Choice Care (HMO)
| $0.00 |
$8,300 |
$125 | No additional gap coverage, only the Donut Hole Discount |
H9955 -002 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,221
2023 Formulary |
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2024 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 | 3,248 2024 Formulary |
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2023 Molina Medicare Choice Care Select (HMO)
| $0.00 |
$8,300 |
$375 | No additional gap coverage, only the Donut Hole Discount |
H9955 -004 -0 | $15.00 | $20.00 | $47.00 | $47.00 | 3,221
2023 Formulary |
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2024 Molina Medicare Choice Care Select (HMO)
| $0.00 |
$8,300 |
$375 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $20.00 | $47.00 | $47.00 | 3,248 2024 Formulary |
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-- This plan not offered in 2023 --
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H3668 -030 -0 | | | | | |
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2024 Mount Carmel MediGold Cash Back No Premium (HMO)
| $0.00 |
$5,900 |
$150 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,392 2024 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 2023 --
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H3668 -019 -1 | | | | | |
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2024 Mount Carmel MediGold No Premium (HMO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,392 2024 Formulary |
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-- This plan not offered in 2023 --
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H1846 -005 -0 | | | | | |
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2024 Mount Carmel MediGold No Premium Choice (PPO)
| $0.00 |
$5,700 |
$150 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,392 2024 Formulary |
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2023 The Health Plan SecureCare - Option II (HMO)
| $33.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H3672 -020 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,178
2023 Formulary |
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2024 The Health Plan SecureCare - Option II (HMO)
| $0.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,494 2024 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 2023 --
|
H8604 -014 -1 | | | | | |
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2024 The Health Plan SecureChoice Optimum (PPO)
| $0.00 |
$4,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,494 2024 Formulary |
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2023 Wellcare Giveback (HMO)
| $0.00 |
$7,500 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0908 -005 -0 | $0.00 | $15.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
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2024 Wellcare Giveback (HMO)
| $0.00 |
$7,500 |
$275 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $42.00 | $42.00 | 3,371 2024 Formulary |
|
2023 Wellcare No Premium (HMO)
| $0.00 |
$4,700 |
$75 | Yes, some additional gap coverage. |
H0908 -003 -0 | $0.00 | $9.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
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2024 Wellcare No Premium (HMO)
| $0.00 |
$4,700 |
$75 | Yes, some additional gap coverage. | $0.00 | $9.00 | $42.00 | $42.00 | 3,371 2024 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 |
2023 Wellcare No Premium Open (PPO)
| $0.00 |
$5,900 |
$160 | No additional gap coverage, only the Donut Hole Discount |
H7169 -001 -0 | $0.00 | $7.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
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2024 Wellcare No Premium Open (PPO)
| $0.00 |
$5,900 |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $42.00 | $42.00 | 3,371 2024 Formulary |
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-- This plan not offered in 2023 --
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H0908 -006 -0 | | | | | |
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2024 Wellcare All Dual Assure (HMO D-SNP)
| $17.20 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
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-- This plan not offered in 2023 --
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H5216 -401 -0 | | | | | |
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2024 Humana Together in Health (PPO I-SNP)
| $18.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 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 |
2023 Anthem MediBlue Extra (HMO)
| $10.40 |
$7,550 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3655 -041 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,603
2023 Formulary |
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2024 Anthem Extra Help (HMO)
| $19.20 |
$7,550 |
$545 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $47.00 | $47.00 | 3,581 2024 Formulary |
|
2023 Molina Medicare Complete Care (HMO D-SNP)
| $34.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H9955 -001 -0 | $0.00 | $4.00 | $44.00 | $44.00 | 3,270
2023 Formulary |
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2024 Molina Medicare Complete Care (HMO D-SNP)
| $20.50 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,303 2024 Formulary |
|
2023 Wellcare Assist (HMO)
| $10.80 |
$4,700 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0908 -004 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,392
2023 Formulary |
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2024 Wellcare Assist (HMO)
| $21.40 |
$4,700 |
$535 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,371 2024 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 |
2023 AARP Medicare Advantage Plan 2 (HMO-POS)
| $18.00 |
$4,200 |
$0 | Yes, some additional gap coverage. |
H5253 -109 -1 | $0.00 | $10.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC OH-0003 (HMO-POS)
| $25.00 |
$4,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H3655 -048 -0 | | | | | |
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2024 Anthem Dual Advantage (HMO D-SNP)
| $26.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,581 2024 Formulary |
|
2023 Wellcare Dual Access Open (PPO D-SNP)
| $26.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H7169 -003 -0 | | | | | 3,394
2023 Formulary |
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2024 Wellcare Dual Access Open (PPO D-SNP)
| $26.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 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 |
2023 Molina Medicare Complete Care Select (HMO D-SNP)
| $34.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H9955 -003 -0 | $0.00 | $0.00 | $29.00 | $29.00 | 3,270
2023 Formulary |
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2024 Molina Medicare Complete Care Select (HMO D-SNP)
| $27.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,303 2024 Formulary |
|
2023 HumanaChoice H5525-042 (PPO)
| $0.00 |
$7,550 |
$250 | No additional gap coverage, only the Donut Hole Discount |
H5525 -042 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
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2024 HumanaChoice H5525-042 (PPO)
| $30.00 |
$8,850 |
$545 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 MedMutual Advantage Secure (HMO)
| $30.00 |
$4,200 |
$95 | Yes, some additional gap coverage. |
H6723 -005 -2 | $0.00 | $5.00 | $42.00 | $42.00 | 3,467
2023 Formulary |
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|
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2024 MedMutual Advantage Secure (HMO)
| $30.00 |
$4,200 |
$95 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,490 2024 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 |
2023 AARP Medicare Advantage Choice Flex (PPO)
| $30.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H8768 -007 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
|
|
|
|
2024 AARP Medicare Advantage from UHC OH-0014 (PPO)
| $34.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
2023 HumanaChoice H5216-023 (PPO)
| $53.00 |
$6,200 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H5216 -023 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
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|
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2024 HumanaChoice H5216-023 (PPO)
| $36.00 |
$6,200 |
$100 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Aetna Medicare Assure 1 (HMO D-SNP)
| $14.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0628 -013 -0 | | | | | 3,597
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Assure 1 (HMO D-SNP)
| $36.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,633 2024 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 |
2023 Anthem MediBlue Plus (HMO)
| $37.00 |
$4,100 |
$0 | Yes, some additional gap coverage. |
H3655 -034 -0 | $2.00 | $10.00 | $37.00 | $37.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage 3 (HMO)
| $37.00 |
$4,100 |
$0 | Yes, some additional gap coverage. | $2.00 | $10.00 | $37.00 | $37.00 | 3,581 2024 Formulary |
|
2023 Humana Value Plus H5525-041 (PPO)
| $25.90 |
$7,550 |
$260 | No additional gap coverage, only the Donut Hole Discount |
H5525 -041 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Value Plus H5525-041 (PPO)
| $37.10 |
$8,850 |
$260 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $15.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Wellcare Dual Access (HMO D-SNP)
| $28.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0908 -001 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
2024 Wellcare Dual Access (HMO D-SNP)
| $37.80 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 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 |
2023 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $28.90 |
n/a |
$480 | No additional gap coverage, only the Donut Hole Discount |
H3655 -033 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Full Dual Advantage (HMO D-SNP)
| $38.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,581 2024 Formulary |
|
2023 MedMutual Advantage Choice (HMO)
| $40.00 |
$4,400 |
$55 | Yes, some additional gap coverage. |
H6723 -002 -3 | $0.00 | $5.00 | $42.00 | $42.00 | 3,467
2023 Formulary |
|
|
|
|
2024 MedMutual Advantage Choice (HMO)
| $40.00 |
$3,950 |
$55 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,490 2024 Formulary |
|
2023 The Health Plan SecureCare SNP (HMO D-SNP)
| $40.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3672 -019 -0 | | | | | 3,178
2023 Formulary |
|
|
|
|
2024 The Health Plan SecureCare SNP (HMO D-SNP)
| $40.20 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,494 2024 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 |
2023 CareSource Dual Advantage (HMO D-SNP)
| $34.70 |
n/a |
$505 | Yes, some additional gap coverage. |
H6396 -005 -0 | $0.00 | 25% | 25% | 25% | 3,467
2023 Formulary |
|
|
|
|
2024 CareSource Dual Advantage (HMO D-SNP)
| $40.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,494 2024 Formulary |
|
2023 HumanaChoice SNP-DE H5525-046 (PPO D-SNP)
| $34.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5525 -046 -0 | | | | | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice SNP-DE H5525-046 (PPO D-SNP)
| $40.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP)
| $34.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5322 -028 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete OH-D002 (HMO-POS D-SNP)
| $40.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 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 |
2023 UnitedHealthcare Dual Complete Choice (PPO D-SNP)
| $34.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0271 -055 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete OH-S001 (PPO D-SNP)
| $40.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
2023 UnitedHealthcare Dual Complete Select (HMO-POS D-SNP)
| $34.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5322 -034 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete OH-V002 (HMO-POS D-SNP)
| $40.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H1119 -001 -0 | | | | | |
|
-- |
|
|
2024 Valor Health Plan (HMO I-SNP)
| $40.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,460 2024 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 2023 --
|
H3668 -022 -0 | | | | | |
|
|
|
|
2024 Mount Carmel MediGold Plus (HMO)
| $47.00 |
$4,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,392 2024 Formulary |
|
2023 Anthem MediBlue Access (PPO)
| $56.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H4036 -025 -0 | $4.00 | $15.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage 3 (PPO)
| $49.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 3,581 2024 Formulary |
|
2023 MedMutual Advantage Select (PPO)
| $50.00 |
$6,400 |
$95 | Yes, some additional gap coverage. |
H4497 -001 -3 | $0.00 | $5.00 | $42.00 | $42.00 | 3,467
2023 Formulary |
|
|
|
|
2024 MedMutual Advantage Select (PPO)
| $49.00 |
$6,400 |
$95 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,490 2024 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 |
2023 HumanaChoice R5495-002 (Regional PPO)
| $84.00 |
$6,700 |
$505 | No additional gap coverage, only the Donut Hole Discount |
R5495 -002 -0 | $18.00 | $20.00 | 18% | 18% | 3,409
2023 Formulary |
|
|
|
|
2024 HumanaChoice R5495-002 (Regional PPO)
| $51.00 |
$6,700 |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
2023 Humana Gold Choice H8145-032 (PFFS)
| $82.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H8145 -032 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,409
2023 Formulary |
|
|
|
|
2024 Humana Gold Choice H8145-032 (PFFS)
| $63.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Anthem MediBlue Access Plus (PPO)
| $87.00 |
$4,300 |
$40 | Yes, some additional gap coverage. |
H4036 -017 -0 | $4.00 | $15.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage 4 (PPO)
| $69.00 |
$4,300 |
$40 | Yes, some additional gap coverage. | $4.00 | $15.00 | $42.00 | $42.00 | 3,581 2024 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 |
2023 Anthem MediBlue Access Basic (Regional PPO)
| $78.00 |
$6,050 |
$50 | Yes, some additional gap coverage. |
R5941 -014 -0 | $6.00 | $15.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage (Regional PPO)
| $73.00 |
$6,050 |
$50 | Yes, some additional gap coverage. | $6.00 | $15.00 | $42.00 | $42.00 | 3,581 2024 Formulary |
|
2023 MedMutual Advantage Preferred (PPO)
| $80.00 |
$6,100 |
$55 | Yes, some additional gap coverage. |
H4497 -002 -3 | $0.00 | $5.00 | $42.00 | $42.00 | 3,467
2023 Formulary |
|
|
|
|
2024 MedMutual Advantage Preferred (PPO)
| $73.00 |
$6,400 |
$55 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,490 2024 Formulary |
|
2023 MedMutual Advantage Plus (HMO)
| $97.00 |
$3,450 |
$55 | Yes, some additional gap coverage. |
H6723 -003 -3 | $0.00 | $5.00 | $42.00 | $42.00 | 3,467
2023 Formulary |
|
|
|
|
2024 MedMutual Advantage Plus (HMO)
| $90.00 |
$3,450 |
$55 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,490 2024 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 |
2023 Aetna Medicare Premier 2 (PPO)
| $101.00 |
$4,800 |
$0 | Yes, some additional gap coverage. |
H5521 -020 -0 | $0.00 | $0.00 | $42.00 | $42.00 | 3,622
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Premier 2 (PPO)
| $92.00 |
$4,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,658 2024 Formulary |
|
2023 AARP Medicare Advantage Plan 3 (HMO-POS)
| $109.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H5253 -051 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
|
|
|
|
2024 AARP Medicare Advantage from UHC OH-0001 (HMO-POS)
| $104.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
2023 Aetna Medicare Premier 1 (PPO)
| $120.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H5521 -134 -0 | $0.00 | $0.00 | $42.00 | $42.00 | 3,622
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Premier 1 (PPO)
| $110.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,658 2024 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 |
2023 HumanaChoice H5525-030 (PPO)
| $150.00 |
$3,400 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H5525 -030 -0 | $1.00 | $4.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice H5525-030 (PPO)
| $115.00 |
$3,400 |
$100 | No additional gap coverage, only the Donut Hole Discount | $1.00 | $4.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H3668 -018 -1 | | | | | |
|
|
|
|
2024 Mount Carmel MediGold Premier (HMO)
| $119.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,392 2024 Formulary |
|
2023 MedMutual Advantage Premium (PPO)
| $136.00 |
$3,450 |
$55 | Yes, some additional gap coverage. |
H4497 -003 -3 | $0.00 | $5.00 | $42.00 | $42.00 | 3,467
2023 Formulary |
|
|
|
|
2024 MedMutual Advantage Premium (PPO)
| $129.00 |
$3,450 |
$55 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,490 2024 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 |
2023 Aetna Medicare Premier Plus 2 (Regional PPO)
| $137.00 |
$5,100 |
$505 | No additional gap coverage, only the Donut Hole Discount |
R6694 -005 -0 | $0.00 | $10.00 | 18% | 18% | 3,597
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Premier Plus 2 (Regional PPO)
| $149.00 |
$5,100 |
$250 | Yes, some additional gap coverage. | $0.00 | $0.00 | 20% | 20% | 3,633 2024 Formulary |
|
2023 The Health Plan SecureChoice - Option II (PPO)
| $113.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H8604 -011 -0 | $3.00 | $10.00 | $47.00 | $47.00 | 3,178
2023 Formulary |
|
|
|
|
2024 The Health Plan SecureChoice - Option II (PPO)
| $153.40 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $10.00 | $47.00 | $47.00 | 3,494 2024 Formulary |
|
2023 Aetna Medicare Premier Plus 1 (Regional PPO)
| $198.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
R6694 -003 -0 | $0.00 | $0.00 | $42.00 | $42.00 | 3,622
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Premier Plus 1 (Regional PPO)
| $208.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,658 2024 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 |
2023 MedMutual Advantage Access (PPO)
| $0.00 |
$6,050 |
$0 | Yes, some additional gap coverage. |
H4497 -005 -2 | $4.00 | $8.00 | $42.00 | $42.00 | 3,178
2023 Formulary |
|
|
|
|
-- Members will be assigned to MedMutual Advantage Access (PPO) H4497-005 --
| | | | | |
|
2023 MedMutual Advantage Signature (HMO)
| $0.00 |
$4,200 |
$0 | Yes, some additional gap coverage. |
H6723 -006 -2 | $4.00 | $8.00 | $42.00 | $42.00 | 3,178
2023 Formulary |
|
|
|
|
-- Members will be assigned to MedMutual Advantage Signature (HMO) H6723-006 --
| | | | | |
|
2023 Wellcare No Premium Medicare (HMO)
| $0.00 |
$6,500 |
$75 | Yes, some additional gap coverage. |
H0724 -001 -0 | $0.00 | $9.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
|
-- |
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
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 |
2023 Wellcare Assist Complement (HMO)
| $11.90 |
$6,000 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0724 -006 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,392
2023 Formulary |
|
-- |
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Wellcare Giveback Boost (HMO)
| $0.00 |
$8,300 |
$150 | Yes, some additional gap coverage. |
H0724 -007 -0 | $0.00 | $9.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
|
-- |
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Lasso Healthcare Growth (MSA)
| $0.00 |
n/a |
No Rx Coverage |
H1924 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
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 |
2023 Lasso Healthcare Growth Plus (MSA)
| $0.00 |
n/a |
No Rx Coverage |
H1924 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Wellcare Patriot Giveback Open (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H7169 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 AARP Medicare Advantage Choice Plan 4 (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H8768 -033 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|