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The 2019 Medicare Advantage Plans in Merced County CA.

2016 Medicare Advantage Plans in Merced County California

There are 5 Medicare Advantage Plans available in Merced County CA from 2 health insurance providers and 0 Special Needs Plans available. 2 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. The highest rated plan available in Merced County received a 4 overall star rating from CMS and the lowest rated plan is 3.5 stars.

(Click the Plan Name for More Details)

Plan Name Monthly
Part D
Type  Gap  Max Out
Overall Rating Formulary
Return to Counties In California
AARP MedicareComplete SecureHorizons (HMO)
$35.00 $280.00 Local HMO No $6,700 Browse
Care1st AdvantageOptimum Plan (HMO)
$0.00 $0.00 Local HMO Yes $3,400 Browse
Coordinated Choice Plan (HMO)
$31.00 $360.00 Local HMO Yes $6,700 Browse
UnitedHealthcare MedicareDirect Essential (PFFS)
$23.00 PFFS * N/A
UnitedHealthcare MedicareDirect Rx (PFFS)
$50.00 $270.00 PFFS No N/A Browse

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

Medicare Special Needs Plans in Merced county California

Plan Name Monthly
Premium C+D
Part D
 Gap  Special Needs
Overall Rating Formulary
Sorry, No Special Needs Plans in merced County Found!

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
  • (EA) 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.

  • (DS) Defined Standard Benefit
  • (BA) Basic Alternative
  • (AE) Actuarially Equivalent Standard

  • GAP

    In 2016 once you and your plan provider have spent $3310 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 plans cost for covered brand-name prescription drugs and 58% 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.

    Plans as of September 9, 2015.

    Plans are subject to change as contracts are finalized.

    Includes 2016 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded. For 2016, 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.

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