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2021 Medicare Advantage Plans: SNPs,
    Health (MAs), Health & Rx Drug (MA-PDs)

Not sure where to begin? Just select your state below to get started:
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Choose Your Medicare Advantage Plan Preferences
  *required  
Scroll down to see plans meeting your criteria.
Queens, New York

  Partial Plan Name(s):
 1:
 2:
ex: AARP
Only plans with MOOP ≤ $3,450   5-star rated plans   limit search to 10 plans   Part B Giveback plans   Insulin $35 or less plans  
 none  
 LIS 100%    LIS 75%  
 LIS 50%    LIS 25%

$  max: $351

$  max: $445
Only show SNPs (All 3 Types)
OR only: Dual-Eligible  
Chronic Condition  
Institutional

$  
tip: enter 0 to show plans with a $0 Tier 1 Co-pay
* required
There are 109 New York 2021 Medicare Advantage plans (MAPD) meeting your criteria.
Caution: The 2021 Medicare Part D plan information below is for research purposes.
Click here to see 2022 Medicare Part D plans
2021 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
AARP Medicare Advantage Mosaic Choice (PPO) - H3418-001-0
Benefit Details
           
Queens $0.00 $250
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 28%

select insulin pay $35 copay
$6,700
Browse Formulary
new new new  
AARP Medicare Advantage Patriot (HMO) - H3307-018-0
Benefit Details
        
Queens $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,700
AARP Medicare Advantage Patriot (HMO) - H3307-018-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Patriot (HMO) - H3307-018-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP Medicare Advantage Patriot (HMO) - H3307-018-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
AARP Medicare Advantage Prime (HMO) - H3307-015-0
Benefit Details
           
Queens $0.00 $295
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 27%

select insulin pay $35 copay
$6,700
Browse Formulary
AARP Medicare Advantage Prime (HMO) - H3307-015-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Prime (HMO) - H3307-015-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP Medicare Advantage Prime (HMO) - H3307-015-0 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
Aetna Medicare Eagle Plan (PPO) - H5521-320-0
Benefit Details
        
Queens $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$7,550
Aetna Medicare Eagle Plan (PPO) - H5521-320-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Eagle Plan (PPO) - H5521-320-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Eagle Plan (PPO) - H5521-320-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Aetna Medicare Elite Plan (PPO) - H5521-120-0
Benefit Details
           
Queens $0.00 $250
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 28%
$7,550
Browse Formulary
Aetna Medicare Elite Plan (PPO) - H5521-120-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Elite Plan (PPO) - H5521-120-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Elite Plan (PPO) - H5521-120-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Bright Advantage (HMO) - H2288-001-0
Benefit Details
           
Queens $0.00 $445
Tier 1 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%
Select Care Drugs: $0.00
$6,200
Browse Formulary
new new Bright Advantage (HMO) - H2288-001-0 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
Bright Advantage Choice (PPO) - H9516-001-0
Benefit Details
           
Queens $0.00 $445
Tier 1 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%
Select Care Drugs: $0.00
$6,500
Browse Formulary
new new new  
Bright Advantage Senior Savings (HMO C-SNP) - H2288-009-0
Benefit Details
           
Queens $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $90.00
Specialty Tier: 33%
Select Care Drugs: $0.00

select insulin pay $0 copay
n/a
Browse Formulary
new new Bright Advantage Senior Savings (HMO C-SNP) - H2288-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Centers Plan for Medicare Advantage Care (HMO) - H6988-001-0
Benefit Details
           
Queens $0.00 $395
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Brand: $100.00
Specialty Tier: 25%
$7,550
Browse Formulary
Centers Plan for Medicare Advantage Care (HMO) - H6988-001-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- Centers Plan for Medicare Advantage Care (HMO) - H6988-001-0 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
EmblemHealth VIP Essential (HMO) - H3330-032-1
Benefit Details
           
Queens $0.00 $295
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $15.00
Preferred Brand: $42.00
Non-Preferred Drug: $95.00
Specialty Tier: 27%
$7,550
Browse Formulary
EmblemHealth VIP Essential (HMO) - H3330-032-1 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) EmblemHealth VIP Essential (HMO) - H3330-032-1 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) EmblemHealth VIP Essential (HMO) - H3330-032-1 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
EmblemHealth VIP Part B Saver (HMO) - H3330-040-0
Benefit Details
           
Queens $0.00 $445
Tier 1 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $15.00
Preferred Brand: $42.00
Non-Preferred Drug: $95.00
Specialty Tier: 25%
$7,550
Browse Formulary
EmblemHealth VIP Part B Saver (HMO) - H3330-040-0 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) EmblemHealth VIP Part B Saver (HMO) - H3330-040-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) EmblemHealth VIP Part B Saver (HMO) - H3330-040-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
EmblemHealth VIP Reserve (HMO) - H5991-009-0
Benefit Details
           
Queens $0.00 $295
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $15.00
Preferred Brand: $42.00
Non-Preferred Drug: $95.00
Specialty Tier: 27%
$7,550
Browse Formulary
EmblemHealth VIP Reserve (HMO) - H5991-009-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- EmblemHealth VIP Reserve (HMO) - H5991-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
EmblemHealth VIP Value (HMO) - H3330-036-0
Benefit Details
           
Queens $0.00 $295
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $15.00
Preferred Brand: $42.00
Non-Preferred Drug: $95.00
Specialty Tier: 27%
$7,550
Browse Formulary
EmblemHealth VIP Value (HMO) - H3330-036-0 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) EmblemHealth VIP Value (HMO) - H3330-036-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) EmblemHealth VIP Value (HMO) - H3330-036-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Empire MediBlue Core (HMO) - H8432-037-1
Benefit Details
        
Queens $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$7,550
Empire MediBlue Core (HMO) - H8432-037-1 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Empire MediBlue Core (HMO) - H8432-037-1 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Empire MediBlue Core (HMO) - H8432-037-1 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Empire MediBlue Core Select (HMO) - H8432-036-0
Benefit Details
        
Queens $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,700
Empire MediBlue Core Select (HMO) - H8432-036-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Empire MediBlue Core Select (HMO) - H8432-036-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Empire MediBlue Core Select (HMO) - H8432-036-0 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
Empire MediBlue HealthPlus (HMO) - H1732-004-0
Benefit Details
           
Queens $0.00 $350
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $3.00
Generic: $15.00
Preferred Brand: $42.00
Non-Preferred Drug: $94.00
Specialty Tier: 26%
Select Care Drugs: $0.00
$6,900
Browse Formulary
new new new Higher cost-sharing at standard network pharmacies. Details:
Empire MediBlue Select (HMO) - H8432-027-0
Benefit Details
           
Queens $0.00 $350
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $3.00
Generic: $15.00
Preferred Brand: $42.00
Non-Preferred Drug: $94.00
Specialty Tier: 26%
Select Care Drugs: $0.00
$7,550
Browse Formulary
Empire MediBlue Select (HMO) - H8432-027-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Empire MediBlue Select (HMO) - H8432-027-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Empire MediBlue Select (HMO) - H8432-027-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Healthfirst 65 Plus Plan (HMO) - H3359-001-0
Benefit Details
           
Queens $0.00 $350
Tier 1 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 26%

select insulin pay $35 copay
$7,550
Browse Formulary
Healthfirst 65 Plus Plan (HMO) - H3359-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) 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
        
Queens $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$7,550
Healthfirst Coordinated Benefits Plan (HMO) - H3359-027-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) 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 Signature (HMO) - H5989-011-0
Benefit Details
           
Queens $0.00 $350
Tier 1 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 26%

select insulin pay $35 copay
$7,550
Browse Formulary
-- -- --  
Humana Gold Plus H3533-027 (HMO) - H3533-027-0
Benefit Details
           
Queens $0.00 $400
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $6.00
Generic: $16.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%
$7,550
Browse Formulary
Humana Gold Plus H3533-027 (HMO) - H3533-027-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Gold Plus H3533-027 (HMO) - H3533-027-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Humana Gold Plus H3533-027 (HMO) - H3533-027-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Humana Gold Plus H3533-033 (HMO) - H3533-033-0
Benefit Details
           
Queens $0.00 $350
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $9.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 26%

select insulin pay $35 copay
$7,550
Browse Formulary
Humana Gold Plus H3533-033 (HMO) - H3533-033-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Gold Plus H3533-033 (HMO) - H3533-033-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Humana Gold Plus H3533-033 (HMO) - H3533-033-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Humana Honor (PPO) - H5970-016-0
Benefit Details
        
Queens $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$4,500
Humana Honor (PPO) - H5970-016-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Honor (PPO) - H5970-016-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana Honor (PPO) - H5970-016-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
HumanaChoice H5970-024 (PPO) - H5970-024-1
Benefit Details
           
Queens $0.00 $350
Tier 1, 2 and 3 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $9.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 26%
$7,200
Browse Formulary
HumanaChoice H5970-024 (PPO) - H5970-024-1 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) HumanaChoice H5970-024 (PPO) - H5970-024-1 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5970-024 (PPO) - H5970-024-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
PHP Care Complete FIDA-IDD Plan (Medicare-Medicaid Plan) - H9869-001-0
Benefit Details
           
Queens $0.00 $0 All Generics,
All Brands
Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
n/a
Browse Formulary
-- -- --  
UnitedHealthcare Medicare Advantage Patriot (Regional PPO) - R5342-002-0
Benefit Details
        
Queens $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,700
UnitedHealthcare Medicare Advantage Patriot (Regional PPO) - R5342-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Medicare Advantage Patriot (Regional PPO) - R5342-002-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare Medicare Advantage Patriot (Regional PPO) - R5342-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
WellCare Absolute (PPO) - H2775-111-0
Benefit Details
           
Queens $0.00 $150
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 30%
$7,550
Browse Formulary
WellCare Absolute (PPO) - H2775-111-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) WellCare Absolute (PPO) - H2775-111-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) WellCare Absolute (PPO) - H2775-111-0 Medicare Part D Plan Drug Pricing and Patient Safety - 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
WellCare Choice (HMO) - H4868-020-0
Benefit Details
           
Queens $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: 48%
Specialty Tier: 33%
$6,700
Browse Formulary
WellCare Choice (HMO) - H4868-020-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) new WellCare Choice (HMO) - H4868-020-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
WellCare Element (HMO) - H4868-022-0
Benefit Details
           
Queens $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: 48%
Specialty Tier: 33%
$6,700
Browse Formulary
WellCare Element (HMO) - H4868-022-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) new WellCare Element (HMO) - H4868-022-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
WellCare Today's Options Advantage Plus 550B (PPO) - H2775-106-0
Benefit Details
           
Queens $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $7.00
Preferred Brand: $37.00
Non-Preferred Drug: $90.00
Specialty Tier: 33%
$6,700
Browse Formulary
WellCare Today's Options Advantage Plus 550B (PPO) - H2775-106-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) WellCare Today's Options Advantage Plus 550B (PPO) - H2775-106-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) WellCare Today's Options Advantage Plus 550B (PPO) - H2775-106-0 Medicare Part D Plan Drug Pricing and Patient Safety - 5 Stars (Excellent) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
WellCare Summit (PPO) - H2775-113-0
Benefit Details
           
Queens $5.10 $445
Tier 1 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: 50%
Specialty Tier: 25%
$6,700
Browse Formulary
WellCare Summit (PPO) - H2775-113-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) WellCare Summit (PPO) - H2775-113-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) WellCare Summit (PPO) - H2775-113-0 Medicare Part D Plan Drug Pricing and Patient Safety - 5 Stars (Excellent)  
WellCare Compass (HMO) - H4868-016-0
Benefit Details
           
Queens $12.30 $445
Tier 1 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: 50%
Specialty Tier: 25%
$6,700
Browse Formulary
WellCare Compass (HMO) - H4868-016-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) new WellCare Compass (HMO) - H4868-016-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
WellCare Imperial (PPO D-SNP) - H2775-112-0
Benefit Details
           
Queens $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
Generic: $9.00
Preferred Brand: $45.00
Non-Preferred Drug: 49%
Specialty Tier: 25%
n/a
Browse Formulary
WellCare Imperial (PPO D-SNP) - H2775-112-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) WellCare Imperial (PPO D-SNP) - H2775-112-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) WellCare Imperial (PPO D-SNP) - H2775-112-0 Medicare Part D Plan Drug Pricing and Patient Safety - 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
Empire MediBlue Plus (HMO) - H8432-008-6
Benefit Details
           
Queens $16.00 $350
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $15.00
Preferred Brand: $42.00
Non-Preferred Drug: $94.00
Specialty Tier: 26%
$7,550
Browse Formulary
Empire MediBlue Plus (HMO) - H8432-008-6 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Empire MediBlue Plus (HMO) - H8432-008-6 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Empire MediBlue Plus (HMO) - H8432-008-6 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO) - R5342-001-0
Benefit Details
           
Queens $16.00 $300
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 27%

select insulin coverage $35 or less
$6,700
Browse Formulary
UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO) - R5342-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO) - R5342-001-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare Medicare Advantage Choice Plan 1 (Regional PPO) - R5342-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Humana Gold Plus H3533-032 (HMO) - H3533-032-1
Benefit Details
           
Queens $21.00 $200
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $9.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 29%
$6,500
Browse Formulary
Humana Gold Plus H3533-032 (HMO) - H3533-032-1 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Gold Plus H3533-032 (HMO) - H3533-032-1 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Humana Gold Plus H3533-032 (HMO) - H3533-032-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Fidelis Dual Advantage Flex (HMO D-SNP) - H5599-001-0
Benefit Details
           
Queens $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
Generic: $10.00
Preferred Brand: 24%
Non-Preferred Drug: 39%
Specialty Tier: 25%
n/a
Browse Formulary
new new new  
Aetna Medicare Value Plan (PPO) - H5521-312-0
Benefit Details
           
Queens $22.00 $250
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $5.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 28%
$7,550
Browse Formulary
Aetna Medicare Value Plan (PPO) - H5521-312-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Value Plan (PPO) - H5521-312-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Value Plan (PPO) - H5521-312-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Fidelis Medicaid Advantage Plus (HMO D-SNP) - H5599-003-0
Benefit Details
           
Queens $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
Generic: $7.00
Preferred Brand: $40.00
Non-Preferred Drug: 50%
Specialty Tier: 25%
n/a
Browse Formulary
new new new  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Fidelis Dual Advantage (HMO D-SNP) - H5599-006-0
Benefit Details
           
Queens $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
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: 47%
Specialty Tier: 25%
n/a
Browse Formulary
new new new  
Elderplan Extra Help (HMO) - H3347-009-0
Benefit Details
           
Queens $25.30 $445
Tier 1, 2 and 3 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $4.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%
$7,550
Browse Formulary
Elderplan Extra Help (HMO) - H3347-009-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Elderplan Extra Help (HMO) - H3347-009-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Elderplan Extra Help (HMO) - H3347-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Aetna Medicare Assure Plan (HMO D-SNP) - H3312-069-0
Benefit Details
           
Queens $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
Generic: $0.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 29%
n/a
Browse Formulary
Aetna Medicare Assure Plan (HMO D-SNP) - H3312-069-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Assure Plan (HMO D-SNP) - H3312-069-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Aetna Medicare Assure Plan (HMO D-SNP) - H3312-069-0 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 D-SNP) - H4868-014-0
Benefit Details
           
Queens $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
Generic: $4.00
Preferred Brand: $40.00
Non-Preferred Drug: 45%
Specialty Tier: 25%
n/a
Browse Formulary
WellCare Access (HMO D-SNP) - H4868-014-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) new WellCare Access (HMO D-SNP) - H4868-014-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Elderplan Plus Long Term Care (HMO D-SNP) - H3347-007-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
Elderplan Plus Long Term Care (HMO D-SNP) - H3347-007-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Elderplan Plus Long Term Care (HMO D-SNP) - H3347-007-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Elderplan Plus Long Term Care (HMO D-SNP) - H3347-007-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) - H2292-002-0
Benefit Details
           
Queens $32.60 $445 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 1 (PPO I-SNP) - H2292-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) new UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) - H2292-002-0 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
Bright Advantage Senior Savings Assist (HMO C-SNP) - H2288-010-0
Benefit Details
           
Queens $33.90 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $90.00
Specialty Tier: 33%
Select Care Drugs: $0.00

select insulin pay $0 copay
n/a
Browse Formulary
new new Bright Advantage Senior Savings Assist (HMO C-SNP) - H2288-010-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
AARP Medicare Advantage Plan 2 (HMO) - H3379-001-0
Benefit Details
           
Queens $34.00 $395
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%

select insulin pay $35 copay
$6,700
Browse Formulary
AARP Medicare Advantage Plan 2 (HMO) - H3379-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Plan 2 (HMO) - H3379-001-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP Medicare Advantage Plan 2 (HMO) - H3379-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Elderplan For Medicaid Beneficiaries (HMO D-SNP) - H3347-002-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
Elderplan For Medicaid Beneficiaries (HMO D-SNP) - H3347-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Elderplan For Medicaid Beneficiaries (HMO D-SNP) - H3347-002-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Elderplan For Medicaid Beneficiaries (HMO D-SNP) - H3347-002-0 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
Elderplan Advantage For Nursing Home Residents (HMO I-SNP) - H3347-003-0
Benefit Details
           
Queens $35.50 $445 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
Elderplan Advantage For Nursing Home Residents (HMO I-SNP) - H3347-003-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Elderplan Advantage For Nursing Home Residents (HMO I-SNP) - H3347-003-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Elderplan Advantage For Nursing Home Residents (HMO I-SNP) - H3347-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) - H3379-002-0
Benefit Details
           
Queens $35.90 $445 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 2 (HMO I-SNP) - H3379-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) - H3379-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) - H3379-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Aetna Medicare Elite Plan (HMO) - H3312-068-0
Benefit Details
           
Queens $39.00 $300
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $5.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 27%
$7,550
Browse Formulary
Aetna Medicare Elite Plan (HMO) - H3312-068-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Elite Plan (HMO) - H3312-068-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Aetna Medicare Elite Plan (HMO) - H3312-068-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Aetna Medicare Elite Plan 3 (PPO) - H5521-310-0
Benefit Details
           
Queens $39.00 $300
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $5.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 27%
$7,550
Browse Formulary
Aetna Medicare Elite Plan 3 (PPO) - H5521-310-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Elite Plan 3 (PPO) - H5521-310-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Elite Plan 3 (PPO) - H5521-310-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Humana Gold Plus SNP-DE H3533-031 (HMO D-SNP) - H3533-031-0
Benefit Details
           
Queens $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: $2.00
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%
n/a
Browse Formulary
Humana Gold Plus SNP-DE H3533-031 (HMO D-SNP) - H3533-031-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Humana Gold Plus SNP-DE H3533-031 (HMO D-SNP) - H3533-031-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Humana Gold Plus SNP-DE H3533-031 (HMO D-SNP) - H3533-031-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
AgeWell New York Advantage Plus (HMO D-SNP) - H4922-010-0
Benefit Details
           
Queens $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: $0.00
Tier 2: $0.00
Tier 3: $0.00
Tier 4: $0.00
Tier 5: $0.00
n/a
Browse Formulary
AgeWell New York Advantage Plus (HMO D-SNP) - H4922-010-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- AgeWell New York Advantage Plus (HMO D-SNP) - H4922-010-0 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
AgeWell New York CareWell (HMO I-SNP) - H4922-004-0
Benefit Details
           
Queens $42.30 $445 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
AgeWell New York CareWell (HMO I-SNP) - H4922-004-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- AgeWell New York CareWell (HMO I-SNP) - H4922-004-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
AgeWell New York FeelWell (HMO D-SNP) - H4922-003-0
Benefit Details
           
Queens $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: $0.00
Tier 2: $0.00
Tier 3: $0.00
Tier 4: $0.00
Tier 5: $0.00
n/a
Browse Formulary
AgeWell New York FeelWell (HMO D-SNP) - H4922-003-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- AgeWell New York FeelWell (HMO D-SNP) - H4922-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
AgeWell New York LiveWell (HMO) - H4922-011-0
Benefit Details
           
Queens $42.30 $350
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $3.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 26%
$7,550
Browse Formulary
AgeWell New York LiveWell (HMO) - H4922-011-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- AgeWell New York LiveWell (HMO) - H4922-011-0 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
ArchCare Advantage (HMO I-SNP) - H1777-007-0
Benefit Details
           
Queens $42.30 $445 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
ArchCare  Advantage (HMO I-SNP) - H1777-007-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- ArchCare  Advantage (HMO I-SNP) - H1777-007-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Bright Advantage Assist (HMO) - H2288-005-0
Benefit Details
           
Queens $42.30 $445
Tier 1 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: 25%
Preferred Brand: 25%
Non-Preferred Drug: 25%
Specialty Tier: 25%
Select Care Drugs: $0.00
$6,500
Browse Formulary
new new Bright Advantage Assist (HMO) - H2288-005-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Bright Advantage Special Care (HMO D-SNP) - H2288-003-0
Benefit Details
           
Queens $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: $0.00
Tier 2: $0.00
Tier 3: $0.00
Tier 4: $0.00
Tier 5: $0.00
Tier 6: $0.00
n/a
Browse Formulary
new new Bright Advantage Special Care (HMO D-SNP) - H2288-003-0 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
Centers Plan for Dual Coverage Care (HMO D-SNP) - H6988-002-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
Centers Plan for Dual Coverage Care (HMO D-SNP) - H6988-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- Centers Plan for Dual Coverage Care (HMO D-SNP) - H6988-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Centers Plan for Nursing Home Care (HMO I-SNP) - H6988-003-0
Benefit Details
           
Queens $42.30 $445 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
Centers Plan for Nursing Home Care (HMO I-SNP) - H6988-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- Centers Plan for Nursing Home Care (HMO I-SNP) - H6988-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Elderplan Assist (HMO I-SNP) - H3347-015-0
Benefit Details
           
Queens $42.30 $445
Tier 1, 2 and 3 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $4.00
Generic: $14.00
Preferred Brand: $47.00
Non-Preferred Drug: 25%
Specialty Tier: 25%
n/a
Browse Formulary
Elderplan Assist (HMO I-SNP) - H3347-015-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Elderplan Assist (HMO I-SNP) - H3347-015-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Elderplan Assist (HMO I-SNP) - H3347-015-0 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
EmblemHealth VIP Assist (HMO D-SNP) - H5991-008-0
Benefit Details
           
Queens $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: $0.00
Tier 2: $0.00
Tier 3: $0.00
Tier 4: $0.00
Tier 5: $0.00
n/a
Browse Formulary
EmblemHealth VIP Assist (HMO D-SNP) - H5991-008-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- EmblemHealth VIP Assist (HMO D-SNP) - H5991-008-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
EmblemHealth VIP Connect (HMO D-SNP) - H5991-007-0
Benefit Details
           
Queens $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: $0.00
Tier 2: $0.00
Tier 3: $0.00
Tier 4: $0.00
Tier 5: $0.00
n/a
Browse Formulary
EmblemHealth VIP Connect (HMO D-SNP) - H5991-007-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- EmblemHealth VIP Connect (HMO D-SNP) - H5991-007-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
EmblemHealth VIP Dual (HMO D-SNP) - H3330-042-1
Benefit Details
           
Queens $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: $0.00
Tier 2: $0.00
Tier 3: $0.00
Tier 4: $0.00
Tier 5: $0.00
n/a
Browse Formulary
EmblemHealth VIP Dual (HMO D-SNP) - H3330-042-1 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) EmblemHealth VIP Dual (HMO D-SNP) - H3330-042-1 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) EmblemHealth VIP Dual (HMO D-SNP) - H3330-042-1 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
EmblemHealth VIP Dual Reserve (HMO D-SNP) - H5991-010-0
Benefit Details
           
Queens $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: $0.00
Tier 2: $0.00
Tier 3: $0.00
Tier 4: $0.00
Tier 5: $0.00
n/a
Browse Formulary
EmblemHealth VIP Dual Reserve (HMO D-SNP) - H5991-010-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- EmblemHealth VIP Dual Reserve (HMO D-SNP) - H5991-010-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
EmblemHealth VIP Dual Select (HMO D-SNP) - H5991-001-0
Benefit Details
           
Queens $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: $0.00
Tier 2: $0.00
Tier 3: $0.00
Tier 4: $0.00
Tier 5: $0.00
n/a
Browse Formulary
EmblemHealth VIP Dual Select (HMO D-SNP) - H5991-001-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- EmblemHealth VIP Dual Select (HMO D-SNP) - H5991-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
EmblemHealth VIP Passport NYC (HMO) - H5991-006-0
Benefit Details
           
Queens $42.30 $295
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $15.00
Preferred Brand: $42.00
Non-Preferred Drug: $95.00
Specialty Tier: 27%
$7,550
Browse Formulary
EmblemHealth VIP Passport NYC (HMO) - H5991-006-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- EmblemHealth VIP Passport NYC (HMO) - H5991-006-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
EmblemHealth VIP Solutions (HMO D-SNP) - H5991-002-0
Benefit Details
           
Queens $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: 15%
Tier 2: 15%
Tier 3: 15%
Tier 4: 15%
Tier 5: 15%
n/a
Browse Formulary
EmblemHealth VIP Solutions (HMO D-SNP) - H5991-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- EmblemHealth VIP Solutions (HMO D-SNP) - H5991-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Empire MediBlue Dual Advantage (HMO D-SNP) - H8432-007-0
Benefit Details
           
Queens $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $6.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 25%
Select Care Drugs: $0.00
n/a
Browse Formulary
Empire MediBlue Dual Advantage (HMO D-SNP) - H8432-007-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Empire MediBlue Dual Advantage (HMO D-SNP) - H8432-007-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Empire MediBlue Dual Advantage (HMO D-SNP) - H8432-007-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Empire MediBlue Dual Advantage Select (HMO D-SNP) - H8432-028-0
Benefit Details
           
Queens $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $7.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 25%
Select Care Drugs: $0.00
n/a
Browse Formulary
Empire MediBlue Dual Advantage Select (HMO D-SNP) - H8432-028-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Empire MediBlue Dual Advantage Select (HMO D-SNP) - H8432-028-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Empire MediBlue Dual Advantage Select (HMO D-SNP) - H8432-028-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Empire MediBlue Extra Select (HMO) - H8432-035-0
Benefit Details
           
Queens $42.30 $445
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 25%
Select Care Drugs: $0.00
$5,900
Browse Formulary
Empire MediBlue Extra Select (HMO) - H8432-035-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Empire MediBlue Extra Select (HMO) - H8432-035-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Empire MediBlue Extra Select (HMO) - H8432-035-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Empire MediBlue HealthPlus Dual Advantage (HMO D-SNP) - H1732-002-0
Benefit Details
           
Queens $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $6.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 25%
Select Care Drugs: $0.00
n/a
Browse Formulary
new new new Higher cost-sharing at standard network pharmacies. Details:
Empire MediBlue HealthPlus Dual Connect (HMO D-SNP) - H1732-003-0
Benefit Details
           
Queens $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $7.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 25%
Select Care Drugs: $0.00
n/a
Browse Formulary
new new new Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Empire MediBlue HealthPlus Dual Plus (HMO D-SNP) - H1732-001-0
Benefit Details
           
Queens $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $6.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 25%
Select Care Drugs: $0.00
n/a
Browse Formulary
new new new Higher cost-sharing at standard network pharmacies. Details:
Hamaspik Medicare Choice (HMO D-SNP) - H0034-002-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
new new new  
Hamaspik Medicare Select (HMO D-SNP) - H0034-001-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
new new new  
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 D-SNP) - H3359-034-0
Benefit Details
           
Queens $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: $0.00
n/a
Browse Formulary
Healthfirst CompleteCare (HMO D-SNP) - H3359-034-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Healthfirst CompleteCare (HMO D-SNP) - H3359-034-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst CompleteCare (HMO D-SNP) - H3359-034-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Healthfirst Increased Benefits Plan (HMO) - H3359-019-0
Benefit Details
           
Queens $42.30 $445 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
$7,550
Browse Formulary
Healthfirst Increased Benefits Plan (HMO) - H3359-019-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) 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)  
Healthfirst Life Improvement Plan (HMO D-SNP) - H3359-021-0
Benefit Details
           
Queens $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: $0.00
n/a
Browse Formulary
Healthfirst Life Improvement Plan (HMO D-SNP) - H3359-021-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Healthfirst Life Improvement Plan (HMO D-SNP) - H3359-021-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Healthfirst Life Improvement Plan (HMO D-SNP) - H3359-021-0 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
Integra Balanced Medicaid Advantage (HMO D-SNP) - H1205-007-0
Benefit Details
           
Queens $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: $0.00
n/a
Browse Formulary
new new new  
Integra Harmony (HMO D-SNP) - H1205-001-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
new new new  
Integra Synergy Medicaid Advantage Plus (MAP) (HMO D-SNP) - H1205-002-0
Benefit Details
           
Queens $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: $0.00
n/a
Browse Formulary
new new new  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Longevity Health Plan (HMO I-SNP) - H8457-001-0
Benefit Details
           
Queens $42.30 $445 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
new new Longevity Health Plan (HMO I-SNP) - H8457-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
MetroPlus Advantage Plan (HMO D-SNP) - H0423-001-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
MetroPlus Advantage Plan (HMO D-SNP) - H0423-001-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) MetroPlus Advantage Plan (HMO D-SNP) - H0423-001-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) MetroPlus Advantage Plan (HMO D-SNP) - H0423-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
MetroPlus UltraCare (HMO D-SNP) - H0423-007-0
Benefit Details
           
Queens $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: $0.00
n/a
Browse Formulary
MetroPlus UltraCare (HMO D-SNP) - H0423-007-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) MetroPlus UltraCare (HMO D-SNP) - H0423-007-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) MetroPlus UltraCare (HMO D-SNP) - H0423-007-0 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
RiverSpring MAP (HMO D-SNP) - H6776-002-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
-- -- --  
RiverSpring Star (HMO I-SNP) - H6776-001-0
Benefit Details
           
Queens $42.30 $445 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
-- -- --  
Senior Whole Health of New York NHC (HMO D-SNP) - H5992-007-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
-- -- --  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
UnitedHealthcare Assisted Living Plan (PPO I-SNP) - H2292-003-0
Benefit Details
           
Queens $42.30 $200
Tier 1, 2 and 3 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 29%

select insulin pay $35 copay
n/a
Browse Formulary
UnitedHealthcare Assisted Living Plan (PPO I-SNP) - H2292-003-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) new UnitedHealthcare Assisted Living Plan (PPO I-SNP) - H2292-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
UnitedHealthcare Dual Complete (HMO D-SNP) - H3387-010-0
Benefit Details
           
Queens $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: $0.00
Tier 2: $0.00
Tier 3: $0.00
Tier 4: $0.00
Tier 5: $0.00
n/a
Browse Formulary
UnitedHealthcare Dual Complete (HMO D-SNP) - H3387-010-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Dual Complete (HMO D-SNP) - H3387-010-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare Dual Complete (HMO D-SNP) - H3387-010-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
VillageCareMAX Medicare Health Advantage (HMO D-SNP) - H2168-001-0
Benefit Details
           
Queens $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: 15%
n/a
Browse Formulary
VillageCareMAX Medicare Health Advantage (HMO D-SNP) - H2168-001-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- VillageCareMAX Medicare Health Advantage (HMO D-SNP) - H2168-001-0 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
VNSNY CHOICE Total (HMO D-SNP) - H5549-003-0
Benefit Details
           
Queens $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: $7.00
Generic: $19.00
Preferred Brand: $47.00
Non-Preferred Brand: 39%
Specialty Tier: 25%
n/a
Browse Formulary
VNSNY CHOICE Total (HMO D-SNP) - H5549-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) VNSNY CHOICE Total (HMO D-SNP) - H5549-003-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) VNSNY CHOICE Total (HMO D-SNP) - H5549-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 5 Stars (Excellent)  
UnitedHealthcare Medicare Advantage Choice Plan 3 (Regional PPO) - R5342-005-0
Benefit Details
           
Queens $46.00 $275
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 28%

select insulin coverage $35 or less
$6,700
Browse Formulary
UnitedHealthcare Medicare Advantage Choice Plan 3 (Regional PPO) - R5342-005-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Medicare Advantage Choice Plan 3 (Regional PPO) - R5342-005-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare Medicare Advantage Choice Plan 3 (Regional PPO) - R5342-005-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
AARP Medicare Advantage Plan 1 (HMO) - H3307-002-0
Benefit Details
           
Queens $54.00 $395
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%

select insulin pay $35 copay
$6,700
Browse Formulary
AARP Medicare Advantage Plan 1 (HMO) - H3307-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Plan 1 (HMO) - H3307-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP Medicare Advantage Plan 1 (HMO) - H3307-002-0 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
Bright Advantage Plus (HMO) - H2288-002-0
Benefit Details
           
Queens $59.00 $445
Tier 1 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%
Select Care Drugs: $0.00
$4,900
Browse Formulary
new new Bright Advantage Plus (HMO) - H2288-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
EmblemHealth VIP Go (HMO-POS) - H3330-041-1
Benefit Details
           
Queens $72.00 $250
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $15.00
Preferred Brand: $42.00
Non-Preferred Drug: $95.00
Specialty Tier: 28%
$7,550
Browse Formulary
EmblemHealth VIP Go (HMO-POS) - H3330-041-1 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) EmblemHealth VIP Go (HMO-POS) - H3330-041-1 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) EmblemHealth VIP Go (HMO-POS) - H3330-041-1 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
WellCare Preferred (HMO) - H4868-010-0
Benefit Details
           
Queens $81.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: 48%
Specialty Tier: 33%
$6,700
Browse Formulary
WellCare Preferred (HMO) - H4868-010-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) new WellCare Preferred (HMO) - H4868-010-0 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
UnitedHealthcare Medicare Advantage Choice Plan 4 (Regional PPO) - R5342-006-0
Benefit Details
           
Queens $84.00 $150
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $3.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 30%

select insulin coverage $35 or less
$6,700
Browse Formulary
UnitedHealthcare Medicare Advantage Choice Plan 4 (Regional PPO) - R5342-006-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Medicare Advantage Choice Plan 4 (Regional PPO) - R5342-006-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare Medicare Advantage Choice Plan 4 (Regional PPO) - R5342-006-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Bright Advantage Choice Plus (PPO) - H9516-002-0
Benefit Details
           
Queens $95.00 $445
Tier 1 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%
Select Care Drugs: $0.00
$4,900
Browse Formulary
new new new  
EmblemHealth VIP Gold (HMO) - H3330-021-1
Benefit Details
           
Queens $96.00 $200
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $10.00
Preferred Brand: $40.00
Non-Preferred Drug: $95.00
Specialty Tier: 29%
$7,550
Browse Formulary
EmblemHealth VIP Gold (HMO) - H3330-021-1 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) EmblemHealth VIP Gold (HMO) - H3330-021-1 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) EmblemHealth VIP Gold (HMO) - H3330-021-1 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Aetna Medicare Premier Plan (PPO) - H5521-040-0
Benefit Details
           
Queens $99.00 $200
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 29%
$7,550
Browse Formulary
Aetna Medicare Premier Plan (PPO) - H5521-040-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Premier Plan (PPO) - H5521-040-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Premier Plan (PPO) - H5521-040-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Centers Plan for Medicaid Advantage (HMO D-SNP) - H6988-005-0
Benefit Details
           
Queens $58.70 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: $0.00
n/a
Browse Formulary
Centers Plan for Medicaid Advantage (HMO D-SNP) - H6988-005-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- Centers Plan for Medicaid Advantage (HMO D-SNP) - H6988-005-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Centers Plan for Medicaid Advantage Plus (HMO D-SNP) - H6988-004-0
Benefit Details
           
Queens $58.70 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: $0.00
n/a
Browse Formulary
Centers Plan for Medicaid Advantage Plus (HMO D-SNP) - H6988-004-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- Centers Plan for Medicaid Advantage Plus (HMO D-SNP) - H6988-004-0 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
VillageCareMAX Medicare Total Advantage (HMO D-SNP) - H2168-002-0
Benefit Details
           
Queens $73.70 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: $0.00
n/a
Browse Formulary
VillageCareMAX Medicare Total Advantage (HMO D-SNP) - H2168-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- VillageCareMAX Medicare Total Advantage (HMO D-SNP) - H2168-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
WellCare Today's Options Advantage Plus 150A (PPO) - H2775-105-0
Benefit Details
           
Queens $121.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $5.00
Preferred Brand: $35.00
Non-Preferred Drug: $75.00
Specialty Tier: 33%
$3,400
Browse Formulary
WellCare Today's Options Advantage Plus 150A (PPO) - H2775-105-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) WellCare Today's Options Advantage Plus 150A (PPO) - H2775-105-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) WellCare Today's Options Advantage Plus 150A (PPO) - H2775-105-0 Medicare Part D Plan Drug Pricing and Patient Safety - 5 Stars (Excellent) Higher cost-sharing at standard network pharmacies. Details:
MetroPlus Platinum Plan (HMO) - H0423-004-0
Benefit Details
           
Queens $148.50 $445 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
$7,550
Browse Formulary
MetroPlus Platinum Plan (HMO) - H0423-004-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) MetroPlus Platinum Plan (HMO) - H0423-004-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) MetroPlus Platinum Plan (HMO) - H0423-004-0 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
EmblemHealth VIP Gold Plus (HMO) - H3330-038-0
Benefit Details
           
Queens $302.00 $200
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $2.00
Generic: $10.00
Preferred Brand: $40.00
Non-Preferred Drug: $95.00
Specialty Tier: 29%
$7,550
Browse Formulary
EmblemHealth VIP Gold Plus (HMO) - H3330-038-0 Medicare Part D Plan Customer Service Rating - 2 Stars (Below Average) EmblemHealth VIP Gold Plus (HMO) - H3330-038-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) EmblemHealth VIP Gold Plus (HMO) - H3330-038-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:



Chart Legend:

Below are a few notes to help with the understanding of the 2021 Medicare Advantage 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 plan name is followed by the health plan type (HMO, HMO-POS, PPO, PFFS, etc).  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.

  • County: Medicare Advantage Plans are only available in specific county and in some cases only 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. 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.)

    (Search Tip: If you have selected an amount in the "LIS Subsidy Amount" filed, the premium shown is the premium based on your Low-Income Subsidy selection.

  • Deductible: The standard CMS plan initial deductible is $445. Many Medicare plans do not have a deductible; however their plan 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.) Some plans that have an annual deductible exempt certain drug tiers from the deductible. For example, "Tier 1 exempt" may be shown. This would mean that Tier 1 drugs purchased during the Deductible phase, would not fall into the deductible and would be charged the Initial Coverage Phase tier 1 cost-sharing.

  • Gap Coverage: In the CMS Standard Plan, the beneficiary, or others on their behalf (e.g. the brand-name drug manufacturer discount), pay(s) up to $5,184 in drug costs, depending on your mix of generics and brand-name drugs. The Healthcare Reform provides that for plan year 2021, all formulary drugs will have at least a 75% discount in the coverage gap (Donut Hole). The Gap Coverage Types discussed in this section are supplemental coverage your plan pays 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 receive the 75% Donut Hole Discount and pay up to $5,184 depending on your mix of generics and brand-name drugs, before exiting into Catastrophic Coverage. Read more...
    • Yes: This plan offers some supplemental gap coverage in addition to the 75% Donut Hole Discount. See plan details for a description of the gap coverage. The description may read similar to: Under this plan you may pay even less for the brand and generic drugs on the formulary. Your cost varies by tier. You will need to use your formulary to locate your drug's tier. See the chart that follows to find out how much it will cost you.

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

  • Copay / Coinsurance - Cost Sharing - This is what you will pay for formulary drugs in 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.)

    * When the text, for example: select insulin coverage $35 or less appears, this Part D plan may offer particular forms of insulin as part of the Senior Savings Model.  The Senior Savings Model stipulates that some insulin will cost no more than $35 in the deductible, initial coverage, and coverage gap phases of your Part D plan. Please contact the drug plan for more details.

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.

  • Plan’s Summary Star Rating - This is the overall star rating for the Medicare Part D plan. To learn more about the star ratings, please see our Plan Quality Star Ratings.

  • 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 Plan ID (September 2021 figures) - This is the total number of members in this plan's service area (a "Plan ID" is a specific contract ID and plan ID, for example H1234-001). The number of members for the selected county and the enrollment for the selected state are shown in addition to the plan ID enrollment on the plan details page. you can access the plan details by clicking the plan name, orange enroll options button, or the plan details icon.

  • Initial Coverage Limit (ICL) - The Initial Coverage Phase of a Medicare Part D plan is the phase AFTER the initial deductible is met (if the plan has an initial deductible) and BEFORE the coverage gap (or donut hole) begins. The ICL is the phase of the prescription drug plan during which you and your plan share your prescription costs. During this phase you will pay either a co-payment (a flat fee per prescription) or co-insurance (a percentage of the drug cost). The details of the cost-sharing for the plan are shown in the Cost-Sharing column directly to the left of this column. The CMS standard Initial Coverage Limit for 2021 is $4,130 and increases each year.

  • Medicare Part B Giveback Amount - If the plan rebates a portion of the Medicare Part B premium back to plan members, the amount will be shown in this column. This is also called "Part B premium Buy-Down", "Part B premium reduction", or "Part B premium give-back".

  • 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). Also see, What happens when I reach my Medicare Advantage plan maximum out of pocket limit (MOOP)? N/A means 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.)


(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. You should always verify cost and coverage information with your Medicare plan provider.






Tips & Disclaimers
  • 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 PDP-Compare.com and MA-Compare.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.
  • 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.