There are 125 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 (HMO-POS)
| $0.00 |
$4,900 |
No Rx Coverage |
H0543 -121 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 AARP Medicare Advantage Patriot No Rx CA-MA01 (HMO-POS)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 Aetna Medicare Eagle Plan (HMO)
| $0.00 |
$4,200 |
No Rx Coverage |
H4982 -013 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Aetna Medicare Eagle Plan (HMO)
| $0.00 |
$4,200 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 Aetna Medicare Eagle Plus Plan (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5521 -369 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Aetna Medicare Eagle Plus Plan (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2023 Brand New Day Valor Care Plan (HMO)
| $0.00 |
$3,000 |
No Rx Coverage |
H0838 -048 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Brand New Day Valor Care Plan (HMO)
| $0.00 |
$3,850 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 Humana Honor (HMO)
| $0.00 |
$4,999 |
No Rx Coverage |
H5619 -121 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Humana USAA Honor (HMO)
| $0.00 |
$4,999 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2023 --
|
H5525 -078 -0 | | | | | |
|
|
|
|
2024 Humana USAA Honor (PPO)
| $0.00 |
$5,900 |
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 |
2023 Imperial Courage Plan (HMO)
| $0.00 |
$2,999 |
No Rx Coverage |
H5496 -016 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Imperial Courage Plan (HMO)
| $0.00 |
$2,999 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 AARP Medicare Advantage Rebate (HMO-POS)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. |
H0543 -238 -0 | $0.00 | $14.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
|
|
|
|
2024 AARP Medicare Advantage from UHC CA-0021 (HMO-POS)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H0294 -039 -0 | | | | | |
|
|
|
|
2024 AARP Medicare Advantage from UHC CA-0031 (PPO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 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 AARP Medicare Advantage SecureHorizons Focus (HMO-POS)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. |
H0543 -170 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,682
2023 Formulary |
|
|
|
|
2024 AARP Medicare Advantage from UHC CA-006P (HMO-POS)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,634 2024 Formulary |
|
2023 AARP Medicare Advantage Harmony (HMO-POS)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. |
H0543 -221 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,682
2023 Formulary |
|
|
|
|
2024 AARP Medicare Advantage from UHC CA-022P (HMO-POS)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H5521 -421 -0 | | | | | |
|
|
|
|
2024 Aetna Medicare Core Plan (PPO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | 20% | 20% | 3,619 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 Plus Plan (HMO)
| $0.00 |
$899 |
$0 | Yes, some additional gap coverage. |
H4982 -002 -0 | $0.00 | $0.00 | $37.00 | $37.00 | 3,622
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Plus Plan (HMO)
| $0.00 |
$699 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $37.00 | $37.00 | 3,658 2024 Formulary |
|
2023 Aetna Medicare Select Plan (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H0523 -022 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Select Plan (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
|
2023 Alignment Health CalPlus + Veterans (HMO)
| $0.00 |
$5,900 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3815 -036 -0 | $0.00 | $20.00 | 25% | 25% | 3,467
2023 Formulary |
|
|
|
|
2024 Alignment Health CalPlus + Veterans (HMO)
| $0.00 |
$5,900 |
$545 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | 25% | 25% | 3,517 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 Alignment Health Heart & Diabetes (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H3815 -010 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Alignment Health Heart & Diabetes (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $30.00 | $30.00 | 3,517 2024 Formulary |
|
2023 Alignment Health My Choice (HMO)
| $0.00 |
$780 |
$0 | Yes, some additional gap coverage. |
H3815 -001 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Alignment Health My Choice (HMO)
| $0.00 |
$498 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $30.00 | $30.00 | 3,517 2024 Formulary |
|
2023 Alignment Health My Choice CalPlus (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H3815 -007 -0 | $0.00 | $3.00 | $40.00 | $40.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Alignment Health My Choice CalPlus (HMO)
| $0.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $3.00 | $40.00 | $40.00 | 3,517 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 Alignment Health smartHMO (HMO)
| $0.00 |
$2,499 |
$0 | Yes, some additional gap coverage. |
H3815 -013 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Alignment Health smartHMO (HMO)
| $0.00 |
$2,499 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,517 2024 Formulary |
|
2023 Alignment Health the ONE + Rite Aid (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H3815 -034 -0 | $0.00 | $1.00 | $40.00 | $40.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Alignment Health the ONE + Rite Aid (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $1.00 | $40.00 | $40.00 | 3,517 2024 Formulary |
|
2023 Anthem MediBlue Diabetes Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0544 -010 -0 | $0.00 | $9.50 | $35.00 | $35.00 | 3,157
2023 Formulary |
|
|
|
|
2024 Anthem I Carelon Chronic Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.50 | $35.00 | $35.00 | 3,221 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 Care On Site (HMO I-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0544 -005 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,157
2023 Formulary |
|
|
|
|
2024 Anthem I Carelon Home Care (HMO I-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,221 2024 Formulary |
|
2023 Anthem MediBlue ESRD Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0544 -020 -0 | $0.00 | $9.50 | $40.00 | $40.00 | 3,157
2023 Formulary |
|
|
|
|
2024 Anthem I Carelon Kidney Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.50 | $40.00 | $40.00 | 3,221 2024 Formulary |
|
2023 Anthem MediBlue Lung Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0544 -019 -0 | $0.00 | $9.50 | $40.00 | $40.00 | 3,157
2023 Formulary |
|
|
|
|
2024 Anthem I Carelon Lung Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.50 | $40.00 | $40.00 | 3,221 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 --
|
H4161 -013 -0 | | | | | |
|
new |
new |
|
2024 Anthem I Carelon Medicare Advantage (HMO)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,221 2024 Formulary |
|
2023 Anthem MediBlue Value Plus (HMO)
| $0.00 |
$1,900 |
$0 | Yes, some additional gap coverage. |
H0544 -008 -0 | $0.00 | $9.50 | $40.00 | $40.00 | 3,157
2023 Formulary |
|
|
|
|
2024 Anthem I Carelon Medicare Advantage 2 (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $9.50 | $40.00 | $40.00 | 3,221 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H4161 -012 -0 | | | | | |
|
new |
new |
|
2024 Anthem I Carelon Premium Savings (HMO)
| $0.00 |
$1,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,221 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 StartSmart Plus (HMO)
| $0.00 |
$3,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0544 -007 -0 | $5.00 | $14.50 | $45.00 | $45.00 | 3,157
2023 Formulary |
|
|
|
|
2024 Anthem I Carelon Premium Savings 2 (HMO)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $5.00 | $14.50 | $45.00 | $45.00 | 3,221 2024 Formulary |
|
2023 Anthem MediBlue Plus (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H0544 -127 -0 | $0.00 | $15.00 | $42.00 | $42.00 | 3,583
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $42.00 | $42.00 | 3,557 2024 Formulary |
|
2023 Anthem MediBlue Prime (HMO)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. |
H4161 -002 -0 | $0.00 | $0.00 | $42.00 | $42.00 | 3,583
2023 Formulary |
|
new |
new |
|
2024 Anthem Prime (HMO)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,557 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 Select (HMO)
| $0.00 |
$1,800 |
$0 | Yes, some additional gap coverage. |
H0544 -066 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 3,583
2023 Formulary |
|
|
|
|
2024 Anthem Select (HMO)
| $0.00 |
$1,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,557 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H1993 -007 -0 | | | | | |
|
|
|
|
2024 Astiva Health C-SNP Deluxe (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $28.00 | $28.00 | 3,404 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H1993 -010 -0 | | | | | |
|
|
|
|
2024 Astiva Health Premier Plan (HMO)
| $0.00 |
$1,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $35.00 | $35.00 | 3,404 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 --
|
H1993 -001 -0 | | | | | |
|
|
|
|
2024 Astiva Health Savings Plan (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $45.00 | $45.00 | 3,404 2024 Formulary |
|
2023 Blue Shield 65 Plus (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H0504 -017 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,677
2023 Formulary |
|
|
|
|
2024 Blue Shield 65 Plus (HMO)
| $0.00 |
$1,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $40.00 | $40.00 | 3,671 2024 Formulary |
|
2023 Blue Shield 65 Plus Choice Plan (HMO)
| $0.00 |
$899 |
$0 | Yes, some additional gap coverage. |
H0504 -040 -0 | $0.00 | $3.00 | $35.00 | $35.00 | 3,677
2023 Formulary |
|
|
|
|
2024 Blue Shield 65 Plus Choice Plan (HMO)
| $0.00 |
$899 |
$0 | Yes, some additional gap coverage. | $0.00 | $3.00 | $35.00 | $35.00 | 3,671 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 Brand New Day Classic Care I Plan (HMO)
| $0.00 |
$999 |
$0 | Yes, some additional gap coverage. |
H0838 -050 -1 | $0.00 | $0.00 | $47.00 | $47.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Brand New Day Classic Care I Plan (HMO)
| $0.00 |
$1,199 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,494 2024 Formulary |
|
2023 Brand New Day Embrace Care Plan (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0838 -039 -1 | $0.00 | $9.00 | $47.00 | $47.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Brand New Day Embrace Care Plan (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $47.00 | $47.00 | 3,494 2024 Formulary |
|
2023 Brand New Day Part B Savings Plan (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H0838 -049 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Brand New Day Part B Savings Plan (HMO)
| $0.00 |
$3,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $12.00 | $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 |
2023 Central Health Focus Plan (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5649 -006 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Central Health Focus Plan (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,494 2024 Formulary |
|
2023 Central Health Medicare Plan (HMO)
| $0.00 |
$990 |
$0 | Yes, some additional gap coverage. |
H5649 -001 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Central Health Medicare Plan (HMO)
| $0.00 |
$1,100 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,494 2024 Formulary |
|
2023 Central Health Premier Plan II (HMO)
| $0.00 |
$899 |
$0 | Yes, some additional gap coverage. |
H5649 -021 -1 | $0.00 | $0.00 | $35.00 | $35.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Central Health Premier Plan II (HMO)
| $0.00 |
$1,199 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 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 |
2023 Central Health Savings Plan (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H5649 -019 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Central Health Savings Plan (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,494 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H6170 -001 -0 | | | | | |
new |
new |
new |
|
2024 Champion Advantage (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,332 2024 Formulary |
|
2023 Clever Care Fortune Medicare Advantage (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. |
H7607 -007 -4 | $0.00 | $0.00 | $35.00 | $35.00 | 3,506
2023 Formulary |
|
-- |
|
|
2024 Clever Care Active (HMO)
| $0.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,582 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 Clever Care Longevity Medicare Advantage (HMO)
| $0.00 |
$1,700 |
$0 | Yes, some additional gap coverage. |
H7607 -002 -4 | $0.00 | $0.00 | $35.00 | $35.00 | 3,506
2023 Formulary |
|
-- |
|
|
2024 Clever Care Longevity (HMO)
| $0.00 |
$1,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,582 2024 Formulary |
|
2023 Clever Care Value Medicare Advantage (HMO)
| $0.00 |
$5,000 |
$0 | Yes, some additional gap coverage. |
H7607 -008 -4 | $0.00 | $10.00 | $47.00 | $47.00 | 3,506
2023 Formulary |
|
-- |
|
|
2024 Clever Care Value (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,582 2024 Formulary |
|
2023 Humana Community (HMO)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. |
H7621 -002 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Community (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 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 Humana Gold Plus H5619-039 (HMO)
| $0.00 |
$750 |
$0 | Yes, some additional gap coverage. |
H5619 -039 -2 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus H5619-039 (HMO)
| $0.00 |
$750 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Humana Gold Plus H5619-150 (HMO)
| $0.00 |
$5,000 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H5619 -150 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus H5619-150 (HMO)
| $0.00 |
$5,000 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H5525 -057 -0 | | | | | |
|
|
|
|
2024 Humana USAA Honor with Rx (PPO)
| $0.00 |
$6,100 |
$350 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 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 |
-- This plan not offered in 2023 --
|
H5525 -075 -0 | | | | | |
|
|
|
|
2024 HumanaChoice H5525-075 (PPO)
| $0.00 |
$4,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Imperial Dynamic Plan (HMO)
| $0.00 |
$899 |
$0 | Yes, some additional gap coverage. |
H5496 -012 -0 | $0.00 | $3.00 | $30.00 | $30.00 | 3,346
2023 Formulary |
|
|
|
|
2024 Imperial Dynamic Plan (HMO)
| $0.00 |
$298 |
$0 | Yes, some additional gap coverage. | $0.00 | $3.00 | $30.00 | $30.00 | 3,404 2024 Formulary |
|
2023 Imperial Senior Value (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5496 -005 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,387
2023 Formulary |
|
|
|
|
2024 Imperial Senior Value (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,404 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 Imperial Strong (HMO)
| $0.00 |
$8,300 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5496 -014 -0 | | | | | 3,346
2023 Formulary |
|
|
|
|
2024 Imperial Strong (HMO)
| $0.00 |
$8,850 |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,404 2024 Formulary |
|
2023 Imperial Traditional (HMO)
| $0.00 |
$2,999 |
$0 | Yes, some additional gap coverage. |
H5496 -007 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,346
2023 Formulary |
|
|
|
|
2024 Imperial Traditional (HMO)
| $0.00 |
$1,349 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,404 2024 Formulary |
|
2023 Kaiser Permanente Senior Advantage Inland Empire (HMO)
| $0.00 |
$999 |
$0 | Yes, some additional gap coverage. |
H0524 -015 -0 | $0.00 | $3.00 | $35.00 | $35.00 | 3,388
2023 Formulary |
|
|
|
|
2024 Kaiser Permanente Senior Advantage Inland Empire (HMO)
| $0.00 |
$999 |
$0 | Yes, some additional gap coverage. | $0.00 | $7.00 | $47.00 | $47.00 | 3,403 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 Kaiser Permanente Sr Advantage Inland Empire Value (HMO)
| $0.00 |
$1,999 |
$0 | Yes, some additional gap coverage. |
H0524 -081 -0 | $0.00 | $3.00 | $35.00 | $35.00 | 3,388
2023 Formulary |
|
|
|
|
2024 Kaiser Permanente Sr Advantage Inland Empire Value (HMO)
| $0.00 |
$1,999 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,403 2024 Formulary |
|
2023 Molina Medicare Choice Care (HMO)
| $0.00 |
$8,300 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5810 -014 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,221
2023 Formulary |
|
-- |
|
|
2024 Molina Medicare Choice Care (HMO)
| $0.00 |
$8,300 |
$0 | No additional gap coverage, only the Donut Hole Discount | $3.00 | $12.00 | $47.00 | $47.00 | 3,248 2024 Formulary |
|
2023 Molina Medicare Choice Care Select (HMO)
| $0.00 |
$8,300 |
$450 | No additional gap coverage, only the Donut Hole Discount |
H5810 -015 -0 | $15.00 | $20.00 | $47.00 | $47.00 | 3,221
2023 Formulary |
|
-- |
|
|
2024 Molina Medicare Choice Care Select (HMO)
| $0.00 |
$8,300 |
$450 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $20.00 | $47.00 | $47.00 | 3,248 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 --
|
H5425 -104 -0 | | | | | |
|
|
|
|
2024 SCAN Balance (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $30.00 | $30.00 | 3,535 2024 Formulary |
|
2023 SCAN Classic (HMO)
| $0.00 |
$699 |
$0 | Yes, some additional gap coverage. |
H5425 -009 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,458
2023 Formulary |
|
|
|
|
2024 SCAN Classic (HMO)
| $0.00 |
$399 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,535 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H5425 -115 -0 | | | | | |
|
|
|
|
2024 SCAN Compass (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,535 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 SCAN Embrace (HMO I-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5425 -091 -0 | $0.00 | $0.00 | $37.00 | $37.00 | 3,458
2023 Formulary |
|
|
|
|
2024 SCAN Embrace (HMO I-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $37.00 | $37.00 | 3,535 2024 Formulary |
|
2023 SCAN Healthy at Home (HMO I-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H9104 -006 -0 | $0.00 | $0.00 | $42.00 | $42.00 | 3,458
2023 Formulary |
|
-- |
-- |
|
2024 SCAN Healthy at Home (HMO I-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,535 2024 Formulary |
|
2023 SCAN Heart First (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5425 -033 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,458
2023 Formulary |
|
|
|
|
2024 SCAN Heart First (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,535 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 --
|
H5425 -116 -0 | | | | | |
|
|
|
|
2024 SCAN Navigate (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,535 2024 Formulary |
|
2023 SCAN Venture (HMO)
| $0.00 |
$1,900 |
$0 | Yes, some additional gap coverage. |
H5425 -085 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,458
2023 Formulary |
|
|
|
|
2024 SCAN Venture (HMO)
| $0.00 |
$1,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,535 2024 Formulary |
|
2023 UnitedHealthcare Chronic Complete (HMO-POS C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0543 -219 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Complete Care CA-020P (HMO-POS C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 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 |
-- This plan not offered in 2023 --
|
H5087 -032 -0 | | | | | |
|
-- |
|
|
2024 Wellcare Giveback (HMO)
| $0.00 |
$8,850 |
$545 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,372 2024 Formulary |
|
2023 Wellcare No Premium Best (HMO)
| $0.00 |
$1,000 |
$0 | Yes, some additional gap coverage. |
H5087 -016 -0 | $0.00 | $3.00 | $37.00 | $37.00 | 3,393
2023 Formulary |
|
-- |
|
|
2024 Wellcare No Premium (HMO)
| $0.00 |
$1,000 |
$150 | Yes, some additional gap coverage. | $0.00 | $3.00 | $42.00 | $42.00 | 3,372 2024 Formulary |
|
2023 Wellcare No Premium (HMO)
| $0.00 |
$850 |
$0 | Yes, some additional gap coverage. |
H0562 -126 -0 | $0.00 | $1.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
|
|
|
|
2024 Wellcare No Premium Focus (HMO)
| $0.00 |
$1,000 |
$150 | Yes, some additional gap coverage. | $0.00 | $1.00 | $42.00 | $42.00 | 3,372 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 --
|
H3815 -039 -0 | | | | | |
|
|
|
|
2024 Alignment Health Heart & Diabetes CalPlus (HMO C-SNP)
| $8.50 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,517 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H4982 -018 -0 | | | | | |
|
|
|
|
2024 Aetna Medicare Value Plus Plan (HMO-POS)
| $10.00 |
$699 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $37.00 | $37.00 | 3,658 2024 Formulary |
|
2023 Clever Care Jasmine Medicare Advantage (HMO C-SNP)
| $31.80 |
n/a |
$505 | Yes, some additional gap coverage. |
H7607 -011 -4 | $0.00 | 25% | 25% | 25% | 3,506
2023 Formulary |
|
-- |
|
|
2024 Clever Care Total + (HMO C-SNP)
| $15.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,582 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 --
|
H3038 -001 -0 | | | | | |
new |
new |
new |
|
2024 Molina Medicare Complete Care (HMO D-SNP)
| $16.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,303 2024 Formulary |
|
2023 AARP Medicare Advantage Freedom Plus (HMO-POS)
| $0.00 |
$800 |
$0 | Yes, some additional gap coverage. |
H0543 -216 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,682
2023 Formulary |
|
|
|
|
2024 AARP Medicare Advantage from UHC CA-017P (HMO-POS)
| $19.00 |
$800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H0976 -002 -0 | | | | | |
new |
new |
new |
|
2024 SCAN Connections at Home (HMO D-SNP)
| $19.20 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,535 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 Chronic Complete Focus (HMO C-SNP)
| $11.30 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0543 -241 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Complete Care CA-03AP (HMO C-SNP)
| $20.30 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H3561 -009 -0 | | | | | |
|
|
|
|
2024 Wellcare Dual Liberty (HMO D-SNP)
| $21.30 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
|
2023 SCAN Prime (HMO)
| $23.00 |
$299 |
$0 | Yes, some additional gap coverage. |
H5425 -068 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,458
2023 Formulary |
|
|
|
|
2024 SCAN Prime (HMO)
| $23.00 |
$299 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,535 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 --
|
H0976 -001 -0 | | | | | |
new |
new |
new |
|
2024 SCAN Connections (HMO D-SNP)
| $23.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,535 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H3038 -003 -0 | | | | | |
new |
new |
new |
|
2024 Molina Medicare Complete Care Plus (HMO D-SNP)
| $24.20 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,303 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H5425 -097 -0 | | | | | |
|
|
|
|
2024 SCAN Strive (HMO C-SNP)
| $24.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,535 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 Humana Gold Plus H5619-148 (HMO)
| $24.00 |
$3,200 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5619 -148 -0 | $0.00 | $5.00 | $40.00 | $40.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus H5619-148 (HMO)
| $25.00 |
$3,200 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $40.00 | $40.00 | 3,448 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H0562 -130 -2 | | | | | |
|
|
|
|
2024 Wellcare Low Premium (HMO)
| $29.00 |
$3,850 |
$300 | Yes, some additional gap coverage. | $0.00 | $8.00 | $42.00 | $42.00 | 3,372 2024 Formulary |
|
2023 AARP Medicare Advantage SecureHorizons Premier (HMO-POS)
| $25.90 |
$800 |
$0 | Yes, some additional gap coverage. |
H0543 -166 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
|
|
|
|
2024 AARP Medicare Advantage from UHC CA-0015 (HMO-POS)
| $29.10 |
$800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 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 Brand New Day Classic Care II Plan (HMO)
| $36.70 |
$1,999 |
$50 | Yes, some additional gap coverage. |
H0838 -051 -2 | $0.00 | $12.00 | $47.00 | $47.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Brand New Day Classic Care II Plan (HMO)
| $34.30 |
$899 |
$50 | Yes, some additional gap coverage. | $0.00 | $12.00 | $47.00 | $47.00 | 3,494 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H8794 -001 -0 | | | | | |
new |
new |
new |
|
2024 Senior Advantage Medicare Medi-Cal South P1 (HMO D-SNP)
| $34.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,403 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H1993 -008 -0 | | | | | |
|
|
|
|
2024 Astiva Health C-SNP WOW (HMO C-SNP)
| $40.00 |
n/a |
$545 | Yes, some additional gap coverage. | $0.00 | $12.00 | $35.00 | $35.00 | 3,404 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 --
|
H2819 -003 -0 | | | | | |
new |
new |
new |
|
2024 Blue Shield TotalDual Plan (HMO D-SNP)
| $40.10 |
n/a |
$545 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 3,272 2024 Formulary |
|
2023 Brand New Day Dual Access Plan (HMO D-SNP)
| $38.90 |
n/a |
$505 | Yes, some additional gap coverage. |
H0838 -024 -0 | $0.00 | 25% | 25% | 25% | 3,467
2023 Formulary |
|
|
|
|
2024 Brand New Day Dual Access Plan (HMO D-SNP)
| $41.00 |
n/a |
$545 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 3,494 2024 Formulary |
|
2023 Brand New Day Embrace Choice Plan (HMO C-SNP)
| $38.90 |
n/a |
$505 | Yes, some additional gap coverage. |
H0838 -040 -1 | $0.00 | 25% | 25% | 25% | 3,467
2023 Formulary |
|
|
|
|
2024 Brand New Day Embrace Choice Plan (HMO C-SNP)
| $41.00 |
n/a |
$545 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 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 Central Health Medi-Medi Plan (HMO D-SNP)
| $38.90 |
n/a |
$505 | Yes, some additional gap coverage. |
H5649 -002 -0 | $0.00 | 25% | 25% | 25% | 3,467
2023 Formulary |
|
|
|
|
2024 Central Health Medi-Medi Plan (HMO D-SNP)
| $41.00 |
n/a |
$545 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 3,494 2024 Formulary |
|
2023 Central Health Premier Plan I (HMO)
| $33.10 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5649 -020 -2 | $0.00 | $0.00 | $35.00 | $35.00 | 3,467
2023 Formulary |
|
|
|
|
2024 Central Health Premier Plan I (HMO)
| $41.00 |
$899 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,494 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H6170 -002 -0 | | | | | |
new |
new |
new |
|
2024 Champion Connect (HMO C-SNP)
| $41.00 |
n/a |
$545 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 3,332 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 --
|
H6170 -003 -0 | | | | | |
new |
new |
new |
|
2024 Champion Select (HMO C-SNP)
| $41.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | 25% | 25% | 25% | 3,332 2024 Formulary |
|
2023 IEHP DualChoice (HMO D-SNP)
| $38.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H8894 -001 -0 | | | | | 2,910
2023 Formulary |
|
new |
new |
|
2024 IEHP DualChoice (HMO D-SNP)
| $41.00 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,109 2024 Formulary |
|
2023 VillageHealth (HMO-POS C-SNP)
| $31.20 |
n/a |
$370 | No additional gap coverage, only the Donut Hole Discount |
H5943 -001 -0 | $0.00 | $3.00 | 25% | 25% | 3,458
2023 Formulary |
|
-- |
-- |
|
2024 VillageHealth (HMO-POS C-SNP)
| $41.00 |
n/a |
$370 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $3.00 | 25% | 25% | 3,535 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 --
|
H0294 -036 -0 | | | | | |
|
|
|
|
2024 AARP Medicare Advantage from UHC CA-0028 (PPO)
| $42.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $9.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H5525 -074 -0 | | | | | |
|
|
|
|
2024 HumanaChoice H5525-074 (PPO)
| $46.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $2.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Aetna Medicare Choice Plan (PPO)
| $87.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H5521 -333 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Choice Plan (PPO)
| $77.00 |
$5,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 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 AARP Medicare Advantage Choice Plan 1 (PPO)
| $48.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H4829 -012 -0 | $0.00 | $9.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage from UHC CA-0028 (PPO) H0294-036 --
| | | | | |
|
2023 AARP Medicare Advantage Choice Plan 2 (PPO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H4829 -015 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage from UHC CA-0031 (PPO) H0294-039 --
| | | | | |
|
2023 Aetna Medicare Prime Plan (HMO)
| $0.00 |
$2,200 |
$0 | Yes, some additional gap coverage. |
H0523 -061 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
|
|
|
|
-- Members will be assigned to Aetna Medicare Select Plan (HMO) H0523-022 --
| | | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2023 Alignment Health Platinum (HMO)
| $0.00 |
$998 |
$0 | Yes, some additional gap coverage. |
H3815 -015 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,467
2023 Formulary |
|
|
|
|
-- Members will be assigned to Alignment Health My Choice (HMO) H3815-001 --
| | | | | |
|
2023 Anthem MediBlue Heart Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0544 -038 -0 | $0.00 | $9.50 | $40.00 | $40.00 | 3,157
2023 Formulary |
|
|
|
|
-- Members will be assigned to Anthem I Carelon Chronic Care (HMO C-SNP) H0544-010 --
| | | | | |
|
2023 Blue Shield TotalDual Plan (HMO D-SNP)
| $38.90 |
n/a |
$505 | Yes, some additional gap coverage. |
H5928 -055 -0 | $0.00 | 25% | 25% | 25% | 3,290
2023 Formulary |
|
|
|
|
-- Members will be assigned to Blue Shield TotalDual Plan (HMO D-SNP) H2819-003 --
| | | | | |
|
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 (HMO D-SNP)
| $38.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5810 -001 -0 | $0.00 | $14.00 | $40.00 | $40.00 | 3,270
2023 Formulary |
|
-- |
|
|
-- Members will be assigned to Molina Medicare Complete Care (HMO D-SNP) H3038-001 --
| | | | | |
|
2023 Molina Medicare Complete Care Plus (HMO D-SNP)
| $38.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5810 -016 -0 | $0.00 | $14.00 | $40.00 | $40.00 | 3,270
2023 Formulary |
|
-- |
|
|
-- Members will be assigned to Molina Medicare Complete Care Plus (HMO D-SNP) H3038-003 --
| | | | | |
|
2023 SCAN Connections (HMO D-SNP)
| $38.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5425 -010 -0 | | | | | 3,458
2023 Formulary |
|
|
|
|
-- Members will be assigned to SCAN Connections (HMO D-SNP) H0976-001 --
| | | | | |
|
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 SCAN Connections at Home (HMO D-SNP)
| $37.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5425 -030 -0 | | | | | 3,458
2023 Formulary |
|
|
|
|
-- Members will be assigned to SCAN Connections at Home (HMO D-SNP) H0976-002 --
| | | | | |
|
2023 Senior Advantage Medicare Medi-Cal Inland Empire (HMO D-SNP)
| $29.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0524 -073 -0 | | | | | 3,388
2023 Formulary |
|
|
|
|
-- Members will be assigned to Senior Advantage Medicare Medi-Cal South P1 (HMO D-SNP) H8794-001 --
| | | | | |
|
2023 Wellcare Dual Align 129 (HMO D-SNP)
| $23.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0562 -129 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Dual Align (HMO D-SNP) H3561-008 --
| | | | | |
|
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 Giveback (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H5087 -029 -1 | $0.00 | $5.00 | $37.00 | $37.00 | 3,393
2023 Formulary |
|
-- |
|
|
-- Members will be assigned to Wellcare Giveback (HMO) H5087-032 --
| | | | | |
|
2023 Wellcare Low Premium (HMO)
| $22.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H0562 -123 -0 | $0.00 | $8.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Low Premium (HMO) H0562-130 --
| | | | | |
|
2023 Anthem MediBlue Extra (HMO)
| $23.00 |
$800 |
$505 | Yes, some additional gap coverage. |
H0544 -081 -0 | $0.00 | $2.00 | $47.00 | $47.00 | 3,583
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 Patriot Giveback (HMO)
| $0.00 |
$4,500 |
No Rx Coverage |
H0562 -044 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Brand New Day Bridges Care Plan (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0838 -028 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,467
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Brand New Day Bridges Choice Plan (HMO C-SNP)
| $38.90 |
n/a |
$505 | Yes, some additional gap coverage. |
H0838 -029 -0 | $0.00 | 25% | 25% | 25% | 3,467
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 Brand New Day Select Care I Plan (HMO I-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0838 -042 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,467
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Brand New Day Select Choice I Plan (HMO I-SNP)
| $38.90 |
n/a |
$505 | Yes, some additional gap coverage. |
H0838 -044 -0 | $0.00 | $0.00 | 25% | 25% | 3,467
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Align Premier (HMO I-SNP)
| $38.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3274 -001 -0 | | | | | 3,683
2023 Formulary |
|
new |
new |
|
-- 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 Align Thrive (HMO I-SNP)
| $0.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3274 -002 -0 | $2.00 | $15.00 | $45.00 | $45.00 | 3,833
2023 Formulary |
|
new |
new |
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Align Connect (HMO C-SNP)
| $0.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3274 -003 -0 | $2.00 | $15.00 | $45.00 | $45.00 | 3,833
2023 Formulary |
|
new |
new |
|
-- This plan not offered in 2024 --
|
| | | | |
|