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The 2022 Medicare Advantage Plans in Sussex County DE.

2016 Medicare Advantage Plans in Sussex County Delaware

There are 4 Medicare Advantage Plans available in Sussex County DE from 2 health insurance providers and 3 Special Needs Plans available. 1 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $4500 and the highest out of pocket is $6700. The highest rated plan available in Sussex 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 Monthly
Part D
Type  Gap  Max Out
Overall Rating Formulary
Return to Counties In Delaware
Aetna Medicare Connect Plus (PPO)
$188.00 $0.00 Local PPO Yes $4,500 Browse
Aetna Medicare Premier Plan (PPO)
$149.00 $0.00 Local PPO No $6,700 Browse
Cigna-HealthSpring Preferred (HMO)
$32.00 $280.00 Local HMO No $6,700 Browse
Cigna-HealthSpring PreventiveCare (HMO)
$0.00 $280.00 Local HMO No $6,700 Browse

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

Medicare Special Needs Plans in Sussex county Delaware

Plan Name Monthly
Premium C+D
Part D
 Gap  Special Needs
Overall Rating Formulary
Cigna-HealthSpring Achieve (HMO SNP)
(H2108- 029)
   $70.50 $280.00  No Chronic or Disabling ConditionBrowse
Cigna-HealthSpring TotalCare (HMO SNP)
(H2108- 001)
   $24.70 $360.00  No Dual-EligibleBrowse
Cigna-HealthSpring Traditions (HMO SNP)
(H2108- 020)
   $33.40 $360.00  No InstitutionalBrowse

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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