There are 60 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 |
$3,200 |
No Rx Coverage |
H5253 -113 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 AARP Medicare Advantage Patriot No Rx TC-MA01 (HMO-POS)
| $0.00 |
$3,200 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Aetna Medicare Eagle Plan (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H5521 -355 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Aetna Medicare Eagle Plan (PPO)
| $0.00 |
$6,700 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 BlueAdvantage Freedom (PPO)
| $0.00 |
$3,200 |
No Rx Coverage |
H7917 -039 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 BlueAdvantage Freedom (PPO)
| $0.00 |
$3,200 |
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 Cigna Courage Medicare (HMO)
| $0.00 |
$6,700 |
No Rx Coverage |
H4513 -033 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Cigna Courage Medicare (HMO)
| $0.00 |
$3,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Humana Honor (HMO)
| $0.00 |
$3,200 |
No Rx Coverage |
H4461 -004 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Humana USAA Honor (HMO)
| $0.00 |
$3,200 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Humana Honor (PPO)
| $0.00 |
$3,400 |
No Rx Coverage |
H5216 -235 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Humana USAA Honor (PPO)
| $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 HumanaChoice R7315-001 (Regional PPO)
| $0.00 |
$3,400 |
No Rx Coverage |
R7315 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 HumanaChoice R7315-001 (Regional PPO)
| $0.00 |
$5,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 Wellcare Patriot Giveback (HMO-POS)
| $0.00 |
$4,500 |
No Rx Coverage |
H1416 -061 -0 | This plan does NOT include Prescription Drug coverage. | |
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2024 Wellcare Patriot Giveback (HMO-POS)
| $0.00 |
$5,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2023 AARP Medicare Advantage Plan 1 (HMO-POS)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. |
H5253 -047 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC TC-0002 (HMO-POS)
| $0.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $45.00 | $45.00 | 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 Rebate (HMO-POS)
| $0.00 |
$5,900 |
$395 | Yes, some additional gap coverage. |
H5253 -121 -0 | $0.00 | $14.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC TC-0004 (HMO-POS)
| $0.00 |
$6,300 |
$395 | Yes, some additional gap coverage. | $0.00 | $14.00 | $45.00 | $45.00 | 3,634 2024 Formulary |
|
2023 Aetna Medicare Premier Plan (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H5521 -254 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
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2024 Aetna Medicare Premier Plan (PPO)
| $0.00 |
$6,350 |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $47.00 | $47.00 | 3,633 2024 Formulary |
|
2023 BlueAdvantage Sapphire (PPO)
| $0.00 |
$5,500 |
$0 | Yes, some additional gap coverage. |
H7917 -030 -0 | $0.00 | $10.00 | $42.00 | $42.00 | 3,588
2023 Formulary |
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2024 BlueAdvantage Sapphire (PPO)
| $0.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 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 Cigna Preferred Medicare (HMO)
| $0.00 |
$5,600 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4513 -049 -2 | $0.00 | $5.00 | $42.00 | $42.00 | 3,524
2023 Formulary |
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2024 Cigna Preferred Medicare (HMO)
| $0.00 |
$5,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $47.00 | $47.00 | 3,535 2024 Formulary |
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-- This plan not offered in 2023 --
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H7849 -133 -1 | | | | | |
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2024 Cigna True Choice Medicare (PPO)
| $0.00 |
$5,100 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,535 2024 Formulary |
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-- This plan not offered in 2023 --
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H4863 -001 -0 | | | | | |
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new |
new |
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2024 Farm Bureau Advantage (HMO)
| $0.00 |
$5,300 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $47.00 | $47.00 | 3,292 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 H4461-029 (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4461 -029 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
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2024 Humana Gold Plus H4461-029 (HMO)
| $0.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
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2023 Humana Gold Plus H4461-039 (HMO)
| $0.00 |
$7,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4461 -039 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
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2024 Humana Gold Plus H4461-039 (HMO)
| $0.00 |
$7,950 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
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2023 HumanaChoice H5216-274 (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5216 -274 -0 | $0.00 | $0.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
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2024 HumanaChoice H5216-274 (PPO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $5.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2023 --
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H5253 -136 -0 | | | | | |
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2024 UHC Complete Care TC-0005 (HMO-POS C-SNP)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $45.00 | $45.00 | 3,634 2024 Formulary |
|
2023 UnitedHealthcare Medicare Advantage Choice (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. |
H2577 -020 -0 | $0.00 | $8.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
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2024 UHC Medicare Advantage TC-0001 (PPO)
| $0.00 |
$5,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $45.00 | $45.00 | 3,634 2024 Formulary |
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-- This plan not offered in 2023 --
|
H1416 -079 -0 | | | | | |
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2024 Wellcare Giveback (HMO)
| $0.00 |
$6,700 |
$545 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $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 Giveback Open (PPO)
| $0.00 |
$6,700 |
$90 | Yes, some additional gap coverage. |
H9428 -002 -0 | $0.00 | $10.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
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2024 Wellcare Giveback Open (PPO)
| $0.00 |
$6,700 |
$545 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,371 2024 Formulary |
|
2023 Wellcare No Premium (HMO-POS)
| $0.00 |
$5,500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1416 -077 -0 | $0.00 | $5.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
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2024 Wellcare No Premium (HMO-POS)
| $0.00 |
$5,500 |
$150 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $7.00 | $42.00 | $42.00 | 3,371 2024 Formulary |
|
2023 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$75 | Yes, some additional gap coverage. |
H9428 -001 -0 | $0.00 | $10.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
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2024 Wellcare No Premium Open (PPO)
| $0.00 |
$5,500 |
$300 | Yes, some additional gap coverage. | $0.00 | $10.00 | $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 |
-- This plan not offered in 2023 --
|
H5828 -012 -3 | | | | | |
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2024 Wellpoint Medicare Advantage (HMO-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $8.00 | $42.00 | $42.00 | 3,581 2024 Formulary |
|
2023 Amerivantage Balance Plus (HMO)
| $9.30 |
$4,900 |
$505 | No additional gap coverage, only the Donut Hole Discount |
H5828 -008 -0 | $10.00 | $20.00 | $37.00 | $37.00 | 3,603
2023 Formulary |
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2024 Wellpoint Extra Help (HMO)
| $8.60 |
$4,900 |
$545 | No additional gap coverage, only the Donut Hole Discount | $10.00 | $20.00 | $37.00 | $37.00 | 3,581 2024 Formulary |
|
2023 Aetna Medicare Value Plus Plan (HMO)
| $18.00 |
$6,700 |
$95 | Yes, some additional gap coverage. |
H3146 -012 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,597
2023 Formulary |
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2024 Aetna Medicare Value Plus Plan (HMO)
| $16.00 |
$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 Wellcare Assist (HMO)
| $17.10 |
$4,900 |
$485 | No additional gap coverage, only the Donut Hole Discount |
H1416 -042 -0 | $0.00 | $20.00 | $47.00 | $47.00 | 3,392
2023 Formulary |
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2024 Wellcare Assist (HMO)
| $21.70 |
$4,900 |
$365 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 3,371 2024 Formulary |
|
-- This plan not offered in 2023 --
|
H7917 -041 -0 | | | | | |
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2024 BlueAdvantage Extra (PPO)
| $23.00 |
$3,900 |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,619 2024 Formulary |
|
2023 Cigna TotalCare Plus (HMO D-SNP)
| $22.50 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H4513 -034 -0 | | | | | 3,524
2023 Formulary |
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2024 Cigna TotalCare Plus (HMO D-SNP)
| $30.40 |
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 Wellcare Dual Access (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H1416 -035 -0 | | | | | 3,394
2023 Formulary |
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2024 Wellcare Dual Access (HMO D-SNP)
| $34.00 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,353 2024 Formulary |
|
2023 AARP Medicare Advantage Plan 2 (HMO-POS)
| $28.00 |
$3,000 |
$0 | Yes, some additional gap coverage. |
H5253 -048 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 3,682
2023 Formulary |
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2024 AARP Medicare Advantage from UHC TC-0003 (HMO-POS)
| $36.00 |
$3,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $45.00 | $45.00 | 3,634 2024 Formulary |
|
2023 Amerivantage Dual Premier (HMO D-SNP)
| $22.20 |
n/a |
$490 | No additional gap coverage, only the Donut Hole Discount |
H5828 -002 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,603
2023 Formulary |
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2024 Wellpoint Full Dual Advantage (HMO D-SNP)
| $37.20 |
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 BlueCare Plus Select (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3259 -003 -0 | | | | | 3,588
2023 Formulary |
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2024 BlueCare Plus Select (HMO D-SNP)
| $38.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,619 2024 Formulary |
|
2023 Amerivantage Full Dual Coordination (HMO D-SNP)
| $35.20 |
n/a |
$380 | No additional gap coverage, only the Donut Hole Discount |
H5828 -001 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,603
2023 Formulary |
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2024 Wellpoint Full Dual Advantage Support (HMO D-SNP)
| $38.80 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,581 2024 Formulary |
|
2023 BlueCare Plus (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3259 -001 -0 | | | | | 3,588
2023 Formulary |
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|
|
|
2024 BlueCare Plus (HMO D-SNP)
| $39.90 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 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 BlueCare Plus Choice (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H3259 -002 -0 | | | | | 3,588
2023 Formulary |
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|
|
2024 BlueCare Plus Choice (HMO D-SNP)
| $41.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,619 2024 Formulary |
|
2023 Humana Gold Plus SNP-DE H4461-022 (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H4461 -022 -0 | | | | | 3,404
2023 Formulary |
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|
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2024 Humana Gold Plus SNP-DE H4461-022 (HMO D-SNP)
| $41.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,448 2024 Formulary |
|
2023 Humana Gold Plus SNP-DE H4461-038 (HMO D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H4461 -038 -0 | | | | | 3,404
2023 Formulary |
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|
|
2024 Humana Gold Plus SNP-DE H4461-038 (HMO D-SNP)
| $41.40 |
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 HumanaChoice H5216-180 (PPO)
| $0.00 |
$6,700 |
$350 | No additional gap coverage, only the Donut Hole Discount |
H5216 -180 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 Humana Value Plus H5216-180 (PPO)
| $41.40 |
$3,000 |
$545 | No additional gap coverage, only the Donut Hole Discount | $18.00 | $20.00 | 20% | 20% | 3,448 2024 Formulary |
|
2023 UnitedHealthcare Dual Complete (HMO-POS D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0251 -002 -0 | | | | | 3,682
2023 Formulary |
-- |
|
|
|
2024 UHC Dual Complete TN-S001 (HMO-POS D-SNP)
| $41.40 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,634 2024 Formulary |
|
2023 UnitedHealthcare Dual Complete ONE (HMO-POS D-SNP)
| $35.20 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H0251 -004 -0 | | | | | 3,682
2023 Formulary |
-- |
|
|
|
2024 UHC Dual Complete TN-Y001 (HMO-POS D-SNP)
| $41.40 |
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 NHC Advantage (HMO I-SNP)
| $35.70 |
n/a |
$505 | No additional gap coverage, only the Donut Hole Discount |
H4172 -001 -0 | | | | | 3,683
2023 Formulary |
|
-- |
|
|
2024 NHC Advantage (HMO I-SNP)
| $42.50 |
n/a |
$545 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,665 2024 Formulary |
|
2023 BlueAdvantage Emerald (PPO)
| $36.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H7917 -036 -0 | $0.00 | $5.00 | $35.00 | $35.00 | 3,588
2023 Formulary |
|
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|
|
2024 BlueAdvantage Emerald (PPO)
| $45.00 |
$3,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $35.00 | $35.00 | 3,619 2024 Formulary |
|
2023 HumanaChoice H5216-097 (PPO)
| $58.00 |
$6,700 |
$150 | No additional gap coverage, only the Donut Hole Discount |
H5216 -097 -0 | $0.00 | $5.00 | $47.00 | $47.00 | 3,404
2023 Formulary |
|
|
|
|
2024 HumanaChoice H5216-097 (PPO)
| $53.00 |
$8,850 |
$150 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $47.00 | $47.00 | 3,448 2024 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2023 Cigna Premier Medicare (HMO-POS)
| $55.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount |
H4513 -036 -0 | $3.00 | $12.00 | $42.00 | $42.00 | 3,524
2023 Formulary |
|
|
|
|
2024 Cigna Premier Medicare (HMO-POS)
| $55.00 |
$6,300 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $47.00 | $47.00 | 3,535 2024 Formulary |
|
2023 HumanaChoice R7315-002 (Regional PPO)
| $59.00 |
$6,700 |
$405 | No additional gap coverage, only the Donut Hole Discount |
R7315 -002 -0 | $5.00 | $12.00 | 25% | 25% | 3,409
2023 Formulary |
|
|
|
|
2024 HumanaChoice R7315-002 (Regional PPO)
| $75.00 |
$6,700 |
$545 | No additional gap coverage, only the Donut Hole Discount | $18.00 | $20.00 | 20% | 20% | 3,448 2024 Formulary |
|
2023 BlueAdvantage Ruby (PPO)
| $92.00 |
$3,900 |
$0 | Yes, some additional gap coverage. |
H7917 -014 -0 | $0.00 | $5.00 | $28.00 | $28.00 | 3,588
2023 Formulary |
|
|
|
|
2024 BlueAdvantage Ruby (PPO)
| $92.00 |
$3,800 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $28.00 | $28.00 | 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 BlueAdvantage Diamond (PPO)
| $167.00 |
$3,300 |
$0 | Yes, some additional gap coverage. |
H7917 -010 -0 | $0.00 | $5.00 | $28.00 | $28.00 | 3,588
2023 Formulary |
|
|
|
|
2024 BlueAdvantage Diamond (PPO)
| $149.00 |
$2,750 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $28.00 | $28.00 | 3,619 2024 Formulary |
|
2023 Cigna True Choice Medicare (PPO)
| $0.00 |
$5,200 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H7849 -036 -0 | $0.00 | $4.00 | $40.00 | $40.00 | 3,524
2023 Formulary |
|
|
|
|
-- Members will be assigned to Cigna True Choice Medicare (PPO) H7849-133 --
| | | | | |
|
2023 Wellcare Giveback (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1416 -080 -0 | $0.00 | $7.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
|
|
|
|
-- Members will be assigned to Wellcare Giveback (HMO) H1416-079 --
| | | | | |
|
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-POS)
| $0.00 |
$4,900 |
$0 | Yes, some additional gap coverage. |
H5828 -005 -0 | $2.00 | $8.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
-- Members will be assigned to Wellpoint Medicare Advantage (HMO-POS) H5828-012 --
| | | | | |
|
2023 Amerivantage Dual Coordination (HMO D-SNP)
| $28.70 |
n/a |
$450 | No additional gap coverage, only the Donut Hole Discount |
H2593 -021 -0 | $10.00 | $20.00 | $47.00 | $47.00 | 3,603
2023 Formulary |
|
-- |
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Amerivantage Classic (HMO)
| $15.00 |
$6,100 |
$0 | Yes, some additional gap coverage. |
H2593 -022 -0 | $2.00 | $8.00 | $42.00 | $42.00 | 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 Ascension Complete Saint Thomas Reward (HMO)
| $0.00 |
$3,450 |
$480 | No additional gap coverage, only the Donut Hole Discount |
H2853 -001 -0 | $0.00 | $5.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Ascension Complete Saint Thomas Secure (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. |
H2853 -002 -0 | $0.00 | $1.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Ascension Complete Saint Thomas Access Plus (PPO)
| $0.00 |
$3,450 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H8121 -001 -0 | $0.00 | $5.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
|
new |
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2023 Ascension Complete Saint Thomas Access (PPO)
| $0.00 |
$2,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H8121 -002 -0 | $0.00 | $5.00 | $37.00 | $37.00 | 3,392
2023 Formulary |
|
new |
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Amerivantage Choice (PPO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H8343 -010 -0 | $2.00 | $10.00 | $42.00 | $42.00 | 3,603
2023 Formulary |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|
2023 Amerivantage Courage (PPO)
| $0.00 |
$6,700 |
No Rx Coverage |
H8343 -011 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
-- This plan not offered in 2024 --
|
| | | | |
|