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The 2019 Medicare Advantage Plans in Bronx County NY.



2017 Medicare Advantage Plans in Bronx County New York

There are 36 Medicare Advantage Plans available in Bronx County NY from 15 health insurance providers and 35 Special Needs Plans available. 8 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $2800 and the highest out of pocket is $6700. The highest rated plan available in Bronx County received a 4 overall star rating from CMS and the lowest rated plan is 2.5 stars.

(Click the Plan Name for More Details)

Name Monthly
Premium
C+D
Part D
Deductible
Type  Gap  Max Out
of
Pocket
Overall Rating Formulary
AARP MedicareComplete Essential (HMO)
(H3307-018)
$0.00 Local HMO * $6,700
AARP MedicareComplete Mosaic (HMO)
(H3307-015)
$0.00 $245.00 Local HMO No $5,700 Browse
Formulary
AARP MedicareComplete Plan 1 (HMO)
(H3307-002)
$35.00 $230.00 Local HMO No $6,700 Browse
Formulary
AARP MedicareComplete Plan 2 (HMO)
(H3379-001)
$19.00 $330.00 Local HMO No $6,700 Browse
Formulary
AARP MedicareComplete Plan 3 (HMO)
(H3307-024)
$66.00 $0.00 Local HMO No $2,800 Browse
Formulary
Aetna Medicare Elite Plan (PPO)
(H5521-120)
$0.00 $250.00 Local PPO Yes $6,700 Browse
Formulary
Aetna Medicare Premier Plan (PPO)
(H5521-121)
$99.00 $200.00 Local PPO Yes $6,700 Browse
Formulary
Aetna Medicare Select Plan (HMO)
(H3312-002)
$29.00 $300.00 Local HMO Yes $6,700 Browse
Formulary
Affinity Medicare Passport Essentials NYC (HMO)
(H5991-006)
$0.00 $300.00 Local HMO Yes $6,700 Browse
Formulary
Affinity Medicare Passport Select (HMO)
(H5991-004)
$45.00 $0.00 Local HMO Yes $5,900 Browse
Formulary
AgeWell New York LiveWell (HMO)
(H4922-005)
$0.00 $370.00 Local HMO No $6,700 NABrowse
Formulary
Centers Plan for Medicare Advantage Care (HMO)
(H6988-001)
$0.00 $0.00 Local HMO No $6,700 NABrowse
Formulary
Elderplan Extra Help (HMO)
(H3347-009)
$40.90 $400.00 Local HMO No $6,700 Browse
Formulary
EmblemHealth VIP Essential (HMO)
(H3330-032)
$0.00 $400.00 Local HMO No $6,700 Browse
Formulary
EmblemHealth VIP Gold (HMO)
(H3330-021)
$78.00 $330.00 Local HMO No $6,700 Browse
Formulary
EmblemHealth VIP Gold Plus (HMO)
(H3330-033)
$285.00 $330.00 Local HMO No $6,700 Browse
Formulary
Empire MediBlue Access (PPO)
(H3342-019)
$70.00 $260.00 Local PPO Yes $6,200 Browse
Formulary
Empire MediBlue Core (HMO)
(H3370-033)
$0.00 Local HMO * $6,700
Empire MediBlue Plus (HMO)
(H3370-029)
$0.00 $250.00 Local HMO Yes $6,600 Browse
Formulary
Fidelis Medicare $0 Premium (HMO)
(H3328-020)
$0.00 $0.00 Local HMO No $6,700 Browse
Formulary
Fidelis Medicare Advantage Flex (HMO-POS)
(H3328-003)
$41.00 $250.00 Local HMO No $6,700 Browse
Formulary
Fidelis Medicare Advantage without Rx (HMO-POS)
(H3328-001)
$0.00 Local HMO * $6,700
Healthfirst 65 Plus Plan (HMO)
(H3359-001)
$0.00 $0.00 Local HMO No $6,700 Browse
Formulary
Healthfirst Coordinated Benefits Plan (HMO)
(H3359-027)
$0.00 Local HMO * $6,700
Healthfirst Increased Benefits Plan (HMO)
(H3359-019)
$37.00 $400.00 Local HMO No $6,700 Browse
Formulary
Humana Gold Plus H3533-021 (HMO)
(H3533-021)
$24.10 $400.00 Local HMO No $6,700 Browse
Formulary
Liberty Health Advantage Preferred Choice (HMO)
(H3337-001)
$0.00 $0.00 Local HMO Yes $5,500 Browse
Formulary
MetroPlus Platinum (HMO)
(H0423-004)
$226.20 $400.00 Local HMO No $6,700 Browse
Formulary
UnitedHealthcare MedicareComplete Choice Essential (Regio
(R5342-002)
$0.00 Regional PPO * $6,700
UnitedHealthcare MedicareComplete Choice Plan 1 (Regional
(R5342-001)
$0.00 $290.00 Regional PPO No $6,700 Browse
Formulary
UnitedHealthcare MedicareComplete Choice Plan 3 (Regional
(R5342-005)
$36.00 $150.00 Regional PPO No $5,900 Browse
Formulary
UnitedHealthcare MedicareComplete Choice Plan 4 (Regional
(R5342-006)
$66.00 $0.00 Regional PPO No $5,400 Browse
Formulary
VNSNY CHOICE Medicare Classic (HMO)
(H5549-008)
$41.00 $400.00 Local HMO No $6,700 Browse
Formulary
WellCare Choice (HMO-POS)
(H3361-106)
$0.00 $0.00 Local HMO No $6,700 Browse
Formulary
WellCare Preferred (HMO-POS)
(H3361-135)
$45.00 $0.00 Local HMO No $6,700 Browse
Formulary
WellCare Rx (HMO)
(H3361-130)
$7.00 $400.00 Local HMO No $6,700 Browse
Formulary
Return to 2017 Medicare Advantage Plans in New York

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



Medicare Special Needs Plans in Bronx county New York

Plan Name Monthly
Consolidated
Premium C+D
Part D
Deductible
 Gap  Special Needs
Type
Overall Rating
Affinity Medicare Solutions (HMO SNP)
(H5991- 002)
   $38.10 $400.00  No Dual-EligibleBrowse
Formulary
Affinity Medicare Ultimate (HMO SNP)
(H5991- 001)
   $40.00 $400.00  No Dual-EligibleBrowse
Formulary
AgeWell New York BeWell (HMO SNP)
(H4922- 002)
   $41.00 $400.00  No Dual-EligibleNABrowse
Formulary
AgeWell New York CareWell (HMO SNP)
(H4922- 004)
   $41.00 $400.00  No InstitutionalNABrowse
Formulary
AgeWell New York FeelWell (HMO SNP)
(H4922- 003)
   $41.00 $400.00  No Dual-EligibleNABrowse
Formulary
ArchCare Advantage (HMO SNP)
(H1777- 007)
   $41.00 $400.00  No InstitutionalBrowse
Formulary
CenterLight Healthcare Direct Complete Plan (HMO SNP)
(H5989- 002)
   $38.10 $400.00  No InstitutionalNABrowse
Formulary
Centers Plan for Dual Coverage Care (HMO SNP)
(H6988- 002)
   $41.00 $400.00  No Dual-EligibleNABrowse
Formulary
Centers Plan for Nursing Home Care (HMO SNP)
(H6988- 003)
   $41.00 $400.00  No InstitutionalNABrowse
Formulary
Elderplan Advantage For Nursing Home Residents (HMO SNP)
(H3347- 003)
   $40.90 $400.00  No InstitutionalBrowse
Formulary
Elderplan For Medicaid Beneficiaries (HMO SNP)
(H3347- 002)
   $40.90 $400.00  No Dual-EligibleBrowse
Formulary
Elderplan Plus Long Term Care (HMO SNP)
(H3347- 007)
   $40.90 $400.00  No Dual-EligibleBrowse
Formulary
EmblemHealth VIP Dual (HMO SNP)
(H3330- 037)
   $41.00 $400.00  No Dual-EligibleBrowse
Formulary
Empire MediBlue Dual Advantage (HMO SNP)
(H3370- 028)
   $41.00 $400.00  Yes Dual-EligibleBrowse
Formulary
Fidelis Dual Advantage (HMO SNP)
(H3328- 002)
   $34.60 $400.00  No Dual-EligibleBrowse
Formulary
Fidelis Dual Advantage Flex (HMO SNP)
(H3328- 017)
   $41.00 $400.00  No Dual-EligibleBrowse
Formulary
Fidelis Medicaid Advantage Plus (HMO SNP)
(H3328- 016)
   $33.70 $400.00  No Dual-EligibleBrowse
Formulary
Fresenius Total Health (HMO SNP)
(H3262- 001)
   $40.90 $400.00  No Chronic or Disabling ConditionToo NewBrowse
Formulary
GuildNet Gold (HMO SNP)
(H6864- 001)
   $41.00 $400.00  No Dual-EligibleNABrowse
Formulary
Healthfirst AssuredCare (HMO SNP)
(H3359- 035)
   $41.00 $400.00  No InstitutionalBrowse
Formulary
Healthfirst CompleteCare (HMO SNP)
(H3359- 034)
   $41.00 $400.00  No Dual-EligibleBrowse
Formulary
Healthfirst Life Improvement Plan (HMO SNP)
(H3359- 021)
   $41.00 $400.00  No Dual-EligibleBrowse
Formulary
Humana Gold Plus SNP-DE H3533-004 (HMO SNP)
(H3533- 004)
   $34.60 $260.00  No Dual-EligibleBrowse
Formulary
Liberty Health Advantage Dual Power (HMO SNP)
(H3337- 003)
   $41.00 $400.00  No Dual-EligibleBrowse
Formulary
MetroPlus Advantage Plan (HMO SNP)
(H0423- 001)
   $41.00 $400.00  No Dual-EligibleBrowse
Formulary
RiverSpring Star (HMO SNP)
(H6776- 001)
   $41.00 $400.00  No InstitutionalToo NewBrowse
Formulary
Senior Whole Health of New York NHC (HMO SNP)
(H5992- 007)
   $41.00 $400.00  No Dual-EligibleNABrowse
Formulary
UnitedHealthcare Dual Complete (HMO SNP)
(H3387- 010)
   $41.00 $400.00  No Dual-EligibleBrowse
Formulary
UnitedHealthcare Nursing Home Plan (HMO SNP)
(H3379- 002)
   $34.80 $400.00  No InstitutionalBrowse
Formulary
VillageCareMAX Medicare Health Advantage (HMO SNP)
(H2168- 001)
   $41.00 $400.00  No Dual-EligibleToo NewBrowse
Formulary
VillageCareMAX Medicare Total Advantage (HMO SNP)
(H2168- 002)
   $41.00 $400.00  No Dual-EligibleToo NewBrowse
Formulary
VNSNY CHOICE Medicare Maximum (HMO SNP)
(H5549- 006)
   $109.00 $400.00  No Dual-EligibleBrowse
Formulary
VNSNY CHOICE Medicare Preferred (HMO SNP)
(H5549- 002)
   $41.00 $400.00  No Dual-EligibleBrowse
Formulary
VNSNY CHOICE Total (HMO SNP)
(H5549- 003)
   $41.00 $400.00  No Dual-EligibleBrowse
Formulary
WellCare Access (HMO SNP)
(H3361- 109)
   $26.10 $400.00  No Dual-EligibleBrowse
Formulary


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 provider 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; 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 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 2017 once you and your plan provider have spent $3700 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 40% of the plans cost for covered brand-name prescription drugs and 51% 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.

    Data as of September 6, 2016.

    Plans are subject to change as contracts are finalized.

    Includes 2017 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2017, 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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