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The 2022 Medicare Advantage Plans in Spalding County GA.
2015 Medicare Advantage Plans in Spalding County Georgia
There are 6 Medicare Advantage Plans available in Spalding County GA from 5 health insurance providers and 6 Special Needs Plans available. 2 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3900 and the highest out of pocket is $6700. The highest rated plan available in Spalding County received a 4 overall star rating from CMS and the lowest rated plan is 3 stars.
(Click the Plan Name for More Details)
|Gap|| Max Out of
|Return to Counties In Georgia|
|Care Improvement Plus Medicare Advantage (Regional PPO)
|Regional PPO||$29.00||$295.00||No||$6,700||Browse |
|Cigna-HealthSpring Preferred (HMO)
|Local HMO||$0.00||$0.00||Yes||$4,300||Too New||Browse |
|HumanaChoice R5826-064 (Regional PPO)
|Regional PPO *||$0.00||$5,900|
|HumanaChoice R5826-077 (Regional PPO)
|Regional PPO||$74.00||$200.00||No||$6,700||Browse |
|Piedmont WellStar Medicare Choice (HMO)
|Local HMO||$0.00||$0.00||Yes||$3,900||Too New||Browse |
|WellCare Value (HMO)
|Local HMO||$0.00||$0.00||No||$6,700||Browse |
* Plan Type Indicates plan does not offer Part D drug coverage.
Medicare Special Needs Plans in Spalding county Georgia
|Care Improvement Plus Dual Advantage (Regional PPO SNP)
|Care Improvement Plus Gold Rx (Regional PPO SNP)
|$0.00||$315.00||No||Chronic or Disabling Condition||Browse |
|Care Improvement Plus Silver Rx (Regional PPO SNP)
|$3.40||$320.00||No||Chronic or Disabling Condition||Browse |
|Cigna-HealthSpring TotalCare (HMO SNP)
|$14.90||$320.00||No||Dual-Eligible||Too New||Browse |
|UnitedHealthcare Nursing Home Plan (PPO SNP)
|WellCare Access (HMO SNP)
Plans as of September 2, 2014.
Plans are subject to change as contracts are finalized.
Includes 2015 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded. For 2015, enhanced alternative plans may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.
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 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
In 2015 once you and your plan provider have spent $2,960 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 45% of the plan's cost for covered brand-name prescription drugs unless your plan offers additional coverage. You will still receive a 55% discount on brand-name drugs and a 35% discount on generic drugs.
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