2019 Medicare Advantage Plans in
Richmond County New York

There are 36 Medicare Advantage Plans available in Richmond County NY from 12 different health insurance providers. 9 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3000 and the highest out of pocket is $6700. Richmond County New York residents can also pick from 32 Medicare Special Needs Plans. The highest rated plan available in Richmond County received a 4 overall star rating from CMS and the lowest rated plan is 2.5 stars


(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)

Name ⇅ Premium Deductible MOOP Gap Click
for
Formulary
Plan
Rating
Sign
Up
Advantage Silver - NY City (HMO)
$0 $0 $6,590 YesBrowse
Formulary
Aetna Medicare Elite Plan (PPO)
$0 $245.00 $6,700 YesBrowse
Formulary
Enroll
Aetna Medicare Premier Plan (PPO)
$74.00 $195.00 $6,700 YesBrowse
Formulary
Enroll
Aetna Medicare Value Plan (HMO)
$0 $195.00 $6,700 YesBrowse
Formulary
Enroll
Affinity Medicare Passport Essentials NYC (HMO)
$0 $295.00 $5,700 YesBrowse
Formulary
Enroll
Centers Plan for Medicare Advantage Care (HMO)
$0 $395.00 $6,700 NoBrowse
Formulary
EmblemHealth VIP Essential (HMO)
$55.00 $250.00 $6,700 NoBrowse
Formulary
Enroll
EmblemHealth VIP Go (HMO-POS)
$68.00 $250.00 $6,700 NoBrowse
Formulary
EmblemHealth VIP Gold (HMO)
$119.50 $200.00 $6,700 NoBrowse
Formulary
Enroll
EmblemHealth VIP Gold Plus (HMO)
$298.00 $200.00 $6,700 NoBrowse
Formulary
EmblemHealth VIP Part B Saver (HMO)
$0 $415.00 $6,700 NoBrowse
Formulary
EmblemHealth VIP Value (HMO)
$0 $250.00 $6,700 NoBrowse
Formulary
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Empire MediBlue Select (HMO)
$0 $350.00 $6,400 YesBrowse
Formulary
Healthfirst 65 Plus Plan (HMO)
$0 $350.00 $6,700 NoBrowse
Formulary
Healthfirst Increased Benefits Plan (HMO)
$39.30 $415.00 $6,700 NoBrowse
Formulary
Humana Gold Plus H3533-021 (HMO)
$21.00 $200.00 $6,500 NoBrowse
Formulary
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Humana Gold Plus H3533-023 (HMO)
$67.00 $0 $3,300 NoBrowse
Formulary
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Humana Gold Plus H3533-027 (HMO)
$0 $400.00 $6,700 NoBrowse
Formulary
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HumanaChoice H5970-021 (PPO)
$0 $350.00 $6,700 NoBrowse
Formulary
HumanaChoice H5970-022 (PPO)
$95.00 $0 $3,500 NoBrowse
Formulary
HumanaChoice H5970-023 (PPO)
$199.00 $0 $3,000 NoBrowse
Formulary
MetroPlus Platinum (HMO)
$253.50 $415.00 $6,700 NoBrowse
Formulary
Sunrise Advantage Plan (HMO)
$39.00 $0 $5,700 NoBrowse
Formulary
Too New
WellCare Choice (HMO)
$0 $0 $6,700 YesBrowse
Formulary
Too New
WellCare Preferred (HMO)
$53.00 $0 $6,700 YesBrowse
Formulary
Too New
WellCare Rx (HMO)
$14.70 $415.00 $5,000 YesBrowse
Formulary
Too New


Return to 2019 Medicare Advantage Plans in New York





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
Sign Up
Empire MediBlue Core (HMO)
$0 Local HMO * $6,700
Healthfirst Coordinated Benefits Plan (HMO)
$0 Local HMO * $6,700
HumanaChoice H5970-016 (PPO)
$0 Local PPO * $4,500 Enroll





2019 Medicare Special Needs Plans in Richmond county New York

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Click
for
Formulary
Advantage Health NYC - SNP (HMO SNP)
(H2773- 017)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Advantage Value One NY - Dual (HMO SNP)
(H2773- 018)
    $24.80 $415.0  Yes Dual-EligibleBrowse
Formulary
Affinity Medicare Solutions (HMO SNP)
(H5991- 002)
    $39.30 $415.0  No Dual-EligibleBrowse
Formulary
Affinity Medicare Ultimate (HMO SNP)
(H5991- 001)
    $39.30 $415.0  No Dual-EligibleBrowse
Formulary
ArchCare Advantage (HMO SNP)
(H1777- 007)
    $39.30 $415.0  No InstitutionalBrowse
Formulary
CenterLight Healthcare Direct Complete Plan (HMO SNP)
(H5989- 002)
    $39.30 $415.0  No InstitutionalNABrowse
Formulary
Centers Plan for Dual Coverage Care (HMO SNP)
(H6988- 002)
    $39.30 $415.0  No Dual-EligibleBrowse
Formulary
Centers Plan for Medicaid Advantage Plus (HMO SNP)
(H6988- 004)
    $135.0 $415.0  No Dual-EligibleBrowse
Formulary
Centers Plan for Nursing Home Care (HMO SNP)
(H6988- 003)
    $39.30 $415.0  No InstitutionalBrowse
Formulary
Elderplan Advantage For Nursing Home Residents (HMO SNP)
(H3347- 003)
    $39.30 $415.0  No InstitutionalBrowse
Formulary
Elderplan Plus Long Term Care (HMO SNP)
(H3347- 007)
    $39.30 $415.0  No Dual-EligibleBrowse
Formulary
EmblemHealth VIP Dual (HMO SNP)
(H3330- 042)
    $39.30 $415.0  No Dual-EligibleBrowse
Formulary
Empire MediBlue Dual Advantage (HMO SNP)
(H8432- 007)
    $39.30 $415.0  Yes Dual-EligibleBrowse
Formulary
Empire MediBlue Dual Advantage Select (HMO SNP)
(H8432- 028)
    $39.30 $415.0  Yes Dual-EligibleBrowse
Formulary
Fidelis Dual Advantage (HMO SNP)
(H3328- 002)
    $38.90 $415.0  No Dual-EligibleBrowse
Formulary
Fidelis Dual Advantage Flex (HMO SNP)
(H3328- 017)
    $36.10 $415.0  No Dual-EligibleBrowse
Formulary
Fidelis Medicaid Advantage Plus (HMO SNP)
(H3328- 016)
    $29.20 $415.0  No Dual-EligibleBrowse
Formulary
Healthfirst CompleteCare (HMO SNP)
(H3359- 034)
    $39.30 $415.0  No Dual-EligibleBrowse
Formulary
Healthfirst Life Improvement Plan (HMO SNP)
(H3359- 021)
    $39.30 $415.0  No Dual-EligibleBrowse
Formulary
Humana Gold Plus SNP-DE H3533-004 (HMO SNP)
(H3533- 004)
    $35.70 $385.0  No Dual-EligibleBrowse
Formulary
Longevity Health Plan (HMO SNP)
(H8457- 001)
    $39.30 $415.0  No InstitutionalToo NewBrowse
Formulary
MetroPlus Advantage Plan (HMO SNP)
(H0423- 001)
    $39.00 $415.0  No Dual-EligibleBrowse
Formulary
RiverSpring MAP (HMO SNP)
(H6776- 002)
    $39.30 $415.0  No Dual-EligibleNABrowse
Formulary
RiverSpring Star (HMO SNP)
(H6776- 001)
    $39.30 $415.0  No InstitutionalNABrowse
Formulary
Sunrise Advantage Plan C-SNP (HMO SNP)
(H3930- 002)
    $49.00 $0  No Chronic or Disabling ConditionToo NewBrowse
Formulary
Sunrise Advantage Plan Gold (HMO SNP)
(H3930- 004)
    $175.0 $0  No InstitutionalToo NewBrowse
Formulary
Sunrise Advantage Plan I-SNP (HMO SNP)
(H3930- 001)
    $39.30 $0  No InstitutionalToo NewBrowse
Formulary
VNSNY CHOICE Total (HMO SNP)
(H5549- 003)
    $39.30 $415.0  No Dual-EligibleBrowse
Formulary
WellCare Access (HMO SNP)
(H4868- 005)
    $33.60 $415.0  No Dual-EligibleToo NewBrowse
Formulary



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 2019 once you and your plan provider have spent $3820 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 25% of the plans cost for covered brand-name prescription drugs and 37% 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, 2018.
Star Rating as of October 10, 2018.
For More Information on Ratings Please See the CMS Tech Notes.
Plans are subject to change as contracts are finalized.
Includes 2019 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2019, 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.


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