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The 2020 Medicare Advantage Plans in Orange County CA.
2016 Medicare Advantage Plans in Orange County California
There are 40 Medicare Advantage Plans available in Orange County CA from 18 health insurance providers and 26 Special Needs Plans available. 25 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $1950 and the highest out of pocket is $6700.
The highest rated plan available in Orange County received a 5 overall star rating from CMS and the lowest rated plan is 3 stars.
(Click the Plan Name for More Details)
| Plan Name |
Monthly
Premium
C+D |
Part D
Deductible |
Type |
Gap |
Max Out
of
Pocket |
Overall Rating |
Formulary |
| Return to Counties In California | | | | | |
AARP MedicareComplete SecureHorizons Essential (HMO)
(H0543-121) |
$0.00 |
|
Local HMO * |
|
$4,900 | | |
AARP MedicareComplete SecureHorizons Plan 2 (HMO)
(H0543-138) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
AARP MedicareComplete SecureHorizons Plan 3 (HMO)
(H0543-153) |
$27.40 |
$360.00 |
Local HMO |
No |
$6,700 | | Browse
Formulary |
AARP MedicareComplete SecureHorizons Premier (HMO)
(H0543-004) |
$0.00 |
$0.00 |
Local HMO |
No |
$4,900 | | Browse
Formulary |
Aetna Medicare Choice Plan (PPO)
(H5521-056) |
$107.00 |
$150.00 |
Local PPO |
Yes |
$6,700 | | Browse
Formulary |
Aetna Medicare Connect Plus (PPO)
(H5521-052) |
$188.00 |
$0.00 |
Local PPO |
Yes |
$4,500 | | Browse
Formulary |
Aetna Medicare Prime Plan (HMO)
(H0523-060) |
$0.00 |
$0.00 |
Local HMO |
No |
$1,950 | | Browse
Formulary |
Aetna Medicare Select Plan (HMO)
(H0523-002) |
$27.00 |
$0.00 |
Local HMO |
No |
$6,700 | | Browse
Formulary |
Anthem MediBlue Access (PPO)
(H8552-020) |
$141.00 |
$130.00 |
Local PPO |
No |
$6,700 | | Browse
Formulary |
Anthem MediBlue Coordination Plus (HMO)
(H0564-080) |
$31.00 |
$360.00 |
Local HMO |
Yes |
$6,700 | | Browse
Formulary |
Anthem MediBlue Plus (HMO)
(H0564-068) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$6,700 | | Browse
Formulary |
Anthem MediBlue Select (HMO)
(H0564-063) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
Blue Shield 65 Plus (HMO)
(H0504-015) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$2,800 | | Browse
Formulary |
Blue Shield 65 Plus Choice Plan (HMO)
(H0504-021) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$2,000 | | Browse
Formulary |
CalPlus Plan (HMO)
(H3815-009) |
$31.00 |
$360.00 |
Local HMO |
No |
$3,400 | | Browse
Formulary |
Care1st AdvantageOptimum Plan (HMO)
(H5928-004) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
CareMore Connect Plus (HMO)
(H0544-049) |
$22.00 |
$360.00 |
Local HMO |
No |
$6,700 | | Browse
Formulary |
CareMore StartSmart Plus (HMO)
(H0544-007) |
$0.00 |
$0.00 |
Local HMO |
No |
$5,000 | | Browse
Formulary |
CareMore Value Plus (HMO)
(H0544-002) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,000 | | Browse
Formulary |
Central Health Medicare Plan (HMO)
(H5649-001) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
Central Health Premier Plan (HMO)
(H5649-004) |
$31.10 |
$360.00 |
Local HMO |
Yes |
$6,700 | | Browse
Formulary |
Classic Care (HMO)
(H0838-025) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
Classic Choice for Medi-Medi (HMO)
(H0838-033) |
$31.00 |
$360.00 |
Local HMO |
No |
$6,700 | | Browse
Formulary |
Coordinated Choice Plan (HMO)
(H5928-037) |
$31.00 |
$360.00 |
Local HMO |
Yes |
$6,700 | | Browse
Formulary |
Easy Choice Best Plan (HMO)
(H5087-005) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
Easy Choice Plus Plan (HMO)
(H5087-002) |
$12.00 |
$360.00 |
Local HMO |
No |
$6,700 | | Browse
Formulary |
Golden State Medicare Health Plan, Golden (HMO)
(H2241-006) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
Health Net Gold Select (HMO)
(H0562-101) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$2,200 | | Browse
Formulary |
Health Net Healthy Heart (HMO)
(H0562-100) |
$20.00 |
$0.00 |
Local HMO |
Yes |
$3,000 | | Browse
Formulary |
Health Net Seniority Plus Sapphire (HMO)
(H0562-111) |
$31.00 |
$290.00 |
Local HMO |
No |
$6,700 | | Browse
Formulary |
Health Net Seniority Plus Sapphire Premier (HMO)
(H3561-002) |
$31.00 |
$310.00 |
Local HMO |
No |
$6,700 | Too New | Browse
Formulary |
Humana Gold Plus H5619-021 (HMO)
(H5619-021) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
Humana Gold Plus H5619-022 (HMO)
(H5619-022) |
$39.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
Humana Gold Plus H5619-037 (HMO)
(H5619-037) |
$23.40 |
$360.00 |
Local HMO |
No |
$6,700 | | Browse
Formulary |
Inter Valley Health Plan OC Preferred (HMO)
(H0545-013) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$2,000 | | Browse
Formulary |
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
(H0524-003) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$4,400 | | Browse
Formulary |
My Choice Plan (HMO)
(H3815-001) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
Platinum Plan (HMO)
(H3815-008) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$3,400 | | Browse
Formulary |
SCAN Classic (HMO)
(H5425-007) |
$0.00 |
$0.00 |
Local HMO |
Yes |
$2,900 | | Browse
Formulary |
SCAN Plus (HMO)
(H5425-037) |
$31.10 |
$360.00 |
Local HMO |
No |
$6,000 | | Browse
Formulary |
* Plan Type Indicates plan does not offer Medicare Part D drug coverage.
Medicare Special Needs Plans in Orange county California
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.
