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

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Fulton, Georgia

  Partial Plan Name(s):
 1:
 2:
ex: AARP
Only plans with MOOP ≤ $3,650   5-star rated plans   Limit search to 10 plans   Part B Giveback plans  
 No    Yes

$  max: $327

$  max: $545
Only show SNPs (All 3 Types)
OR only: Dual-Eligible  
Chronic Condition  
Institutional

$  
tip: enter 0 to show plans with a $0 Tier 1 copay
* required
There are 94 Georgia 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.

Click on the plan name or details button below to access plan details and contact information.
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 GA-MA01 (PPO) - H1889-022-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$4,500
AARP Medicare Advantage Patriot No Rx GA-MA01 (PPO) - H1889-022-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage Patriot No Rx GA-MA01 (PPO) - H1889-022-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) AARP Medicare Advantage Patriot No Rx GA-MA01 (PPO) - H1889-022-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Aetna Medicare Eagle (PPO) - H3288-034-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,350
Aetna Medicare Eagle (PPO) - H3288-034-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Eagle (PPO) - H3288-034-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Eagle (PPO) - H3288-034-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Aetna Medicare Eagle Plus (PPO) - H2293-009-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,900
Aetna Medicare Eagle Plus (PPO) - H2293-009-0 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
Anthem Veteran (HMO) - H5422-014-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$7,550
Anthem Veteran (HMO) - H5422-014-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Veteran (HMO) - H5422-014-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Anthem Veteran (HMO) - H5422-014-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Cigna True Choice Courage Medicare (PPO) - H7849-122-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$3,400
Cigna True Choice Courage Medicare (PPO) - H7849-122-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Cigna True Choice Courage Medicare (PPO) - H7849-122-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Cigna True Choice Courage Medicare (PPO) - H7849-122-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Clover Health Valor (PPO) - H5141-056-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$7,499
Clover Health Valor (PPO) - H5141-056-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Clover Health Valor (PPO) - H5141-056-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Clover Health Valor (PPO) - H5141-056-0 Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Humana USAA Honor (PPO) - H5216-217-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,700
Humana USAA Honor (PPO) - H5216-217-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana USAA Honor (PPO) - H5216-217-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana USAA Honor (PPO) - H5216-217-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice H5216-157 (PPO) - H5216-157-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,100
HumanaChoice H5216-157 (PPO) - H5216-157-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-157 (PPO) - H5216-157-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-157 (PPO) - H5216-157-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice R3392-001 (Regional PPO) - R3392-001-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$7,550
HumanaChoice R3392-001 (Regional PPO) - R3392-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice R3392-001 (Regional PPO) - R3392-001-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice R3392-001 (Regional PPO) - R3392-001-0 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
Kaiser Permanente Senior Advantage Liberty (HMO) - H1170-014-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,000
Kaiser Permanente Senior Advantage Liberty (HMO) - H1170-014-0 Medicare Part D Plan Customer Service Rating - 1 Stars (Poor) Kaiser Permanente Senior Advantage Liberty (HMO) - H1170-014-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Kaiser Permanente Senior Advantage Liberty (HMO) - H1170-014-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) - R2604-005-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$7,500
UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) - R2604-005-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) - R2604-005-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UHC Medicare Advantage Patriot No Rx GS-MA01 (Regional PPO) - R2604-005-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Wellcare Patriot No Premium (HMO-POS) - H1112-034-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$3,400
Wellcare Patriot No Premium (HMO-POS) - H1112-034-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare Patriot No Premium (HMO-POS) - H1112-034-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Wellcare Patriot No Premium (HMO-POS) - H1112-034-0 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
AARP Medicare Advantage from UHC GA-0004 (PPO) - H1889-021-0
Benefits & Contact Info
           
Fulton $0.00 $395
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $14.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 27%

all covered insulin pay $35 or less
$7,550
Browse Formulary
AARP Medicare Advantage from UHC GA-0004 (PPO) - H1889-021-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage from UHC GA-0004 (PPO) - H1889-021-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) AARP Medicare Advantage from UHC GA-0004 (PPO) - H1889-021-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
AARP Medicare Advantage from UHC GA-0005 (HMO-POS) - H5322-041-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $14.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$6,300
Browse Formulary
AARP Medicare Advantage from UHC GA-0005 (HMO-POS) - H5322-041-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage from UHC GA-0005 (HMO-POS) - H5322-041-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) AARP Medicare Advantage from UHC GA-0005 (HMO-POS) - H5322-041-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
AARP Medicare Advantage from UHC GA-0007 (PPO) - H1889-023-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $14.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$5,900
Browse Formulary
AARP Medicare Advantage from UHC GA-0007 (PPO) - H1889-023-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage from UHC GA-0007 (PPO) - H1889-023-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) AARP Medicare Advantage from UHC GA-0007 (PPO) - H1889-023-0 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 Walgreens from UHC GA-0001 (HMO-POS) - H5322-039-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$6,300
Browse Formulary
AARP Medicare Advantage Walgreens from UHC GA-0001 (HMO-POS) - H5322-039-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage Walgreens from UHC GA-0001 (HMO-POS) - H5322-039-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) AARP Medicare Advantage Walgreens from UHC GA-0001 (HMO-POS) - H5322-039-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Choice (PPO) - H5521-328-0
Benefits & Contact Info
           
Fulton $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
$6,000
Browse Formulary
Aetna Medicare Choice (PPO) - H5521-328-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Choice (PPO) - H5521-328-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Aetna Medicare Choice (PPO) - H5521-328-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Essential (PPO) - H5521-091-0
Benefits & Contact Info
           
Fulton $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
$6,000
Browse Formulary
Aetna Medicare Essential (PPO) - H5521-091-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Essential (PPO) - H5521-091-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Aetna Medicare Essential (PPO) - H5521-091-0 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
Aetna Medicare Giveback Choice (PPO) - H3288-045-0
Benefits & Contact Info
           
Fulton $0.00 $400
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $10.00
Preferred Brand: 20%
Non-Preferred Drug: 40%
Specialty Tier: 27%

all covered insulin pay $35 or less
$8,850
Browse Formulary
Aetna Medicare Giveback Choice (PPO) - H3288-045-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Giveback Choice (PPO) - H3288-045-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Giveback Choice (PPO) - H3288-045-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Giveback Choice Plus (PPO) - H2293-010-0
Benefits & Contact Info
           
Fulton $0.00 $400
Tier 1 and 2 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $10.00
Preferred Brand: 20%
Non-Preferred Drug: 40%
Specialty Tier: 27%

all covered insulin pay $35 or less
$8,850
Browse Formulary
Aetna Medicare Giveback Choice Plus (PPO) - H2293-010-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) new new Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Select (HMO) - H1109-005-0
Benefits & Contact Info
           
Fulton $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
$6,350
Browse Formulary
Aetna Medicare Select (HMO) - H1109-005-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Select (HMO) - H1109-005-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Select (HMO) - H1109-005-0 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 Signature (PPO) - H5521-360-0
Benefits & Contact Info
           
Fulton $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
Browse Formulary
Aetna Medicare Signature (PPO) - H5521-360-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Signature (PPO) - H5521-360-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Aetna Medicare Signature (PPO) - H5521-360-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Anthem Grocery (PPO) - H4036-033-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $4.00
Generic: $13.00
Preferred Brand: $35.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$6,700
Browse Formulary
Anthem Grocery (PPO) - H4036-033-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Grocery (PPO) - H4036-033-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Anthem Grocery (PPO) - H4036-033-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Anthem Kidney Care (HMO C-SNP) - H5422-015-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $4.00
Generic: $10.00
Preferred Brand: $42.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
n/a
Browse Formulary
Anthem Kidney Care (HMO C-SNP) - H5422-015-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Kidney Care (HMO C-SNP) - H5422-015-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Anthem Kidney Care (HMO C-SNP) - H5422-015-0 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
Anthem Medicare Advantage (HMO) - H5422-011-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $4.00
Generic: $11.00
Preferred Brand: $35.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$7,100
Browse Formulary
Anthem Medicare Advantage (HMO) - H5422-011-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Medicare Advantage (HMO) - H5422-011-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Anthem Medicare Advantage (HMO) - H5422-011-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Anthem Medicare Advantage (PPO) - H4036-031-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $4.00
Generic: $13.00
Preferred Brand: $35.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$6,700
Browse Formulary
Anthem Medicare Advantage (PPO) - H4036-031-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Medicare Advantage (PPO) - H4036-031-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Anthem Medicare Advantage (PPO) - H4036-031-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Cigna Preferred GA Medicare (HMO) - H0439-003-1
Benefits & Contact Info
           
Fulton $0.00 $200
Tier 1, 2 and 3 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $12.00
Preferred Brand: $45.00
Non-Preferred Drug: 38%
Specialty Tier: 30%

all covered insulin pay $35 or less
$5,500
Browse Formulary
Cigna Preferred GA Medicare (HMO) - H0439-003-1 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Cigna Preferred GA Medicare (HMO) - H0439-003-1 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Cigna Preferred GA Medicare (HMO) - H0439-003-1 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
Cigna Preferred Medicare (HMO) - H0439-007-0
Benefits & Contact Info
           
Fulton $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $8.00
Preferred Brand: $45.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$6,750
Browse Formulary
Cigna Preferred Medicare (HMO) - H0439-007-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Cigna Preferred Medicare (HMO) - H0439-007-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Cigna Preferred Medicare (HMO) - H0439-007-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Cigna True Choice Medicare (PPO) - H7849-003-0
Benefits & Contact Info
           
Fulton $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $45.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$6,900
Browse Formulary
Cigna True Choice Medicare (PPO) - H7849-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Cigna True Choice Medicare (PPO) - H7849-003-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Cigna True Choice Medicare (PPO) - H7849-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Cigna True Choice Savings Medicare (PPO) - H7849-117-1
Benefits & Contact Info
           
Fulton $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $4.00
Preferred Brand: $45.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$6,400
Browse Formulary
Cigna True Choice Savings Medicare (PPO) - H7849-117-1 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Cigna True Choice Savings Medicare (PPO) - H7849-117-1 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Cigna True Choice Savings Medicare (PPO) - H7849-117-1 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
Clear Spring Health Choice Plan (PPO) - H9589-003-0
Benefits & Contact Info
           
Fulton $0.00 $250
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $0.00
Preferred Brand: $42.00
Non-Preferred Drug: $95.00
Specialty Tier: 29%

all covered insulin pay $35 or less
$6,700
Browse Formulary
Clear Spring Health Choice Plan (PPO) - H9589-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- -- Higher cost-sharing at standard network pharmacies. Details:
Clear Spring Health Select Plus (HMO) - H6672-005-0
Benefits & Contact Info
           
Fulton $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $0.00
Preferred Brand: $42.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$3,450
Browse Formulary
Clear Spring Health Select Plus (HMO) - H6672-005-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- -- Higher cost-sharing at standard network pharmacies. Details:
Clover Health LiveHealthy (PPO) - H5141-026-0
Benefits & Contact Info
           
Fulton $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $8.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$7,999
Browse Formulary
Clover Health LiveHealthy (PPO) - H5141-026-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Clover Health LiveHealthy (PPO) - H5141-026-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Clover Health LiveHealthy (PPO) - H5141-026-0 Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average)  
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 H8145-069 (PFFS) - H8145-069-0
Benefits & Contact Info
           
Fulton $0.00 $340
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $7.00
Generic: $17.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 28%

all covered insulin pay $35 or less
n/a
Browse Formulary
Humana Gold Choice H8145-069 (PFFS) - H8145-069-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Gold Choice H8145-069 (PFFS) - H8145-069-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Humana Gold Choice H8145-069 (PFFS) - H8145-069-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Humana Gold Plus H4141-015 (HMO) - H4141-015-0
Benefits & Contact Info
           
Fulton $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
$6,350
Browse Formulary
Humana Gold Plus H4141-015 (HMO) - H4141-015-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Gold Plus H4141-015 (HMO) - H4141-015-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Humana Gold Plus H4141-015 (HMO) - H4141-015-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Humana Gold Plus H4141-017 (HMO) - H4141-017-3
Benefits & Contact Info
           
Fulton $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
Browse Formulary
Humana Gold Plus H4141-017 (HMO) - H4141-017-3 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Gold Plus H4141-017 (HMO) - H4141-017-3 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Humana Gold Plus H4141-017 (HMO) - H4141-017-3 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
Humana USAA Honor (PPO) - H5216-286-0
Benefits & Contact Info
        
Fulton $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$8,600
Humana USAA Honor (PPO) - H5216-286-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana USAA Honor (PPO) - H5216-286-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana USAA Honor (PPO) - H5216-286-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice - Diabetes and Heart (PPO C-SNP) - H5216-246-0
Benefits & Contact Info
           
Fulton $0.00 $145
Tier 1, 2, 3 and 6 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 31%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
n/a
Browse Formulary
HumanaChoice - Diabetes and Heart (PPO C-SNP) - H5216-246-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice - Diabetes and Heart (PPO C-SNP) - H5216-246-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice - Diabetes and Heart (PPO C-SNP) - H5216-246-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice H5216-154 (PPO) - H5216-154-0
Benefits & Contact Info
           
Fulton $0.00 $400
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $5.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 27%

all covered insulin pay $35 or less
$8,850
Browse Formulary
HumanaChoice H5216-154 (PPO) - H5216-154-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-154 (PPO) - H5216-154-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-154 (PPO) - H5216-154-0 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 H5216-203 (PPO) - H5216-203-1
Benefits & Contact Info
           
Fulton $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
$8,850
Browse Formulary
HumanaChoice H5216-203 (PPO) - H5216-203-1 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-203 (PPO) - H5216-203-1 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-203 (PPO) - H5216-203-1 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice H5216-279 (PPO) - H5216-279-0
Benefits & Contact Info
           
Fulton $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
$3,450
Browse Formulary
HumanaChoice H5216-279 (PPO) - H5216-279-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-279 (PPO) - H5216-279-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-279 (PPO) - H5216-279-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice H5216-345 (PPO) - H5216-345-0
Benefits & Contact Info
           
Fulton $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
$8,700
Browse Formulary
HumanaChoice H5216-345 (PPO) - H5216-345-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-345 (PPO) - H5216-345-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-345 (PPO) - H5216-345-0 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 R3392-004 (Regional PPO) - R3392-004-0
Benefits & Contact Info
           
Fulton $0.00 $195
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $4.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 30%

all covered insulin pay $35 or less
$8,850
Browse Formulary
HumanaChoice R3392-004 (Regional PPO) - R3392-004-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice R3392-004 (Regional PPO) - R3392-004-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice R3392-004 (Regional PPO) - R3392-004-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Kaiser Permanente Senior Advantage Basic 1 (HMO) - H1170-009-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%
Vaccines ($0 cost sharing): $0.00

all covered insulin pay $35 or less
$5,900
Browse Formulary
Kaiser Permanente Senior Advantage Basic 1 (HMO) - H1170-009-0 Medicare Part D Plan Customer Service Rating - 1 Stars (Poor) Kaiser Permanente Senior Advantage Basic 1 (HMO) - H1170-009-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Kaiser Permanente Senior Advantage Basic 1 (HMO) - H1170-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Kaiser Permanente Senior Advantage Care Plus (HMO-POS) - H1170-013-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%
Vaccines ($0 cost sharing): $0.00

all covered insulin pay $35 or less
$6,500
Browse Formulary
Kaiser Permanente Senior Advantage Care Plus (HMO-POS) - H1170-013-0 Medicare Part D Plan Customer Service Rating - 1 Stars (Poor) Kaiser Permanente Senior Advantage Care Plus (HMO-POS) - H1170-013-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Kaiser Permanente Senior Advantage Care Plus (HMO-POS) - H1170-013-0 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
UHC Complete Care GA-0003 (PPO C-SNP) - H1889-020-0
Benefits & Contact Info
           
Fulton $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
n/a
Browse Formulary
UHC Complete Care GA-0003 (PPO C-SNP) - H1889-020-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Complete Care GA-0003 (PPO C-SNP) - H1889-020-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UHC Complete Care GA-0003 (PPO C-SNP) - H1889-020-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Wellcare Giveback (HMO) - H1112-042-0
Benefits & Contact Info
           
Fulton $0.00 $545
Tier 1, 2 and 6 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $5.00
Preferred Brand: $42.00
Non-Preferred Drug: 50%
Specialty Tier: 25%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$8,850
Browse Formulary
Wellcare Giveback (HMO) - H1112-042-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare Giveback (HMO) - H1112-042-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Wellcare Giveback (HMO) - H1112-042-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Wellcare Mutual of Omaha No Premium Open (PPO) - H0111-001-0
Benefits & Contact Info
           
Fulton $0.00 $200
Tier 1, 2 and 6 exempt
Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $5.00
Preferred Brand: $42.00
Non-Preferred Drug: 50%
Specialty Tier: 30%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$7,500
Browse Formulary
Wellcare Mutual of Omaha No Premium Open (PPO) - H0111-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare Mutual of Omaha No Premium Open (PPO) - H0111-001-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Wellcare Mutual of Omaha No Premium Open (PPO) - H0111-001-0 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
Wellcare No Premium (HMO) - H1112-038-0
Benefits & Contact Info
           
Fulton $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $5.00
Preferred Brand: $42.00
Non-Preferred Drug: 41%
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$6,350
Browse Formulary
Wellcare No Premium (HMO) - H1112-038-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare No Premium (HMO) - H1112-038-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Wellcare No Premium (HMO) - H1112-038-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Humana Together in Health (PPO I-SNP) - H5216-242-0
Benefits & Contact Info
           
Fulton $18.00 $545 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%

all covered insulin pay $35 or less
n/a
Browse Formulary
Humana Together in Health (PPO I-SNP) - H5216-242-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Together in Health (PPO I-SNP) - H5216-242-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana Together in Health (PPO I-SNP) - H5216-242-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
PruittHealth Premier Advantage (HMO I-SNP) - H3291-003-0
Benefits & Contact Info
           
Fulton $20.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $7.00
Preferred Brand: $45.00
Non-Preferred Brand: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less
n/a
Browse Formulary
PruittHealth Premier Advantage (HMO I-SNP) - H3291-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- PruittHealth Premier Advantage (HMO I-SNP) - H3291-003-0 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
UHC Nursing Home Plan EX-F005 (PPO I-SNP) - H2406-031-0
Benefits & Contact Info
           
Fulton $20.00 $545 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%

all covered insulin pay $35 or less
n/a
Browse Formulary
UHC Nursing Home Plan EX-F005 (PPO I-SNP) - H2406-031-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Nursing Home Plan EX-F005 (PPO I-SNP) - H2406-031-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) UHC Nursing Home Plan EX-F005 (PPO I-SNP) - H2406-031-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
UHC Complete Care GS-001A (Regional PPO C-SNP) - R2604-002-0
Benefits & Contact Info
           
Fulton $20.70 $545 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%

all covered insulin pay $35 or less
n/a
Browse Formulary
UHC Complete Care GS-001A (Regional PPO C-SNP) - R2604-002-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Complete Care GS-001A (Regional PPO C-SNP) - R2604-002-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UHC Complete Care GS-001A (Regional PPO C-SNP) - R2604-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Cigna Preferred Plus Medicare (HMO) - H0439-006-0
Benefits & Contact Info
           
Fulton $28.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $4.00
Preferred Brand: $45.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$7,200
Browse Formulary
Cigna Preferred Plus Medicare (HMO) - H0439-006-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Cigna Preferred Plus Medicare (HMO) - H0439-006-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Cigna Preferred Plus Medicare (HMO) - H0439-006-0 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
UHC Complete Care GS-0002 (Regional PPO C-SNP) - R2604-003-0
Benefits & Contact Info
           
Fulton $28.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $12.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less
n/a
Browse Formulary
UHC Complete Care GS-0002 (Regional PPO C-SNP) - R2604-003-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Complete Care GS-0002 (Regional PPO C-SNP) - R2604-003-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UHC Complete Care GS-0002 (Regional PPO C-SNP) - R2604-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Anthem Grocery (HMO D-SNP) - H5422-016-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
Anthem Grocery (HMO D-SNP) - H5422-016-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Grocery (HMO D-SNP) - H5422-016-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Anthem Grocery (HMO D-SNP) - H5422-016-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Anthem Dual Advantage (HMO D-SNP) - H5422-018-0
Benefits & Contact Info
           
Fulton $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%
Tier 6: 15%

all covered insulin pay $35 or less
n/a
Browse Formulary
Anthem Dual Advantage (HMO D-SNP) - H5422-018-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Dual Advantage (HMO D-SNP) - H5422-018-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Anthem Dual Advantage (HMO D-SNP) - H5422-018-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Aetna Medicare Dual Signature (HMO D-SNP) - H5302-012-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
Aetna Medicare Dual Signature (HMO D-SNP) - H5302-012-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Dual Signature (HMO D-SNP) - H5302-012-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Dual Signature (HMO D-SNP) - H5302-012-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UHC Dual Complete GA-D002 (HMO-POS D-SNP) - H5322-030-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
UHC Dual Complete GA-D002 (HMO-POS D-SNP) - H5322-030-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Dual Complete GA-D002 (HMO-POS D-SNP) - H5322-030-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UHC Dual Complete GA-D002 (HMO-POS D-SNP) - H5322-030-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Aetna Medicare Dual Signature Select (PPO D-SNP) - H2293-003-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
Aetna Medicare Dual Signature Select (PPO D-SNP) - H2293-003-0 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
Aetna Medicare Dual Signature Choice (PPO D-SNP) - H2293-002-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
Aetna Medicare Dual Signature Choice (PPO D-SNP) - H2293-002-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) new new  
Anthem Extra Help (HMO) - H5422-013-0
Benefits & Contact Info
           
Fulton $32.00 $545 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $5.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 25%
Select Care Drugs: $5.00

all covered insulin pay $35 or less
$5,900
Browse Formulary
Anthem Extra Help (HMO) - H5422-013-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Extra Help (HMO) - H5422-013-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Anthem Extra Help (HMO) - H5422-013-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Cigna TotalCare (HMO D-SNP) - H0439-002-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
Cigna TotalCare (HMO D-SNP) - H0439-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Cigna TotalCare (HMO D-SNP) - H0439-002-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Cigna TotalCare (HMO D-SNP) - H0439-002-0 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
Aetna Medicare Value Plus Signature (PPO) - H5521-364-0
Benefits & Contact Info
           
Fulton $34.70 $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: 28%

all covered insulin pay $35 or less
$7,900
Browse Formulary
Aetna Medicare Value Plus Signature (PPO) - H5521-364-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Value Plus Signature (PPO) - H5521-364-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Aetna Medicare Value Plus Signature (PPO) - H5521-364-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
UHC Nursing Home Plan GA-F001 (PPO I-SNP) - H0710-033-0
Benefits & Contact Info
           
Fulton $34.90 $545 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%
Tier 2: 25%
Tier 3: 25%
Tier 4: 25%
Tier 5: 25%

all covered insulin pay $35 or less
n/a
Browse Formulary
UHC Nursing Home Plan GA-F001 (PPO I-SNP) - H0710-033-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- UHC Nursing Home Plan GA-F001 (PPO I-SNP) - H0710-033-0 Medicare Part D Plan Drug Pricing and Patient Safety - 5 Stars (Excellent)  
Wellcare Assist (HMO) - H1112-043-0
Benefits & Contact Info
           
Fulton $35.00 $410
Tier 1 and 6 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $20.00
Preferred Brand: $47.00
Non-Preferred Drug: 45%
Specialty Tier: 25%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$3,650
Browse Formulary
Wellcare Assist (HMO) - H1112-043-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare Assist (HMO) - H1112-043-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Wellcare Assist (HMO) - H1112-043-0 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
Clover Health LiveHealthy Value (PPO) - H5141-045-0
Benefits & Contact Info
           
Fulton $35.50 $545
Tier 1 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $8.00
Preferred Brand: 23%
Non-Preferred Drug: 33%
Specialty Tier: 25%

all covered insulin pay $35 or less
$7,499
Browse Formulary
Clover Health LiveHealthy Value (PPO) - H5141-045-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Clover Health LiveHealthy Value (PPO) - H5141-045-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Clover Health LiveHealthy Value (PPO) - H5141-045-0 Medicare Part D Plan Drug Pricing and Patient Safety - 2 Stars (Below Average)  
Cigna TotalCare Plus (HMO D-SNP) - H0439-012-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
Cigna TotalCare Plus (HMO D-SNP) - H0439-012-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Cigna TotalCare Plus (HMO D-SNP) - H0439-012-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Cigna TotalCare Plus (HMO D-SNP) - H0439-012-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
AARP Medicare Advantage from UHC GA-0006 (HMO-POS) - H5322-042-0
Benefits & Contact Info
           
Fulton $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
$4,900
Browse Formulary
AARP Medicare Advantage from UHC GA-0006 (HMO-POS) - H5322-042-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage from UHC GA-0006 (HMO-POS) - H5322-042-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) AARP Medicare Advantage from UHC GA-0006 (HMO-POS) - H5322-042-0 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
Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) - H4141-021-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) - H4141-021-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) - H4141-021-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Humana Gold Plus SNP-DE H4141-021 (HMO D-SNP) - H4141-021-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UHC Dual Complete GA-S001 (PPO D-SNP) - H3256-001-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
UHC Dual Complete GA-S001 (PPO D-SNP) - H3256-001-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Dual Complete GA-S001 (PPO D-SNP) - H3256-001-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UHC Dual Complete GA-S001 (PPO D-SNP) - H3256-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Wellcare Dual Liberty (HMO D-SNP) - H1112-033-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
Wellcare Dual Liberty (HMO D-SNP) - H1112-033-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare Dual Liberty (HMO D-SNP) - H1112-033-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Wellcare Dual Liberty (HMO D-SNP) - H1112-033-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Senior Advantage Medicare Medicaid Plan 1 (HMO D-SNP) - H1170-008-0
Benefits & Contact Info
           
Fulton $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: $14.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 25%
Vaccines ($0 cost sharing): $0.00

all covered insulin pay $35 or less
n/a
Browse Formulary
Senior Advantage Medicare Medicaid Plan 1 (HMO D-SNP) - H1170-008-0 Medicare Part D Plan Customer Service Rating - 1 Stars (Poor) Senior Advantage Medicare Medicaid Plan 1 (HMO D-SNP) - H1170-008-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Senior Advantage Medicare Medicaid Plan 1 (HMO D-SNP) - H1170-008-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Anthem Full Dual Advantage (PPO D-SNP) - H4036-032-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
Anthem Full Dual Advantage (PPO D-SNP) - H4036-032-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Full Dual Advantage (PPO D-SNP) - H4036-032-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Anthem Full Dual Advantage (PPO D-SNP) - H4036-032-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) - H4141-003-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) - H4141-003-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) - H4141-003-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP) - H4141-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Wellcare All Dual (HMO D-SNP) - H1112-006-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
Wellcare All Dual (HMO D-SNP) - H1112-006-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare All Dual (HMO D-SNP) - H1112-006-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Wellcare All Dual (HMO D-SNP) - H1112-006-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Anthem Full Dual Advantage (HMO D-SNP) - H5422-019-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
Anthem Full Dual Advantage (HMO D-SNP) - H5422-019-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Full Dual Advantage (HMO D-SNP) - H5422-019-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Anthem Full Dual Advantage (HMO D-SNP) - H5422-019-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Anthem Full Dual Advantage 2 (HMO D-SNP) - H5422-007-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
Anthem Full Dual Advantage 2 (HMO D-SNP) - H5422-007-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Full Dual Advantage 2 (HMO D-SNP) - H5422-007-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Anthem Full Dual Advantage 2 (HMO D-SNP) - H5422-007-0 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
CareSource Dual Advantage (HMO D-SNP) - H8390-015-0
Benefits & Contact Info
           
Fulton $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: 25%
Preferred Brand: 25%
Non-Preferred Drug: 25%
Specialty Tier: 25%

all covered insulin pay $35 or less
n/a
Browse Formulary
CareSource Dual Advantage (HMO D-SNP) - H8390-015-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- --  
HumanaChoice H5216-280 (PPO) - H5216-280-1
Benefits & Contact Info
           
Fulton $44.20 $545
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%

all covered insulin pay $35 or less
$8,850
Browse Formulary
HumanaChoice H5216-280 (PPO) - H5216-280-1 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-280 (PPO) - H5216-280-1 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-280 (PPO) - H5216-280-1 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice SNP-DE H5216-205 (PPO D-SNP) - H5216-205-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
HumanaChoice SNP-DE H5216-205 (PPO D-SNP) - H5216-205-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice SNP-DE H5216-205 (PPO D-SNP) - H5216-205-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice SNP-DE H5216-205 (PPO D-SNP) - H5216-205-0 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 SNP-DE H5216-206 (PPO D-SNP) - H5216-206-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
HumanaChoice SNP-DE H5216-206 (PPO D-SNP) - H5216-206-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice SNP-DE H5216-206 (PPO D-SNP) - H5216-206-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice SNP-DE H5216-206 (PPO D-SNP) - H5216-206-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
PruittHealth Premier (HMO I-SNP) - H3291-001-0
Benefits & Contact Info
           
Fulton $44.20 $545 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%

all covered insulin pay $35 or less
n/a
Browse Formulary
PruittHealth Premier (HMO I-SNP) - H3291-001-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- PruittHealth Premier (HMO I-SNP) - H3291-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 5 Stars (Excellent)  
PruittHealth Premier D-SNP (HMO D-SNP) - H3291-002-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
PruittHealth Premier D-SNP (HMO D-SNP) - H3291-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) -- PruittHealth Premier D-SNP (HMO D-SNP) - H3291-002-0 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
UHC Care Advantage GA-E001 (PPO I-SNP) - H0710-054-0
Benefits & Contact Info
           
Fulton $44.20 $0 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: 33%

all covered insulin pay $35 or less
n/a
Browse Formulary
UHC Care Advantage GA-E001 (PPO I-SNP) - H0710-054-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) -- UHC Care Advantage GA-E001 (PPO I-SNP) - H0710-054-0 Medicare Part D Plan Drug Pricing and Patient Safety - 5 Stars (Excellent)  
UHC Dual Complete GA-D001 (PPO D-SNP) - H2406-052-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
UHC Dual Complete GA-D001 (PPO D-SNP) - H2406-052-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Dual Complete GA-D001 (PPO D-SNP) - H2406-052-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) UHC Dual Complete GA-D001 (PPO D-SNP) - H2406-052-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
UHC Dual Complete GA-V001 (PPO D-SNP) - H3256-002-0
Benefits & Contact Info
           
Fulton $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%

all covered insulin pay $35 or less
n/a
Browse Formulary
UHC Dual Complete GA-V001 (PPO D-SNP) - H3256-002-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Dual Complete GA-V001 (PPO D-SNP) - H3256-002-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UHC Dual Complete GA-V001 (PPO D-SNP) - H3256-002-0 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
Wellcare Dual Access Open (PPO D-SNP) - H0111-004-0
Benefits & Contact Info
           
Fulton $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

all covered insulin pay $35 or less
n/a
Browse Formulary
Wellcare Dual Access Open (PPO D-SNP) - H0111-004-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare Dual Access Open (PPO D-SNP) - H0111-004-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Wellcare Dual Access Open (PPO D-SNP) - H0111-004-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Aetna Medicare Advantra Preferred (PPO) - H1608-028-0
Benefits & Contact Info
           
Fulton $46.00 $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
Browse Formulary
Aetna Medicare Advantra Preferred (PPO) - H1608-028-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Advantra Preferred (PPO) - H1608-028-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Advantra Preferred (PPO) - H1608-028-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
HumanaChoice H5216-073 (PPO) - H5216-073-0
Benefits & Contact Info
           
Fulton $55.00 $360
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $7.00
Generic: $17.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 27%

all covered insulin pay $35 or less
$8,850
Browse Formulary
HumanaChoice H5216-073 (PPO) - H5216-073-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-073 (PPO) - H5216-073-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-073 (PPO) - H5216-073-0 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
Anthem Medicare Advantage 2 (PPO) - H4036-030-0
Benefits & Contact Info
           
Fulton $59.00 $0 Yes, some additional gap coverage.Preferred Generic: $4.00
Generic: $13.00
Preferred Brand: $35.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$6,050
Browse Formulary
Anthem Medicare Advantage 2 (PPO) - H4036-030-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Anthem Medicare Advantage 2 (PPO) - H4036-030-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Anthem Medicare Advantage 2 (PPO) - H4036-030-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
UHC Medicare Advantage GS-0001 (Regional PPO) - R2604-001-0
Benefits & Contact Info
           
Fulton $62.00 $345
Tier 1 and 2 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
$6,300
Browse Formulary
UHC Medicare Advantage GS-0001 (Regional PPO) - R2604-001-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) UHC Medicare Advantage GS-0001 (Regional PPO) - R2604-001-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) UHC Medicare Advantage GS-0001 (Regional PPO) - R2604-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Kaiser Permanente Senior Advantage Enhanced 1 (HMO) - H1170-002-0
Benefits & Contact Info
           
Fulton $66.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $47.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%
Vaccines ($0 cost sharing): $0.00

all covered insulin pay $35 or less
$3,900
Browse Formulary
Kaiser Permanente Senior Advantage Enhanced 1 (HMO) - H1170-002-0 Medicare Part D Plan Customer Service Rating - 1 Stars (Poor) Kaiser Permanente Senior Advantage Enhanced 1 (HMO) - H1170-002-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Kaiser Permanente Senior Advantage Enhanced 1 (HMO) - H1170-002-0 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
HumanaChoice R3392-002 (Regional PPO) - R3392-002-0
Benefits & Contact Info
           
Fulton $92.00 $340
Tier 1 and 2 exempt
No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $7.00
Generic: $17.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 28%

all covered insulin pay $35 or less
$8,850
Browse Formulary
HumanaChoice R3392-002 (Regional PPO) - R3392-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice R3392-002 (Regional PPO) - R3392-002-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice R3392-002 (Regional PPO) - R3392-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  



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.

    • 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 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.)




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