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This is archive material for research purposes. Please see PDPFinder.com or MAFinder.com for current plans.

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Only plans with MOOP ≤ $3,450   5-star rated plans   Limit search to 10 plans   Part B Giveback plans   Insulin $35 or less plans  
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tip: enter 0 to show plans with a $0 Tier 1 copay
There are 26 Texas 2022 Medicare Advantage plans (MAPD) meeting your criteria.

Caution: The 2022 Medicare Advantage plan information below is for research purposes.
Click here to see 2024 Medicare Advantage plans
2022 Medicare Advantage Plan Information
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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
Exemplar Health Freedom 1 (MSA) - H9295-001-0
Benefit Details
        
Anderson $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.n/a
 
Exemplar Health Freedom 2 (MSA) - H9295-002-0
Benefit Details
        
Anderson $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.n/a
 
Exemplar Health Freedom 3 (MSA) - H9295-003-0
Benefit Details
        
Anderson $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.n/a
 
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Lasso Healthcare Growth (MSA) - H1924-001-0
Benefit Details
        
Anderson $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.n/a
 
Lasso Healthcare Growth Plus (MSA) - H1924-004-0
Benefit Details
        
Anderson $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.n/a
 
AARP Medicare Advantage (HMO-POS) - H4590-042-0
Benefit Details
           
Anderson $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $3.00
Generic: $14.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

select insulin pay $35 copay
$4,500
Browse Formulary
AARP Medicare Advantage (HMO-POS) - H4590-042-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage (HMO-POS) - H4590-042-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) AARP Medicare Advantage (HMO-POS) - H4590-042-0 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 Medicare Advantage Choice (PPO) - H1278-015-0
Benefit Details
           
Anderson $0.00 $295
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred 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
AARP Medicare Advantage Choice (PPO) - H1278-015-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Choice (PPO) - H1278-015-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP Medicare Advantage Choice (PPO) - H1278-015-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Aetna Medicare Choice Plan (PPO) - H3288-008-0
Benefit Details
           
Anderson $0.00 $200
Tier 1, 2 and 3 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 29%
$6,700
Browse Formulary
Aetna Medicare Choice Plan (PPO) - H3288-008-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Choice Plan (PPO) - H3288-008-0 Medicare Part D Plan Member Experience with Drug Plan - 1 Stars (Poor) Aetna Medicare Choice Plan (PPO) - H3288-008-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Humana Honor (PPO) - H5216-128-0
Benefit Details
        
Anderson $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,400
Humana Honor (PPO) - H5216-128-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Honor (PPO) - H5216-128-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana Honor (PPO) - H5216-128-0 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
HumanaChoice H0473-005 (PPO) - H0473-005-0
Benefit Details
           
Anderson $0.00 $300
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $3.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $99.00
Specialty Tier: 28%
$6,900
Browse Formulary
HumanaChoice H0473-005 (PPO) - H0473-005-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H0473-005 (PPO) - H0473-005-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H0473-005 (PPO) - H0473-005-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
HumanaChoice R4182-001 (Regional PPO) - R4182-001-0
Benefit Details
        
Anderson $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,700
HumanaChoice R4182-001 (Regional PPO) - R4182-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice R4182-001 (Regional PPO) - R4182-001-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) HumanaChoice R4182-001 (Regional PPO) - R4182-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Molina Medicare Choice Care (HMO) - H7678-004-0
Benefit Details
           
Anderson $0.00 $125
Tier 6 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: 31%
Select Care Drugs: $0.00

select insulin pay $35 copay
$7,550
Browse Formulary
Molina Medicare Choice Care (HMO) - H7678-004-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- Molina Medicare Choice Care (HMO) - H7678-004-0 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
Molina Medicare Choice Care Select (HMO) - H7678-005-0
Benefit Details
           
Anderson $0.00 $480 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $15.00
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%
Select Care Drugs: $5.00
$7,550
Browse Formulary
Molina Medicare Choice Care Select (HMO) - H7678-005-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- Molina Medicare Choice Care Select (HMO) - H7678-005-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UnitedHealthcare Medicare Silver (Regional PPO C-SNP) - R6801-008-0
Benefit Details
           
Anderson $3.70 $480 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
UnitedHealthcare Medicare Silver (Regional PPO C-SNP) - R6801-008-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Medicare Silver (Regional PPO C-SNP) - R6801-008-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare Medicare Silver (Regional PPO C-SNP) - R6801-008-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
American Health Advantage of Texas (HMO I-SNP) - H6891-001-0
Benefit Details
           
Anderson $25.10 $480 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
American Health Advantage of Texas (HMO I-SNP) - H6891-001-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) new new  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Molina Medicare Complete Care (HMO D-SNP) - H7678-001-0
Benefit Details
           
Anderson $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. Some GenericsPreferred Generic: $0.00
Generic: $5.00
Preferred Brand: $42.00
Non-Preferred Drug: 30%
Specialty Tier: 25%
n/a
Browse Formulary
Molina Medicare Complete Care (HMO D-SNP) - H7678-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- Molina Medicare Complete Care (HMO D-SNP) - H7678-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Provider Partners Texas Advantage Plan (HMO I-SNP) - H4054-001-0
Benefit Details
           
Anderson $25.10 $480 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
n/a
Browse Formulary
new new new  
Provider Partners Texas Community Plan (HMO I-SNP) - H4054-002-0
Benefit Details
           
Anderson $25.10 $480 No additional gap coverage, only the Donut Hole DiscountTier 1: 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
UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0
Benefit Details
           
Anderson $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
UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UnitedHealthcare Dual Complete (HMO D-SNP) - H5322-025-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP) - R6801-011-0
Benefit Details
           
Anderson $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
UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP) - R6801-011-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP) - R6801-011-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP) - R6801-011-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UnitedHealthcare Medicare Gold (Regional PPO C-SNP) - R6801-009-0
Benefit Details
           
Anderson $29.00 $295
Tier 1, 2 and 3 exempt
Some GenericsPreferred Generic: $4.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 28%

select insulin coverage $35 or less
n/a
Browse Formulary
UnitedHealthcare Medicare Gold (Regional PPO C-SNP) - R6801-009-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Medicare Gold (Regional PPO C-SNP) - R6801-009-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare Medicare Gold (Regional PPO C-SNP) - R6801-009-0 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
HumanaChoice H5216-043 (PPO) - H5216-043-2
Benefit Details
           
Anderson $33.00 $250
Tier 1, 2 and 3 exempt
Yes, some additional gap coverage.Preferred Generic: $3.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $99.00
Specialty Tier: 28%

select insulin pay $35 copay
$6,700
Browse Formulary
HumanaChoice H5216-043 (PPO) - H5216-043-2 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-043 (PPO) - H5216-043-2 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-043 (PPO) - H5216-043-2 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
UnitedHealthcare Medicare Advantage Choice (Regional PPO) - R6801-012-0
Benefit Details
           
Anderson $49.00 $395
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $4.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 26%

select insulin coverage $35 or less
$7,550
Browse Formulary
UnitedHealthcare Medicare Advantage Choice (Regional PPO) - R6801-012-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Medicare Advantage Choice (Regional PPO) - R6801-012-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UnitedHealthcare Medicare Advantage Choice (Regional PPO) - R6801-012-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice R4182-004 (Regional PPO) - R4182-004-0
Benefit Details
           
Anderson $54.00 $175
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $6.00
Generic: $13.00
Preferred Brand: $47.00
Non-Preferred Drug: $99.00
Specialty Tier: 30%
$7,200
Browse Formulary
HumanaChoice R4182-004 (Regional PPO) - R4182-004-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice R4182-004 (Regional PPO) - R4182-004-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) HumanaChoice R4182-004 (Regional PPO) - R4182-004-0 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
HumanaChoice R4182-003 (Regional PPO) - R4182-003-0
Benefit Details
           
Anderson $92.00 $175
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $7.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $99.00
Specialty Tier: 30%
$7,200
Browse Formulary
HumanaChoice R4182-003 (Regional PPO) - R4182-003-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice R4182-003 (Regional PPO) - R4182-003-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) HumanaChoice R4182-003 (Regional PPO) - R4182-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice H5216-042 (PPO) - H5216-042-0
Benefit Details
           
Anderson $94.00 $200
Tier 1, 2 and 3 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $7.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $99.00
Specialty Tier: 29%
$6,700
Browse Formulary
HumanaChoice H5216-042 (PPO) - H5216-042-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-042 (PPO) - H5216-042-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-042 (PPO) - H5216-042-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:



Chart Legend:

Below are a few notes to help with the understanding of the 2022 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 $480. 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 $5,583 in drug costs, depending on your mix of generics and brand-name drugs. The Healthcare Reform provides that for plan year 2022, 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 $5,583 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 2022 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 2022 is $4,430 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.