Compare Winnebago County Illinois
Medicare Advantage Plans

A Medicare Advantage Plan in Winnebago County, IL can provide additional benefits above and beyond Original Medicare. There are 58 Medicare Advantage Plans (Part-C) available in Winnebago County from 14 different health insurance providers to compare in 2023. 35 of these Medicare Advantage Plans offer additional gap coverage to help avoid the “donut hole”. The plan with the lowest out-of-pocket expense is $1500 and the highest out-of-pocket is $8300. Winnebago County Illinois qualifying beneficiaries can also pick from 5 Medicare Special Needs Plans. The highest rated Medicare Advantage Plan in Winnebago County Illinois received a 5 overall star rating from CMS.



Most Popular Plans by Enrollment in Winnebago County, Illinois

Plan Name Plan ID Marketing Name Monthly
Premium
Enrollment
Blue Medicare Advantage (Medicare-Medicaid Plan)
H0927-001
Blue Cross Community MMAI $0 23084
Humana Gold Plus H1468-007 (HMO)
H1468-007
Humana $0 19290
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid
H6080-001
MeridianComplete $0 17747
Molina Dual Options (Medicare-Medicaid Plan)
H8046-001
Molina Healthcare of Illinois $0 17292
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid
H0336-001
Humana $0 17210


2023 Medicare Advantage Plans in Winnebago County, IL

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


Name ⇅ Monthly
Premium
Deductible MOOP Gap 2023 Plan
Stars
Rating
Zing Premium Giveback IL (HMO)
(H7330-005)

$0 $0 $6,700 YesNA
Zing Open Access IL (HMO-POS)
(H4624-002)

$25.00 $0 $3,650 YesNA
Zing Choice IL (HMO)
(H4624-001)

$0 $0 $3,650 YesNA
Wellcare No Premium Open (PPO)
(H6713-001)

$0 $0 $3,450 Yes
Wellcare No Premium Essential (HMO)
(H5779-002)

$0 $0 $3,450 No
Wellcare Giveback Open (PPO)
(H6713-002)

$0 $0 $3,450 Yes
Wellcare Assist (HMO)
(H5779-008)

$10.40 $505.00 $3,450 No
UW Health IL Quartz Med Advantage Value D(w/Rx) (HMO)
(H5262-018)

$27.00 $0 $4,700 Yes
UW Health IL Quartz Med Advantage Elite D(w/Rx) (HMO)
(H5262-026)

$63.10 $0 $3,450 Yes
UW Health IL Quartz Med Advantage Core D (w/Rx) (HMO)
(H5262-019)

$0 $0 $5,700 Yes
OSF MedAdvantage Open (HMO-POS)
(H1463-036)

$39.00 $0 $4,750 Yes
OSF MedAdvantage Enrich (HMO-POS)
(H1463-042)

$150.00 $175.00 $- Yes
OSF MedAdvantage Core (HMO)
(H1463-035)

$0 $0 $3,900 Yes
Molina Dual Options (Medicare-Medicaid Plan)
(H8046-001)

$0 $0 $- YesNA
Meridian Medicare-Medicaid Plan (MMP) (Medicare-Medicaid
(H6080-001)

$0 $0 $- YesNA
HumanaChoice R5361-002 (Regional PPO)

$96.00 $505.00 $6,700 No
HumanaChoice H5525-004 (PPO)

$84.00 $250.00 $5,500 No
HumanaChoice H5216-357 (PPO)

$95.00 $505.00 $1,500 Yes
HumanaChoice H5216-283 (PPO)

$25.00 $0 $2,900 Yes
HumanaChoice H5216-251 (PPO)

$0 $0 $3,200 Yes
Humana Gold Plus Integrated H0336-001 (Medicare-Medicaid

$0 $0 $- YesNA
Humana Gold Plus H1468-007 (HMO)

$0 $0 $3,000 Yes
Humana Gold Choice H8145-008 (PFFS)

$137.00 $380.00 $- No
Health Alliance Medicare POS Basic Rx (HMO-POS)
(H1463-015)

$53.00 $0 $6,700 Yes
Health Alliance Medicare POS 30 Rx (HMO-POS)
(H1463-017)

$105.00 $0 $5,500 Yes
Health Alliance Medicare POS 10 Rx (HMO-POS)
(H1463-019)

$165.00 $0 $4,500 Yes
Health Alliance Medicare HMO Classic Rx (HMO)
(H1463-043)

$0 $100.00 $8,300 Yes
Health Alliance Medicare HMO Basic Rx (HMO)
(H1463-009)

$33.00 $0 $6,700 Yes
Health Alliance Medicare HMO 40 Rx (HMO)
(H1463-010)

$75.00 $0 $4,700 Yes
Health Alliance Medicare HMO 20 Rx (HMO)
(H1463-003)

$125.00 $0 $4,000 Yes
Clear Spring Health Essential (HMO)
(H5454-001)

$0 $0 $2,900 NoNA
Clear Spring Health Community Advantage Plan (HMO)
(H3071-002)

$0 $0 $2,950 No
Blue Medicare Advantage (Medicare-Medicaid Plan)
(H0927-001)

$0 $0 $- YesNA
Blue Cross Medicare Advantage Saver Plus (PPO)
(H8634-020)

$0 $505.00 $6,900 No
Blue Cross Medicare Advantage Health Choice (PPO)
(H8634-018)

$0 $505.00 $6,900 No
Blue Cross Medicare Advantage Flex (PPO)
(H8634-014)

$187.00 $505.00 $- No
Blue Cross Medicare Advantage Dental Premier (PPO)
(H8634-021)

$0 $505.00 $7,550 No
Blue Cross Medicare Advantage Classic (PPO)
(H8634-012)

$0 $0 $5,900 Yes
Blue Cross Medicare Advantage Basic (HMO)
(H3822-014)

$0 $0 $2,900 Yes
Aetna Medicare Value Advantra (PPO)
(H7301-006)

$0 $0 $4,900 Yes
Aetna Medicare Premier Advantra (PPO)
(H7301-002)

$22.00 $0 $4,450 Yes
Aetna Medicare Premier (HMO-POS)
(H3192-013)

$0 $0 $4,150 Yes
Aetna Better Health Premier Plan MMAI (Medicare-Medicaid
(H2506-001)

$0 $0 $- YesNA
AARP Medicare Advantage Walgreens (PPO)
(H8768-011)

$0 $0 $5,900 Yes
AARP Medicare Advantage Choice (PPO)
(H8768-003)

$47.00 $0 $3,400 Yes
AARP Medicare Advantage (HMO-POS)
(H5253-108)

$25.00 $0 $3,900 Yes






Illinois Part-C Plans Without Drug Coverage





Medicare Special Needs Plans in Winnebago County Illinois

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special
Needs
Type
2023 Plan
Stars
Rating
Zing Essential Wellness Diabetes and Heart IL (HMO C-SNP)
(H4624-010)
   $0 $0  Yes Chronic or Disabling ConditionNA
UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP)
(H0710-039)
   $27.40 $505.00  No Institutional
UnitedHealthcare Chronic Complete Assure (PPO C-SNP)
(H0271-027)
   $9.80 $505.00  No Chronic or Disabling Condition
Provider Partners Illinois Community Plan (HMO I-SNP)
(H3800-002)
   $27.40 $505.00  No Institutional
Provider Partners Illinois Advantage Plan (HMO I-SNP)
(H3800-001)
   $27.40 $505.00  No Institutional



Types of MA Plan in IL


HMO - Health Maintenance Organization. A Health Maintenance Organization manages your Part A and Part B health insurance benefits. In most cases you need to choose a primary care doctor. Health Maintenance Organization's offers services through a network of contracted hospitals, doctors and other providers, and the plan pays the providers directly. You generally must receive all Healthcare from the plan providers or through referrals from the plan provider. Emergency care, and out-of-area urgent care is still covered. An HMO-POS plan allows you to get some services out-of-network.

PPO - Preferred Provider Organization. A Preferred Provider Organization offers a network of doctors, hospitals, and other providers you can choose from. Because providers are preferred, you can save money by using in network providers or usually pay a higher cost to use out-of-network providers. A primary care doctor is not required.

PFFS - Private Fee For Service. A Private Fee For Service plan allows you greater flexibility in choosing a Illinois provider. You may obtain covered services from any Medicare eligible provider who is willing to accept the plan's terms. The Healthcare provider must agree to accept the plan's terms before each visit. Some of these plans have a network of approved providers that have agreed to treat plan members.

SNP - Special Needs Plan. A Special Needs Plan is for individuals who receive Medicare and Medicaid, have specific severe or disabling chronic conditions or reside in a licensed nursing home or skilled facility. SNP plans must provide prescription drug coverage to Winnebago County Illinois residents.

Cost - Cost Plan. A cost plan doesn't replace your Original Medicare. It offers additional benefits to Original Medicare. If the cost plan doesn't include prescription drug coverage, you can enroll in a Part-D plan separately.





Can I get help in the coverage gap in Winnebago County, IL?


Yes. 35 Medicare Advantage Plans in Winnebago County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

Are there Medicare Advantage Plans in Winnebago County, IL?


There are 58 Medicare Advantage Plans available in Winnebago County, Illinois from 14 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare. Medicare beneficiaries who are interested in a Part-C policy may choose among many plans to compare versus Woodford County Medicare Advantage Plans.



How much is a Medicare Plan in Winnebago County, IL?


Individuals who are interested in a Medicare Advantage Plan in Illinois may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $187. The deductibles in Winnebago County range from $0-$505. The plan with the lowest out-of-pocket (MOOP) expense is $1500 and the highest out-of-pocket is $8300.



Things to consider when choosing a MA Plan in Winnebago


  • Are you eligible for a Medicare Advantage Plan?

  • How much are the premiums, deductibles, and other costs?

  • Is there a yearly limit on what you could pay out-of-pocket?

  • Does the plan cover your prescription drugs?

  • Will you hit the prescription drug coverage gap?

  • Is your pharmacy in the plan’s network?

  • Will your prescription drugs require prior authorization?

  • How well does the plan cover the services you need like vision, hearing, or dental?

  • Are your doctors in-network?

  • Will you need to be referred to see a specialist?

  • Does the plan cover services from out-of-network providers?

  • How does the plan compare to your current coverage?

  • Do you want to juggle multiple Medicare plans?


Special Needs Plan in Winnebago County Explained


C-SNP - Chronic Condition SNP. These plans help individuals receive customized care to fit their unique health care needs. You may qualify for C-SNP if you have one or more specific severe or disabling chronic conditions like:

  • Stroke
  • Certain neurologic disorders
  • Certain chronic and disabling mental health conditions
  • HIV/AIDS
  • Certain chronic lung disorders
  • Diabetes mellitus
  • End-Stage Renal Disease (ESRD)
  • End-stage liver disease
  • Certain severe hematologic disorders
  • Chronic alcohol and other drug dependence
  • Certain cardiovascular disorders
  • Cancer
  • Chronic heart failure
  • Certain autoimmune disorders
  • Dementia

I-SNP - Institutional SNP. These plans require 90 days or longer stay in a facility, or are expected to need the level of services provided in a long-term care (LTC) skilled nursing facility (SNF), a LTC nursing facility (NF), an intermediate care facility for individuals with intellectual disabilities, or an inpatient psychiatric facility.

D-SNP - Dual Eligible SNP. Illinois Medicare and Medicaid enrollees who have limited income and resources may get help paying for their premiums and out-of-pocket medical expenses from Medicaid. Eligibility is based on a percentage of Federal Poverty Levels.


When to sign up for a Illinois Medicare Advantage Plan?


Below mentioned are the types of the enrollment period, along with the instructions on what to do during this period:

Initial Enrollment Period (IEP). This period starts 3 months prior to the month you will turn 65. It ends after 3 months you have turned 65. At this stage, you can sign up for a Illinois Medicare Advantage Plan.

Annual Enrollment Period (AEP). Also known as the Open Enrollment Period, it starts on the 15th of October and ends on the 7th of December. At this stage, you can either sign up for the plan, switch or leave your current plan.

Special Enrollment Period (SEP). This enrollment period depends on the personal circumstances of the beneficiaries, like if you move or lose insurance coverage. Check to determine if you qualify to modify your plan.

Open Enrollment Period. Jan 1 – Mar 31. If you’re enrolled in a Illinois Medicare Advantage Plan, you can switch to a different Medicare Part-C Plan in Winnebago County, IL or switch to Original Medicare once during this time.

5-star Special Enrollment Period. Dec 8 - Nov 30. If a Centers for Medicare and Medicaid Services (CMS) 5-star plan is available in your area you can switch to the 5-star plan once during this period.



Check for CMS Star Ratings

Centers for Medicare & Medicaid Service (CMS) assesses the quality of medical services of Medicare Advantage Plan using a 5-star rating system. A report is released yearly for the public to assess the quality of healthcare services. Thus, if you are searching for the highest Medicare Advantage Plan in your state, research the CMS ratings and costs of the plans report for further information.


Can I get a Medicare Advantage Plans in Winnebago County, IL?

Yes. There are 58 Medicare Advantage Plans available in Winnebago County, Illinois from 14 different health insurance providers. These plans offer additional benefits that aren't available through Original Medicare.

How much is a Medicare Plan in Winnebago County, Illinois?

Illinois residents who are interested in a Medicare Advantage Plan may choose among many cost options depending on your necessary benefits. The lowest plan premium is $0 and the highest premium is $187. The deductibles in Winnebago County range from $0-$505

Can I get help in the coverage gap in Winnebago County, IL?

Yes. 35 Medicare Advantage Plans in Winnebago County offer additional gap coverage. Once in the coverage gap, you’ll pay no more than 25% of the cost for brand-name and generic prescription drugs. If you choose a drug plan that includes coverage in the gap, you may get a discount applied to the drug's price.

What is the most popular plan in Winnebago, IL?

The most popular plan by enrollment in Winnebago is the Blue Medicare Advantage (Medicare-Medicaid Plan) with 23084 enrollment.



Source: CMS. Data as of Oct 1, 2022.
Plans are subject to change as contracts are finalized.
Includes 2023 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2023, 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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MedicareHelp.org is a privately-owned Non-governmental agency. The government website can be found at HealthCare.gov.

Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.