2014 Medicare Advantage Plans in Beaver County Pennsylvania


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2014 Medicare Advantage Plans in Beaver County Pennsylvania

There are 24 Medicare Advantage Plans available in Beaver County PA from 6 health insurance providers and 6 Special Needs Plans available. 5 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $ and the highest out of pocket is $6700. The highest rated plan available in Beaver County received a 4.5 overall star rating from CMS and the lowest rated plan is 3.5 stars.

(Click the Plan Name for More Details)

Plan Name Type Premium C+D Part D
Deductible
Gap Max Out of Pocket Overall Rating
Return to Counties In Pennsylvania
Advantra Elite (PPO)
(H5522-009)
Local PPO $0 $0 No Gap Coverage $6,700
Advantra Gold (HMO)
(H3959-002)
Local HMO $96.00 $0 Some Generics $5,900
Advantra Silver (HMO)
(H3959-011)
Local HMO $0 $0 No Gap Coverage $6,700
Advantra Silver (PPO)
(H5522-005)
Local PPO $48.00 $0 No Gap Coverage $6,700
Freedom Blue PPO Classic (PPO)
(H3916-001)
Local PPO $232.00 $0 Many Generics $6,700
Freedom Blue PPO HD Rx (PPO)
(H3916-019)
Local PPO $21.00 $0 No Gap Coverage $6,700
Freedom Blue PPO Select (PPO)
(H3916-022)
Local PPO $109.00 $0 No Gap Coverage $6,700
Freedom Blue PPO ValueRx (PPO)
(H3916-032)
Local PPO $40.00 $0 No Gap Coverage $6,700
Geisinger Gold Reserve (MSA)
(H8468-001)
MSA * NA
Humana Gold Choice H8145-053 (PFFS)
(H8145-053)
PFFS $197.00 $0 Few Generics, Few Brands N/A
HumanaChoice R5826-002 (Regional PPO)
(R5826-002)
Regional PPO $88.00 $0 Few Generics, Few Brands $5,900
HumanaChoice R5826-062 (Regional PPO)
(R5826-062)
Regional PPO * $0 $3,400
HumanaChoice R5826-081 (Regional PPO)
(R5826-081)
Regional PPO $78.00 $310.00 No Gap Coverage $6,700
Security Blue Deluxe (HMO)
(H3957-020)
Local HMO $253.00 $0 Many Generics $6,700
Security Blue HD (HMO)
(H3957-036)
Local HMO $0 $0 No Gap Coverage $6,700
Security Blue Standard (HMO)
(H3957-003)
Local HMO $179.00 $0 No Gap Coverage $6,700
Security Blue Value (HMO)
(H3957-024)
Local HMO * $37.00 $6,700
Security Blue ValueRx (HMO)
(H3957-031)
Local HMO $20.00 $0 No Gap Coverage $6,700
UPMC for Life (HMO)
(H3907-002)
Local HMO * $0 $3,400
UPMC for Life HMO Deductible with Rx (HMO)
(H3907-037)
Local HMO $37.50 $0 No Gap Coverage $4,000
UPMC for Life HMO Rx (HMO)
(H3907-029)
Local HMO $84.00 $0 No Gap Coverage $3,400
UPMC for Life HMO Rx Enhanced (HMO)
(H3907-006)
Local HMO $224.00 $0 No Gap Coverage $3,400
UPMC for Life PPO High Deductible with Rx (PPO)
(H5533-003)
Local PPO $40.00 $0 No Gap Coverage $6,700
UPMC for Life PPO Rx Enhanced (PPO)
(H5533-005)
Local PPO $118.50 $0 No Gap Coverage $6,700

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



Medicare Special Needs Plans in Beaver county Pennsylvania

Plan Name Type Consolidated Premium C+D Part D
Deductible
Gap Special Needs Type Overall Rating
Advantra Cares (HMO SNP)
(H3959- 036)
Local HMO $35.50 $310.00 No Gap Coverage Dual-Eligible
Gateway Health Medicare Assured Ruby (HMO SNP)
(H5932- 009)
Local HMO $32.70 $310.00 No Gap Coverage Dual-Eligible
Gateway Health Medicare Assured Gold (HMO SNP)
(H5932- 007)
Local HMO $34.20 $0 No Gap Coverage Chronic or Disabling Condition
Gateway Health Medicare Assured Platinum (HMO SNP)
(H5932- 008)
Local HMO $56.40 $0 No Gap Coverage Chronic or Disabling Condition
Gateway Health Medicare Assured Diamond (HMO SNP)
(H5932- 001)
Local HMO $35.50 $310.00 No Gap Coverage Dual-Eligible
UPMC for You Advantage (HMO SNP)
(H4279- 001)
Local HMO $35.50 $310.00 No Gap Coverage Dual-Eligible


Source: CMS.

Plans as of September 3, 2013.

Plans are subject to change as contracts are finalized.

Includes 2014 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.



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

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescrition 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

Coverage gap ("donut hole"). This means there's a temporary limit on what the drug plan will cover for drugs. (Unless you get the low-income subsidy) Once you reach the coverage gap in 2014, you will pay 47.5% of the plan's cost for covered brand-name prescription drugs. You get these savings if you buy your prescriptions at a pharmacy or order them through the mail.

Additional gap coverage levels are determined separately for formulary generic and brand products and are described as follows:

  • All: 100% of formulary drugs are covered through the gap
  • Many: 65% to 100% of formulary drugs are covered through the gap
  • Some: 10% to 65 % of formulary drugs are covered through the gap
  • Few: 0% to 10% of formulary drugs are covered through the gap (and must also be >15 "brand" products covered through the gap)
  • No Gap Coverage: 0% of formulary drugs are covered through the gap (or 15 "brand" products covered through the gap)
  • All Formulary Drugs: cover 100% of “generic” and 100% of “brand” products (either by covering all formulary drug products in the gap or by having no initial coverage limit)

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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