2018 Medicare Advantage Plans in Wake County North Carolina

There are 17 Medicare Advantage Plans available in Wake County NC from 7 different health insurance providers. 7 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3400 and the highest out of pocket is $6700. The highest rated plan available in Wake County received a 4.5 overall star rating from CMS and the lowest rated plan is 2.5 stars. Wake County North Carolina residents can also pick from 7 Medicare Special Needs Plans.

(Click the Plan Name for More Details)

Name	Premium C+D	Part D Deductible	Type	Gap	MOOP	Overall Rating	Sign Up
AARP MedicareComplete (HMO)	$15.00	$200.00	Local HMO	No	$6,700		Enroll
AARP MedicareComplete Essential (HMO)	$0.00		Local HMO *		$4,400		Enroll
Aetna Medicare Essential Plan (PPO)	$0.00	$95.00	Local PPO	Yes	$6,700
Aetna Medicare Premier Plan (PPO)	$47.00	$200.00	Local PPO	Yes	$5,500
Aetna Medicare Prime Plan (HMO)	$0.00	$0.00	Local HMO	Yes	$4,500		Enroll
Aetna Medicare Value Plan (HMO)	$0.00	$150.00	Local HMO	Yes	$4,950		Enroll
Blue Medicare HMO Essential (HMO)	$76.00	$355.00	Local HMO	Yes	$6,700
Blue Medicare HMO Medical Only (HMO)	$0.00		Local HMO *		$5,500
Blue Medicare PPO Enhanced (PPO)	$113.60	$0.00	Local PPO	Yes	$6,700
FirstMedicare Direct preferredPLUS (HMO)	$30.20	$405.00	Local HMO	No	$3,400
FirstMedicare Direct smartHMO (HMO-POS)	$0.00	$0.00	Local HMO	Yes	$3,400
Gateway Health Medicare Assured Prime (HMO)	$107.00	$250.00	Local HMO	No	$6,700
Gateway Health Medicare Assured Select (HMO)	$0.00	$200.00	Local HMO	No	$6,700
Humana Gold Plus H1036-233 (HMO)	$0.00	$195.00	Local HMO	No	$4,900		Enroll
HumanaChoice H5216-015 (PPO)	$56.00	$195.00	Local PPO	No	$6,700		Enroll
HumanaChoice R1390-001 (Regional PPO)	$0.00		Regional PPO *		$5,500		Enroll
HumanaChoice R1390-002 (Regional PPO)	$79.00	$390.00	Regional PPO	No	$6,700		Enroll
Return to 2018 Medicare Advantage Plans in North Carolina

* Plan Type does not offer Medicare Part D drug coverage.

2018 Medicare Special Needs Plans in Wake county North Carolina

Plan Name	Monthly Consolidated Premium C+D	Part D Deductible	Gap	Special Needs Type	Overall Rating
Fresenius Total Health (HMO SNP) (H6320- 001)	$30.20	$405.00	No	Chronic or Disabling Condition
Gateway Health Medicare Assured Diamond (HMO SNP) (H9190- 007)	$30.10	$405.00	No	Dual-Eligible
Gateway Health Medicare Assured Ruby (HMO SNP) (H9190- 008)	$30.10	$405.00	No	Dual-Eligible
UnitedHealthcare Assisted Living Plan (HMO-POS SNP) (H5253- 043)	$30.00	$200.00	No	Institutional
UnitedHealthcare Dual Complete (HMO SNP) (H5253- 041)	$20.30	$405.00	No	Dual-Eligible
UnitedHealthcare Dual Complete RP (Regional PPO SNP) (R1548- 001)	$25.20	$405.00	No	Dual-Eligible
UnitedHealthcare Nursing Home Plan (HMO SNP) (H5253- 042)	$30.20	$405.00	No	Institutional

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 provider 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; 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

(EA) Enhanced Alternative 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.

(DS) Defined Standard Benefit

(BA) Basic Alternative

(AE) Actuarially Equivalent Standard

GAP

In 2018 once you and your plan provider have spent $3750 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 35% of the plans cost for covered brand-name prescription drugs and 44% on generic drugs unless your plan offers additional coverage.

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

Source: CMS.

Data as of September 5, 2017.

Plans are subject to change as contracts are finalized.

Includes 2018 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2018, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.