Medicare Blue Choice Prime (HMO)
Available to residents of Monroe County, NY for 2026. Contract H3351, plan 023, segment 0.
Plan details
| Monthly drug premium | $55.00 |
|---|---|
| Drug deductible | $615.00Tier 1 exempt |
| Plan type | Medicare Advantage |
| Contract / plan | H3351-023-0 |
| Offered by | Excellus Health Plan, Inc |
| Parent organization | Lifetime Healthcare, Inc. |
| Formulary drugs | 4,068 |
CMS star ratings
- Overall
- 4 out of 5 stars for Overall
- Health plan (Part C)
- 4 out of 5 stars for Health plan (Part C)
- Drug plan (Part D)
- 4 out of 5 stars for Drug plan (Part D)
Published per contract — every plan under contract H3351 shares this rating.
Drug tiers — preferred pharmacy, initial coverage
| Tier | Cost-sharing |
|---|---|
| Tier 1 | $4.00 |
| Tier 2 | $15.00 |
| Tier 3 | 21% |
| Tier 4 | 25% |
| Tier 5 | 25% |
Also available in 5 other NY counties
Plan facts come from the CMS quarterly prescription drug plan public use files.