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Clark, Illinois

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tip: enter 0 to show plans with a $0 Tier 1 copay
There are 30 Illinois 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
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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
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) - H8768-019-0
Benefits & Contact Info
        
Clark $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,900
AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) - H8768-019-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) - H8768-019-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP Medicare Advantage Patriot No Rx IL-MA01 (PPO) - H8768-019-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Blue Cross Medicare Advantage Protect (PPO) - H8634-019-0
Benefits & Contact Info
        
Clark $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,350
Blue Cross Medicare Advantage Protect (PPO) - H8634-019-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Blue Cross Medicare Advantage Protect (PPO) - H8634-019-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Blue Cross Medicare Advantage Protect (PPO) - H8634-019-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Health Alliance Medicare HMO Basic (HMO) - H1463-008-0
Benefits & Contact Info
        
Clark $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$6,700
Health Alliance Medicare HMO Basic (HMO) - H1463-008-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Health Alliance Medicare HMO Basic (HMO) - H1463-008-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Health Alliance Medicare HMO Basic (HMO) - H1463-008-0 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
Humana USAA Honor (PPO) - H5216-355-0
Benefits & Contact Info
        
Clark $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,500
Humana USAA Honor (PPO) - H5216-355-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana USAA Honor (PPO) - H5216-355-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana USAA Honor (PPO) - H5216-355-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Humana USAA Honor (PPO) - H5216-258-0
Benefits & Contact Info
        
Clark $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,500
Humana USAA Honor (PPO) - H5216-258-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana USAA Honor (PPO) - H5216-258-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Humana USAA Honor (PPO) - H5216-258-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Humana USAA Honor (Regional PPO) - R5361-001-0
Benefits & Contact Info
        
Clark $0.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.$5,500
Humana USAA Honor (Regional PPO) - R5361-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) -- Humana USAA Honor (Regional PPO) - R5361-001-0 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
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO) - H8768-011-0
Benefits & Contact Info
           
Clark $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
$5,900
Browse Formulary
AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO) - H8768-011-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO) - H8768-011-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP Medicare Advantage Walgreens from UHC IL-0006 (PPO) - H8768-011-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid Plan) - H2506-001-0
Benefits & Contact Info
           
Clark $0.00 $0 Yes, some additional gap coverage.Tier 1: 0%
Tier 2: 0%
Tier 3: 0%

all covered insulin pay $35 or less
n/a
Browse Formulary
-- -- --  
Aetna Medicare Value (PPO) - H7301-007-0
Benefits & Contact Info
           
Clark $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
$4,650
Browse Formulary
Aetna Medicare Value (PPO) - H7301-007-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Value (PPO) - H7301-007-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Value (PPO) - H7301-007-0 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
Blue Cross Medicare Advantage Basic (HMO) - H3822-012-0
Benefits & Contact Info
           
Clark $0.00 $0 Yes, some additional gap coverage.Preferred 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
$4,900
Browse Formulary
Blue Cross Medicare Advantage Basic (HMO) - H3822-012-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Blue Cross Medicare Advantage Basic (HMO) - H3822-012-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Blue Cross Medicare Advantage Basic (HMO) - H3822-012-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Blue Cross Medicare Advantage Classic (PPO) - H8634-017-0
Benefits & Contact Info
           
Clark $0.00 $0 Yes, some additional gap coverage.Preferred 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
$5,900
Browse Formulary
Blue Cross Medicare Advantage Classic (PPO) - H8634-017-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Blue Cross Medicare Advantage Classic (PPO) - H8634-017-0 Medicare Part D Plan Member Experience with Drug Plan - 3 Stars (Average) Blue Cross Medicare Advantage Classic (PPO) - H8634-017-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Blue Medicare Advantage (Medicare-Medicaid Plan) - H0927-001-0
Benefits & Contact Info
           
Clark $0.00 $0 Yes, some additional gap coverage.Tier 1: 0%
Tier 2: 0%
Tier 3: 0%

all covered insulin pay $35 or less
n/a
Browse Formulary
-- -- --  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Health Alliance Medicare POS Choice Rx (HMO-POS) - H1463-044-0
Benefits & Contact Info
           
Clark $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $2.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: 50%
Specialty Tier: 33%

all covered insulin pay $35 or less
$3,500
Browse Formulary
Health Alliance Medicare POS Choice Rx (HMO-POS) - H1463-044-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Health Alliance Medicare POS Choice Rx (HMO-POS) - H1463-044-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Health Alliance Medicare POS Choice Rx (HMO-POS) - H1463-044-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid Plan) - H0336-001-0
Benefits & Contact Info
           
Clark $0.00 $0 Yes, some additional gap coverage.Tier 1: 0%
Tier 2: 0%
Tier 3: 0%
Tier 4: 0%

all covered insulin pay $35 or less
n/a
Browse Formulary
-- -- --  
HumanaChoice H5216-215 (PPO) - H5216-215-0
Benefits & Contact Info
           
Clark $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
$5,000
Browse Formulary
HumanaChoice H5216-215 (PPO) - H5216-215-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-215 (PPO) - H5216-215-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-215 (PPO) - H5216-215-0 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
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid Plan) - H6080-001-0
Benefits & Contact Info
           
Clark $0.00 $0 Yes, some additional gap coverage.Tier 1: 0%
Tier 2: 0%
Tier 3: 0%

all covered insulin pay $35 or less
n/a
Browse Formulary
-- -- --  
Molina Dual Options (Medicare-Medicaid Plan) - H8046-001-0
Benefits & Contact Info
           
Clark $0.00 $0 Yes, some additional gap coverage.Tier 1: 0%
Tier 2: 0%
Tier 3: 0%

all covered insulin pay $35 or less
n/a
Browse Formulary
-- -- --  
Wellcare No Premium Essential (HMO) - H5779-002-0
Benefits & Contact Info
           
Clark $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $42.00
Non-Preferred Drug: 46%
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$2,900
Browse Formulary
Wellcare No Premium Essential (HMO) - H5779-002-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare No Premium Essential (HMO) - H5779-002-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Wellcare No Premium Essential (HMO) - H5779-002-0 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 Essential Value (HMO) - H5779-009-0
Benefits & Contact Info
           
Clark $0.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $0.00
Generic: $10.00
Preferred Brand: $42.00
Non-Preferred Drug: 50%
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$2,900
Browse Formulary
Wellcare No Premium Essential Value (HMO) - H5779-009-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare No Premium Essential Value (HMO) - H5779-009-0 Medicare Part D Plan Member Experience with Drug Plan - 2 Stars (Below Average) Wellcare No Premium Essential Value (HMO) - H5779-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Wellcare No Premium Open (PPO) - H6713-001-0
Benefits & Contact Info
           
Clark $0.00 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $10.00
Preferred Brand: $42.00
Non-Preferred Drug: 47%
Specialty Tier: 33%
Select Care Drugs: $0.00

all covered insulin pay $35 or less
$3,200
Browse Formulary
Wellcare No Premium Open (PPO) - H6713-001-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Wellcare No Premium Open (PPO) - H6713-001-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Wellcare No Premium Open (PPO) - H6713-001-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average) Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Premier (PPO) - H7301-009-0
Benefits & Contact Info
           
Clark $13.00 $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
$4,650
Browse Formulary
Aetna Medicare Premier (PPO) - H7301-009-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Premier (PPO) - H7301-009-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Premier (PPO) - H7301-009-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
Humana Gold Choice H8145-126 (PFFS) - H8145-126-0
Benefits & Contact Info
        
Clark $15.00 No Rx CoverageThis Plan does NOT include Prescription Drug coverage.n/a
Humana Gold Choice H8145-126 (PFFS) - H8145-126-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) Humana Gold Choice H8145-126 (PFFS) - H8145-126-0 Medicare Part D Plan Member Experience with Drug Plan - 5 Stars (Excellent) Humana Gold Choice H8145-126 (PFFS) - H8145-126-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Aetna Medicare Discover Value Plus (PPO) - H7301-017-0
Benefits & Contact Info
           
Clark $27.80 $0 Yes, some additional gap coverage.Preferred Generic: $0.00
Generic: $10.00
Preferred Brand: 20%
Non-Preferred Drug: 50%
Specialty Tier: 33%

all covered insulin pay $35 or less
$3,950
Browse Formulary
Aetna Medicare Discover Value Plus (PPO) - H7301-017-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) Aetna Medicare Discover Value Plus (PPO) - H7301-017-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Aetna Medicare Discover Value Plus (PPO) - H7301-017-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average) Higher cost-sharing at standard network pharmacies. Details:
AARP Medicare Advantage from UHC IA-0002 (HMO-POS) - H5253-108-1
Benefits & Contact Info
           
Clark $29.00 $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
$3,800
Browse Formulary
AARP Medicare Advantage from UHC IA-0002 (HMO-POS) - H5253-108-1 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage from UHC IA-0002 (HMO-POS) - H5253-108-1 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP Medicare Advantage from UHC IA-0002 (HMO-POS) - H5253-108-1 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Plan Name County Monthly
Prem.
Deduct-
ible
Additional
Gap
Coverage
Preferred Pharmacy
Copay/
Coinsurance
MOOP for
A & B
Service Exper. Cost Info
HumanaChoice H5216-399 (PPO) - H5216-399-0
Benefits & Contact Info
           
Clark $30.00 $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
$3,900
Browse Formulary
HumanaChoice H5216-399 (PPO) - H5216-399-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-399 (PPO) - H5216-399-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-399 (PPO) - H5216-399-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
AARP Medicare Advantage from UHC IL-0003 (PPO) - H8768-003-0
Benefits & Contact Info
           
Clark $49.00 $0 Yes, some additional gap coverage.Preferred 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
$3,400
Browse Formulary
AARP Medicare Advantage from UHC IL-0003 (PPO) - H8768-003-0 Medicare Part D Plan Customer Service Rating - 4 Stars (Above Average) AARP Medicare Advantage from UHC IL-0003 (PPO) - H8768-003-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) AARP Medicare Advantage from UHC IL-0003 (PPO) - H8768-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Health Alliance Medicare POS Basic Rx (HMO-POS) - H1463-015-0
Benefits & Contact Info
           
Clark $53.00 $0 Yes, some additional gap coverage.Preferred Generic: $2.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: 50%
Specialty Tier: 33%

all covered insulin pay $35 or less
$5,400
Browse Formulary
Health Alliance Medicare POS Basic Rx (HMO-POS) - H1463-015-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Health Alliance Medicare POS Basic Rx (HMO-POS) - H1463-015-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Health Alliance Medicare POS Basic Rx (HMO-POS) - H1463-015-0 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 H5216-013 (PPO) - H5216-013-0
Benefits & Contact Info
           
Clark $100.00 $0 No additional gap coverage, only the Donut Hole DiscountPreferred Generic: $6.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: $100.00
Specialty Tier: 33%

all covered insulin pay $35 or less
$5,700
Browse Formulary
HumanaChoice H5216-013 (PPO) - H5216-013-0 Medicare Part D Plan Customer Service Rating - 5 Stars (Excellent) HumanaChoice H5216-013 (PPO) - H5216-013-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) HumanaChoice H5216-013 (PPO) - H5216-013-0 Medicare Part D Plan Drug Pricing and Patient Safety - 3 Stars (Average)  
Health Alliance Medicare HMO 20 Rx (HMO) - H1463-003-0
Benefits & Contact Info
           
Clark $125.00 $0 Yes, some additional gap coverage.Preferred Generic: $2.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: 50%
Specialty Tier: 33%

all covered insulin pay $35 or less
$4,000
Browse Formulary
Health Alliance Medicare HMO 20 Rx (HMO) - H1463-003-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Health Alliance Medicare HMO 20 Rx (HMO) - H1463-003-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Health Alliance Medicare HMO 20 Rx (HMO) - H1463-003-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above Average)  
Health Alliance Medicare POS 10 Rx (HMO-POS) - H1463-019-0
Benefits & Contact Info
           
Clark $165.00 $0 Yes, some additional gap coverage.Preferred Generic: $2.00
Generic: $15.00
Preferred Brand: $47.00
Non-Preferred Drug: 50%
Specialty Tier: 33%

all covered insulin pay $35 or less
$2,900
Browse Formulary
Health Alliance Medicare POS 10 Rx (HMO-POS) - H1463-019-0 Medicare Part D Plan Customer Service Rating - 3 Stars (Average) Health Alliance Medicare POS 10 Rx (HMO-POS) - H1463-019-0 Medicare Part D Plan Member Experience with Drug Plan - 4 Stars (Above Average) Health Alliance Medicare POS 10 Rx (HMO-POS) - H1463-019-0 Medicare Part D Plan Drug Pricing and Patient Safety - 4 Stars (Above 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 (January 2024 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.