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2013 Medicare Advantage Plans: SNPs,
    Health (MAs), Health & Rx Drug (MA-PDs)

This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.
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Choose Your Medicare Advantage Plan Preferences
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New York, New York

  Partial Plan Name(s):
 1:
 2:
ex: AARP
Only plans with MOOP ≤ $3,400   5-star rated plans   Limit search to 10 plans  
 none  
 LIS 100%    LIS 75%  
 LIS 50%    LIS 25%

$  max: $343

$  max: $325
Only show SNPs (All 3 Types)
OR only: Dual-Eligible  
Chronic Condition  
Institutional

$  
tip: enter 0 to show plans with a $0 Tier 1 copay
* required
There are 84 New York 2013 Medicare Advantage plans (MAPD) meeting your criteria.

Caution: The 2013 Medicare Advantage plan information below is for research purposes.
Click here to see 2024 Medicare Advantage plans
2013 Medicare Advantage Plan Information
Click here to jump to the Chart Legend & Search Tips
Plan Name County Monthly
Prem. (Parts C & D)
Deduct-
ible
(Donut Hole)
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
30-Day Supply
MOOP for Part A & B Benefits
Cust.
Service
Rating
Member
Plan
Exper.
RxCost
Info
Rating
ActiveSaver MSA (MSA) - H9788-004-0
Benefit Details
        
New York $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.n/a
 
AARP MedicareComplete Essential (HMO) - H3307-018-0
Benefit Details
        
New York $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,900
AARP MedicareComplete Essential (HMO) - H3307-018-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareComplete Essential (HMO) - H3307-018-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP MedicareComplete Essential (HMO) - H3307-018-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
AARP MedicareComplete Mosaic (HMO) - H3307-015-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Non-Preferred Generic: $4.00
Preferred Brand: $44.00
Non-Preferred Brand: $92.00
Specialty Tier: 33%
$3,500
Browse Formulary
AARP MedicareComplete Mosaic (HMO) - H3307-015-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareComplete Mosaic (HMO) - H3307-015-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP MedicareComplete Mosaic (HMO) - H3307-015-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
AARP MedicareComplete Plan 1 (HMO) - H3307-002-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Non-Preferred Generic: $6.00
Preferred Brand: $44.00
Non-Preferred Brand: $92.00
Specialty Tier: 33%
$5,900
Browse Formulary
AARP MedicareComplete Plan 1 (HMO) - H3307-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareComplete Plan 1 (HMO) - H3307-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP MedicareComplete Plan 1 (HMO) - H3307-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
AARP MedicareComplete Plan 2 (HMO) - H3379-001-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Non-Preferred Generic: $8.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 33%
$3,900
Browse Formulary
AARP MedicareComplete Plan 2 (HMO) - H3379-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP MedicareComplete Plan 2 (HMO) - H3379-001-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP MedicareComplete Plan 2 (HMO) - H3379-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Access Medicare Gold (HMO) - H4866-003-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountGeneric: $0.00
Preferred Brand: $30.00
Non-Preferred Brand: $70.00
Specialty Tier: 30%
$3,400
Browse Formulary
Access Medicare Gold (HMO) - H4866-003-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- Access Medicare Gold (HMO) - H4866-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Amerivantage Balance + Rx (HMO) - H6181-009-0
Benefit Details
           
New York $0.00 $0 Some GenericsPreferred Generic: $0.00
Non-Preferred Generic: $4.00
Preferred Brand: $35.00
Non-Preferred Brand: $80.00
Specialty Tier: 33%
$3,400
Browse Formulary
Amerivantage Balance + Rx (HMO) - H6181-009-0 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Amerivantage Balance + Rx (HMO) - H6181-009-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Amerivantage Balance + Rx (HMO) - H6181-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Amerivantage Classic Choice + Rx Plan (HMO-POS) - H6181-015-0
Benefit Details
           
New York $0.00 $0 Some GenericsPreferred Generic: $3.00
Non-Preferred Generic: $3.00
Preferred Brand: $40.00
Non-Preferred Brand: $65.00
Specialty Tier: 25%
$6,700
Browse Formulary
Amerivantage Classic Choice + Rx Plan (HMO-POS) - H6181-015-0 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Amerivantage Classic Choice + Rx Plan (HMO-POS) - H6181-015-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Amerivantage Classic Choice + Rx Plan (HMO-POS) - H6181-015-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Easy Choice Diamond Rewards (HMO SNP) - H9285-003-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Preferred Brand: $20.00
Non-Preferred Brand: $69.00
Specialty Tier: 33%
n/a
Browse Formulary
Easy Choice Diamond Rewards (HMO SNP) - H9285-003-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- --  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Easy Choice Diamond Rewards COPD (HMO SNP) - H9285-004-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Preferred Brand: $20.00
Non-Preferred Brand: $69.00
Specialty Tier: 33%
n/a
Browse Formulary
Easy Choice Diamond Rewards COPD (HMO SNP) - H9285-004-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- --  
Easy Choice Rewards (HMO) - H9285-001-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Preferred Brand: $39.00
Non-Preferred Brand: $79.00
Specialty Tier: 33%
$3,400
Browse Formulary
Easy Choice Rewards (HMO) - H9285-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- --  
Easy Choice Value (HMO) - H9285-002-0
Benefit Details
           
New York $0.00 $0 Many GenericsPreferred Generic: $0.00
Preferred Brand: $20.00
Non-Preferred Brand: $69.00
Specialty Tier: 33%
$3,400
Browse Formulary
Easy Choice Value (HMO) - H9285-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- --  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Elderplan Classic: Zero Premium (HMO) - H3347-005-0
Benefit Details
           
New York $0.00 $325 No additional gap coverage, only the Donut Hole DiscountGeneric: $4.00
Preferred Brand: $30.00
Non-Preferred Brand: $90.00
Specialty Tier: 25%
$6,700
Browse Formulary
Elderplan Classic: Zero Premium (HMO) - H3347-005-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Elderplan Classic: Zero Premium (HMO) - H3347-005-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Elderplan Classic: Zero Premium (HMO) - H3347-005-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Empire MediBlue Essential (HMO) - H3370-019-0
Benefit Details
        
New York $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$4,000
Empire MediBlue Essential (HMO) - H3370-019-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Empire MediBlue Essential (HMO) - H3370-019-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Empire MediBlue Essential (HMO) - H3370-019-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Empire MediBlue Plus (HMO) - H3370-001-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $6.00
Non-Preferred Generic: $10.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Injectable Drugs: $95.00
Specialty Tier: 33%
$3,400
Browse Formulary
Empire MediBlue Plus (HMO) - H3370-001-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Empire MediBlue Plus (HMO) - H3370-001-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Empire MediBlue Plus (HMO) - H3370-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Fidelis Medicare $0 Premium (HMO) - H3328-019-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Non-Preferred Generic: $15.00
Preferred Brand: $35.00
Non-Preferred Brand: $75.00
Specialty Tier: 33%
$6,700
Browse Formulary
Fidelis Medicare $0 Premium (HMO) - H3328-019-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Fidelis Medicare $0 Premium (HMO) - H3328-019-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Fidelis Medicare $0 Premium (HMO) - H3328-019-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Fidelis Medicare Advantage without Rx (HMO-POS) - H3328-001-0
Benefit Details
        
New York $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,700
Fidelis Medicare Advantage without Rx (HMO-POS) - H3328-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Fidelis Medicare Advantage without Rx (HMO-POS) - H3328-001-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Fidelis Medicare Advantage without Rx (HMO-POS) - H3328-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Healthfirst 65 Plus Plan (HMO) - H3359-001-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountGeneric: $0.00
Preferred Brand: $40.00
Non-Preferred Brand: $80.00
Specialty Tier: 33%
$6,700
Browse Formulary
Healthfirst 65 Plus Plan (HMO) - H3359-001-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Healthfirst 65 Plus Plan (HMO) - H3359-001-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst 65 Plus Plan (HMO) - H3359-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Healthfirst Coordinated Benefits Plan (HMO) - H3359-027-0
Benefit Details
        
New York $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,700
Healthfirst Coordinated Benefits Plan (HMO) - H3359-027-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Healthfirst Coordinated Benefits Plan (HMO) - H3359-027-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst Coordinated Benefits Plan (HMO) - H3359-027-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Healthfirst Jade Benefits Plan (HMO) - H3359-032-0
Benefit Details
           
New York $0.00 $0 Many Generics,
Few Brands
Generic: $0.00
Preferred Brand: $40.00
Non-Preferred Brand: $80.00
Specialty Tier: 33%
$6,700
Browse Formulary
Healthfirst Jade Benefits Plan (HMO) - H3359-032-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Healthfirst Jade Benefits Plan (HMO) - H3359-032-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst Jade Benefits Plan (HMO) - H3359-032-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Liberty Health Advantage Preferred Choice (HMO) - H3337-001-0
Benefit Details
           
New York $0.00 $0 All GenericsPreferred Generic: $0.00
Non-Preferred Generic: $10.00
Preferred Brand: $25.00
Non-Preferred Brand: $50.00
Specialty Tier: 25%
$3,400
Browse Formulary
Liberty Health Advantage Preferred Choice (HMO) - H3337-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Liberty Health Advantage Preferred Choice (HMO) - H3337-001-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Liberty Health Advantage Preferred Choice (HMO) - H3337-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
PPO I (PPO) - H5528-001-0
Benefit Details
        
New York $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$3,400
PPO I (PPO) - H5528-001-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) PPO I (PPO) - H5528-001-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) PPO I (PPO) - H5528-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
PPO II (PPO) - H5528-002-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $5.00
Preferred Brand: $35.00
Non-Preferred Brand: $95.00
Specialty Tier: 25%
$3,400
Browse Formulary
PPO II (PPO) - H5528-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) PPO II (PPO) - H5528-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) PPO II (PPO) - H5528-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Touchstone Health Medicare Clear (HMO-POS) - H3327-039-0
Benefit Details
        
New York $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$3,400
Touchstone Health Medicare Clear (HMO-POS) - H3327-039-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Touchstone Health Medicare Clear (HMO-POS) - H3327-039-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Touchstone Health Medicare Clear (HMO-POS) - H3327-039-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Touchstone Health Medicare Freedom (HMO-POS) - H3327-038-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountGeneric: $6.00
Preferred Brand: $40.00
Non-Preferred Brand: $80.00
Specialty Tier: 33%
$3,400
Browse Formulary
Touchstone Health Medicare Freedom (HMO-POS) - H3327-038-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Touchstone Health Medicare Freedom (HMO-POS) - H3327-038-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Touchstone Health Medicare Freedom (HMO-POS) - H3327-038-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Touchstone Health Medicare Power (HMO) - H3327-001-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountGeneric: $0.00
Preferred Brand: $45.00
Non-Preferred Brand: $80.00
Specialty Tier: 33%
$3,400
Browse Formulary
Touchstone Health Medicare Power (HMO) - H3327-001-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Touchstone Health Medicare Power (HMO) - H3327-001-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Touchstone Health Medicare Power (HMO) - H3327-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UnitedHealthcare MedicareComplete Choice (Regional PPO) - R5342-001-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Non-Preferred Generic: $6.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 33%
$4,900
Browse Formulary
UnitedHealthcare MedicareComplete Choice (Regional PPO) - R5342-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare MedicareComplete Choice (Regional PPO) - R5342-001-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare MedicareComplete Choice (Regional PPO) - R5342-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
UnitedHealthcare MedicareComplete Choice Essential (Regional PPO) - R5342-002-0
Benefit Details
        
New York $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$3,900
UnitedHealthcare MedicareComplete Choice Essential (Regional PPO) - R5342-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare MedicareComplete Choice Essential (Regional PPO) - R5342-002-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare MedicareComplete Choice Essential (Regional PPO) - R5342-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
VIP (HMO) - H3330-021-1
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $5.00
Preferred Brand: $35.00
Non-Preferred Brand: 50%
Specialty Tier: 25%
$3,400
Browse Formulary
VIP (HMO) - H3330-021-1 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) VIP (HMO) - H3330-021-1 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) VIP (HMO) - H3330-021-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
VIP Essential (HMO) - H3330-032-1
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $5.00
Preferred Brand: $35.00
Non-Preferred Brand: 50%
Specialty Tier: 25%
$3,400
Browse Formulary
VIP Essential (HMO) - H3330-032-1 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) VIP Essential (HMO) - H3330-032-1 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) VIP Essential (HMO) - H3330-032-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
VNSNY CHOICE Medicare Enhanced (HMO) - H5549-004-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $1.00
Non-Preferred Generic: $4.00
Preferred Brand: $30.00
Non-Preferred Brand: $90.00
Specialty Tier: 25%
$3,400
Browse Formulary
VNSNY CHOICE Medicare Enhanced (HMO) - H5549-004-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) VNSNY CHOICE Medicare Enhanced (HMO) - H5549-004-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) VNSNY CHOICE Medicare Enhanced (HMO) - H5549-004-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
WellCare Choice (HMO-POS) - H3361-106-0
Benefit Details
           
New York $0.00 $0 No additional gap coverage, only the Donut Hole DiscountGeneric: $0.00
Preferred Brand: $39.00
Non-Preferred Brand: $79.00
Specialty Tier: 33%
$6,700
Browse Formulary
WellCare Choice (HMO-POS) - H3361-106-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) WellCare Choice (HMO-POS) - H3361-106-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) WellCare Choice (HMO-POS) - H3361-106-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
WellCare Rx (HMO) - H3361-130-0
Benefit Details
           
New York $1.60 $0 No additional gap coverage, only the Donut Hole DiscountGeneric: $8.00
Preferred Brand: $35.00
Non-Preferred Brand: $79.00
Specialty Tier: 33%
$6,700
Browse Formulary
WellCare Rx (HMO) - H3361-130-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) WellCare Rx (HMO) - H3361-130-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) WellCare Rx (HMO) - H3361-130-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
WellCare Liberty (HMO SNP) - H3361-043-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountGeneric: $0.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 25%
n/a
Browse Formulary
WellCare Liberty (HMO SNP) - H3361-043-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) WellCare Liberty (HMO SNP) - H3361-043-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) WellCare Liberty (HMO SNP) - H3361-043-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
WellCare Advocate Complete (HMO SNP) - H3361-105-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountGeneric: $0.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 25%
n/a
Browse Formulary
WellCare Advocate Complete (HMO SNP) - H3361-105-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) WellCare Advocate Complete (HMO SNP) - H3361-105-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) WellCare Advocate Complete (HMO SNP) - H3361-105-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
MetroPlus Platinum (HMO) - H0423-004-0
Benefit Details
           
New York $34.70 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
$6,700
Browse Formulary
MetroPlus Platinum (HMO) - H0423-004-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) MetroPlus Platinum (HMO) - H0423-004-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) MetroPlus Platinum (HMO) - H0423-004-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Healthfirst Increased Benefits Plan (HMO) - H3359-019-0
Benefit Details
           
New York $35.00 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
$6,700
Browse Formulary
Healthfirst Increased Benefits Plan (HMO) - H3359-019-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Healthfirst Increased Benefits Plan (HMO) - H3359-019-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst Increased Benefits Plan (HMO) - H3359-019-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UnitedHealthcare Nursing Home Plan (HMO SNP) - H3379-002-0
Benefit Details
           
New York $35.00 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%
n/a
Browse Formulary
UnitedHealthcare Nursing Home Plan (HMO SNP) - H3379-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Nursing Home Plan (HMO SNP) - H3379-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) UnitedHealthcare Nursing Home Plan (HMO SNP) - H3379-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Touchstone Health Medicare Total (HMO) - H3327-002-0
Benefit Details
           
New York $38.60 $0 No additional gap coverage, only the Donut Hole DiscountGeneric: $0.00
Preferred Brand: $30.00
Non-Preferred Brand: $80.00
Specialty Tier: 33%
$1,700
Browse Formulary
Touchstone Health Medicare Total (HMO) - H3327-002-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Touchstone Health Medicare Total (HMO) - H3327-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Touchstone Health Medicare Total (HMO) - H3327-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
HHH Choices Gold (HMO SNP) - H3635-001-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
new new new  
VNSNY CHOICE Medicare Preferred (HMO SNP) - H5549-002-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%
n/a
Browse Formulary
VNSNY CHOICE Medicare Preferred (HMO SNP) - H5549-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) VNSNY CHOICE Medicare Preferred (HMO SNP) - H5549-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) VNSNY CHOICE Medicare Preferred (HMO SNP) - H5549-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Elderplan Advantage For Nursing Home Residents (HMO SNP) - H3347-003-0
Benefit Details
           
New York $40.20 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
Elderplan Advantage For Nursing Home Residents (HMO SNP) - H3347-003-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Elderplan Advantage For Nursing Home Residents (HMO SNP) - H3347-003-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Elderplan Advantage For Nursing Home Residents (HMO SNP) - H3347-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
WellCare Access (HMO SNP) - H3361-109-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountGeneric: $0.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 25%
n/a
Browse Formulary
WellCare Access (HMO SNP) - H3361-109-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) WellCare Access (HMO SNP) - H3361-109-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) WellCare Access (HMO SNP) - H3361-109-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UnitedHealthcare Dual Complete (HMO SNP) - H3387-010-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%
n/a
Browse Formulary
UnitedHealthcare Dual Complete (HMO SNP) - H3387-010-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- UnitedHealthcare Dual Complete (HMO SNP) - H3387-010-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
GuildNet Health Advantage (HMO-POS SNP) - H6864-002-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
n/a
Browse Formulary
-- -- GuildNet Health Advantage (HMO-POS SNP) - H6864-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
MetroPlus Advantage Plan (HMO SNP) - H0423-001-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
n/a
Browse Formulary
MetroPlus Advantage Plan (HMO SNP) - H0423-001-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) MetroPlus Advantage Plan (HMO SNP) - H0423-001-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) MetroPlus Advantage Plan (HMO SNP) - H0423-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UnitedHealthcare Dual Complete LP (HMO SNP) - H3307-020-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%
n/a
Browse Formulary
UnitedHealthcare Dual Complete LP (HMO SNP) - H3307-020-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Dual Complete LP (HMO SNP) - H3307-020-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) UnitedHealthcare Dual Complete LP (HMO SNP) - H3307-020-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Healthfirst AssuredCare (HMO SNP) - H3359-035-0
Benefit Details
           
New York $43.00 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
n/a
Browse Formulary
Healthfirst AssuredCare (HMO SNP) - H3359-035-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Healthfirst AssuredCare (HMO SNP) - H3359-035-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst AssuredCare (HMO SNP) - H3359-035-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Healthfirst CompleteCare (HMO SNP) - H3359-034-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
n/a
Browse Formulary
Healthfirst CompleteCare (HMO SNP) - H3359-034-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Healthfirst CompleteCare (HMO SNP) - H3359-034-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst CompleteCare (HMO SNP) - H3359-034-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Healthfirst Life Improvement Plan (HMO SNP) - H3359-021-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
n/a
Browse Formulary
Healthfirst Life Improvement Plan (HMO SNP) - H3359-021-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Healthfirst Life Improvement Plan (HMO SNP) - H3359-021-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst Life Improvement Plan (HMO SNP) - H3359-021-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Healthfirst Maximum Plan (HMO SNP) - H3359-033-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
n/a
Browse Formulary
Healthfirst Maximum Plan (HMO SNP) - H3359-033-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Healthfirst Maximum Plan (HMO SNP) - H3359-033-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst Maximum Plan (HMO SNP) - H3359-033-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
MetroPlus Select Plan (HMO SNP) - H0423-003-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
n/a
Browse Formulary
MetroPlus Select Plan (HMO SNP) - H0423-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) MetroPlus Select Plan (HMO SNP) - H0423-003-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) MetroPlus Select Plan (HMO SNP) - H0423-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Access Medicare Pearl (HMO SNP) - H4866-005-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
n/a
Browse Formulary
Access Medicare Pearl (HMO SNP) - H4866-005-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- Access Medicare Pearl (HMO SNP) - H4866-005-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Access Medicare Platinum (HMO) - H4866-002-0
Benefit Details
           
New York $43.20 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
$3,400
Browse Formulary
Access Medicare Platinum (HMO) - H4866-002-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- Access Medicare Platinum (HMO) - H4866-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Access Medicare Silver (HMO SNP) - H4866-006-0
Benefit Details
           
New York $43.20 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
n/a
Browse Formulary
Access Medicare Silver (HMO SNP) - H4866-006-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- Access Medicare Silver (HMO SNP) - H4866-006-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Affinity Medicare Solutions (HMO SNP) - H5991-002-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
n/a
Browse Formulary
Affinity Medicare Solutions (HMO SNP) - H5991-002-0 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Affinity Medicare Solutions (HMO SNP) - H5991-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Affinity Medicare Solutions (HMO SNP) - H5991-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Affinity Medicare Ultimate (HMO SNP) - H5991-001-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountGeneric: 0%
Brand: 25%
n/a
Browse Formulary
Affinity Medicare Ultimate (HMO SNP) - H5991-001-0 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Affinity Medicare Ultimate (HMO SNP) - H5991-001-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Affinity Medicare Ultimate (HMO SNP) - H5991-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Amerivantage Specialty + Rx (HMO SNP) - H6181-007-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. Many Generics,
Few Brands
Preferred Generic: $0.00
Non-Preferred Generic: $0.00
Preferred Brand: 25%
Non-Preferred Brand: 25%
Specialty Tier: 25%
n/a
Browse Formulary
Amerivantage Specialty + Rx (HMO SNP) - H6181-007-0 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) Amerivantage Specialty + Rx (HMO SNP) - H6181-007-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Amerivantage Specialty + Rx (HMO SNP) - H6181-007-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
ArchCare - Inst and IE SNP - All Counties (HMO SNP) - H1777-007-0
Benefit Details
           
New York $43.20 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
n/a
Browse Formulary
ArchCare  - Inst and IE SNP - All Counties (HMO SNP) - H1777-007-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- ArchCare  - Inst and IE SNP - All Counties (HMO SNP) - H1777-007-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
CenterLight Direct Complete Plan (HMO SNP) - H5989-002-0
Benefit Details
           
New York $43.20 $325 No additional gap coverage, only the Donut Hole DiscountGeneric: $7.25
Preferred Brand: $42.00
Non-Preferred Brand: $95.00
Specialty Tier: 25%
n/a
Browse Formulary
-- -- CenterLight Direct Complete Plan (HMO SNP) - H5989-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
CenterLight Direct Total Plan (HMO SNP) - H5989-008-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountGeneric: $8.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 28%
n/a
Browse Formulary
-- -- CenterLight Direct Total Plan (HMO SNP) - H5989-008-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Dual Eligible (HMO SNP) - H3330-029-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $4.00
Preferred Brand: 25%
Non-Preferred Brand: 30%
Specialty Tier: 25%
n/a
Browse Formulary
Dual Eligible (HMO SNP) - H3330-029-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Dual Eligible (HMO SNP) - H3330-029-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Dual Eligible (HMO SNP) - H3330-029-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Dual Eligible (PPO SNP) - H5528-018-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $4.00
Preferred Brand: 25%
Non-Preferred Brand: 30%
Specialty Tier: 25%
n/a
Browse Formulary
Dual Eligible (PPO SNP) - H5528-018-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Dual Eligible (PPO SNP) - H5528-018-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Dual Eligible (PPO SNP) - H5528-018-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Elderplan Extra Help (HMO) - H3347-009-0
Benefit Details
           
New York $43.20 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
$6,700
Browse Formulary
Elderplan Extra Help (HMO) - H3347-009-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Elderplan Extra Help (HMO) - H3347-009-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Elderplan Extra Help (HMO) - H3347-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Elderplan For Medicaid Beneficiaries (HMO SNP) - H3347-002-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
Elderplan For Medicaid Beneficiaries (HMO SNP) - H3347-002-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Elderplan For Medicaid Beneficiaries (HMO SNP) - H3347-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Elderplan For Medicaid Beneficiaries (HMO SNP) - H3347-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Elderplan Medicaid Advantage (HMO SNP) - H3347-008-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
Elderplan Medicaid Advantage (HMO SNP) - H3347-008-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Elderplan Medicaid Advantage (HMO SNP) - H3347-008-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Elderplan Medicaid Advantage (HMO SNP) - H3347-008-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Elderplan Plus Long Term Care (HMO SNP) - H3347-007-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
Elderplan Plus Long Term Care (HMO SNP) - H3347-007-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Elderplan Plus Long Term Care (HMO SNP) - H3347-007-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Elderplan Plus Long Term Care (HMO SNP) - H3347-007-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Fidelis Dual Advantage (HMO SNP) - H3328-002-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Non-Preferred Generic: $15.00
Preferred Brand: $35.00
Non-Preferred Brand: $70.00
Specialty Tier: 25%
n/a
Browse Formulary
Fidelis Dual Advantage (HMO SNP) - H3328-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Fidelis Dual Advantage (HMO SNP) - H3328-002-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Fidelis Dual Advantage (HMO SNP) - H3328-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Fidelis Dual Advantage Flex (HMO SNP) - H3328-017-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Non-Preferred Generic: $15.00
Preferred Brand: $35.00
Non-Preferred Brand: $95.00
Specialty Tier: 25%
n/a
Browse Formulary
Fidelis Dual Advantage Flex (HMO SNP) - H3328-017-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Fidelis Dual Advantage Flex (HMO SNP) - H3328-017-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Fidelis Dual Advantage Flex (HMO SNP) - H3328-017-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Fidelis Long Term Care Advantage (HMO SNP) - H3328-018-0
Benefit Details
           
New York $43.20 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%
n/a
Browse Formulary
Fidelis Long Term Care Advantage (HMO SNP) - H3328-018-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Fidelis Long Term Care Advantage (HMO SNP) - H3328-018-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Fidelis Long Term Care Advantage (HMO SNP) - H3328-018-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Fidelis Medicaid Advantage Plus (HMO SNP) - H3328-016-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Non-Preferred Generic: $15.00
Preferred Brand: $35.00
Non-Preferred Brand: $91.00
Specialty Tier: 25%
n/a
Browse Formulary
Fidelis Medicaid Advantage Plus (HMO SNP) - H3328-016-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Fidelis Medicaid Advantage Plus (HMO SNP) - H3328-016-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Fidelis Medicaid Advantage Plus (HMO SNP) - H3328-016-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Fidelis Medicare Advantage Flex (HMO-POS) - H3328-003-0
Benefit Details
           
New York $43.20 $320 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Non-Preferred Generic: $15.00
Preferred Brand: $35.00
Non-Preferred Brand: $75.00
Specialty Tier: 25%
$6,700
Browse Formulary
Fidelis Medicare Advantage Flex (HMO-POS) - H3328-003-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Fidelis Medicare Advantage Flex (HMO-POS) - H3328-003-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Fidelis Medicare Advantage Flex (HMO-POS) - H3328-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
GuildNet Gold (HMO-POS SNP) - H6864-001-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
n/a
Browse Formulary
-- -- GuildNet Gold (HMO-POS SNP) - H6864-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Liberty Health Advantage Dual Power (HMO SNP) - H3337-003-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%
n/a
Browse Formulary
Liberty Health Advantage Dual Power (HMO SNP) - H3337-003-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Liberty Health Advantage Dual Power (HMO SNP) - H3337-003-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Liberty Health Advantage Dual Power (HMO SNP) - H3337-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Senior Whole Health of New York (HMO SNP) - H5992-006-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountGeneric: $0.00
Brand: $45.00
n/a
Browse Formulary
-- Senior Whole Health of New York (HMO SNP) - H5992-006-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Senior Whole Health of New York (HMO SNP) - H5992-006-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Aetna Medicare Value Plan (HMO) - H3312-043-0
Benefit Details
           
New York $50.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $6.00
Non-Preferred Generic: $33.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 33%
$6,700
Browse Formulary
Aetna Medicare Value Plan (HMO) - H3312-043-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Value Plan (HMO) - H3312-043-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Aetna Medicare Value Plan (HMO) - H3312-043-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
PPO III (PPO) - H5528-003-0
Benefit Details
           
New York $54.50 $0 All GenericsPreferred Generic: $5.00
Preferred Brand: $35.00
Non-Preferred Brand: $95.00
Specialty Tier: 25%
$3,400
Browse Formulary
PPO III (PPO) - H5528-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) PPO III (PPO) - H5528-003-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) PPO III (PPO) - H5528-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
MetroPlus Medicare Partnership in Care Plan (HMO SNP) - H0423-002-0
Benefit Details
           
New York $67.10 $325 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
n/a
Browse Formulary
MetroPlus Medicare Partnership in Care Plan (HMO SNP) - H0423-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) MetroPlus Medicare Partnership in Care Plan (HMO SNP) - H0423-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) MetroPlus Medicare Partnership in Care Plan (HMO SNP) - H0423-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
VNSNY CHOICE Medicare Maximum (HMO SNP) - H5549-006-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%
n/a
Browse Formulary
VNSNY CHOICE Medicare Maximum (HMO SNP) - H5549-006-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) VNSNY CHOICE Medicare Maximum (HMO SNP) - H5549-006-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) VNSNY CHOICE Medicare Maximum (HMO SNP) - H5549-006-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Aetna Medicare Standard Plan (HMO) - H3312-025-0
Benefit Details
           
New York $80.00 $0 Some GenericsPreferred Generic: $6.00
Non-Preferred Generic: $33.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 33%
$3,400
Browse Formulary
Aetna Medicare Standard Plan (HMO) - H3312-025-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Standard Plan (HMO) - H3312-025-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Aetna Medicare Standard Plan (HMO) - H3312-025-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Aetna Medicare Standard Plan (PPO) - H5521-040-0
Benefit Details
           
New York $85.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $6.00
Non-Preferred Generic: $33.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 33%
$6,700
Browse Formulary
Aetna Medicare Standard Plan (PPO) - H5521-040-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Aetna Medicare Standard Plan (PPO) - H5521-040-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Aetna Medicare Standard Plan (PPO) - H5521-040-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
VNSNY CHOICE Total (HMO SNP) - H5549-003-0
Benefit Details
           
New York $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%
n/a
Browse Formulary
VNSNY CHOICE Total (HMO SNP) - H5549-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) VNSNY CHOICE Total (HMO SNP) - H5549-003-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) VNSNY CHOICE Total (HMO SNP) - H5549-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
PPO High Option (PPO) - H5528-019-0
Benefit Details
           
New York $132.50 $0 All GenericsPreferred Generic: $5.00
Preferred Brand: $35.00
Non-Preferred Brand: $95.00
Specialty Tier: 25%
$3,400
Browse Formulary
PPO High Option (PPO) - H5528-019-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) PPO High Option (PPO) - H5528-019-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) PPO High Option (PPO) - H5528-019-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
VIP High Option (HMO) - H3330-033-1
Benefit Details
           
New York $157.50 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $5.00
Preferred Brand: $35.00
Non-Preferred Brand: 50%
Specialty Tier: 25%
$3,400
Browse Formulary
VIP High Option (HMO) - H3330-033-1 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) VIP High Option (HMO) - H3330-033-1 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) VIP High Option (HMO) - H3330-033-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  



Chart Legend:

Below are a few notes to help with the understanding of the 2013 Medicare Advantage Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.



A few notes to help with the understanding of the 2013 Medicare Part D Prescription Drug Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.
  • Plan Name: This is the official plan name from the Centers for Medicare and Medicaid Services (CMS). The same plan name generally has a different plan id in each state. (Search Tip: If you would like to reduce the plans shown to just plans for one or two specific carriers, you can select the carrier name in the "Plan Family" fields 1 and 2. Select the empty (blank) option at the top of the list to remove the criteria. You can also click the "National Plans" checkbox to limit your search to just national plans.)

  • CMS Plan Ratings: these are found under the Plan Name at the left side of the chart.

    This is a 1 to 5 star rating system with five (5) stars as excellent, four (4) stars as very good, three (3) stars as good, two (2) stars as fair and one (1) star as poor.

    Cust. Service Rating - Drug Plan Customer Service - Medicare and members rate the drug plan and how well a drug plan provides customer service.

    This category includes measures of how drug plans rate on the following areas:
    • Time on Hold When Customer and Pharmacist Calls Drug Plan.
    • Calls Disconnected When Customer and Pharmacist Calls Drug Plan.
    • Drug Plan’s Timeliness in Giving a Decision for Members Who Make an Appeal.
    • Fairness of Drug Plan’s Denials to a Member’s Appeal, Based on an Independent Reviewer.

  • Member Plan Exper. - Member Experience with Drug Plan - This category shows how well drug plans make prescription drugs available to their members.

    This category includes measures of how drug plans rate on the following areas:
    • Drug Plan Provides Information or Help When Members Need It.
    • Members’ Overall Rating of Drug Plan.
    • Members’ Ability to Get Prescriptions Filled Easily When Using the Drug Plan.

  • RxCost Info Rating - This category shows how well drug plans are doing with pricing prescriptions and providing information on the Medicare website.

    This category includes measures of how drug plans rate on the following areas:
    • Completeness of the Drug Plan’s Information on Members Who Need Extra Help.
    • Drug Plan Provides Current Information on Costs and Coverage for Medicare’s Website (the same data is used on this Q1Medicare.com).
    • Drug Plan’s Prices that Did Not Increase More Than Expected During the Year.
    • Drug Plan’s Prices on Medicare’s Website (and this website) Are Similar to the Prices Members Pay at the Pharmacy.
    • Drug Plan’s Members 65 and Older Who Received Prescriptions for Certain Drugs with a High Risk of Side Effects, when There May Be Safer Drug Choices.

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  • County: Medicare Advantage Plans are only available in specific county and in some cases on in part of a county. This field will note the county where the plan is available or in some cases, "Statewide" if the plan is available in every county. (Search Tip: You must enter your 5 digit ZIP Code in the criteria field to begin your search. We will determine your county from your ZIP code and only show appropriate plans.)

  • Monthly Premium: This is the amount you must pay each month to use the plan. For the Medicare Advantage Plans shown above, this premium includes Medicare Part C AND Part D (if the plan has prescription drug coverage). This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase. (Search Tip: If you would like to reduce the plans shown to just plans under a certain premium, enter this value in the "Maximum Premium" field.)

  • Deductible: This is the $325 deductible that was presented in the CMS Standard Plan. Many provider’s plans do not have a deductible, however the premium may be higher. (Search Tip: If you would like to reduce the plans shown to just plans with a deductible under a certain value, enter this value in the "Maximum Deductible field" field.)


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  • Gap Coverage: the Donut Hole: In the CMS Standard Plan, the beneficiary must pay the next $3763.75 in drug costs (the Donut Hole). The Healthcare Reform provides that for Plan Year 2013, ALL formulary generics will have at least a 21% discount and ALL brand drugs will have at least a 52.5% discount in the coverage gap. The Gap Coverage Types discussed in this section are in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
    • No Rx Cov.: This plan does not include prescription drug coverage. You are 100% responsible for your medication costs. If you would like to see ONLY those plans that do include some type of prescription coverage, please select ":Show only plans WITH Drug Coverage" in the "Prescription Drug Coverage" selector above (this is the default setting);
    • No Gap Coverage: you must pay the $3763.75;
    • All Generics and All Brands: All formulary generics and all formulary Brand drugs are covered through the donut hole. This gap coverage option is available in Los Angeles and Orange counties in CA on the CareMore Value Plus (HMO) plan and in Dade county, FL on the Medica HealthCare Plans MedicareMax(PSO) plan;
    • All Generics and Some Brands: All formulary generics and a some (10% to 65%) of formulary Brands are covered through the donut hole; Plans available in Riverside, CA, Many counties in LA, and Washoe, NV.
    • All Generics and Few Brands: All formulary generics and a few (less than 10%) of formulary Brands are covered through the donut hole; Plans available in Los Angeles, Orange and San Bernadino, CA and many counties in NY.
    • All Generics: All formulary generics and no Brands are covered through the donut hole. You must pay for Brand Drugs up to $3763.75;
    • Many Generics and Some Brands: Many formulary generics (65% to 100%) and a some (10% to 65%) formulary Brands are covered through the donut hole;
    • Many Generics and Few Brands: Many formulary generics (65% to 100%) and a few (less than 10%) formulary Brands are covered through the donut hole;
    • Many Generics: 65% to 100% of formulary generics are covered, but you must pay for Brand Drugs up to $3763.75;
    • Some Generics and Few Brands: Some formulary generics (10% to 65%) and a few (less than 10%) formulary Brands are covered through the donut hole;
    • Some Generics: 10% to 65% of formulary generics are covered, but you must pay for Brand Drugs up to $3763.75;
    • Few Generics and Few Brands: Less than 10% of formulary generics and a few (less than 10%) formulary Brands are covered through the donut hole;
    • Few Generics: Less than 10% of formulary generics and no Brands are covered through the donut hole. You must pay for Brand Drugs up to $3763.75;

  • Plan ID: This is the unique id for this particular plan.

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  • Copay / Coinsurance - Cost Sharing - These figures apply to the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. Plans can form their own tiers, so you should contact the plan or reference their summary of benefits to find out what copays and limitations are associated with each tier. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. (Search Tip: If you would like to reduce the plans shown to just plans that have a tier 1 (Generics) co-pay of up to a certain value (ex: $0 co-pay), enter the value (ex: 0) in the "Max. Co-pay Tier 1 (Generics)" field.)

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Additional Information Fields:
You can select one of the following additional pieces of plan information to display (Search Tip: to change the type of information shown in the last column of the chart, select the data to be shown in the "Additional Info" field.)
  • Total Formulary Drugs (default) - This is the total number of medications on the plans formulary or drug list. This total drug count does not include "Bonus Drugs". These are non-Medicare Part D drugs which are covered by the plan, however they do not count toward your plan deductible, retail drug cost, or TrOOP.
  • Offers Mail Order - "Yes" is displayed if this plan offers mail order on any medications. It does NOT mean that ALL medications are available through mail order.
  • Members in This County (August 2013 figures) - This is the total number of members in this plan's service area (a "plan" is a specific contract ID and plan ID, for example H1234-001) Generally speaking, this service area is a county, but could include multiple counties. We are showing the latest Medicare Advantage plan enrollment figures. We update this figure as new enrollment statistics are released by Medicare.

  • MOOP for Part A & B Benefits - MOOP is the Maximum Out-of-Pocket limit set by the Medicare Advantage Plan. The figure shown is the beneficiaries yearly maximum out of pocket cost-sharing expenditure (co-payments / co-insurance) for Medicare Parts A & B (NOT Part D - prescription drug cost-sharing) . N/A That this plan does not actually offer health cost-sharing benefits. Example: a Medicare Savings Account (MSA).
  • Health Plan Type - This the organization type for the Medicare Advantage Plan. This could be Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), etc. (Search Tip: If you would like to limit your search to a specific type of Medicare Advantage Plans, please select the health plan type in the "Type of Health Coverage" field.);
  • SNP Eligibility Requirements - Special Needs Plans (SNPs) have an eligibility requirement whereas all other Medicare Advantage plans do not. (Search Tip: If you would like to limit your search to specific types of Special Needs Medicare Advantage Plans, please check the appropriate boxes in the "Special Needs Plans (SNP) Options" field.)


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(Chart Source: various files provided by the Centers for Medicare and Medicaid Services along with data from the Medicare.gov website plan finder.)

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, we cannot guarantee the accuracy of this information.





Tips & Disclaimers
  • Q1Medicare®, Q1Rx®, and Q1Group® are registered Service Marks of Q1Group LLC and may not be used in any advertising, publicity, or for commercial purposes without the express authorization of Q1Group.
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDPCompare.com and MACompare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.