There are 68 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 |
-- This plan not offered in 2023 --
|
H2406 -074 -0 | | | | | |
|
|
|
|
2024 AARP Medicare Advantage Patriot No Rx IN-MA01 (PPO)
| $0.00 |
$8,850 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 Aetna Medicare Eagle (PPO)
| $0.00 |
$4,390 |
No Rx Coverage |
H5521 -286 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Aetna Medicare Eagle (PPO)
| $0.00 |
$4,390 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 Anthem MediBlue Service (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H7093 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Anthem Veteran (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 Health Alliance Medicare HMO Basic (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H1463 -008 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Health Alliance Medicare HMO Basic (HMO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 Humana Honor (PPO)
| $0.00 |
$5,900 |
No Rx Coverage |
H5216 -218 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 Humana USAA Honor (PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 HumanaChoice R0865-001 (Regional PPO)
| $0.00 |
$3,900 |
No Rx Coverage |
R0865 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2024 HumanaChoice R0865-001 (Regional PPO)
| $0.00 |
$4,350 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2023 --
|
H2406 -067 -0 | | | | | |
|
|
|
|
2024 AARP Medicare Advantage from UHC IN-0007 (PPO)
| $0.00 |
$4,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $45.00 | $45.00 | 3,634 2024 Formulary |
|
2023 AARP Medicare Advantage (HMO-POS)
| $0.00 |
$3,700 |
$0 | Yes, some additional gap coverage. |
H2802 -010 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,682
2023 Formulary |
|
|
|
|
2024 AARP Medicare Advantage from UHC IN-0012 (HMO-POS)
| $0.00 |
$3,700 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H2802 -056 -0 | | | | | |
|
|
|
|
2024 AARP Medicare Advantage from UHC IN-0017 (HMO-POS)
| $0.00 |
$6,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $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 --
|
H2802 -059 -0 | | | | | |
|
|
|
|
2024 AARP Medicare Advantage from UHC IN-0020 (HMO-POS)
| $0.00 |
$6,500 |
$395 | Yes, some additional gap coverage. | $0.00 | $14.00 | $47.00 | $47.00 | 3,634 2024 Formulary |
|
2023 Aetna Medicare Prime (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H3192 -006 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Premier (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H5521 -405 -0 | | | | | |
|
|
|
|
2024 Aetna Medicare SmartFit (PPO)
| $0.00 |
$3,900 |
$250 | 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 Value (PPO)
| $0.00 |
$4,950 |
$0 | Yes, some additional gap coverage. |
H5521 -231 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Value (PPO)
| $0.00 |
$4,950 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
|
2023 Anthem MediBlue Plus (HMO)
| $0.00 |
$4,250 |
$0 | Yes, some additional gap coverage. |
H3447 -042 -4 | $2.00 | $9.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage (HMO)
| $0.00 |
$4,250 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $42.00 | $42.00 | 3,581 2024 Formulary |
|
2023 Anthem MediBlue Access (PPO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H7093 -002 -0 | $5.00 | $15.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $15.00 | $42.00 | $42.00 | 3,581 2024 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2023 --
|
H1463 -044 -0 | | | | | |
|
|
|
|
2024 Health Alliance Medicare POS Choice Rx (HMO-POS)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,867 2024 Formulary |
|
2023 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$445 | No additional gap coverage, only the Donut Hole Discount |
H5619 -055 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus - Diabetes and Heart (HMO C-SNP)
| $0.00 |
n/a |
$495 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Humana Gold Plus H5619-049 (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H5619 -049 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus H5619-049 (HMO-POS)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $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 USAA Honor with Rx (PPO)
| $0.00 |
$6,550 |
$350 | Yes, some additional gap coverage. |
H5216 -307 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana USAA Honor with Rx (PPO)
| $0.00 |
$8,850 |
$350 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 HumanaChoice H5216-192 (PPO)
| $0.00 |
$6,700 |
$250 | Yes, some additional gap coverage. |
H5216 -192 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice H5216-192 (PPO)
| $0.00 |
$6,700 |
$545 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 HumanaChoice H5216-229 (PPO)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H5216 -229 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice H5216-229 (PPO)
| $0.00 |
$5,900 |
$0 | 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 |
2023 HumanaChoice H5216-309 (PPO)
| $0.00 |
$6,500 |
$350 | Yes, some additional gap coverage. |
H5216 -309 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice H5216-309 (PPO)
| $0.00 |
$7,550 |
$545 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 MyTruAdvantage Choice Plus (PPO)
| $0.00 |
$4,225 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H9042 -002 -1 | $0.00 | $5.00 | $37.00 | $37.00 | 3,196
2023 Formulary |
|
-- |
|
|
2024 MyTruAdvantage Choice Plus (PPO)
| $0.00 |
$4,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $37.00 | $37.00 | 3,332 2024 Formulary |
|
2023 MyTruAdvantage Select (HMO)
| $0.00 |
$3,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H6529 -001 -1 | $0.00 | $7.00 | $42.00 | $42.00 | 3,196
2023 Formulary |
|
-- |
|
|
2024 MyTruAdvantage Select (HMO)
| $0.00 |
$3,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $37.00 | $37.00 | 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 --
|
H6529 -002 -0 | | | | | |
|
-- |
|
|
2024 MyTruAdvantage Select Plus (HMO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $37.00 | $37.00 | 3,332 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H9042 -003 -1 | | | | | |
|
-- |
|
|
2024 Red, White and Tru (PPO)
| $0.00 |
$4,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2023 Anthem MediBlue Extra (HMO)
| $21.10 |
$6,700 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3447 -024 -0 | $10.00 | $20.00 | $37.00 | $37.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Extra Help (HMO)
| $16.70 |
$4,900 |
$545 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $37.00 | $37.00 | 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 |
-- This plan not offered in 2023 --
|
H5216 -400 -0 | | | | | |
|
|
|
|
2024 Humana Together in Health (PPO I-SNP)
| $20.80 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
2023 Aetna Medicare Premier (PPO)
| $24.00 |
$4,300 |
$0 | Yes, some additional gap coverage. |
H5521 -302 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
|
|
|
|
2024 Aetna Medicare Value Plus (PPO)
| $28.00 |
$4,100 |
$400 | Yes, some additional gap coverage. | $0.00 | $10.00 | 20% | 20% | 3,619 2024 Formulary |
|
2023 Anthem MediBlue Access Preferred (PPO)
| $19.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H1607 -015 -0 | $4.00 | $13.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage 2 (PPO)
| $28.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $13.00 | $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 |
-- This plan not offered in 2023 --
|
H3447 -046 -0 | | | | | |
|
|
|
|
2024 Anthem Dual Advantage (HMO D-SNP)
| $29.50 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,581 2024 Formulary |
|
2023 Wellcare Dual Access Open (PPO D-SNP)
| $26.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H6348 -006 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
2024 Wellcare Dual Access Open (PPO D-SNP)
| $35.00 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H0271 -063 -0 | | | | | |
|
|
|
|
2024 UHC Dual Complete IN-S001 (PPO D-SNP)
| $36.10 |
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 Wellcare Dual Access (HMO D-SNP)
| $28.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3499 -005 -0 | | | | | 3,394
2023 Formulary |
|
|
|
|
2024 Wellcare Dual Access (HMO D-SNP)
| $37.60 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
|
2023 Anthem MediBlue Dual Advantage (HMO D-SNP)
| $28.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3447 -020 -0 | $15.00 | $20.00 | $47.00 | $47.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Full Dual Advantage (HMO D-SNP)
| $39.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,581 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H3447 -048 -0 | | | | | |
|
|
|
|
2024 Anthem Full Dual Advantage Aligned (HMO D-SNP)
| $42.30 |
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 Humana Gold Plus SNP-DE H5619-054 (HMO D-SNP)
| $28.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5619 -054 -0 | | | | | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Gold Plus Integrated SNP-DE H5619-054 (HMO-POS D-SNP)
| $42.30 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H5619 -156 -0 | | | | | |
|
|
|
|
2024 Humana Gold Plus SNP-DE H5619-156 (HMO-POS D-SNP)
| $42.30 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H5619 -158 -0 | | | | | |
|
|
|
|
2024 Humana Gold Plus SNP-DE H5619-158 (HMO-POS D-SNP)
| $42.30 |
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 Humana Value Plus H5216-193 (PPO)
| $28.10 |
$7,550 |
$260 | No additional gap coverage, only the Donut Hole Discount |
H5216 -193 -0 | $0.00 | $15.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice H5216-193 (PPO)
| $42.30 |
$3,900 |
$150 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 UnitedHealthcare Dual Complete Choice Select (PPO D-SNP)
| $24.40 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0271 -054 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete IN-D001 (PPO D-SNP)
| $42.30 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
2023 UnitedHealthcare Dual Complete (PPO D-SNP)
| $28.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0271 -005 -0 | | | | | 3,682
2023 Formulary |
|
|
|
|
2024 UHC Dual Complete IN-S002 (PPO D-SNP)
| $42.30 |
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 HumanaChoice R0865-003 (Regional PPO)
| $33.00 |
$7,550 |
$195 | Yes, some additional gap coverage. |
R0865 -003 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice R0865-003 (Regional PPO)
| $46.00 |
$7,550 |
$245 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 HumanaChoice H5525-008 (PPO)
| $75.00 |
$6,200 |
$220 | No additional gap coverage, only the Donut Hole Discount |
H5525 -008 -0 | $7.00 | $17.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice H5525-008 (PPO)
| $51.00 |
$6,200 |
$220 | No additional gap coverage, only the Donut Hole Discount | $7.00 | $17.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
2023 Health Alliance Medicare POS Basic Rx (HMO-POS)
| $53.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1463 -015 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
2024 Health Alliance Medicare POS Basic Rx (HMO-POS)
| $53.00 |
$5,400 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,867 2024 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2023 Anthem MediBlue Access Plus (PPO)
| $54.00 |
$6,400 |
$60 | Yes, some additional gap coverage. |
H1607 -012 -0 | $4.00 | $12.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage 3 (PPO)
| $58.00 |
$6,400 |
$60 | Yes, some additional gap coverage. | $4.00 | $12.00 | $42.00 | $42.00 | 3,581 2024 Formulary |
|
2023 Anthem MediBlue Access Basic (Regional PPO)
| $81.00 |
$6,400 |
$0 | Yes, some additional gap coverage. |
R4487 -001 -0 | $6.00 | $15.00 | $37.00 | $37.00 | 3,603
2023 Formulary |
|
|
|
|
2024 Anthem Medicare Advantage (Regional PPO)
| $73.00 |
$6,400 |
$0 | Yes, some additional gap coverage. | $6.00 | $15.00 | $37.00 | $37.00 | 3,581 2024 Formulary |
|
2023 Health Alliance Medicare HMO 20 Rx (HMO)
| $125.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H1463 -003 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
2024 Health Alliance Medicare HMO 20 Rx (HMO)
| $125.00 |
$4,000 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,867 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 Health Alliance Medicare POS 10 Rx (HMO-POS)
| $165.00 |
$4,500 |
$0 | Yes, some additional gap coverage. |
H1463 -019 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
2024 Health Alliance Medicare POS 10 Rx (HMO-POS)
| $165.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $2.00 | $15.00 | $47.00 | $47.00 | 3,867 2024 Formulary |
|
2023 AARP Medicare Advantage Choice Plan 2 (PPO)
| $0.00 |
$4,800 |
$0 | Yes, some additional gap coverage. |
H2228 -081 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage from UHC IN-0007 (PPO) H2406-067 --
| | | | | |
|
2023 AARP Medicare Advantage Patriot (PPO)
| $0.00 |
$5,500 |
No Rx Coverage |
H2228 -091 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to AARP Medicare Advantage Patriot No Rx IN-MA01 (PPO) H2406-074 --
| | | | | |
|
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 Alliance Medicare POS Basic (HMO-POS)
| $23.00 |
$6,700 |
No Rx Coverage |
H1463 -014 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- Members will be assigned to Health Alliance Medicare HMO Basic (HMO) H1463-008 --
| | | | | |
|
2023 Health Alliance Medicare HMO Basic Rx (HMO)
| $33.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H1463 -009 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
-- Members will be assigned to Health Alliance Medicare POS Choice Rx (HMO-POS) H1463-044 --
| | | | | |
|
2023 Health Alliance Medicare HMO 40 Rx (HMO)
| $75.00 |
$4,700 |
$0 | Yes, some additional gap coverage. |
H1463 -010 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
-- Members will be assigned to Health Alliance Medicare POS Choice Rx (HMO-POS) H1463-044 --
| | | | | |
|
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 Alliance Medicare POS 30 Rx (HMO-POS)
| $105.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H1463 -017 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
-- Members will be assigned to Health Alliance Medicare POS Choice Rx (HMO-POS) H1463-044 --
| | | | | |
|
2023 Simplete 1 (HMO)
| $0.00 |
$4,000 |
$0 | Yes, some additional gap coverage. |
H1463 -023 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
-- Members will be assigned to Health Alliance Medicare POS Choice Rx (HMO-POS) H1463-044 --
| | | | | |
|
2023 Simplete 2 (HMO)
| $28.00 |
$4,950 |
$0 | Yes, some additional gap coverage. |
H1463 -024 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
-- Members will be assigned to Health Alliance Medicare POS Choice Rx (HMO-POS) H1463-044 --
| | | | | |
|
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 Simplete 3 (HMO-POS)
| $48.00 |
$4,950 |
$0 | Yes, some additional gap coverage. |
H1463 -025 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
-- Members will be assigned to Health Alliance Medicare POS Choice Rx (HMO-POS) H1463-044 --
| | | | | |
|
2023 Health Alliance Medicare HMO Classic Rx (HMO)
| $0.00 |
$8,300 |
$100 | Yes, some additional gap coverage. |
H1463 -043 -0 | $2.00 | $15.00 | $47.00 | $47.00 | 3,864
2023 Formulary |
|
|
|
|
-- Members will be assigned to Health Alliance Medicare POS Choice Rx (HMO-POS) H1463-044 --
| | | | | |
|
2023 MyTruAdvantage Choice (PPO)
| $0.00 |
$3,650 |
$100 | No additional gap coverage, only the Donut Hole Discount |
H9042 -001 -1 | $2.00 | $8.00 | $42.00 | $42.00 | 3,196
2023 Formulary |
|
-- |
|
|
-- Members will be assigned to MyTruAdvantage Choice Plus (PPO) H9042-002 --
| | | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
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 Aetna Medicare Premier Plus (HMO-POS)
| $187.00 |
$4,250 |
$350 | Yes, some additional gap coverage. |
H3192 -015 -0 | $0.00 | $10.00 | $47.00 | $47.00 | 3,597
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 HumanaChoice SNP-DE H5525-048 (PPO D-SNP)
| $28.10 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5525 -048 -0 | | | | | 3,404
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 CareSource Dual Advantage (HMO D-SNP)
| $28.10 |
n/a |
$505 | Yes, some additional gap coverage. |
H7076 -016 -0 | $0.00 | 25% | 25% | 25% | 3,467
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 IU Health Plans Medicare Select - Medical Only (HMO)
| $0.00 |
$5,000 |
No Rx Coverage |
H7220 -002 -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 IU Health Plans Medicare Choice (HMO-POS)
| $98.00 |
$6,850 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7220 -004 -0 | $3.00 | $15.00 | $37.00 | $37.00 | 3,375
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 IU Health Plans Medicare Select Plus (HMO)
| $46.00 |
$5,150 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7220 -009 -1 | $0.00 | $12.00 | $37.00 | $37.00 | 3,375
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|