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Find a 2023 Medicare Advantage Plan (Health and Health w/Rx Plans)

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ALLEGHENY, Pennsylvania

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Only plans with MOOP ≤ $3,450   5-star rated plans   limit search to 10 plans   Part B Giveback plans  
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Review Medicare Advantage plans

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Free Part D Newsletter?

There are 79 Pennsylvania 2023 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.
2023 Medicare Advantage Plan Information
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Plan Name County Monthly
Prem. (Parts C & D)		 Deduct-
ible		 (Donut Hole)
Additional
Gap
Coverage		 Preferred Pharmacy
Copay/
Coinsurance
30-Day Supply		 MOOP for Part A & B Benefits
Cust.
Service
Rating		 Member
Plan
Exper.		 RxCost
Info
Rating
Lasso Healthcare Growth (MSA) - H1924-001-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.n/a
 
Lasso Healthcare Growth Plus (MSA) - H1924-004-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.n/a
 
AARP Medicare Advantage Choice Plan 2 (PPO) - H2577-029-0
Benefits & Contact Info
            		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		$6,900
Browse Formulary
AARP Medicare Advantage Choice Plan 2 (PPO) - H2577-029-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Choice Plan 2 (PPO) - H2577-029-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP Medicare Advantage Choice Plan 2 (PPO) - H2577-029-0 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 Flex Plan 1 (HMO-POS) - H1944-010-0
Benefits & Contact Info
            		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
Browse Formulary
AARP Medicare Advantage Flex Plan 1 (HMO-POS) - H1944-010-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Flex Plan 1 (HMO-POS) - H1944-010-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP Medicare Advantage Flex Plan 1 (HMO-POS) - H1944-010-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
AARP Medicare Advantage Patriot (HMO-POS) - H1944-030-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,500
AARP Medicare Advantage Patriot (HMO-POS) - H1944-030-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Patriot (HMO-POS) - H1944-030-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP Medicare Advantage Patriot (HMO-POS) - H1944-030-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Aetna Medicare Advantra Credit Value (PPO) - H5522-017-0
Benefits & Contact Info
            		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		$7,550
Browse Formulary
Aetna Medicare Advantra Credit Value (PPO) - H5522-017-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Advantra Credit Value (PPO) - H5522-017-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Aetna Medicare Advantra Credit Value (PPO) - H5522-017-0 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 Advantra Eagle (HMO) - H3959-041-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$4,000
Aetna Medicare Advantra Eagle (HMO) - H3959-041-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Advantra Eagle (HMO) - H3959-041-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Advantra Eagle (HMO) - H3959-041-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Aetna Medicare Advantra Silver (HMO-POS) - H3959-010-0
Benefits & Contact Info
            		Allegheny $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $42.00
Non-Preferred Drug: $99.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$5,900
Browse Formulary
Aetna Medicare Advantra Silver (HMO-POS) - H3959-010-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Advantra Silver (HMO-POS) - H3959-010-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Advantra Silver (HMO-POS) - H3959-010-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Value (PPO) - H5521-261-0
Benefits & Contact Info
            		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		$6,400
Browse Formulary
Aetna Medicare Value (PPO) - H5521-261-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Value (PPO) - H5521-261-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Aetna Medicare Value (PPO) - H5521-261-0 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
Cigna Preferred Medicare (HMO) - H3949-047-0
Benefits & Contact Info
            		Allegheny $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $35.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$4,600
Browse Formulary
Cigna Preferred Medicare (HMO) - H3949-047-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Cigna Preferred Medicare (HMO) - H3949-047-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Cigna Preferred Medicare (HMO) - H3949-047-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Cigna True Choice Medicare (PPO) - H7849-106-0
Benefits & Contact Info
            		Allegheny $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $35.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$6,100
Browse Formulary
Cigna True Choice Medicare (PPO) - H7849-106-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Cigna True Choice Medicare (PPO) - H7849-106-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Cigna True Choice Medicare (PPO) - H7849-106-0 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) - H7849-111-0
Benefits & Contact Info
            		Allegheny $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $35.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$6,050
Browse Formulary
Cigna True Choice Savings Medicare (PPO) - H7849-111-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Cigna True Choice Savings Medicare (PPO) - H7849-111-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Cigna True Choice Savings Medicare (PPO) - H7849-111-0 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
Community Blue Medicare HMO Signature (HMO) - H3957-047-3
Benefits & Contact Info
            		Allegheny $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: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$6,700
Browse Formulary
Community Blue Medicare HMO Signature (HMO) - H3957-047-3 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Community Blue Medicare HMO Signature (HMO) - H3957-047-3 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Community Blue Medicare HMO Signature (HMO) - H3957-047-3 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Complete Blue PPO Signature (PPO) - H3916-041-1
Benefits & Contact Info
            		Allegheny $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $0.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$7,550
Browse Formulary
Complete Blue PPO Signature (PPO) - H3916-041-1 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Complete Blue PPO Signature (PPO) - H3916-041-1 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Complete Blue PPO Signature (PPO) - H3916-041-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Freedom Blue PPO Valor (PPO) - H3916-042-1
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,000
Freedom Blue PPO Valor (PPO) - H3916-042-1 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Freedom Blue PPO Valor (PPO) - H3916-042-1 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Freedom Blue PPO Valor (PPO) - H3916-042-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.		 Deduct-
ible		 Additional
Gap
Coverage		 Preferred Pharmacy
Copay/
Coinsurance		 MOOP for
A & B
Service Exper. Cost Info
Humana Honor (PPO) - H5216-116-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$3,900
Humana Honor (PPO) - H5216-116-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Honor (PPO) - H5216-116-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana Honor (PPO) - H5216-116-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Humana Honor (PPO) - H5216-221-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,700
Humana Honor (PPO) - H5216-221-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Honor (PPO) - H5216-221-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana Honor (PPO) - H5216-221-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Humana USAA Honor with Rx (PPO) - H5525-059-0
Benefits & Contact Info
            		Allegheny $0.00 $250
Tier 1 and 2 exempt		 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $5.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 29%

all covered insulin pay $35 or less		$7,550
Browse Formulary
Humana USAA Honor with Rx (PPO) - H5525-059-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana USAA Honor with Rx (PPO) - H5525-059-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana USAA Honor with Rx (PPO) - H5525-059-0 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 H5525-051 (PPO) - H5525-051-1
Benefits & Contact Info
            		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		$7,550
Browse Formulary
HumanaChoice H5525-051 (PPO) - H5525-051-1 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5525-051 (PPO) - H5525-051-1 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5525-051 (PPO) - H5525-051-1 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice H5525-058 (PPO) - H5525-058-0
Benefits & Contact Info
            		Allegheny $0.00 $505
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: 25%

all covered insulin pay $35 or less		$7,550
Browse Formulary
HumanaChoice H5525-058 (PPO) - H5525-058-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5525-058 (PPO) - H5525-058-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5525-058 (PPO) - H5525-058-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
HumanaChoice H5525-060 (PPO) - H5525-060-0
Benefits & Contact Info
            		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
Browse Formulary
HumanaChoice H5525-060 (PPO) - H5525-060-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5525-060 (PPO) - H5525-060-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5525-060 (PPO) - H5525-060-0 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 R0923-001 (Regional PPO) - R0923-001-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$4,500
HumanaChoice R0923-001 (Regional PPO) - R0923-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice R0923-001 (Regional PPO) - R0923-001-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice R0923-001 (Regional PPO) - R0923-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Together Blue Medicare HMO Signature (HMO) - H3957-048-0
Benefits & Contact Info
            		Allegheny $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred 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		$6,700
Browse Formulary
Together Blue Medicare HMO Signature (HMO) - H3957-048-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Together Blue Medicare HMO Signature (HMO) - H3957-048-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Together Blue Medicare HMO Signature (HMO) - H3957-048-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
UPMC for Life HMO No Rx (HMO) - H3907-002-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,000
UPMC for Life HMO No Rx (HMO) - H3907-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life HMO No Rx (HMO) - H3907-002-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life HMO No Rx (HMO) - H3907-002-0 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
UPMC for Life HMO Premier Rx (HMO) - H3907-046-0
Benefits & Contact Info
            		Allegheny $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$5,500
Browse Formulary
UPMC for Life HMO Premier Rx (HMO) - H3907-046-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life HMO Premier Rx (HMO) - H3907-046-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life HMO Premier Rx (HMO) - H3907-046-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
UPMC for Life PPO Premier Rx (PPO) - H5533-013-0
Benefits & Contact Info
            		Allegheny $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$6,500
Browse Formulary
UPMC for Life PPO Premier Rx (PPO) - H5533-013-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life PPO Premier Rx (PPO) - H5533-013-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life PPO Premier Rx (PPO) - H5533-013-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
UPMC for Life PPO Salute (PPO) - H5533-012-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,500
UPMC for Life PPO Salute (PPO) - H5533-012-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life PPO Salute (PPO) - H5533-012-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life PPO Salute (PPO) - H5533-012-0 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 Giveback (HMO) - H2915-012-0
Benefits & Contact Info
            		Allegheny $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $5.00
Preferred Brand: $37.00
Non-Preferred Drug: 44%
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less		$7,550
Browse Formulary
Wellcare Giveback (HMO) - H2915-012-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Wellcare Giveback (HMO) - H2915-012-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Wellcare Giveback (HMO) - H2915-012-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Wellcare Giveback Open (PPO) - H2128-004-0
Benefits & Contact Info
            		Allegheny $0.00 $350
Tier 1, 2 and 6 exempt		 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $5.00
Preferred Brand: $37.00
Non-Preferred Drug: 48%
Specialty Tier: 27%
Select Care Drugs: $0.00

all covered insulin pay $35 or less		$7,550
Browse Formulary
Wellcare Giveback Open (PPO) - H2128-004-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) new new Higher cost-sharing at standard network pharmacies. Details:
Wellcare No Premium (HMO) - H2915-003-0
Benefits & Contact Info
            		Allegheny $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $5.00
Preferred Brand: $37.00
Non-Preferred Drug: 45%
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less		$6,700
Browse Formulary
Wellcare No Premium (HMO) - H2915-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Wellcare No Premium (HMO) - H2915-003-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Wellcare No Premium (HMO) - H2915-003-0 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
Wellcare No Premium Open (PPO) - H2128-002-0
Benefits & Contact Info
            		Allegheny $0.00 $160
Tier 1, 2 and 6 exempt		 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $7.00
Preferred Brand: $37.00
Non-Preferred Drug: 43%
Specialty Tier: 30%
Select Care Drugs: $0.00

all covered insulin pay $35 or less		$6,700
Browse Formulary
Wellcare No Premium Open (PPO) - H2128-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) new new Higher cost-sharing at standard network pharmacies. Details:
Wellcare Patriot Giveback (HMO) - H2915-013-0
Benefits & Contact Info
         		Allegheny $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$7,550
Wellcare Patriot Giveback (HMO) - H2915-013-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Wellcare Patriot Giveback (HMO) - H2915-013-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Wellcare Patriot Giveback (HMO) - H2915-013-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Wellcare Assist (HMO) - H2915-011-0
Benefits & Contact Info
            		Allegheny $13.50 $445
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		$6,700
Browse Formulary
Wellcare Assist (HMO) - H2915-011-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Wellcare Assist (HMO) - H2915-011-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Wellcare Assist (HMO) - H2915-011-0 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
Wellcare Assist Open (PPO) - H2128-001-0
Benefits & Contact Info
            		Allegheny $14.20 $395
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: 46%
Specialty Tier: 25%
Select Care Drugs: $0.00

all covered insulin pay $35 or less		$6,700
Browse Formulary
Wellcare Assist Open (PPO) - H2128-001-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) new new Higher cost-sharing at standard network pharmacies. Details:
HumanaChoice H5525-017 (PPO) - H5525-017-0
Benefits & Contact Info
            		Allegheny $18.00 $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		$4,900
Browse Formulary
HumanaChoice H5525-017 (PPO) - H5525-017-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5525-017 (PPO) - H5525-017-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5525-017 (PPO) - H5525-017-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UPMC for Life HMO Deductible Rx (HMO) - H3907-037-0
Benefits & Contact Info
            		Allegheny $22.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$6,000
Browse Formulary
UPMC for Life HMO Deductible Rx (HMO) - H3907-037-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life HMO Deductible Rx (HMO) - H3907-037-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life HMO Deductible Rx (HMO) - H3907-037-0 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
UPMC for Life PPO Rx Choice (PPO) - H5533-014-0
Benefits & Contact Info
            		Allegheny $23.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$5,500
Browse Formulary
UPMC for Life PPO Rx Choice (PPO) - H5533-014-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life PPO Rx Choice (PPO) - H5533-014-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life PPO Rx Choice (PPO) - H5533-014-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Wellcare Dual Access Open (PPO D-SNP) - H2128-005-0
Benefits & Contact Info
            		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 DiscountTier 1: $0.00

all covered insulin pay $35 or less		n/a
Browse Formulary
Wellcare Dual Access Open (PPO D-SNP) - H2128-005-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) new new  
Aetna Medicare Advantra Cares (HMO D-SNP) - H3959-036-0
Benefits & Contact Info
            		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 DiscountTier 1: $0.00

all covered insulin pay $35 or less		n/a
Browse Formulary
Aetna Medicare Advantra Cares (HMO D-SNP) - H3959-036-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Advantra Cares (HMO D-SNP) - H3959-036-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Advantra Cares (HMO D-SNP) - H3959-036-0 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
Cigna TotalCare Plus (HMO D-SNP) - H3949-009-0
Benefits & Contact Info
            		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 DiscountTier 1: $0.00

all covered insulin pay $35 or less		n/a
Browse Formulary
Cigna TotalCare Plus (HMO D-SNP) - H3949-009-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Cigna TotalCare Plus (HMO D-SNP) - H3949-009-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Cigna TotalCare Plus (HMO D-SNP) - H3949-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Complete Blue PPO Distinct (PPO) - H3916-035-1
Benefits & Contact Info
            		Allegheny $25.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred 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		$6,500
Browse Formulary
Complete Blue PPO Distinct (PPO) - H3916-035-1 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Complete Blue PPO Distinct (PPO) - H3916-035-1 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Complete Blue PPO Distinct (PPO) - H3916-035-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Cigna Preferred Plus Medicare (HMO) - H3949-048-0
Benefits & Contact Info
            		Allegheny $26.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $35.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$3,900
Browse Formulary
Cigna Preferred Plus Medicare (HMO) - H3949-048-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Cigna Preferred Plus Medicare (HMO) - H3949-048-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Cigna Preferred Plus Medicare (HMO) - H3949-048-0 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
Cigna True Choice Plus Medicare (PPO) - H7849-107-0
Benefits & Contact Info
            		Allegheny $27.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $35.00
Non-Preferred Drug: $95.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$5,500
Browse Formulary
Cigna True Choice Plus Medicare (PPO) - H7849-107-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Cigna True Choice Plus Medicare (PPO) - H7849-107-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Cigna True Choice Plus Medicare (PPO) - H7849-107-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Wellcare Low Premium Open (PPO) - H2128-003-0
Benefits & Contact Info
            		Allegheny $29.00 $100
Tier 1, 2 and 6 exempt		 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $7.00
Preferred Brand: $37.00
Non-Preferred Drug: 43%
Specialty Tier: 31%
Select Care Drugs: $0.00

all covered insulin pay $35 or less		$5,000
Browse Formulary
Wellcare Low Premium Open (PPO) - H2128-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) new new Higher cost-sharing at standard network pharmacies. Details:
Wellcare Dual Access (HMO D-SNP) - H2915-002-0
Benefits & Contact Info
            		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 DiscountTier 1: $0.00

all covered insulin pay $35 or less		n/a
Browse Formulary
Wellcare Dual Access (HMO D-SNP) - H2915-002-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Wellcare Dual Access (HMO D-SNP) - H2915-002-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Wellcare Dual Access (HMO D-SNP) - H2915-002-0 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 SNP-DE H5216-227 (PPO D-SNP) - H5216-227-0
Benefits & Contact Info
            		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 DiscountTier 1: $0.00

all covered insulin pay $35 or less		n/a
Browse Formulary
HumanaChoice SNP-DE H5216-227 (PPO D-SNP) - H5216-227-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice SNP-DE H5216-227 (PPO D-SNP) - H5216-227-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice SNP-DE H5216-227 (PPO D-SNP) - H5216-227-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
AARP Medicare Advantage Flex Plan 2 (HMO-POS) - H1944-011-0
Benefits & Contact Info
            		Allegheny $33.00 $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
Browse Formulary
AARP Medicare Advantage Flex Plan 2 (HMO-POS) - H1944-011-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Flex Plan 2 (HMO-POS) - H1944-011-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP Medicare Advantage Flex Plan 2 (HMO-POS) - H1944-011-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Aetna Medicare Advantra Premier Plus (PPO) - H5522-001-0
Benefits & Contact Info
            		Allegheny $33.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $42.00
Non-Preferred Drug: $99.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$6,001
Browse Formulary
Aetna Medicare Advantra Premier Plus (PPO) - H5522-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Advantra Premier Plus (PPO) - H5522-001-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Aetna Medicare Advantra Premier Plus (PPO) - H5522-001-0 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
UPMC for Life PPO High Deductible Rx (PPO) - H5533-003-0
Benefits & Contact Info
            		Allegheny $33.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$7,550
Browse Formulary
UPMC for Life PPO High Deductible Rx (PPO) - H5533-003-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life PPO High Deductible Rx (PPO) - H5533-003-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life PPO High Deductible Rx (PPO) - H5533-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
UnitedHealthcare Dual Complete (HMO-POS D-SNP) - H3113-009-0
Benefits & Contact Info
            		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 DiscountTier 1: $0.00

all covered insulin pay $35 or less		n/a
Browse Formulary
UnitedHealthcare Dual Complete (HMO-POS D-SNP) - H3113-009-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Dual Complete (HMO-POS D-SNP) - H3113-009-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UnitedHealthcare Dual Complete (HMO-POS D-SNP) - H3113-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
AARP Medicare Advantage Choice Plan 1 (PPO) - H2577-021-0
Benefits & Contact Info
            		Allegheny $35.00 $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
Browse Formulary
AARP Medicare Advantage Choice Plan 1 (PPO) - H2577-021-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AARP Medicare Advantage Choice Plan 1 (PPO) - H2577-021-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) AARP Medicare Advantage Choice Plan 1 (PPO) - H2577-021-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.		 Deduct-
ible		 Additional
Gap
Coverage		 Preferred Pharmacy
Copay/
Coinsurance		 MOOP for
A & B
Service Exper. Cost Info
Aetna Medicare Advantra Gold (HMO) - H3959-001-0
Benefits & Contact Info
            		Allegheny $35.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $0.00
Preferred Brand: $37.00
Non-Preferred Drug: $99.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$5,500
Browse Formulary
Aetna Medicare Advantra Gold (HMO) - H3959-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Advantra Gold (HMO) - H3959-001-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Advantra Gold (HMO) - H3959-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
UPMC for Life HMO Rx Choice (HMO) - H3907-049-0
Benefits & Contact Info
            		Allegheny $36.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$4,500
Browse Formulary
UPMC for Life HMO Rx Choice (HMO) - H3907-049-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life HMO Rx Choice (HMO) - H3907-049-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life HMO Rx Choice (HMO) - H3907-049-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) - H3113-014-0
Benefits & Contact Info
            		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 DiscountTier 1: 15%

all covered insulin pay $35 or less		n/a
Browse Formulary
UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) - H3113-014-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) - H3113-014-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UnitedHealthcare Dual Complete Select (HMO-POS D-SNP) - H3113-014-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.		 Deduct-
ible		 Additional
Gap
Coverage		 Preferred Pharmacy
Copay/
Coinsurance		 MOOP for
A & B
Service Exper. Cost Info
Aetna Medicare Longevity Plan (HMO I-SNP) - H3959-066-0
Benefits & Contact Info
            		Allegheny $41.00 $505 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%

all covered insulin pay $35 or less		n/a
Browse Formulary
Aetna Medicare Longevity Plan (HMO I-SNP) - H3959-066-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Longevity Plan (HMO I-SNP) - H3959-066-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Longevity Plan (HMO I-SNP) - H3959-066-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP) - H0710-017-0
Benefits & Contact Info
            		Allegheny $41.00 $505 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%

all covered insulin pay $35 or less		n/a
Browse Formulary
UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP) - H0710-017-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP) - H0710-017-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
AmeriHealth Caritas VIP Care (HMO D-SNP) - H4227-002-0
Benefits & Contact Info
            		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 DiscountGeneric: $8.00
Brand: 25%

all covered insulin pay $35 or less		n/a
Browse Formulary
AmeriHealth Caritas VIP Care (HMO D-SNP) - H4227-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) AmeriHealth Caritas VIP Care (HMO D-SNP) - H4227-002-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AmeriHealth Caritas VIP Care (HMO D-SNP) - H4227-002-0 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
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) - H5932-001-0
Benefits & Contact Info
            		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 DiscountPreferred Generic: $4.00
Generic: $11.00
Preferred Brand: $35.00
Non-Preferred Drug: 40%
Specialty Tier: 25%

all covered insulin pay $35 or less		n/a
Browse Formulary
Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) - H5932-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) - H5932-001-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Highmark Wholecare Medicare Assured Diamond (HMO D-SNP) - H5932-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) - H5932-009-0
Benefits & Contact Info
            		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 DiscountPreferred Generic: $4.00
Generic: $13.00
Preferred Brand: $42.00
Non-Preferred Drug: 45%
Specialty Tier: 25%

all covered insulin pay $35 or less		n/a
Browse Formulary
Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) - H5932-009-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) - H5932-009-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Highmark Wholecare Medicare Assured Ruby (HMO D-SNP) - H5932-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Humana Value Plus H5216-117 (PPO) - H5216-117-0
Benefits & Contact Info
            		Allegheny $41.10 $505
Tier 1 and 2 exempt		 No additional gap coverage, only the Donut Hole DiscountPreferred 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		$7,000
Browse Formulary
Humana Value Plus H5216-117 (PPO) - H5216-117-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Value Plus H5216-117 (PPO) - H5216-117-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana Value Plus H5216-117 (PPO) - H5216-117-0 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
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) - H4093-001-0
Benefits & Contact Info
            		Allegheny $41.10 $505 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%

all covered insulin pay $35 or less		n/a
Browse Formulary
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) - H4093-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) - H4093-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Provider Partners Pennsylvania Community Plan (HMO I-SNP) - H4093-004-0
Benefits & Contact Info
            		Allegheny $41.10 $505 No additional gap coverage, only the Donut Hole DiscountTier 1: 25%

all covered insulin pay $35 or less		n/a
Browse Formulary
Provider Partners Pennsylvania Community Plan (HMO I-SNP) - H4093-004-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- Provider Partners Pennsylvania Community Plan (HMO I-SNP) - H4093-004-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UnitedHealthcare Dual Complete Choice (PPO D-SNP) - H1889-007-0
Benefits & Contact Info
            		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 DiscountTier 1: $0.00

all covered insulin pay $35 or less		n/a
Browse Formulary
UnitedHealthcare Dual Complete Choice (PPO D-SNP) - H1889-007-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UnitedHealthcare Dual Complete Choice (PPO D-SNP) - H1889-007-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UnitedHealthcare Dual Complete Choice (PPO D-SNP) - H1889-007-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Plan Name County Monthly
Prem.		 Deduct-
ible		 Additional
Gap
Coverage		 Preferred Pharmacy
Copay/
Coinsurance		 MOOP for
A & B
Service Exper. Cost Info
UPMC for Life Complete Care (HMO D-SNP) - H4279-001-0
Benefits & Contact Info
            		Allegheny $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: $6.00
Generic: $12.00
Preferred Brand: $30.00
Non-Preferred Drug: 49%
Specialty Tier: 25%

all covered insulin pay $35 or less		n/a
Browse Formulary
UPMC for Life Complete Care (HMO D-SNP) - H4279-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life Complete Care (HMO D-SNP) - H4279-001-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life Complete Care (HMO D-SNP) - H4279-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Silver (HMO) - H3931-070-0
Benefits & Contact Info
            		Allegheny $47.00 $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		$7,550
Browse Formulary
Aetna Medicare Silver (HMO) - H3931-070-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Silver (HMO) - H3931-070-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Aetna Medicare Silver (HMO) - H3931-070-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Community Blue Medicare HMO Prestige (HMO) - H3957-039-0
Benefits & Contact Info
            		Allegheny $50.00 $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
Browse Formulary
Community Blue Medicare HMO Prestige (HMO) - H3957-039-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Community Blue Medicare HMO Prestige (HMO) - H3957-039-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Community Blue Medicare HMO Prestige (HMO) - H3957-039-0 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
Security Blue HMO-POS Basic (HMO-POS) - H3957-043-1
Benefits & Contact Info
         		Allegheny $50.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,900
Security Blue HMO-POS Basic (HMO-POS) - H3957-043-1 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Security Blue HMO-POS Basic (HMO-POS) - H3957-043-1 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Security Blue HMO-POS Basic (HMO-POS) - H3957-043-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Security Blue HMO-POS ValueRx (HMO-POS) - H3957-031-0
Benefits & Contact Info
            		Allegheny $59.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred 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
Browse Formulary
Security Blue HMO-POS ValueRx (HMO-POS) - H3957-031-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Security Blue HMO-POS ValueRx (HMO-POS) - H3957-031-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Security Blue HMO-POS ValueRx (HMO-POS) - H3957-031-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Freedom Blue PPO ValueRx (PPO) - H3916-032-0
Benefits & Contact Info
            		Allegheny $71.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred 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
Browse Formulary
Freedom Blue PPO ValueRx (PPO) - H3916-032-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Freedom Blue PPO ValueRx (PPO) - H3916-032-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Freedom Blue PPO ValueRx (PPO) - H3916-032-0 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
HumanaChoice R0923-002 (Regional PPO) - R0923-002-0
Benefits & Contact Info
            		Allegheny $71.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred 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
Browse Formulary
HumanaChoice R0923-002 (Regional PPO) - R0923-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice R0923-002 (Regional PPO) - R0923-002-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice R0923-002 (Regional PPO) - R0923-002-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
UPMC for Life HMO Rx (HMO) - H3907-029-0
Benefits & Contact Info
            		Allegheny $81.00 $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		$5,500
Browse Formulary
UPMC for Life HMO Rx (HMO) - H3907-029-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life HMO Rx (HMO) - H3907-029-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life HMO Rx (HMO) - H3907-029-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
HumanaChoice H5216-120 (PPO) - H5216-120-0
Benefits & Contact Info
            		Allegheny $123.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred 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		$6,700
Browse Formulary
HumanaChoice H5216-120 (PPO) - H5216-120-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-120 (PPO) - H5216-120-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-120 (PPO) - H5216-120-0 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
UPMC for Life PPO Rx Enhanced (PPO) - H5533-005-0
Benefits & Contact Info
            		Allegheny $134.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$7,550
Browse Formulary
UPMC for Life PPO Rx Enhanced (PPO) - H5533-005-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life PPO Rx Enhanced (PPO) - H5533-005-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life PPO Rx Enhanced (PPO) - H5533-005-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Freedom Blue PPO Select (PPO) - H3916-022-0
Benefits & Contact Info
            		Allegheny $166.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred 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
Browse Formulary
Freedom Blue PPO Select (PPO) - H3916-022-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Freedom Blue PPO Select (PPO) - H3916-022-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Freedom Blue PPO Select (PPO) - H3916-022-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Gold Plan (PPO) - H5521-122-0
Benefits & Contact Info
            		Allegheny $176.00 $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		$7,550
Browse Formulary
Aetna Medicare Gold Plan (PPO) - H5521-122-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Aetna Medicare Gold Plan (PPO) - H5521-122-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Aetna Medicare Gold Plan (PPO) - H5521-122-0 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
Security Blue HMO-POS Standard (HMO-POS) - H3957-045-1
Benefits & Contact Info
            		Allegheny $193.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred 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
Browse Formulary
Security Blue HMO-POS Standard (HMO-POS) - H3957-045-1 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Security Blue HMO-POS Standard (HMO-POS) - H3957-045-1 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Security Blue HMO-POS Standard (HMO-POS) - H3957-045-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Security Blue HMO-POS Deluxe (HMO-POS) - H3957-046-1
Benefits & Contact Info
            		Allegheny $256.00 $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
Browse Formulary
Security Blue HMO-POS Deluxe (HMO-POS) - H3957-046-1 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Security Blue HMO-POS Deluxe (HMO-POS) - H3957-046-1 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Security Blue HMO-POS Deluxe (HMO-POS) - H3957-046-1 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Freedom Blue PPO Classic (PPO) - H3916-001-0
Benefits & Contact Info
            		Allegheny $278.00 $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
Browse Formulary
Freedom Blue PPO Classic (PPO) - H3916-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Freedom Blue PPO Classic (PPO) - H3916-001-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Freedom Blue PPO Classic (PPO) - H3916-001-0 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
UPMC for Life HMO Rx Enhanced (HMO) - H3907-006-0
Benefits & Contact Info
            		Allegheny $295.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less		$7,550
Browse Formulary
UPMC for Life HMO Rx Enhanced (HMO) - H3907-006-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) UPMC for Life HMO Rx Enhanced (HMO) - H3907-006-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) UPMC for Life HMO Rx Enhanced (HMO) - H3907-006-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:

Review Medicare Advantage plans

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Chart Legend:

Below are a few notes to help with the understanding of the 2023 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 $505. Many Medicare plans do not have a deductible; however their plan premium may be higher. (Search Tip: If you would like to reduce the plans shown to just plans with a deductible under a certain value, enter this value in the "Maximum Deductible" field.) Some plans that have an annual deductible exempt certain drug tiers from the deductible. For example, "Tier 1 exempt" may be shown. This would mean that Tier 1 drugs purchased during the Deductible phase, would not fall into the deductible and would be charged the Initial Coverage Phase tier 1 cost-sharing.

    • Gap Coverage: In the CMS Standard Plan, the beneficiary, or others on their behalf (e.g. the brand-name drug manufacturer discount), pay(s) up to $5,856 in drug costs, depending on your mix of generics and brand-name drugs. The Healthcare Reform provides that for plan year 2023, all formulary drugs will have at least a 75% discount in the coverage gap (Donut Hole). The Gap Coverage Types discussed in this section are supplemental coverage your plan pays in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
      • No Rx Cov.: This plan does not include prescription drug coverage. You are 100% responsible for your medication costs. If you would like to see ONLY those plans that do include some type of prescription coverage, please select "Show only plans WITH Drug Coverage" in the "Prescription Drug Coverage" selector above (this is the default setting);
      • No Gap Coverage: You receive the 75% Donut Hole Discount and pay up to $5,856 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 2023 is $4,660 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.



 
 

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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.
.