2019 Medicare Advantage Plans in
Worcester County Massachusetts

There are 30 Medicare Advantage Plans available in Worcester County MA from 6 different health insurance providers. 4 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. Worcester County Massachusetts residents can also pick from 8 Medicare Special Needs Plans. The highest rated plan available in Worcester County received a 5 overall star rating from CMS and the lowest rated plan is 3.5 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
Aetna Medicare Freedom Complete (PPO)
$57.00 $0 $6,700 YesBrowse
Formulary
Aetna Medicare Freedom Plan (PPO)
$0 $195.00 $6,700 YesBrowse
Formulary
Aetna Medicare Value Plan (HMO)
$0 $195.00 $6,700 YesBrowse
Formulary
Fallon Senior Plan Flex Enhanced Rx (HMO)
$0 $300.00 $6,700 NoBrowse
Formulary
Fallon Senior Plan Plus Enhanced Rx (HMO)
$275.00 $0 $3,400 NoBrowse
Formulary
Fallon Senior Plan Saver Enhanced Rx (HMO-POS)
$103.00 $300.00 $5,000 NoBrowse
Formulary
Fallon Senior Plan Standard Enhanced Rx (HMO)
$218.00 $200.00 $6,700 NoBrowse
Formulary
Fallon Senior Plan Super Saver Rx (HMO)
$22.00 $415.00 $6,700 NoBrowse
Formulary
Harvard Pilgrim Stride Basic Rx (HMO)
$0 $415.00 $6,700 NoBrowse
Formulary
Harvard Pilgrim Stride Value Rx (HMO)
$79.00 $350.00 $3,400 NoBrowse
Formulary
Harvard Pilgrim Stride Value Rx Plus (HMO)
$190.00 $0 $3,400 YesBrowse
Formulary
Medicare HMO Blue FlexRx (HMO-POS)
$106.00 $260.00 $3,900 NoBrowse
Formulary
Medicare HMO Blue PlusRx (HMO)
$292.00 $200.00 $3,400 NoBrowse
Formulary
Medicare HMO Blue SaverRx (HMO)
$0 $320.00 $6,700 NoBrowse
Formulary
Medicare HMO Blue ValueRx (HMO)
$56.00 $320.00 $4,900 NoBrowse
Formulary
Medicare PPO Blue PlusRx (PPO)
$262.00 $200.00 $3,400 NoBrowse
Formulary
Medicare PPO Blue SaverRx (PPO)
$0 $405.00 $6,700 NoBrowse
Formulary
Medicare PPO Blue ValueRx (PPO)
$86.00 $320.00 $4,900 NoBrowse
Formulary
Tufts Medicare Preferred HMO Basic Rx (HMO)
$42.00 $350.00 $3,400 NoBrowse
Formulary
Tufts Medicare Preferred HMO Prime Rx (HMO)
$185.00 $0 $3,400 NoBrowse
Formulary
Tufts Medicare Preferred HMO Saver Rx (HMO)
$0 $400.00 $6,000 NoBrowse
Formulary
Tufts Medicare Preferred HMO Value Rx (HMO)
$146.00 $300.00 $3,400 NoBrowse
Formulary


Return to 2019 Medicare Advantage Plans in Massachusetts





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
Sign Up
Fallon Senior Plan Saver (HMO)
$93.00 Local HMO * $6,700
Tufts Medicare Preferred HMO Basic No Rx (HMO)
$20.00 Local HMO * $3,400
Tufts Medicare Preferred HMO Prime No Rx (HMO)
$152.00 Local HMO * $3,400
Tufts Medicare Preferred HMO Value No Rx (HMO)
$112.00 Local HMO * $3,400





2019 Medicare Special Needs Plans in Worcester county Massachusetts

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Click
for
Formulary
NaviCare (HMO SNP)
(H9001- 019)
    $36.20 $415.0  No Dual-EligibleBrowse
Formulary
Senior Care Options Program (HMO SNP)
(H2225- 001)
    $36.20 $415.0  No Dual-EligibleBrowse
Formulary
Senior Whole Health (HMO SNP)
(H2224- 001)
    $36.20 $415.0  No Dual-EligibleBrowse
Formulary
Senior Whole Health NHC (HMO SNP)
(H2224- 003)
    $36.20 $415.0  No Dual-EligibleBrowse
Formulary
Tufts Health Plan Senior Care Options (HMO SNP)
(H2256- 029)
    $36.20 $415.0  No Dual-EligibleBrowse
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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