2015 Medicare Advantage Plans in Fulton County Georgia


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2015 Medicare Advantage Plans in Fulton County Georgia

There are 21 Medicare Advantage Plans available in Fulton County GA from 13 health insurance providers and 13 Special Needs Plans available. 8 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3300 and the highest out of pocket is $6700. The highest rated plan available in Fulton County received a 4.5 overall star rating from CMS and the lowest rated plan is 2.5 stars.

(Click the Plan Name for More Details)

Plan Name Type Premium
C+D
Part D
Deductible
 Gap  Max Out of
Pocket
Overall Rating Formulary
Return to Counties In Georgia
AARP MedicareComplete (HMO)
(H1111-006)
Local HMO $0.00 $215.00 No $6,700 Browse
Formulary
Advantra Preferred (PPO)
(H9847-005)
Local PPO $19.00 $0.00 No $4,650 Browse
Formulary
Advantra Silver (HMO-POS)
(H5302-003)
Local HMO $0.00 $0.00 No $5,300 Browse
Formulary
Aetna Medicare Essential Plan (PPO)
(H5521-091)
Local PPO $0.00 $0.00 No $4,300 Browse
Formulary
Aetna Medicare Select Plan (HMO)
(H1109-005)
Local HMO $0.00 $0.00 No $4,650 Browse
Formulary
Aetna Medicare Select Plus Plan (PPO)
(H5521-052)
Local PPO $139.00 $0.00 Yes $3,300 Browse
Formulary
Amerivantage Classic + Rx (HMO)
(H4211-003)
Local HMO $0.00 $0.00 Yes $6,700 NABrowse
Formulary
BlueValue Basic (HMO)
(H5422-008)
Local HMO $34.00 $172.00 No $5,900 Browse
Formulary
Care Improvement Plus Medicare Advantage (PPO)
(H6528-006)
Local PPO $29.00 $310.00 No $6,700 Browse
Formulary
Care Improvement Plus Medicare Advantage (Regional PPO)
(R9896-012)
Regional PPO $29.00 $295.00 No $6,700 Browse
Formulary
Cigna-HealthSpring Preferred (HMO)
(H0439-001)
Local HMO $0.00 $0.00 Yes $4,300 Too NewBrowse
Formulary
Humana Gold Choice H8145-069 (PFFS)
(H8145-069)
PFFS $73.00 $320.00 No N/A Browse
Formulary
Humana Gold Plus H4141-001 (HMO)
(H4141-001)
Local HMO $0.00 $200.00 Yes $5,900 Browse
Formulary
HumanaChoice H6609-122 (PPO)
(H6609-122)
Local PPO $52.00 $320.00 Yes $6,700 Browse
Formulary
HumanaChoice R5826-064 (Regional PPO)
(R5826-064)
Regional PPO * $0.00 $5,900
HumanaChoice R5826-077 (Regional PPO)
(R5826-077)
Regional PPO $74.00 $200.00 No $6,700 Browse
Formulary
Kaiser Permanente Senior Advantage Basic (HMO)
(H1170-009)
Local HMO $0.00 $0.00 Yes $4,900 Browse
Formulary
Kaiser Permanente Senior Advantage Enhanced (HMO)
(H1170-002)
Local HMO $66.00 $0.00 Yes $4,000 Browse
Formulary
Medicare Preferred Core (PPO)
(H9947-005)
Local PPO $62.00 $103.00 No $6,700 Browse
Formulary
Piedmont WellStar Medicare Choice (HMO)
(H9857-001)
Local HMO $0.00 $0.00 Yes $3,900 Too NewBrowse
Formulary
WellCare Value (HMO)
(H1112-027)
Local HMO $0.00 $0.00 No $6,700 Browse
Formulary

* Plan Type Indicates plan does not offer Part D drug coverage.



Medicare Special Needs Plans in Fulton county Georgia

Plan Name Consolidated
Premium C+D
Part D
Deductible
 Gap  Special Needs
Type
Overall Rating Formulary
Amerivantage Specialty + Rx (HMO SNP)
(H4211- 001)
   $26.40 $320.00  Yes Dual-EligibleNABrowse
Formulary
Care Improvement Plus Dual Advantage (Regional PPO SNP)
(R9896- 021)
   $26.80 $320.00  No Dual-EligibleBrowse
Formulary
Care Improvement Plus Gold Rx (PPO SNP)
(H6528- 016)
   $0.00 $315.00  No Chronic or Disabling ConditionBrowse
Formulary
Care Improvement Plus Gold Rx (Regional PPO SNP)
(R9896- 009)
   $0.00 $315.00  No Chronic or Disabling ConditionBrowse
Formulary
Care Improvement Plus Silver Rx (Regional PPO SNP)
(R9896- 008)
   $3.40 $320.00  No Chronic or Disabling ConditionBrowse
Formulary
Cigna-HealthSpring TotalCare (HMO SNP)
(H0439- 002)
   $14.90 $320.00  No Dual-EligibleToo NewBrowse
Formulary
Humana Gold Plus - Diabetes and Heart (HMO SNP)
(H4141- 009)
   $0.00 $200.00  Yes Chronic or Disabling ConditionBrowse
Formulary
Humana Gold Plus SNP-DE H4141-003 (HMO SNP)
(H4141- 003)
   $26.40 $210.00  No Dual-EligibleBrowse
Formulary
Peach State Health Plan Advantage (HMO SNP)
(H7173- 001)
   $26.40 $320.00  No Dual-EligibleNABrowse
Formulary
Senior Advantage Medicare Medicaid Plan (HMO SNP)
(H1170- 008)
   $26.00 $0.00  No Dual-EligibleBrowse
Formulary
UnitedHealthcare Dual Complete (PPO SNP)
(H1108- 002)
   $26.50 $320.00  No Dual-EligibleBrowse
Formulary
UnitedHealthcare Nursing Home Plan (PPO SNP)
(H1108- 001)
   $25.30 $320.00  No InstitutionalBrowse
Formulary
WellCare Access (HMO SNP)
(H1112- 006)
   $26.50 $320.00  No Dual-EligibleBrowse
Formulary


Source: CMS.

Plans as of September 2, 2014.

Plans are subject to change as contracts are finalized.

Includes 2015 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded. For 2015, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.



Plan Type Is the type of organization offering the Medicare Plans.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescription Drug Plan
  • SNP - Special Needs Plan
  • POS - Point of Service
  • PFFS - Private Fee For Service

Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your plan for details.

Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage plans; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.

Benefit Type

Enhanced Alternative plans may offer additional gap coverage which is calculated as the percentage of “generic” formulary products with coverage above standard "generic" coverage gap cost-sharing benefit and/or the percentage of “brand” formulary products covered in addition to the coverage gap discount for applicable drugs.

GAP

In 2015 once you and your plan provider have spent $2,960 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") Once you reach the coverage gap you will pay 45% of the plan's cost for covered brand-name prescription drugs unless your plan offers additional coverage. You will still receive a 55% discount on brand-name drugs and a 35% discount on generic drugs.

Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable

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  • Mon-Fri 8:30am-8:00pm
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