2014 Medicare Advantage Plans in Broome County New York


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2014 Medicare Advantage Plans in Broome County New York

There are 37 Medicare Advantage Plans available in Broome County NY from 10 health insurance providers and 5 Special Needs Plans available. 12 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 Broome County received a 4.5 overall star rating from CMS and the lowest rated plan is 3 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 New York
ActiveSaver MSA (MSA)
(H9788-003)
MSA * NA
Aetna Medicare Standard Plan (PPO)
(H5521-040)
Local PPO $87.00 $0 Few Generics $6,700
Aetna Medicare Value Plan (HMO)
(H3312-048)
Local HMO $0 $0 Few Generics $6,700
BasiCare with Part D (PPO)
(H9615-008)
Local PPO $27.00 $310.00 No Gap Coverage $4,000
CDPHP Choice (HMO)
(H3388-001)
Local HMO * $24.00 $2,500
CDPHP Choice Rx (HMO)
(H3388-002)
Local HMO $81.00 $0 Some Generics, Few Brands $2,500
CDPHP Classic (PPO)
(H5042-004)
Local PPO * $110.00 $3,400
CDPHP Classic Rx (PPO)
(H5042-001)
Local PPO $182.00 $0 Some Generics, Few Brands $3,400
CDPHP Core Rx (PPO)
(H5042-005)
Local PPO $126.00 $0 No Gap Coverage $3,400
CDPHP Prime Rx (PPO)
(H5042-007)
Local PPO $256.00 $0 Some Generics, Few Brands $3,400
CDPHP Value Rx (HMO)
(H3388-004)
Local HMO $32.00 $0 No Gap Coverage $3,300
Fidelis Medicare $0 Premium (HMO)
(H3328-019)
Local HMO $0 $0 No Gap Coverage $6,700
Fidelis Medicare Advantage Flex (HMO-POS)
(H3328-003)
Local HMO $37.20 $240.00 No Gap Coverage $6,700
Fidelis Medicare Advantage without Rx (HMO-POS)
(H3328-001)
Local HMO * $0 $6,700
GoldAnywhere with Part D - Option 1 (PPO)
(H9615-002)
Local PPO $238.00 $0 Few Generics $2,000
GoldAnywhere with Part D - Option 2 (PPO)
(H9615-007)
Local PPO $64.00 $0 Few Generics $4,000
GoldValue with Part D (HMO-POS)
(H9859-013)
Local HMO $59.50 $0 Few Generics $6,000
Humana Gold Choice H1291-001 (PFFS)
(H1291-001)
PFFS $72.00 $0 Few Generics, Few Brands N/A NA
HumanaChoice H5970-001 (PPO)
(H5970-001)
Local PPO $24.00 $0 Few Generics, Few Brands $6,700
HumanaChoice H5970-004 (PPO)
(H5970-004)
Local PPO $152.00 $200.00 Few Generics, Few Brands $6,700
Medicare BlueBasic PPO (PPO)
(H3335-042)
Local PPO * $50.00 $4,800
Medicare BlueClassic PPO (PPO)
(H3335-037)
Local PPO $0 $0 No Gap Coverage $5,000
Medicare BlueEnhanced PPO (PPO)
(H3335-009)
Local PPO $118.00 $0 No Gap Coverage $4,000
Medicare BlueSecure PPO (PPO)
(H3335-008)
Local PPO $77.00 $0 No Gap Coverage $4,500
Preferred Gold with Part D (HMO-POS)
(H9859-002)
Local HMO $117.00 $0 Few Generics $4,500
Preferred Gold without Part D (HMO-POS)
(H9859-001)
Local HMO * $18.40 $4,500
Today's Options Advantage 800 (PPO)
(H2775-094)
Local PPO * $0 $6,700
Today's Options Advantage Plus 350A (PPO)
(H2775-082)
Local PPO $90.00 $0 No Gap Coverage $3,250
Today's Options Advantage Plus 850B (PPO)
(H2775-088)
Local PPO $36.00 $0 No Gap Coverage $6,700
Today's Options Premier 100 (PFFS)
(H2816-001)
PFFS * $40.00 N/A
Today's Options Premier 400 (PFFS)
(H2816-007)
PFFS * $0 $4,400
Today's Options Premier Plus 350A (PFFS)
(H2816-013)
PFFS $92.00 $0 No Gap Coverage N/A
Today's Options Premier Plus 850B (PFFS)
(H2816-019)
PFFS $37.00 $0 No Gap Coverage N/A
UnitedHealthcare MedicareComplete Choice (Regional PPO)
(R5342-001)
Regional PPO $0 $0 No Gap Coverage $5,200
UnitedHealthcare MedicareComplete Choice Essential (Regiona
(R5342-002)
Regional PPO * $0 $5,200
WellCare Advance (HMO)
(H3361-059)
Local HMO * $0 $6,700
WellCare Value (HMO-POS)
(H3361-099)
Local HMO $0 $0 No Gap Coverage $3,400

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



Medicare Special Needs Plans in Broome county New York

Plan Name Type Consolidated Premium C+D Part D
Deductible
Gap Special Needs Type Overall Rating
Fidelis Dual Advantage (HMO SNP)
(H3328- 002)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
Fidelis Dual Advantage Flex (HMO SNP)
(H3328- 017)
Local HMO $37.20 $310.00 Some Generics Dual-Eligible
UnitedHealthcare Nursing Home Plan (HMO SNP)
(H3379- 022)
Local HMO $35.20 $310.00 No Gap Coverage Institutional
WellCare Access (HMO SNP)
(H3361- 065)
Local HMO $23.40 $310.00 No Gap Coverage Dual-Eligible
WellCare Liberty (HMO SNP)
(H3361- 043)
Local HMO $26.90 $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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