There are 95 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 (Regional PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
R0759 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 AARP Medicare Advantage Patriot No Rx FL-MA01 (Regional PPO)
| $0.00 |
$7,500 |
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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H5521 -347 -0 | | | | | |
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2024 Aetna Medicare Eagle (PPO)
| $0.00 |
$5,000 |
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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H5434 -044 -0 | | | | | |
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2024 BlueMedicare Patriot (PPO)
| $0.00 |
$5,500 |
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 CareSalute (HMO-POS)
| $0.00 |
$4,900 |
No Rx Coverage |
H1019 -143 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 CareSalute (HMO-POS)
| $0.00 |
$4,900 |
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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H5410 -058 -0 | | | | | |
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2024 Cigna Courage Medicare (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Freedom Savings Plan (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H5427 -052 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Freedom Savings Plan (HMO)
| $0.00 |
$3,400 |
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 Health First Secure Plan (HMO)
| $0.00 |
$3,000 |
No Rx Coverage |
H1099 -009 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Health First Secure Plan (HMO)
| $0.00 |
$3,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 AARP Medicare Advantage (HMO-POS)
| $0.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H1045 -028 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC FL-0006 (HMO-POS)
| $0.00 |
$3,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $45.00 | $45.00 | 3,634 2024 Formulary |
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2023 AARP Medicare Advantage Focus (HMO-POS)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H1045 -036 -0 | $0.00 | $6.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC FL-001P (HMO-POS)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $6.00 | $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 |
2023 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. |
H2406 -017 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC FL-0025 (PPO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,634 2024 Formulary |
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2023 AARP Medicare Advantage Choice Plan 2 (Regional PPO)
| $0.00 |
$6,700 |
$195 | Yes, some additional gap coverage. |
R0759 -001 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC FL-0031 (Regional PPO)
| $0.00 |
$7,900 |
$395 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
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2023 Advantage Care by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H2962 -033 -0 | $0.00 | $20.00 | $70.00 | $70.00 | 3,806
2023 Formulary |
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2024 Advantage Care by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $20.00 | $70.00 | $70.00 | 3,782 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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H2962 -023 -0 | | | | | |
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2024 Advantage Care COPD by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $20.00 | $60.00 | $60.00 | 3,782 2024 Formulary |
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-- This plan not offered in 2023 --
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H5521 -432 -0 | | | | | |
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2024 Aetna Medicare Explorer Premier (PPO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
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2023 Aetna Medicare Premier (PPO)
| $0.00 |
$6,700 |
$300 | Yes, some additional gap coverage. |
H5521 -033 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
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2024 Aetna Medicare Premier (PPO)
| $0.00 |
$6,700 |
$300 | 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 Aetna Medicare Premier Plus (PPO)
| $0.00 |
$4,500 |
$150 | Yes, some additional gap coverage. |
H5521 -273 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
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2024 Aetna Medicare Premier (PPO)
| $0.00 |
$4,700 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
|
2023 Aetna Medicare Select (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1609 -063 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,622
2023 Formulary |
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2024 Aetna Medicare Select (HMO)
| $0.00 |
$2,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,658 2024 Formulary |
|
2023 BlueMedicare Value (PPO)
| $0.00 |
$3,651 |
$150 | Yes, some additional gap coverage. |
H5434 -026 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 2,939
2023 Formulary |
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2024 BlueMedicare Value (PPO)
| $0.00 |
$3,851 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 2,997 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 CareBreeze Platinum (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H1019 -117 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,404
2023 Formulary |
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2024 CareBreeze Platinum (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,448 2024 Formulary |
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2023 CareComplete Platinum (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H1019 -108 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,404
2023 Formulary |
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2024 CareComplete Platinum (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,448 2024 Formulary |
|
2023 CareFree (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1019 -134 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,404
2023 Formulary |
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2024 CareFree (HMO)
| $0.00 |
$3,850 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $25.00 | $25.00 | 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 CareFree Platinum (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1019 -139 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,404
2023 Formulary |
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2024 CareFree Platinum (HMO)
| $0.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,448 2024 Formulary |
|
2023 CareOne Platinum (HMO-POS)
| $0.00 |
$3,750 |
$0 | Yes, some additional gap coverage. |
H1019 -110 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,404
2023 Formulary |
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2024 CareOne Platinum (HMO-POS)
| $0.00 |
$3,750 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $30.00 | $30.00 | 3,448 2024 Formulary |
|
2023 CareOne Plus (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1019 -043 -0 | $0.00 | $5.00 | $25.00 | $25.00 | 3,404
2023 Formulary |
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2024 CareOne Plus (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $25.00 | $25.00 | 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 Cigna Preferred Medicare (HMO)
| $0.00 |
$3,600 |
$0 | Yes, some additional gap coverage. |
H5410 -037 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,524
2023 Formulary |
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2024 Cigna Preferred Medicare (HMO)
| $0.00 |
$3,250 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,535 2024 Formulary |
|
2023 Cigna Preferred Savings Medicare (HMO)
| $0.00 |
$3,700 |
$0 | Yes, some additional gap coverage. |
H5410 -040 -0 | $0.00 | $0.00 | $42.00 | $42.00 | 3,524
2023 Formulary |
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2024 Cigna Preferred Savings Medicare (HMO)
| $0.00 |
$3,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $45.00 | $45.00 | 3,535 2024 Formulary |
|
2023 Cigna True Choice Medicare (PPO)
| $0.00 |
$4,600 |
$150 | Yes, some additional gap coverage. |
H7849 -014 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,524
2023 Formulary |
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2024 Cigna True Choice Medicare (PPO)
| $0.00 |
$4,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $45.00 | $45.00 | 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 Devoted CHOICE East Coast Florida (PPO)
| $0.00 |
$5,900 |
$150 | Yes, some additional gap coverage. |
H9884 -008 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,364
2023 Formulary |
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new |
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2024 Devoted CHOICE GIVEBACK East Coast Florida (PPO)
| $0.00 |
$4,850 |
$350 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,391 2024 Formulary |
|
2023 Devoted CORE East Coast Florida (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1290 -046 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,364
2023 Formulary |
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2024 Devoted CORE East Coast Florida (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,391 2024 Formulary |
|
2023 Devoted ESSENTIALS East Coast Florida (HMO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H1290 -045 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 3,364
2023 Formulary |
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2024 Devoted ESSENTIALS East Coast Florida (HMO)
| $0.00 |
$4,900 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,391 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 Freedom Platinum Plan Rx (HMO)
| $0.00 |
$1,750 |
$0 | Yes, some additional gap coverage. |
H5427 -088 -0 | $0.00 | $30.00 | $75.00 | $75.00 | 3,308
2023 Formulary |
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2024 Freedom Platinum Plan Rx (HMO)
| $0.00 |
$1,750 |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $75.00 | $75.00 | 3,309 2024 Formulary |
|
2023 Freedom Platinum Rewards Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5427 -106 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 3,308
2023 Formulary |
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2024 Freedom Platinum Rewards Plan Rx (HMO)
| $0.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $30.00 | $80.00 | $80.00 | 3,309 2024 Formulary |
|
2023 Freedom VIP Rewards (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5427 -108 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 3,308
2023 Formulary |
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2024 Freedom VIP Rewards (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | 3,310 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 Freedom VIP Savings (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5427 -082 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 3,308
2023 Formulary |
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|
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2024 Freedom VIP Savings (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | 3,310 2024 Formulary |
|
2023 Freedom VIP Savings COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H5427 -083 -0 | $0.00 | $30.00 | $80.00 | $80.00 | 3,308
2023 Formulary |
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|
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2024 Freedom VIP Savings COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $30.00 | $80.00 | $80.00 | 3,309 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H1099 -014 -0 | | | | | |
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2024 Health First Rewards Plan (HMO)
| $0.00 |
$4,200 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,437 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 - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1036 -292 -0 | $0.00 | $5.00 | $35.00 | $35.00 | 3,404
2023 Formulary |
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2024 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $35.00 | $35.00 | 3,448 2024 Formulary |
|
2023 Humana Gold Plus H1036-229 (HMO)
| $0.00 |
$1,950 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1036 -229 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,404
2023 Formulary |
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2024 Humana Gold Plus H1036-229 (HMO)
| $0.00 |
$2,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $30.00 | $30.00 | 3,448 2024 Formulary |
|
2023 Humana Gold Plus H1036-286 (HMO)
| $0.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1036 -286 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,404
2023 Formulary |
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|
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2024 Humana Gold Plus H1036-286 (HMO)
| $0.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $45.00 | $45.00 | 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 Lung (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1036 -298 -0 | $0.00 | $5.00 | $35.00 | $35.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus Lung (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $35.00 | $35.00 | 3,448 2024 Formulary |
|
2023 Humana Honor (PPO)
| $0.00 |
$4,900 |
No Rx Coverage |
H5216 -256 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Humana USAA Honor (PPO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 HumanaChoice Florida H5216-062 (PPO)
| $0.00 |
$3,350 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H5216 -062 -0 | $0.00 | $5.00 | $30.00 | $30.00 | 3,404
2023 Formulary |
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|
|
2024 HumanaChoice Florida H5216-062 (PPO)
| $0.00 |
$3,350 |
$150 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $30.00 | $30.00 | 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 HumanaChoice Florida H5216-311 (PPO)
| $0.00 |
$4,850 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H5216 -311 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice Florida H5216-311 (PPO)
| $0.00 |
$4,850 |
$350 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Optimum Diamond Rewards (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5594 -034 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 3,308
2023 Formulary |
|
|
|
|
2024 Optimum Diamond Rewards (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $35.00 | $85.00 | $85.00 | 3,309 2024 Formulary |
|
2023 Optimum Diamond Rewards COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5594 -035 -0 | $0.00 | $35.00 | $85.00 | $85.00 | 3,308
2023 Formulary |
|
|
|
|
2024 Optimum Diamond Rewards COPD (HMO C-SNP)
| $0.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $35.00 | $85.00 | $85.00 | 3,309 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 --
|
H2962 -001 -0 | | | | | |
|
|
|
|
2024 Premier by Ultimate (HMO)
| $0.00 |
$1,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $60.00 | $60.00 | 3,782 2024 Formulary |
|
2023 Simply Freedom (PPO)
| $0.00 |
$4,500 |
$150 | Yes, some additional gap coverage. |
H9469 -002 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,927
2023 Formulary |
|
new |
new |
|
2024 Simply Freedom (PPO)
| $0.00 |
$4,500 |
$150 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,889 2024 Formulary |
|
2023 Wellcare Giveback (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H1032 -193 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,393
2023 Formulary |
|
|
|
|
2024 Wellcare Giveback (HMO)
| $0.00 |
$5,000 |
$545 | Yes, some additional gap coverage. | $0.00 | $10.00 | $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 |
2023 Wellcare No Premium (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H1032 -194 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,393
2023 Formulary |
|
|
|
|
2024 Wellcare No Premium (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,372 2024 Formulary |
|
2023 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$150 | Yes, some additional gap coverage. |
H5199 -008 -0 | $0.00 | $0.00 | $37.00 | $37.00 | 3,393
2023 Formulary |
|
|
|
|
2024 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$450 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,372 2024 Formulary |
|
2023 Devoted DUAL East Coast Florida (HMO D-SNP)
| $31.70 |
n/a |
$505 | Yes, some additional gap coverage. |
H1290 -039 -0 | 25% | 25% | 25% | 25% | 3,364
2023 Formulary |
|
|
|
|
2024 Devoted DUAL East Coast Florida (HMO D-SNP)
| $16.10 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,391 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 --
|
H1290 -052 -0 | | | | | |
|
|
|
|
2024 Devoted DUAL PLUS Florida (HMO D-SNP)
| $16.20 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,391 2024 Formulary |
|
2023 Freedom Medi-Medi Full (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5427 -087 -0 | $15.00 | $45.00 | $95.00 | $95.00 | 3,308
2023 Formulary |
|
|
|
|
2024 Freedom Medi-Medi Full (HMO D-SNP)
| $16.80 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $45.00 | $95.00 | $95.00 | 3,309 2024 Formulary |
|
2023 Optimum Emerald Partial (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5594 -016 -0 | $15.00 | $45.00 | $95.00 | $95.00 | 3,308
2023 Formulary |
|
|
|
|
2024 Optimum Emerald Partial (HMO D-SNP)
| $24.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $45.00 | $95.00 | $95.00 | 3,309 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 Florida H7284-007 (PPO)
| $10.00 |
$3,400 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H7284 -007 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice Florida H7284-007 (PPO)
| $25.00 |
$3,400 |
$150 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $30.00 | $30.00 | 3,448 2024 Formulary |
|
2023 Optimum Emerald Full (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5594 -017 -0 | $15.00 | $45.00 | $95.00 | $95.00 | 3,308
2023 Formulary |
|
|
|
|
2024 Optimum Emerald Full (HMO D-SNP)
| $25.30 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $45.00 | $95.00 | $95.00 | 3,309 2024 Formulary |
|
2023 Wellcare Dual Access Open (PPO D-SNP)
| $18.60 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5199 -016 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
2024 Wellcare Dual Access Open (PPO D-SNP)
| $25.50 |
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 Freedom Medi-Medi Partial (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5427 -078 -0 | $15.00 | $45.00 | $95.00 | $95.00 | 3,308
2023 Formulary |
|
|
|
|
2024 Freedom Medi-Medi Partial (HMO D-SNP)
| $25.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $45.00 | $95.00 | $95.00 | 3,309 2024 Formulary |
|
2023 Cigna TotalCare (HMO D-SNP)
| $20.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5410 -055 -0 | | | | | 3,524
2023 Formulary |
|
|
|
|
2024 Cigna TotalCare (HMO D-SNP)
| $27.60 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,535 2024 Formulary |
|
2023 Cigna TotalCare Plus (HMO D-SNP)
| $20.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5410 -047 -0 | | | | | 3,524
2023 Formulary |
|
|
|
|
2024 Cigna TotalCare Plus (HMO D-SNP)
| $27.60 |
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 CareNeeds Plus (HMO D-SNP)
| $17.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1019 -073 -0 | $7.00 | $15.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 CareNeeds Plus (HMO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
2023 Advantage Plus by Ultimate (Full) (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H2962 -035 -0 | 25% | 25% | 25% | 25% | 3,806
2023 Formulary |
|
|
|
|
2024 Advantage Plus by Ultimate (Full) (HMO D-SNP)
| $29.30 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,782 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H1099 -006 -0 | | | | | |
|
|
|
|
2024 Health First Value Plan (HMO)
| $31.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,437 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 R5826-074 (Regional PPO)
| $4.00 |
$7,550 |
$395 | No additional gap coverage, only the Donut Hole Discount |
R5826 -074 -0 | $6.00 | $20.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice R5826-074 (Regional PPO)
| $31.00 |
$7,550 |
$395 | No additional gap coverage, only the Donut Hole Discount | $6.00 | $20.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 UnitedHealthcare Nursing Home Plan (PPO I-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0710 -010 -0 | | | | | 3,682
2023 Formulary |
|
-- |
|
|
2024 UHC Nursing Home Plan FL-F001 (PPO I-SNP)
| $32.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H1019 -146 -0 | | | | | |
|
|
|
|
2024 CareNeeds Platinum (HMO D-SNP)
| $32.50 |
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 Advantage Plus by Ultimate (Partial) (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H2962 -036 -0 | 25% | 25% | 25% | 25% | 3,806
2023 Formulary |
|
|
|
|
2024 Advantage Plus by Ultimate (Partial) (HMO D-SNP)
| $32.60 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | 25% | 25% | 25% | 25% | 3,782 2024 Formulary |
|
2023 Wellcare Dual Access (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1032 -124 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
2024 Wellcare All Dual (HMO D-SNP)
| $34.10 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
|
2023 Aetna Medicare Assure Plus (HMO D-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1609 -062 -0 | $10.00 | $15.00 | 25% | 25% | 3,622
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Assure Plus (HMO D-SNP)
| $34.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | 25% | 25% | 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 Wellcare Dual Liberty (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1032 -175 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
2024 Wellcare Dual Liberty (HMO D-SNP)
| $37.60 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H9986 -001 -0 | | | | | |
|
new |
|
|
2024 Florida Complete Care (HMO I-SNP)
| $37.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,291 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H9986 -003 -0 | | | | | |
|
new |
|
|
2024 Florida Complete Care- D-SNP (HMO D-SNP)
| $37.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,291 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 --
|
H9986 -002 -0 | | | | | |
|
new |
|
|
2024 Florida Complete Care- In The Community (HMO I-SNP)
| $37.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,291 2024 Formulary |
|
2023 Humana Gold Plus SNP-DE H1036-226 (HMO D-SNP)
| $24.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1036 -226 -0 | $6.00 | $20.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus SNP-DE H1036-226 (HMO D-SNP)
| $37.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
2023 HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H7284 -010 -0 | | | | | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice Florida SNP-DE H7284-010 (PPO D-SNP)
| $37.70 |
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 Longevity Health Plan (HMO I-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1644 -001 -0 | | | | | 3,970
2023 Formulary |
|
-- |
|
|
2024 Longevity Health Plan (HMO I-SNP)
| $37.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 4,149 2024 Formulary |
|
2023 UnitedHealthcare Assisted Living Plan (PPO I-SNP)
| $35.90 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount |
H0710 -012 -0 | $2.00 | $12.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
|
-- |
|
|
2024 UHC Care Advantage FL-E001 (PPO I-SNP)
| $37.70 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
2023 UnitedHealthcare Dual Complete LP (HMO-POS D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1045 -039 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete FL-D002 (HMO-POS D-SNP)
| $37.70 |
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)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1889 -002 -1 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete FL-D003 (PPO D-SNP)
| $37.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
2023 UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
R0759 -003 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete FL-D005 (Regional PPO D-SNP)
| $37.70 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H1032 -202 -0 | | | | | |
|
|
|
|
2024 Wellcare Dual Reserve (HMO D-SNP)
| $37.70 |
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 Freedom Platinum Plus Plan Rx (HMO)
| $50.00 |
$1,500 |
$0 | Yes, some additional gap coverage. |
H5427 -109 -0 | $0.00 | $25.00 | $70.00 | $70.00 | 3,308
2023 Formulary |
|
|
|
|
2024 Freedom Platinum Plus Plan Rx (HMO)
| $43.00 |
$1,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $25.00 | $70.00 | $70.00 | 3,309 2024 Formulary |
|
2023 HumanaChoice R5826-018 (Regional PPO)
| $0.00 |
$7,550 |
No Rx Coverage |
R5826 -018 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 HumanaChoice R5826-018 (Regional PPO)
| $59.00 |
$7,550 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 BlueMedicare Choice (Regional PPO)
| $49.90 |
$6,500 |
$250 | Yes, some additional gap coverage. |
R3332 -001 -0 | $0.00 | $10.00 | $40.00 | $40.00 | 3,534
2023 Formulary |
|
|
|
|
2024 BlueMedicare Choice (Regional PPO)
| $67.40 |
$6,500 |
$250 | Yes, some additional gap coverage. | $0.00 | $10.00 | $40.00 | $40.00 | 2,997 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 Premium Enhanced Open (PPO)
| $99.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H5199 -010 -0 | $0.00 | $0.00 | $37.00 | $37.00 | 3,393
2023 Formulary |
|
|
|
|
2024 Wellcare Premium Enhanced Open (PPO)
| $93.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,372 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H1099 -001 -0 | | | | | |
|
|
|
|
2024 Health First Classic Plan (HMO-POS)
| $95.00 |
$3,250 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,437 2024 Formulary |
|
2023 HumanaChoice R5826-005 (Regional PPO)
| $111.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount |
R5826 -005 -0 | $5.00 | $15.00 | $45.00 | $45.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice R5826-005 (Regional PPO)
| $173.00 |
$6,700 |
$100 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $15.00 | $45.00 | $45.00 | 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 Advantage Care COPD by Ultimate (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H2962 -034 -0 | $0.00 | $20.00 | $60.00 | $60.00 | 3,806
2023 Formulary |
|
|
|
|
-- Members will be assigned to Advantage Care COPD by Ultimate (HMO C-SNP) H2962-023 --
| | | | | |
|
2023 CareBreeze (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H1019 -126 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,404
2023 Formulary |
|
|
|
|
-- Members will be assigned to CareBreeze Platinum (HMO C-SNP) H1019-117 --
| | | | | |
|
2023 CareComplete (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H1019 -129 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,404
2023 Formulary |
|
|
|
|
-- Members will be assigned to CareComplete Platinum (HMO C-SNP) H1019-108 --
| | | | | |
|
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 Premier by Ultimate (HMO)
| $0.00 |
$2,000 |
$0 | Yes, some additional gap coverage. |
H2962 -031 -0 | $0.00 | $25.00 | $65.00 | $65.00 | 3,806
2023 Formulary |
|
|
|
|
-- Members will be assigned to Premier by Ultimate (HMO) H2962-001 --
| | | | | |
|
2023 Premier Plus by Ultimate (HMO)
| $0.00 |
$1,200 |
$0 | Yes, some additional gap coverage. |
H2962 -032 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,806
2023 Formulary |
|
|
|
|
-- Members will be assigned to Premier by Ultimate (HMO) H2962-001 --
| | | | | |
|
2023 Wellcare Dual Select (HMO D-SNP)
| $35.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1032 -182 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Dual Reserve (HMO D-SNP) H1032-202 --
| | | | | |
|
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 (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 --
|
| | | | |
|
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 --
|
| | | | |
|