x

You are Currently Viewing the 2018 Medicare Plans.
Click here If you Would Like to See
The 2019 Medicare Advantage Plans in Aguas Buenas County PR.



2018 Medicare Advantage Plans in Aguas Buenas County Puerto Rico

There are 20 Medicare Advantage Plans available in Aguas Buenas County PR from 9 different health insurance providers. 10 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3250 and the highest out of pocket is $6700. The highest rated plan available in Aguas Buenas County received a 4.5 overall star rating from CMS and the lowest rated plan is 3.5 stars. Aguas Buenas County Puerto Rico residents can also pick from 18 Medicare Special Needs Plans.



(Click the Plan Name for More Details)

Name Premium
C+D
Part D
Deductible
 Gap  MOOP Overall Rating Formulary Sign Up
Basic (HMO)
$0.00 $3,400
CMC Care Advantage Ahorro (HMO) (HMO)
$0.00 $0.00 No $3,400 Formulary
CMC Care Advantage Maximo (HMO) (HMO)
$98.00 $0.00 No $3,400 Formulary
CMC Care Advantage Vida (HMO) (HMO)
$0.00 $0.00 No $3,400 Formulary
First+Plus - Advantage (PPO)
$47.00 $0.00 Yes $6,700 Formulary
Humana Gold Plus H4007-012 (HMO)
$0.00 $0.00 No $5,000 Formulary
Humana Gold Plus H4007-013 (HMO)
$0.00 $0.00 No $6,700 Formulary
HumanaChoice Value H2029-001 (PPO)
$43.00 $360.00 No $6,700 Formulary
MCS Classicare Essential (HMO-POS)
$0.00 $0.00 Yes $3,400 Formulary
MCS Classicare InteliCare (HMO)
$0.00 $0.00 Yes $3,400 Formulary
MCS Classicare MediCa$h (HMO)
$0.00 $405.00 No $6,700 Formulary
MCS Classicare MediOnlyNoRx (HMO)
$0.00 $3,400
MMM - Elite Excel (HMO-POS)
$0.00 $0.00 Yes $3,250 Formulary
MMM - Elite Ultra (HMO-POS)
$0.00 $0.00 Yes $3,250 Formulary
MMM - Unico (HMO)
$26.90 $0.00 Yes $3,250 Formulary
Optimo (PPO)
$0.00 $6,700
Optimo Plus
$121.00 $0.00 Yes $6,700 Formulary
PMC - Max Extra (HMO)
$0.00 $0.00 Yes $3,250 Formulary
Royal (HMO)
$0.00 $0.00 Yes $3,400 Formulary
Royal Plus (HMO-POS)
$53.00 $0.00 Yes $3,400 Formulary
Return to 2018 Medicare Advantage Plans in Puerto Rico

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



2018 Medicare Special Needs Plans in Aguas Buenas county Puerto Rico

Plan Name Monthly
Consolidated
Premium C+D
Part D
Deductible
 Gap  Special Needs
Type
Overall Rating
Humana Gold Plus SNP-DE H4007-016 (HMO SNP)
(H4007- 016)
   $0.00 $405.00  No Dual-Eligible
Humana Gold Plus SNP-DE H4007-018 (HMO SNP)
(H4007- 018)
   $0.00 $405.00  No Dual-Eligible
MCS Classicare Platino C
(H5577- 027)
   $0.00 $405.00  No Dual-Eligible
MCS Classicare Platino Cl
(H5577- 028)
   $0.00 $405.00  No Dual-Eligible
MCS Classicare Platino Ideal (HMO SNP)
(H5577- 002)
   $0.00 $405.00  No Dual-Eligible
MCS Classicare Platino M
(H5577- 029)
   $0.00 $405.00  No Dual-Eligible
MCS Classicare Platino Original (HMO SNP)
(H5577- 026)
   $0.00 $405.00  No Dual-Eligible
MCS Classicare Platino Progreso (HMO SNP)
(H5577- 017)
   $0.00 $405.00  No Dual-Eligible
MMM - Diamante Choice Platino (HMO SNP)
(H4003- 017)
   $0.00 $405.00  No Dual-Eligible
MMM - Diamante Choice Plus Platino (HMO SNP)
(H4003- 041)
   $0.00 $405.00  No Dual-Eligible
MMM - Diamante Excel Platino (HMO SNP)
(H4003- 033)
   $0.00 $405.00  No Dual-Eligible
MMM - Diamante Excel Plus Platino (HMO SNP)
(H4004- 061)
   $0.00 $405.00  No Dual-Eligible
MMM - Supremo (HMO SNP)
(H4003- 009)
   $0.00 $0.00  Yes Chronic or Disabling Condition
Platino Advance (HMO SNP)
(H5774- 026)
   $0.00 $405.00  No Dual-Eligible
Platino Plus (HMO SNP)
(H5774- 024)
   $0.00 $405.00  No Dual-Eligible
Platino Ultra (HMO SNP)
(H5774- 025)
   $0.00 $405.00  No Dual-Eligible
PMC - Premier Preferred Platino (HMO SNP)
(H4004- 048)
   $0.00 $405.00  No Dual-Eligible
Vital Plus (HMO SNP)
(H5774- 022)
   $0.00 $0.00  Yes Chronic or Disabling Condition


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 2018 once you and your plan provider have spent $3750 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 35% of the plans cost for covered brand-name prescription drugs and 44% 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 5, 2017.

Plans are subject to change as contracts are finalized.

Includes 2018 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2018, 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.

Call For A licensed Sales Agent

1-855-492-4169

  • Mon-Fri 8:30am-8:00pm


Call to Enroll!