There are 66 Medicare Advantage plans meeting your criteria.
2015 / 2016 Medicare Advantage Plan Information
Click here to jump to the Chart Legend |
Plan Name |
Monthly Premium |
Part A&B Maximum Out-Of Pocket |
Part D Deduct- ible |
(Donut Hole) Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Formulary Drugs |
Cust. Service Rating |
Member Plan Exper. |
RxCost Info Rating |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 AARP MedicareComplete (HMO)
| $0.00 |
$6,700 |
$165 | No additional gap coverage, only the Donut Hole Discount |
H4514 -007 -0 | $2.00 | $8.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
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|
|
|
2016 AARP MedicareComplete (HMO)
| $0.00 |
$6,700 |
$280 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $14.00 | $47.00 | $47.00 | 3,529 2016 Formulary |
|
2015 Aetna Medicare Premier Plan (HMO)
| $0.00 |
$6,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H4523 -015 -0 | $0.00 | $6.00 | $45.00 | $45.00 | 2,816
2015 Formulary |
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2016 Aetna Medicare Premier Plan (HMO)
| $0.00 |
$6,500 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,279 2016 Formulary |
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-- This plan not offered in 2015 --
|
H4523 -024 -0 | | | | | |
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2016 Aetna Medicare Prime Plan (HMO)
| $0.00 |
$2,950 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $65.00 | $65.00 | 3,543 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H8786 -001 -0 | | | | | |
new |
new |
new |
|
2016 Amerigroup Medicare-Medicaid Plan (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | $0.00 | 2,977 2016 Formulary |
|
2015 Amerivantage Classic + Rx (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5817 -020 -1 | $4.00 | $14.00 | $40.00 | $40.00 | 3,025
2015 Formulary |
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-- |
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2016 Amerivantage Classic (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. | $4.00 | $12.00 | $42.00 | $42.00 | 3,266 2016 Formulary |
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-- This plan not offered in 2015 --
|
H5817 -023 -0 | | | | | |
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-- |
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|
2016 Amerivantage Select (HMO)
| $0.00 |
$4,500 |
$0 | Yes, some additional gap coverage. | $2.00 | $8.00 | $42.00 | $42.00 | 3,266 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Blue Cross Medicare Advantage Basic (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H8133 -001 -0 | $0.00 | $6.00 | $39.00 | $39.00 | 2,975
2015 Formulary |
new |
new |
new |
|
2016 Blue Cross Medicare Advantage Basic (HMO)
| $0.00 |
$2,900 |
$0 | Yes, some additional gap coverage. | $0.00 | $6.00 | $39.00 | $39.00 | 3,108 2016 Formulary |
|
2015 Cigna-HealthSpring Advantage (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H4513 -009 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 Cigna-HealthSpring Advantage (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2015 --
|
H4513 -025 -0 | | | | | |
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|
|
2016 Cigna-HealthSpring Preferred (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $4.00 | $40.00 | $40.00 | 3,253 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H2649 -052 -0 | | | | | |
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2016 Humana Gold Plus H2649-052 (HMO)
| $0.00 |
$6,700 |
$200 | Yes, some additional gap coverage. | $3.00 | $10.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
2015 HumanaChoice R5826-026 (Regional PPO)
| $0.00 |
$3,400 |
No Rx Coverage |
R5826 -026 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 HumanaChoice R5826-026 (Regional PPO)
| $0.00 |
$4,900 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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2015 KelseyCare Advantage Essential (HMO)
| $0.00 |
$3,400 |
No Rx Coverage |
H0332 -001 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 KelseyCare Advantage Essential (HMO)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
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Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 KelseyCare Advantage Essential+Choice (HMO-POS)
| $0.00 |
$3,400 |
No Rx Coverage |
H0332 -003 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 KelseyCare Advantage Essential+Choice (HMO-POS)
| $0.00 |
$3,400 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 KelseyCare Advantage Rx (HMO)
| $0.00 |
$3,400 |
$50 | Yes, some additional gap coverage. |
H0332 -002 -0 | $3.00 | $30.00 | $40.00 | $40.00 | 3,444
2015 Formulary |
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2016 KelseyCare Advantage Rx (HMO)
| $0.00 |
$3,400 |
$50 | Yes, some additional gap coverage. | $3.00 | $17.00 | $40.00 | $40.00 | 3,651 2016 Formulary |
|
2015 Memorial Hermann Advantage (HMO)
| $0.00 |
$3,400 |
$100 | Yes, some additional gap coverage. |
H7115 -001 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 2,956
2015 Formulary |
new |
new |
new |
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2016 Memorial Hermann Advantage (HMO)
| $0.00 |
$3,900 |
$100 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,085 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Memorial Hermann Advantage (PPO)
| $0.00 |
$6,600 |
$100 | Yes, some additional gap coverage. |
H2968 -001 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 2,956
2015 Formulary |
new |
new |
new |
|
2016 Memorial Hermann Advantage (PPO)
| $0.00 |
$6,700 |
$100 | Yes, some additional gap coverage. | $0.00 | $5.00 | $47.00 | $47.00 | 3,085 2016 Formulary |
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-- This plan not offered in 2015 --
|
H8197 -001 -0 | | | | | |
new |
new |
new |
|
2016 Molina Dual Options (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | | 3,041 2016 Formulary |
|
2015 TexanPlus Classic (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4506 -003 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 2,885
2015 Formulary |
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2016 TexanPlus Classic (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,020 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 TexanPlus Value (HMO)
| $0.00 |
$3,000 |
No Rx Coverage |
H4506 -010 -0 | This plan does NOT include Prescription Drug coverage. | |
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2016 TexanPlus Value (HMO)
| $0.00 |
$3,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
-- This plan not offered in 2015 --
|
H7833 -001 -0 | | | | | |
new |
new |
new |
|
2016 UnitedHealthcare Connected (Medicare-Medicaid Plan)
| $0.00 |
n/a |
$0 | Yes, some additional gap coverage. | $0.00 | $0.00 | $0.00 | | 3,279 2016 Formulary |
|
2015 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1264 -008 -0 | $3.00 | $10.00 | $30.00 | $30.00 | 2,947
2015 Formulary |
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2016 WellCare Dividend (HMO)
| $0.00 |
$6,700 |
$200 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $20.00 | $47.00 | $47.00 | 2,801 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H1264 -019 -0 | | | | | |
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|
|
2016 WellCare Essential (HMO-POS)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $12.00 | $47.00 | $47.00 | 2,801 2016 Formulary |
|
2015 WellCare Value (HMO-POS)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1264 -004 -0 | $3.00 | $10.00 | $30.00 | $30.00 | 2,947
2015 Formulary |
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2016 WellCare Value (HMO-POS)
| $0.00 |
$6,700 |
$0 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $20.00 | $47.00 | $47.00 | 2,801 2016 Formulary |
|
2015 Care Improvement Plus Silver Rx (Regional PPO SNP)
| $0.00 |
$6,700 |
$307 | No additional gap coverage, only the Donut Hole Discount |
R6801 -008 -0 | 25% | 25% | 25% | 25% | n/a |
|
|
|
|
2016 Care Improvement Plus Silver Rx (Regional PPO SNP)
| $5.70 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | tbd |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Care Improvement Plus Dual Advantage (Regional PPO SNP)
| $15.00 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
R6801 -011 -0 | | | | | n/a |
|
|
|
|
2016 Care Improvement Plus Dual Advantage (Regional PPO SNP)
| $11.90 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | tbd |
|
2015 Blue Cross Medicare Advantage Choice Plus (PPO)
| $35.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1666 -006 -0 | $0.00 | $6.00 | $39.00 | $39.00 | 2,975
2015 Formulary |
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|
|
|
2016 Blue Cross Medicare Advantage Choice Plus (PPO)
| $15.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $6.00 | $39.00 | $39.00 | 3,108 2016 Formulary |
|
2015 Aetna Medicare Choice Plan (PPO)
| $19.00 |
$5,900 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5521 -060 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 2,816
2015 Formulary |
|
-- |
|
|
2016 Aetna Medicare Choice Plan (PPO)
| $19.00 |
$6,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $42.00 | $42.00 | 3,279 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Care Improvement Plus Gold Rx (Regional PPO SNP)
| $0.00 |
$6,700 |
$315 | No additional gap coverage, only the Donut Hole Discount |
R6801 -009 -0 | $3.00 | $10.00 | $45.00 | $45.00 | n/a |
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|
|
|
2016 Care Improvement Plus Gold Rx (Regional PPO SNP)
| $19.00 |
n/a |
$250 | No additional gap coverage, only the Donut Hole Discount | $4.00 | $11.00 | $47.00 | $47.00 | tbd |
|
2015 WellCare Access (HMO SNP)
| $21.00 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H1264 -007 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,947
2015 Formulary |
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|
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2016 WellCare Access (HMO SNP)
| $19.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $6.00 | $32.00 | $32.00 | 2,801 2016 Formulary |
|
2015 Humana Gold Choice H8145-126 (PFFS)
| $15.00 |
n/a |
No Rx Coverage |
H8145 -126 -0 | This plan does NOT include Prescription Drug coverage. | |
|
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2016 Humana Gold Choice H8145-126 (PFFS)
| $20.00 |
n/a |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 HumanaChoice R5826-091 (Regional PPO)
| $15.00 |
$6,700 |
$320 | Yes, some additional gap coverage. |
R5826 -091 -0 | $6.00 | $13.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2016 HumanaChoice R5826-091 (Regional PPO)
| $20.00 |
$6,700 |
$360 | Yes, some additional gap coverage. | $6.00 | $13.00 | $47.00 | $47.00 | tbd |
|
2015 UnitedHealthcare Dual Complete (HMO SNP)
| $27.30 |
$2,500 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H4514 -001 -0 | | | | | 3,649
2015 Formulary |
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|
|
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2016 UnitedHealthcare Dual Complete (HMO SNP)
| $21.80 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,529 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H0710 -020 -0 | | | | | |
|
-- |
|
|
2016 UnitedHealthcare Nursing Home Plan (PPO SNP)
| $26.50 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,529 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H2649 -048 -0 | | | | | |
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|
|
|
2016 Humana Gold Plus SNP-DE H2649-048 (HMO SNP)
| $27.80 |
n/a |
$300 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $13.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H5817 -024 -2 | | | | | |
|
-- |
|
|
2016 Amerivantage Dual Coordination (HMO SNP)
| $28.00 |
n/a |
$360 | Yes, some additional gap coverage. | $0.00 | $13.00 | $47.00 | $47.00 | 3,266 2016 Formulary |
|
2015 Cigna-HealthSpring TotalCare (HMO SNP)
| $27.30 |
$3,400 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H4513 -010 -0 | | | | | 3,087
2015 Formulary |
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|
|
|
2016 Cigna-HealthSpring TotalCare (HMO SNP)
| $28.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,253 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H2649 -056 -0 | | | | | |
|
|
|
|
2016 Humana Kidney Care (HMO-POS SNP)
| $28.00 |
n/a |
$0 | Yes, some additional gap coverage. | $8.00 | $15.00 | $47.00 | $47.00 | 3,617 2016 Formulary |
|
2015 Molina Medicare Options Plus (HMO SNP)
| $27.30 |
$6,700 |
$320 | Yes, some additional gap coverage. |
H7678 -001 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 2,895
2015 Formulary |
|
|
|
|
2016 Molina Medicare Options Plus (HMO SNP)
| $28.00 |
n/a |
$360 | Yes, some additional gap coverage. | $0.00 | $15.00 | $47.00 | $47.00 | 3,041 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H0174 -001 -0 | | | | | |
new |
new |
new |
|
2016 TexanPlus Star (HMO SNP)
| $28.00 |
n/a |
$360 | No additional gap coverage, only the Donut Hole Discount | | | | | 3,020 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H8133 -011 -0 | | | | | |
new |
new |
new |
|
2016 Blue Cross Medicare Advantage Premier (HMO)
| $29.00 |
$2,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $6.00 | $39.00 | $39.00 | 3,108 2016 Formulary |
|
-- This plan not offered in 2015 --
|
H5652 -003 -0 | | | | | |
|
|
|
|
2016 Erickson Advantage Guardian (HMO-POS SNP)
| $29.10 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $4.00 | $28.00 | $28.00 | 3,529 2016 Formulary |
|
2015 TexanPlus Choice (HMO-POS)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4506 -029 -0 | $0.00 | $0.00 | $40.00 | $40.00 | 2,885
2015 Formulary |
|
|
|
|
2016 TexanPlus Choice (HMO-POS)
| $30.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $5.00 | $40.00 | $40.00 | 3,020 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Care Improvement Plus Medicare Advantage (Regional PPO)
| $23.00 |
$6,700 |
$315 | No additional gap coverage, only the Donut Hole Discount |
R6801 -012 -0 | $3.00 | $12.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2016 Care Improvement Plus Medicare Advantage (Regional PPO)
| $32.00 |
$6,700 |
$220 | No additional gap coverage, only the Donut Hole Discount | $2.00 | $12.00 | $47.00 | $47.00 | tbd |
|
2015 Erickson Advantage Freedom (HMO-POS)
| $48.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5652 -006 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
|
|
|
|
2016 Erickson Advantage Freedom (HMO-POS)
| $49.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $45.00 | $45.00 | 3,529 2016 Formulary |
|
2015 Blue Cross Medicare Advantage Choice Premier (PPO)
| $55.00 |
$3,400 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H1666 -003 -0 | $0.00 | $6.00 | $39.00 | $39.00 | 2,975
2015 Formulary |
|
|
|
|
2016 Blue Cross Medicare Advantage Choice Premier (PPO)
| $55.00 |
$3,500 |
$0 | Yes, some additional gap coverage. | $0.00 | $6.00 | $39.00 | $39.00 | 3,108 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 HumanaChoice H6609-108 (PPO)
| $66.00 |
$6,600 |
$0 | Yes, some additional gap coverage. |
H6609 -108 -0 | $7.00 | $12.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
|
|
|
2016 HumanaChoice H6609-108 (PPO)
| $71.00 |
$6,700 |
$200 | Yes, some additional gap coverage. | $7.00 | $12.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
2015 HumanaChoice R5826-012 (Regional PPO)
| $69.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
R5826 -012 -0 | $7.00 | $12.00 | $45.00 | $45.00 | n/a |
|
|
|
|
2016 HumanaChoice R5826-012 (Regional PPO)
| $72.00 |
$6,700 |
$200 | Yes, some additional gap coverage. | $7.00 | $12.00 | $47.00 | $47.00 | tbd |
|
2015 KelseyCare Advantage Rx+Choice (HMO-POS)
| $77.00 |
$3,400 |
$50 | Yes, some additional gap coverage. |
H0332 -004 -0 | $3.00 | $30.00 | $40.00 | $40.00 | 3,444
2015 Formulary |
|
|
|
|
2016 KelseyCare Advantage Rx+Choice (HMO-POS)
| $77.00 |
$3,400 |
$50 | Yes, some additional gap coverage. | $3.00 | $17.00 | $40.00 | $40.00 | 3,651 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
-- This plan not offered in 2015 --
|
H5521 -106 -0 | | | | | |
|
-- |
|
|
2016 Aetna Medicare TX Connect Plus 2 (PPO)
| $81.00 |
$3,400 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $42.00 | $42.00 | 3,417 2016 Formulary |
|
2015 Aetna Medicare Value Plan (PPO)
| $92.00 |
$5,700 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5521 -094 -0 | $0.00 | $5.00 | $45.00 | $45.00 | 2,816
2015 Formulary |
|
-- |
|
|
2016 Aetna Medicare Value Plan (PPO)
| $92.00 |
$6,000 |
$0 | Yes, some additional gap coverage. | $0.00 | $10.00 | $100.00 | $100.00 | 3,543 2016 Formulary |
|
2015 Humana Gold Choice H8145-084 (PFFS)
| $89.00 |
n/a |
$200 | Yes, some additional gap coverage. |
H8145 -084 -0 | $6.00 | $12.00 | $45.00 | $45.00 | 3,630
2015 Formulary |
|
|
|
|
2016 Humana Gold Choice H8145-084 (PFFS)
| $95.00 |
n/a |
$250 | Yes, some additional gap coverage. | $6.00 | $12.00 | $47.00 | $47.00 | 3,615 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Erickson Advantage Signature without Drugs (HMO-POS)
| $149.00 |
$5,000 |
No Rx Coverage |
H5652 -002 -0 | This plan does NOT include Prescription Drug coverage. | |
|
|
|
|
2016 Erickson Advantage Signature without Drugs (HMO-POS)
| $149.00 |
$5,000 |
No Rx Coverage | This plan does NOT include Prescription Drug coverage. | |
|
2015 Erickson Advantage Champion (HMO-POS SNP)
| $189.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5652 -004 -0 | $0.00 | $10.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
|
|
|
|
2016 Erickson Advantage Champion (HMO-POS SNP)
| $190.00 |
n/a |
$0 | No additional gap coverage, only the Donut Hole Discount | $0.00 | $10.00 | $45.00 | $45.00 | 3,529 2016 Formulary |
|
2015 Erickson Advantage Signature with Drugs (HMO-POS)
| $189.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5652 -001 -0 | $5.00 | $10.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
|
|
|
|
2016 Erickson Advantage Signature with Drugs (HMO-POS)
| $190.00 |
$5,000 |
$0 | No additional gap coverage, only the Donut Hole Discount | $5.00 | $10.00 | $45.00 | $45.00 | 3,529 2016 Formulary |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Amerivantage Specialty + Rx (HMO SNP)
| $0.00 |
$6,700 |
$320 | Yes, some additional gap coverage. |
H5817 -009 -0 | $0.00 | $0.00 | $0.00 | $0.00 | 3,025
2015 Formulary |
|
-- |
|
|
-- Members will be assigned to Amerivantage Dual Coordination (HMO SNP) H5817-024 --
| | | | | |
|
2015 Cigna-HealthSpring Preferred (HMO)
| $0.00 |
$3,400 |
$0 | Yes, some additional gap coverage. |
H4513 -024 -1 | $0.00 | $4.00 | $30.00 | $30.00 | 3,087
2015 Formulary |
|
|
|
|
-- Members will be assigned to Cigna-HealthSpring Preferred (HMO) H4513-025 --
| | | | | |
|
2015 Humana Gold Plus H4510-028 (HMO)
| $0.00 |
$6,700 |
$0 | Yes, some additional gap coverage. |
H4510 -028 -0 | $3.00 | $10.00 | $40.00 | $40.00 | 3,630
2015 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus H2649-052 (HMO) H2649-052 --
| | | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Humana Gold Plus SNP-DE H4510-021 (HMO SNP)
| $26.20 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H4510 -021 -0 | | | | | 3,630
2015 Formulary |
|
|
|
|
-- Members will be assigned to Humana Gold Plus SNP-DE H2649-048 (HMO SNP) H2649-048 --
| | | | | |
|
2015 KelseyCare Advantage Rx Premier (HMO)
| $221.00 |
$3,400 |
$50 | Yes, some additional gap coverage. |
H0332 -006 -0 | $0.00 | $20.00 | $20.00 | $20.00 | 3,444
2015 Formulary |
|
|
|
|
-- Members will be assigned to KelseyCare Advantage Rx (HMO) H0332-002 --
| | | | | |
|
2015 Care Improvement Plus Medicare Advantage (PPO)
| $19.00 |
$6,700 |
$315 | No additional gap coverage, only the Donut Hole Discount |
H0084 -001 -0 | $4.00 | $12.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Advantra (PPO)
| $41.00 |
$6,000 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H7306 -001 -0 | | | | | 3,463
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Care Improvement Plus Gold Rx (PPO SNP)
| $0.00 |
$6,700 |
$315 | No additional gap coverage, only the Donut Hole Discount |
H0084 -004 -0 | $3.00 | $12.00 | $45.00 | $45.00 | 3,649
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Advantra (HMO)
| $0.00 |
$3,000 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5048 -002 -0 | $0.00 | $0.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
Plan Name |
Monthly Premium |
Parts A&B MOOP |
Part D Deduct- ible |
Additional Gap Coverage |
Plan ID |
Cost-Sharing |
Total Drugs |
Cust. Serv. |
Plan Exper. |
Cost Info. |
Tier 1 |
Tier 2 |
Tier 3 |
Tier 4 |
2015 Erickson Advantage Guardian (HMO-POS SNP)
| $0.00 |
$500 |
$0 | No additional gap coverage, only the Donut Hole Discount |
H5322 -019 -0 | $0.00 | $4.00 | $20.00 | $20.00 | 3,649
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 Aetna Medicare Select Plus Plan (PPO)
| $139.00 |
$3,300 |
$0 | Yes, some additional gap coverage. |
H5521 -052 -0 | $0.00 | $3.00 | $45.00 | $45.00 | 3,112
2015 Formulary |
|
-- |
|
|
-- This plan not offered in 2016 --
|
| | | | |
|
2015 UnitedHealthcare Nursing Home Plan (HMO SNP)
| $27.30 |
$6,700 |
$320 | No additional gap coverage, only the Donut Hole Discount |
H4514 -012 -0 | | | | | 3,649
2015 Formulary |
|
|
|
|
-- This plan not offered in 2016 --
|
| | | | |
|