2024 Medicare Advantage Plans: SNPs,
    Health (MAs), Health & Rx Drug (MA-PDs)

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Selected County:* ALLEGHENY, Pennsylvania

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Other Options: Only plans with MOOP ≤ $3,650   limit search to 10 plans   Part B Giveback plans  

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Maximum Premium:
$  max: $327

Maximum Deductible:
$  max: $545

Health Coverage Type: All Types of Health Plans Cost Plans Local Health Maintenance Org. (HMO) Plans Medicare-Medicaid Plan Medicare Savings Account (MSA) Plans Private-Fee-For-Services (PFFS) Plans Local Preferred Provider Org. (PPO) Plans Regional Preferred Provider Org. (PPO) Plans Local and Regional (PPO) Plans

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Chronic Condition  
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Max. Co-pay Tier 1 (Generics):
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tip: enter 0 to show plans with a $0 Tier 1 Co-pay

Prescription Drug Coverage: Show plans with AND without Drug Coverage Show only plans WITH Drug Coverage Show only plans WITHOUT Drug Coverage

Type of Gap Coverage: No Gap Coverage Required Only Plans with No Gap Coverage Plans With Some Gap Coverage

Additional Info: Display the Part A & B Benefit MOOP Limit Display the Total Number of Formulary Drugs Display the Number of Plan Members in this Plan ID Display the Plan's Initial Coverage Limit Display Medicare Part B Giveback Amount Display the Health Plan Type (HMO, PPO, etc.) Eligibility Requirement if SNP

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There are 82 Pennsylvania 2024 Medicare Advantage plans (MAPD) meeting your criteria.
Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less. Open Enrollment for the 2024 Medicare Advantage plans begins on October 15, 2023.

2024 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 Patriot No Rx PA-MA01 (HMO-POS) - H1944-030-0 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$6,700
Aetna Medicare Advantra Eagle (HMO-POS) - H3959-041-0 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$3,900
Freedom Blue PPO Valor (PPO) - H3916-042-1 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$6,000
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Geisinger Gold Heritage (HMO) - H3954-162-0 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$6,700
Humana USAA Honor (PPO) - H5216-221-0 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$6,700
HumanaChoice H5216-116 (PPO) - H5216-116-0 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$3,900
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
HumanaChoice R0923-001 (Regional PPO) - R0923-001-0 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$4,500
Wellcare Patriot Giveback (HMO) - H2915-013-0 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$7,550
AARP Medicare Advantage from UHC PA-0002 (HMO-POS) - H1944-010-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,900
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 from UHC PA-0012 (PPO) - H2406-101-0 Benefit Details			Allegheny	$0.00	$295 Some Tiers exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $14.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28% all covered insulin pay $35 or less	$8,300
AARP Medicare Advantage from UHC PA-0017 (PPO) - H2406-117-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,500
Aetna Medicare Advantra Credit Value (PPO) - H5522-017-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$7,550
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Aetna Medicare Advantra Silver (HMO-POS) - H3959-010-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Aetna Medicare Value (PPO) - H5521-261-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 33% all covered insulin pay $35 or less	$6,400
Cigna Preferred Medicare (HMO) - H3949-047-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Cigna True Choice Medicare (PPO) - H7849-106-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,400
Cigna True Choice Savings Medicare (PPO) - H7849-111-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,400
Community Blue Medicare HMO Signature (HMO) - H3957-047-3 Benefit Details			Allegheny	$0.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,200
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Complete Blue PPO Signature (PPO) - H3916-041-1 Benefit Details			Allegheny	$0.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,500
Humana USAA Honor with Rx (PPO) - H5525-059-0 Benefit Details			Allegheny	$0.00	$250 Some Tiers exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 29% all covered insulin pay $35 or less	$7,850
HumanaChoice H5525-051 (PPO) - H5525-051-1 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$7,800
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
HumanaChoice H5525-058 (PPO) - H5525-058-0 Benefit Details			Allegheny	$0.00	$505 Some Tiers exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25% all covered insulin pay $35 or less	$7,000
HumanaChoice H5525-060 (PPO) - H5525-060-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$8,050
Provider Partners Pennsylvania Community Plan (HMO I-SNP) - H4093-004-0 Benefit Details			Allegheny	$0.00	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Together Blue Medicare HMO Signature (HMO) - H3957-048-0 Benefit Details			Allegheny	$0.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,900
UPMC for Life HMO No Rx (HMO) - H3907-002-0 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$5,000
UPMC for Life HMO Premier Rx (HMO) - H3907-046-0 Benefit Details			Allegheny	$0.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
UPMC for Life PPO Premier Rx (PPO) - H5533-013-0 Benefit Details			Allegheny	$0.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,500
UPMC for Life PPO Salute (PPO) - H5533-012-0 Benefit Details			Allegheny	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$5,500
Wellcare Giveback Open (PPO) - H2128-004-0 Benefit Details			Allegheny	$0.00	$545 Some Tiers exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 49% Specialty Tier: 25% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$7,550
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Wellcare No Premium (HMO) - H2915-003-0 Benefit Details			Allegheny	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$6,700
Wellcare No Premium (HMO) - H2915-016-0 Benefit Details			Allegheny	$0.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 48% Specialty Tier: 33% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$7,000
Wellcare No Premium Open (PPO) - H2128-002-0 Benefit Details			Allegheny	$0.00	$160 Some Tiers exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Drug: 43% Specialty Tier: 30% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$6,700
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
UPMC for Life PPO Rx Choice (PPO) - H5533-015-1 Benefit Details			Allegheny	$19.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Cigna Preferred Plus Medicare (HMO) - H3949-048-0 Benefit Details			Allegheny	$20.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$4,200
UPMC for Life HMO Deductible Rx (HMO) - H3907-037-0 Benefit Details			Allegheny	$20.80	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,000
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Wellcare Assist (HMO) - H2915-011-0 Benefit Details			Allegheny	$21.30	$435 Some Tiers exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 48% Specialty Tier: 25% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$7,550
Aetna Medicare Advantra Gold (HMO-POS) - H3959-001-0 Benefit Details			Allegheny	$22.60	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Geisinger Gold Value Rx (HMO) - H3954-163-0 Benefit Details			Allegheny	$23.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% Vaccines ($0 cost sharing): $0.00 all covered insulin pay $35 or less	$8,850
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
HumanaChoice H5525-017 (PPO) - H5525-017-0 Benefit Details			Allegheny	$26.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,300
Cigna True Choice Plus Medicare (PPO) - H7849-107-0 Benefit Details			Allegheny	$27.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Complete Blue PPO Distinct (PPO) - H3916-035-1 Benefit Details			Allegheny	$27.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Aetna Medicare Value Plus (PPO) - H5522-001-0 Benefit Details			Allegheny	$29.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Wellcare Dual Access Open (PPO D-SNP) - H2128-005-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
UHC Dual Complete PA-V001 (HMO-POS D-SNP) - H3113-014-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
UPMC for Life PPO High Deductible Rx (PPO) - H5533-003-0 Benefit Details			Allegheny	$29.50	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$7,550
UHC Nursing Home Plan EX-F002 (PPO I-SNP) - H0710-017-0 Benefit Details			Allegheny	$32.20	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
UHC Care Advantage PA-E001 (PPO I-SNP) - H0710-067-0 Benefit Details			Allegheny	$35.60	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $2.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	n/a
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
UPMC for Life HMO Rx Choice (HMO) - H3907-057-1 Benefit Details			Allegheny	$36.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$4,500
Aetna Medicare Silver (HMO-POS) - H3931-070-0 Benefit Details			Allegheny	$37.00	$250 Some Tiers exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 29% all covered insulin pay $35 or less	$7,550
Aetna Medicare Advantra Cares (HMO D-SNP) - H3959-036-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Cigna TotalCare Plus (HMO D-SNP) - H3949-009-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
AARP Medicare Advantage from UHC PA-0003 (HMO-POS) - H1944-011-0 Benefit Details			Allegheny	$39.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,200
Aetna Medicare Longevity Plan (HMO I-SNP) - H3959-066-0 Benefit Details			Allegheny	$39.00	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
UHC Dual Complete PA-S002 (HMO-POS D-SNP) - H3113-009-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
AARP Medicare Advantage from UHC PA-0014 (PPO) - H2577-021-0 Benefit Details			Allegheny	$40.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
AmeriHealth Caritas VIP Care (HMO D-SNP) - H4227-002-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Geisinger Gold Secure Rx (HMO D-SNP) - H3954-097-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) - H5932-001-0 Benefit Details			Allegheny	$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 Discount	Preferred Generic: $4.00 Generic: $13.00 Preferred Brand: $38.00 Non-Preferred Drug: 40% Specialty Tier: 25% all covered insulin pay $35 or less	n/a
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) - H5932-009-0 Benefit Details			Allegheny	$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 Discount	Preferred Generic: $4.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 46% Specialty Tier: 25% all covered insulin pay $35 or less	n/a
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Humana Value Plus H5216-117 (PPO) - H5216-117-0 Benefit Details			Allegheny	$40.20	$545 Some Tiers exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25% all covered insulin pay $35 or less	$7,800
HumanaChoice SNP-DE H5216-227 (PPO D-SNP) - H5216-227-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) - H4093-001-0 Benefit Details			Allegheny	$40.20	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
UHC Dual Complete PA-S001 (PPO D-SNP) - H1889-007-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
UPMC for Life Complete Care (HMO D-SNP) - H4279-001-0 Benefit Details			Allegheny	$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 Discount	Preferred Generic: $5.00 Generic: $15.00 Preferred Brand: $35.00 Non-Preferred Drug: 49% Specialty Tier: 25% all covered insulin pay $35 or less	n/a
Wellcare Dual Access (HMO D-SNP) - H2915-002-0 Benefit Details			Allegheny	$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 Discount	Tier 1: tbd all covered insulin pay $35 or less	n/a
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Community Blue Medicare HMO Prestige (HMO) - H3957-039-0 Benefit Details			Allegheny	$41.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Complete Blue PPO Premier (PPO) - H3916-044-1 Benefit Details			Allegheny	$46.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$4,900
HumanaChoice R0923-002 (Regional PPO) - R0923-002-0 Benefit Details			Allegheny	$46.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $6.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: $99.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,700
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Security Blue HMO-POS Basic (HMO-POS) - H3957-043-1 Benefit Details			Allegheny	$48.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$5,900
Security Blue HMO-POS ValueRx (HMO-POS) - H3957-031-0 Benefit Details			Allegheny	$48.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $13.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Freedom Blue PPO ValueRx (PPO) - H3916-032-0 Benefit Details			Allegheny	$64.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $13.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,500
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Humana Gold Choice H8145-163 (PFFS) - H8145-163-0 Benefit Details			Allegheny	$75.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	n/a
UPMC for Life HMO Rx (HMO) - H3907-029-0 Benefit Details			Allegheny	$81.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$4,500
HumanaChoice H5216-120 (PPO) - H5216-120-0 Benefit Details			Allegheny	$123.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $5.00 Generic: $15.00 Preferred Brand: $47.00 Non-Preferred Drug: $97.00 Specialty Tier: 33% all covered insulin pay $35 or less	$7,600
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
UPMC for Life PPO Rx Enhanced (PPO) - H5533-005-0 Benefit Details			Allegheny	$134.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$7,550
Aetna Medicare Gold Plan (PPO) - H5521-122-0 Benefit Details			Allegheny	$145.00	$250 Some Tiers exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 29% all covered insulin pay $35 or less	$7,550
Freedom Blue PPO Select (PPO) - H3916-022-0 Benefit Details			Allegheny	$158.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $13.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,000
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
Security Blue HMO-POS Standard (HMO-POS) - H3957-045-1 Benefit Details			Allegheny	$182.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $13.00 Preferred Brand: $44.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$5,000
Security Blue HMO-POS Deluxe (HMO-POS) - H3957-046-1 Benefit Details			Allegheny	$245.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $13.00 Preferred Brand: $42.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$4,500
Freedom Blue PPO Classic (PPO) - H3916-001-0 Benefit Details			Allegheny	$271.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $13.00 Preferred Brand: $45.00 Non-Preferred Drug: $95.00 Specialty Tier: 33% all covered insulin pay $35 or less	$4,500
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info
UPMC for Life HMO Rx Enhanced (HMO) - H3907-006-0 Benefit Details			Allegheny	$295.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$7,550

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Chart Legend:

Below are a few notes to help with the understanding of the 2024 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.
    
    
  Note: Plan ratings are by contract. This means that a Medicare Advantage plan that does NOT offer prescription drug coverage will still show drug plan ratings in the table above because these ratings are for the entire contract -- which may include plans that offer drug coverage and plans that do not. Click on the star icons to see further star rating details for the plan -- including the health plan ratings.
  
  
  • 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 $545. 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 $6,334 in drug costs, depending on your mix of generics and brand-name drugs. The Healthcare Reform provides that for plan year 2024, 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 $6,334 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.)
    
    All forms of insulin covered by any Medicare Part D plan will have a copay of $35 or less through all phases of coverage. 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.
    
    
  • Members in This Plan ID (September 2023 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 2024 is $5,030 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.)

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

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Medicare plan provider.