There are 103 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 |
$5,500 |
No Rx Coverage |
H4527 -024 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 AARP Medicare Advantage Patriot No Rx TX-MA01 (HMO-POS)
| $0.00 |
$5,500 |
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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H1278 -027 -0 | | | | | |
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2024 AARP Medicare Advantage Patriot No Rx TX-MA05 (PPO)
| $0.00 |
$6,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Aetna Medicare Eagle II (PPO)
| $0.00 |
$5,000 |
No Rx Coverage |
H2293 -015 -0 | This plan does NOT include Prescription Drug coverage. | |
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new |
new |
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2024 Aetna Medicare Eagle II (PPO)
| $0.00 |
$5,000 |
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 Blue Cross Medicare Advantage Protect (PPO)
| $0.00 |
$5,000 |
No Rx Coverage |
H4801 -019 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Blue Cross Medicare Advantage Protect (PPO)
| $0.00 |
$6,350 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Cigna Courage Medicare (HMO)
| $0.00 |
$4,300 |
No Rx Coverage |
H4513 -009 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Cigna Courage Medicare (HMO)
| $0.00 |
$4,300 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Humana Honor (PPO)
| $0.00 |
$5,400 |
No Rx Coverage |
H5216 -128 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Humana USAA Honor (PPO)
| $0.00 |
$5,400 |
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 Humana Honor (PPO)
| $0.00 |
$6,900 |
No Rx Coverage |
H5216 -348 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Humana USAA Honor (PPO)
| $0.00 |
$6,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 HumanaChoice R4182-001 (Regional PPO)
| $0.00 |
$5,700 |
No Rx Coverage |
R4182 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 HumanaChoice R4182-001 (Regional PPO)
| $0.00 |
$5,100 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Memorial Hermann Prime Value MA Only (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H7115 -006 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Memorial Hermann Prime Value MA Only (HMO)
| $0.00 |
$2,950 |
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 Wellcare TexanPlus Patriot Giveback (HMO)
| $0.00 |
$3,000 |
No Rx Coverage |
H4506 -010 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Wellcare TexanPlus Patriot Giveback (HMO)
| $0.00 |
$3,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 AARP Medicare Advantage Choice (PPO)
| $0.00 |
$6,700 |
$245 | Yes, some additional gap coverage. |
H1278 -014 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC TX-0006 (PPO)
| $0.00 |
$6,700 |
$245 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
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2023 AARP Medicare Advantage Plan 2 (HMO-POS)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H4514 -007 -0 | $0.00 | $14.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC TX-0009 (HMO-POS)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $14.00 | $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 Plan 1 (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H4527 -037 -0 | $0.00 | $12.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC TX-0015 (HMO-POS)
| $0.00 |
$3,800 |
$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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H4514 -014 -0 | | | | | |
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2024 AARP Medicare Advantage from UHC TX-001P (HMO-POS)
| $0.00 |
$3,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
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-- This plan not offered in 2023 --
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H1278 -021 -0 | | | | | |
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2024 AARP Medicare Advantage from UHC TX-0031 (PPO)
| $0.00 |
$7,900 |
$350 | Yes, some additional gap coverage. | $0.00 | $14.00 | $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 Aetna Medicare Choice Plan (PPO)
| $0.00 |
$7,550 |
$300 | Yes, some additional gap coverage. |
H3288 -006 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
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2024 Aetna Medicare Choice Plan (PPO)
| $0.00 |
$5,900 |
$250 | Yes, some additional gap coverage. | $0.00 | $10.00 | 20% | 20% | 3,619 2024 Formulary |
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2023 Aetna Medicare Freedom Plan (PPO)
| $0.00 |
$5,900 |
$200 | Yes, some additional gap coverage. |
H2293 -016 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
|
new |
new |
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2024 Aetna Medicare Freedom Plan (PPO)
| $0.00 |
$5,900 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
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2023 Aetna Medicare Premier Plan (HMO)
| $0.00 |
$6,700 |
$200 | Yes, some additional gap coverage. |
H4523 -015 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
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2024 Aetna Medicare Premier Plan (HMO)
| $0.00 |
$6,350 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $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 Select Plan (HMO)
| $0.00 |
$3,900 |
$150 | Yes, some additional gap coverage. |
H8332 -003 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
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2024 Aetna Medicare Select Plan (HMO)
| $0.00 |
$3,850 |
$150 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
|
2023 Blue Cross Medicare Advantage Basic (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H8133 -001 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,503
2023 Formulary |
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2024 Blue Cross Medicare Advantage Basic (HMO)
| $0.00 |
$3,850 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,543 2024 Formulary |
|
2023 Blue Cross Medicare Advantage Choice Plus (PPO)
| $0.00 |
$6,700 |
$505 | Yes, some additional gap coverage. |
H1666 -006 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,503
2023 Formulary |
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2024 Blue Cross Medicare Advantage Choice Plus (PPO)
| $0.00 |
$7,950 |
$545 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,543 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 Blue Cross Medicare Advantage Classic (PPO)
| $0.00 |
$6,500 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H4801 -002 -0 | $0.00 | $5.00 | $44.00 | $44.00 | 3,177
2023 Formulary |
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|
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2024 Blue Cross Medicare Advantage Classic (PPO)
| $0.00 |
$5,900 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,200 2024 Formulary |
|
2023 Blue Cross Medicare Advantage Dental Premier (PPO)
| $0.00 |
$6,500 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H4801 -016 -0 | $0.00 | $5.00 | $44.00 | $44.00 | 3,177
2023 Formulary |
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2024 Blue Cross Medicare Advantage Dental Premier (PPO)
| $0.00 |
$6,700 |
$545 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,200 2024 Formulary |
|
2023 Blue Cross Medicare Advantage Health Choice (PPO)
| $0.00 |
$6,900 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H4801 -018 -0 | $0.00 | $5.00 | $44.00 | $44.00 | 3,177
2023 Formulary |
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|
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2024 Blue Cross Medicare Advantage Health Choice (PPO)
| $0.00 |
$6,900 |
$545 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,200 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 Alliance Medicare (HMO)
| $0.00 |
$2,600 |
$0 | Yes, some additional gap coverage. |
H4513 -064 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,524
2023 Formulary |
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|
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2024 Cigna Alliance Medicare (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $4.00 | $45.00 | $45.00 | 3,535 2024 Formulary |
|
2023 Cigna Preferred Medicare (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H4513 -061 -1 | $0.00 | $4.00 | $42.00 | $42.00 | 3,524
2023 Formulary |
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|
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2024 Cigna Preferred Medicare (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $4.00 | $45.00 | $45.00 | 3,535 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H4513 -083 -1 | | | | | |
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2024 Cigna Preferred Savings Medicare (HMO)
| $0.00 |
$6,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $4.00 | $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 Cigna True Choice Medicare (PPO)
| $0.00 |
$6,100 |
$0 | Yes, some additional gap coverage. |
H7849 -038 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,524
2023 Formulary |
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2024 Cigna True Choice Medicare (PPO)
| $0.00 |
$6,100 |
$0 | Yes, some additional gap coverage. | $0.00 | $4.00 | $45.00 | $45.00 | 3,535 2024 Formulary |
|
2023 Devoted CORE Greater Houston (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H7993 -001 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 3,364
2023 Formulary |
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2024 Devoted CORE Greater Houston (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 3,391 2024 Formulary |
|
2023 Devoted GIVEBACK Greater Houston (HMO)
| $0.00 |
$6,900 |
$300 | Yes, some additional gap coverage. |
H7993 -006 -0 | $0.00 | $7.00 | $47.00 | $47.00 | 3,364
2023 Formulary |
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2024 Devoted GIVEBACK Greater Houston (HMO)
| $0.00 |
$6,900 |
$395 | Yes, some additional gap coverage. | $0.00 | $7.00 | $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 Humana Gold Plus H0028-042 (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. |
H0028 -042 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
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|
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2024 Humana Gold Plus H0028-042 (HMO)
| $0.00 |
$3,450 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 HumanaChoice H5216-043 (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5216 -043 -6 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
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|
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2024 HumanaChoice H5216-043 (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 KelseyCare Advantage Gold (HMO)
| $0.00 |
$3,450 |
$100 | Yes, some additional gap coverage. |
H0332 -002 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 3,361
2023 Formulary |
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|
|
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2024 KelseyCare Advantage Classic (HMO)
| $0.00 |
$3,450 |
$100 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 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 |
2023 KelseyCare Advantage Gold Freedom (HMO-POS)
| $0.00 |
$3,450 |
$100 | Yes, some additional gap coverage. |
H0332 -004 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 3,361
2023 Formulary |
|
|
|
|
2024 KelseyCare Advantage Freedom (HMO-POS)
| $0.00 |
$3,450 |
$100 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 3,392 2024 Formulary |
|
2023 KelseyCare Advantage Silver (HMO)
| $0.00 |
$3,450 |
No Rx Coverage |
H0332 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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|
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2024 KelseyCare Advantage Honor (HMO)
| $0.00 |
$3,850 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2023 --
|
H0332 -010 -0 | | | | | |
|
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|
|
2024 KelseyCare Advantage Secure (HMO)
| $0.00 |
$3,850 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 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 |
2023 KelseyCare Advantage Platinum (HMO)
| $0.00 |
$3,450 |
$100 | Yes, some additional gap coverage. |
H0332 -009 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 3,361
2023 Formulary |
|
|
|
|
2024 KelseyCare Advantage Signature (HMO)
| $0.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 3,392 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H0332 -011 -0 | | | | | |
|
|
|
|
2024 KelseyCare Advantage Thrive (HMO-POS)
| $0.00 |
$6,000 |
$100 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,392 2024 Formulary |
|
2023 Memorial Hermann Advantage (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H7115 -001 -0 | $0.00 | $5.00 | $39.00 | $39.00 | 3,833
2023 Formulary |
|
|
|
|
2024 Memorial Hermann Advantage (HMO)
| $0.00 |
$2,950 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,677 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 |
H7678 -004 -0 | $3.00 | $12.00 | $47.00 | $47.00 | 3,221
2023 Formulary |
|
|
|
|
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 |
|
2023 Molina Medicare Choice Care Select (HMO)
| $0.00 |
$8,300 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H7678 -005 -0 | $15.00 | $20.00 | $47.00 | $47.00 | 3,221
2023 Formulary |
|
|
|
|
2024 Molina Medicare Choice Care Select (HMO)
| $0.00 |
$8,300 |
$200 | No additional gap coverage, only the Donut Hole Discount | $15.00 | $20.00 | $47.00 | $47.00 | 3,248 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H4514 -015 -0 | | | | | |
|
|
|
|
2024 UHC Complete Care TX-002P (HMO-POS C-SNP)
| $0.00 |
n/a |
$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 |
-- This plan not offered in 2023 --
|
H5163 -001 -0 | | | | | |
new |
new |
new |
|
2024 Verda Noble Care (HMO)
| $0.00 |
$1,899 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $35.00 | $35.00 | 3,332 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H5163 -002 -0 | | | | | |
new |
new |
new |
|
2024 Verda Noble Chronic Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $32.00 | $32.00 | 3,582 2024 Formulary |
|
2023 Wellcare Giveback (HMO)
| $0.00 |
$7,550 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H0174 -019 -0 | $0.00 | $5.00 | $20.00 | $20.00 | 3,392
2023 Formulary |
|
|
|
|
2024 Wellcare Giveback (HMO)
| $0.00 |
$8,850 |
$545 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $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 |
$6,400 |
$200 | Yes, some additional gap coverage. |
H7323 -003 -0 | $0.00 | $3.00 | $25.00 | $25.00 | 3,393
2023 Formulary |
|
|
|
|
2024 Wellcare Mutual of Omaha No Premium Open (PPO)
| $0.00 |
$6,700 |
$200 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,372 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H7323 -012 -0 | | | | | |
|
|
|
|
2024 Wellcare Mutual of Omaha No Premium Secure Open (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $42.00 | $42.00 | 3,372 2024 Formulary |
|
2023 Wellcare No Premium (HMO)
| $0.00 |
$3,300 |
$0 | Yes, some additional gap coverage. |
H0174 -010 -0 | $0.00 | $0.00 | $20.00 | $20.00 | 3,393
2023 Formulary |
|
|
|
|
2024 Wellcare No Premium (HMO)
| $0.00 |
$3,700 |
$275 | Yes, some additional gap coverage. | $0.00 | $5.00 | $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 Rx Plus Open (PPO)
| $0.00 |
$6,000 |
$300 | No additional gap coverage, only the Donut Hole Discount |
H7323 -006 -0 | $0.00 | $0.00 | $35.00 | $35.00 | 3,392
2023 Formulary |
|
|
|
|
2024 Wellcare No Premium Rx Plus Open (PPO)
| $0.00 |
$6,000 |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $0.00 | $42.00 | $42.00 | 3,371 2024 Formulary |
|
2023 Wellcare TexanPlus Classic No Premium (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4506 -003 -0 | $0.00 | $0.00 | $25.00 | $25.00 | 3,393
2023 Formulary |
|
|
|
|
2024 Wellcare TexanPlus Classic No Premium (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,372 2024 Formulary |
|
2023 Wellcare TexanPlus No Premium (HMO-POS)
| $0.00 |
$3,400 |
$250 | Yes, some additional gap coverage. |
H4506 -029 -0 | $0.00 | $0.00 | $30.00 | $30.00 | 3,393
2023 Formulary |
|
|
|
|
2024 Wellcare TexanPlus No Premium (HMO-POS)
| $0.00 |
$3,400 |
$250 | Yes, some additional gap coverage. | $0.00 | $0.00 | $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 Amerivantage ESRD Care Plus (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H2593 -043 -0 | $5.00 | $12.00 | $42.00 | $42.00 | 3,579
2023 Formulary |
|
-- |
|
|
2024 Wellpoint Kidney Care (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $5.00 | $12.00 | $42.00 | $42.00 | 3,562 2024 Formulary |
|
2023 Amerivantage Classic (HMO)
| $0.00 |
$8,300 |
$0 | Yes, some additional gap coverage. |
H2593 -029 -0 | $3.00 | $10.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
-- |
|
|
2024 Wellpoint Medicare Advantage 2 (HMO)
| $0.00 |
$8,300 |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $42.00 | $42.00 | 3,581 2024 Formulary |
|
2023 Amerivantage Select Plus (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H8849 -009 -0 | $3.00 | $10.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Wellpoint Select (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $3.00 | $10.00 | $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 UnitedHealthcare Medicare Silver (Regional PPO C-SNP)
| $8.90 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
R6801 -008 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Complete Care TX-001A (Regional PPO C-SNP)
| $10.00 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
2023 Cigna TotalCare (HMO D-SNP)
| $7.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H4513 -060 -1 | | | | | 3,524
2023 Formulary |
|
|
|
|
2024 Cigna TotalCare (HMO D-SNP)
| $11.00 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,535 2024 Formulary |
|
2023 Devoted PRIME Greater Houston (HMO)
| $25.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H7993 -002 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 3,364
2023 Formulary |
|
|
|
|
2024 Devoted PRIME Greater Houston (HMO)
| $15.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $40.00 | $40.00 | 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 |
-- This plan not offered in 2023 --
|
H0174 -022 -0 | | | | | |
|
|
|
|
2024 Wellcare All Dual Assure (HMO D-SNP)
| $16.80 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
|
2023 Aetna Medicare Choice II Plan (PPO)
| $18.00 |
$7,550 |
$300 | Yes, some additional gap coverage. |
H3288 -018 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Value Plus (PPO)
| $18.70 |
$5,900 |
$300 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
|
2023 Amerivantage Dual Coordination (HMO D-SNP)
| $18.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H2593 -032 -0 | $15.00 | $20.00 | $47.00 | $47.00 | 3,603
2023 Formulary |
|
-- |
|
|
2024 Wellpoint Dual Advantage 2 (HMO D-SNP)
| $21.10 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 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 Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)
| $22.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H9706 -002 -0 | | | | | 3,488
2023 Formulary |
|
|
|
|
2024 Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)
| $21.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,538 2024 Formulary |
|
2023 UnitedHealthcare Medicare Gold (Regional PPO C-SNP)
| $27.00 |
n/a |
$295 | Yes, some additional gap coverage. |
R6801 -009 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Complete Care TX-0029 (Regional PPO C-SNP)
| $22.00 |
n/a |
$295 | Yes, some additional gap coverage. | $4.00 | $12.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
2023 Wellcare Assist (HMO)
| $11.90 |
$3,450 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0174 -009 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,392
2023 Formulary |
|
|
|
|
2024 Wellcare Assist (HMO)
| $22.40 |
$3,450 |
$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 Wellcare Dual Liberty (HMO D-SNP)
| $21.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0174 -006 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
2024 Wellcare Dual Liberty (HMO D-SNP)
| $26.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H2593 -048 -0 | | | | | |
|
-- |
|
|
2024 Wellpoint Full Dual Advantage 2 (HMO D-SNP)
| $27.30 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,581 2024 Formulary |
|
2023 Wellcare Dual Access (HMO D-SNP)
| $23.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0174 -004 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
2024 Wellcare Dual Access (HMO D-SNP)
| $27.70 |
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 Aetna Medicare Dual Complete Plan (HMO D-SNP)
| $19.80 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H8597 -003 -0 | | | | | 3,597
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Dual Complete Plan (HMO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,633 2024 Formulary |
|
2023 American Health Advantage of Texas (HMO I-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H6891 -001 -0 | | | | | 3,478
2023 Formulary |
|
-- |
|
|
2024 American Health Advantage of Texas (HMO I-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,481 2024 Formulary |
|
2023 Community Health Choice (HMO D-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H9826 -002 -2 | | | | | 3,665
2023 Formulary |
|
-- |
|
|
2024 Community Health Choice (HMO D-SNP)
| $28.40 |
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 Humana Gold Plus SNP-DE H0028-031 (HMO D-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0028 -031 -0 | | | | | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus SNP-DE H0028-031 (HMO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
2023 Humana Gold Plus SNP-DE H0028-033 (HMO D-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0028 -033 -0 | | | | | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus SNP-DE H0028-033 (HMO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H0028 -064 -0 | | | | | |
|
|
|
|
2024 Humana Gold Plus SNP-DE H0028-064 (HMO D-SNP)
| $28.40 |
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 Memorial Hermann Dual Advantage (HMO D-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H7115 -005 -0 | | | | | 3,833
2023 Formulary |
|
|
|
|
2024 Memorial Hermann Dual Advantage (HMO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,677 2024 Formulary |
|
2023 Molina Medicare Complete Care (HMO D-SNP)
| $25.00 |
n/a |
$505 | Yes, some additional gap coverage. |
H7678 -001 -0 | $0.00 | $5.00 | $42.00 | $42.00 | 3,270
2023 Formulary |
|
|
|
|
2024 Molina Medicare Complete Care (HMO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,303 2024 Formulary |
|
2023 Texas Independence Health Plan, Inc. (HMO I-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5015 -001 -0 | | | | | 3,445
2023 Formulary |
|
-- |
|
|
2024 Texas Independence Health Plan, Inc. (HMO I-SNP)
| $28.40 |
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 |
2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H4514 -013 -1 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete TX-D002 (HMO-POS D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
2023 UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
R6801 -011 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete TX-S001 (Regional PPO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H4514 -021 -0 | | | | | |
|
|
|
|
2024 UHC Dual Complete TX-S003 (HMO-POS D-SNP)
| $28.40 |
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 Nursing Home Plan (PPO I-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0710 -020 -0 | | | | | 3,682
2023 Formulary |
|
-- |
|
|
2024 UHC Nursing Home Plan TX-F001 (PPO I-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
2023 Wellcare Dual Access Open (PPO D-SNP)
| $25.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H7323 -005 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
2024 Wellcare Dual Access Open (PPO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
|
2023 Amerivantage Dual Secure Plus (HMO D-SNP)
| $24.50 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H8849 -011 -1 | $10.00 | $20.00 | $47.00 | $47.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Wellpoint Dual Advantage (HMO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 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 Amerivantage Dual Coordination Plus (HMO D-SNP)
| $17.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H8849 -010 -1 | $18.00 | $20.00 | $47.00 | $47.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Wellpoint Full Dual Advantage (HMO D-SNP)
| $28.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,581 2024 Formulary |
|
2023 UnitedHealthcare Medicare Advantage Choice (Regional PPO)
| $49.00 |
$7,550 |
$395 | Yes, some additional gap coverage. |
R6801 -012 -0 | $4.00 | $12.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Medicare Advantage TX-0030 (Regional PPO)
| $48.00 |
$7,550 |
$395 | Yes, some additional gap coverage. | $4.00 | $12.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
2023 HumanaChoice R4182-004 (Regional PPO)
| $41.00 |
$6,900 |
$175 | Yes, some additional gap coverage. |
R4182 -004 -0 | $6.00 | $13.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice R4182-004 (Regional PPO)
| $49.00 |
$6,900 |
$275 | Yes, some additional gap coverage. | $6.00 | $13.00 | $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 HumanaChoice H5216-042 (PPO)
| $93.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H5216 -042 -0 | $7.00 | $12.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice H5216-042 (PPO)
| $65.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $12.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 HumanaChoice R4182-003 (Regional PPO)
| $84.00 |
$6,900 |
$175 | Yes, some additional gap coverage. |
R4182 -003 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice R4182-003 (Regional PPO)
| $72.00 |
$6,900 |
$175 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Blue Cross Medicare Advantage Choice Premier (PPO)
| $88.00 |
$6,050 |
$295 | Yes, some additional gap coverage. |
H1666 -003 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,503
2023 Formulary |
|
|
|
|
2024 Blue Cross Medicare Advantage Choice Premier (PPO)
| $88.00 |
$6,355 |
$295 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,543 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 Blue Cross Medicare Advantage Flex (PPO)
| $213.00 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H4801 -014 -0 | $0.00 | $5.00 | $44.00 | $44.00 | 3,177
2023 Formulary |
|
|
|
|
2024 Blue Cross Medicare Advantage Flex (PPO)
| $238.00 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $8.00 | $47.00 | $47.00 | 3,200 2024 Formulary |
|
2023 Cigna True Choice Plus Medicare (PPO)
| $17.00 |
$6,100 |
$0 | Yes, some additional gap coverage. |
H7849 -062 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,524
2023 Formulary |
|
|
|
|
-- Members will be assigned to Cigna True Choice Medicare (PPO) H7849-038 --
| | | | | |
|
2023 Imperial Insurance Traditional Plus (HMO)
| $0.00 |
$8,300 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H2793 -007 -0 | | | | | 3,346
2023 Formulary |
|
|
|
|
-- Members will be assigned to Imperial Insurance Company Traditional (HMO) H2793-003 --
| | | | | |
|
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 KelseyCare Advantage Silver Freedom (HMO-POS)
| $0.00 |
$3,450 |
No Rx Coverage |
H0332 -003 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to KelseyCare Advantage Honor (HMO) H0332-001 --
| | | | | |
|
2023 Memorial Hermann Advantage Plus (HMO)
| $25.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H7115 -003 -0 | $0.00 | $5.00 | $39.00 | $39.00 | 3,833
2023 Formulary |
|
|
|
|
-- Members will be assigned to Memorial Hermann Advantage (HMO) H7115-001 --
| | | | | |
|
2023 Wellcare Specialty No Premium (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H0174 -008 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,393
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 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 --
|
| | | | |
|
2023 Imperial Insurance Company Traditional (HMO)
| $0.00 |
$2,999 |
$0 | Yes, some additional gap coverage. |
H2793 -003 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,346
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 Imperial Insurance Company Dual (HMO D-SNP)
| $25.00 |
n/a |
$505 | Yes, some additional gap coverage. |
H2793 -004 -0 | 0% | 25% | 25% | 25% | 3,346
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Imperial Insurance Value (HMO C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. |
H2793 -005 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,387
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Imperial Courage Plan (HMO)
| $0.00 |
$2,999 |
No Rx Coverage |
H2793 -008 -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 Cigna Preferred Savings Medicare (HMO)
| $0.00 |
$6,400 |
$0 | Yes, some additional gap coverage. |
H4513 -066 -0 | $0.00 | $4.00 | $42.00 | $42.00 | 3,524
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Texas LoneStar Gold (HMO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H6062 -003 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,196
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Amerivantage Choice (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H8343 -001 -0 | $5.00 | $12.00 | $37.00 | $37.00 | 3,603
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 Amerivantage Classic Plus (HMO)
| $0.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H8849 -008 -1 | $5.00 | $12.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|