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The 2019 Medicare Advantage Plans in Orange County CA.


2018 Medicare Advantage Plans in Orange County California

There are 41 Medicare Advantage Plans available in Orange County CA from 17 different health insurance providers. 26 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $1499 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. Orange County California residents can also pick from 26 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
Aetna Medicare Choice Plan (PPO)
 		$107.00 $0.00 Yes $6,700 FormularyEnroll
Aetna Medicare Prime Plan (HMO)
 		$0.00 $0.00 Yes $1,950 FormularyEnroll
Aetna Medicare Select Plan (HMO)
 		$0.00 $0.00 Yes $4,600 FormularyEnroll
Alignment Health Plan CalPlus (HMO)
 		$35.50 $405.00 No $3,400 FormularyEnroll
Alignment Health Plan My Choice (HMO)
 		$0.00 $0.00 Yes $3,400 FormularyEnroll
Alignment Health Plan Platinum (HMO)
 		$0.00 $0.00 Yes $1,499 FormularyEnroll
Alignment Health Plan smartHMO (HMO)
 		$0.00 $0.00 Yes $3,400 FormularyEnroll
Anthem Connect Plus (HMO)
 		$33.00 $405.00 No $6,700 FormularyEnroll
Anthem MediBlue Access (PPO)
 		$161.00 $370.00 No $6,700 FormularyEnroll
Anthem MediBlue Coordination Plus (HMO)
 		$35.50 $405.00 Yes $6,700 Formulary
Anthem MediBlue Plus (HMO)
 		$0.00 $0.00 Yes $6,700 Formulary
Anthem MediBlue Select (HMO)
 		$0.00 $0.00 Yes $1,900 Formulary
Anthem StartSmart Plus (HMO)
 		$0.00 $0.00 No $3,000 FormularyEnroll
Anthem Value Plus (HMO)
 		$0.00 $0.00 Yes $1,900 FormularyEnroll
Blue Shield 65 Plus (HMO)
 		$0.00 $0.00 Yes $2,800 FormularyEnroll
Blue Shield 65 Plus Choice Plan (HMO)
 		$0.00 $0.00 Yes $2,400 FormularyEnroll
Brand New Day Classic Care Drug Savings (HMO)
 		$0.00 $0.00 Yes $3,400 Formulary
Brand New Day Classic Choice for Medi-Medi (HMO)
 		$35.50 $405.00 No $6,700 Formulary
Care1st AdvantageOptimum Plan (HMO)
 		$0.00 $0.00 Yes $2,400 FormularyEnroll
Central Health Medicare Plan (HMO)
 		$0.00 $0.00 Yes $3,400 FormularyEnroll
Central Health Premier Plan (HMO)
 		$35.50 $405.00 Yes $6,700 FormularyEnroll
Coordinated Choice Plan (HMO)
 		$35.50 $405.00 Yes $6,700 FormularyEnroll
Easy Choice Best Plan (HMO)
 		$0.00 $0.00 Yes $3,400 FormularyEnroll
Easy Choice Plus Plan (HMO)
 		$25.70 $405.00 No $6,700 FormularyEnroll
Golden State Medicare Gold (HMO)
 		$0.00 $0.00 Yes $3,400 Formulary
Health Net Gold Select (HMO)
 		$0.00 $0.00 Yes $2,000 FormularyEnroll
Health Net Healthy Heart (HMO)
 		$17.00 $0.00 Yes $2,400 FormularyEnroll
Health Net Seniority Plus Sapphire (HMO)
 		$35.50 $240.00 No $6,700 FormularyEnroll
Health Net Seniority Plus Sapphire Premier (HMO)
 		$35.50 $85.00 No $6,700 FormularyEnroll
Humana Gold Plus H5619-021 (HMO)
 		$0.00 $0.00 Yes $2,200 FormularyEnroll
Humana Value Plus H5619-037 (HMO)
 		$16.30 $405.00 No $6,700 FormularyEnroll
Inter Valley Health Plan Service To Seniors (HMO)
 		$0.00 $0.00 No $2,000 FormularyEnroll
Inter Valley Health Plan Value Preferred Choice (HMO)
 		$35.50 $405.00 No $5,900 FormularyEnroll
Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
 		$0.00 $0.00 Yes $4,900 Formulary
SCAN Classic (HMO)
 		$0.00 $0.00 Yes $2,400 FormularyEnroll
SCAN Plus (HMO)
 		$32.50 $405.00 No $6,700 FormularyEnroll
Return to 2018 Medicare Advantage Plans in California

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



2018 Medicare Special Needs Plans in Orange county California

Plan Name Monthly
Consolidated
Premium C+D		 Part D
Deductible		  Gap  Special Needs
Type		 Overall Rating
Alignment Health Plan Heart & Diabetes (HMO SNP)
(H3815- 010)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Anthem Breathe (HMO SNP)
(H0544- 014)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Anthem Diabetes (HMO SNP)
(H0544- 004)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Anthem ESRD (HMO SNP)
(H0544- 015)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Anthem Heart (HMO SNP)
(H0544- 013)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Anthem Touch (HMO SNP)
(H0544- 005)		    $0.00 $0.00  Yes Institutional
Brand New Day Bridges Choice for Medi-Medi (HMO SNP)
(H0838- 029)		    $35.50 $405.00  No Chronic or Disabling Condition
Brand New Day Bridges Drug Savings (HMO SNP)
(H0838- 028)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Brand New Day Dual Coverage (HMO SNP)
(H0838- 024)		    $35.50 $405.00  No Dual-Eligible
Brand New Day Embrace Care Drug Savings (HMO SNP)
(H0838- 035)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Brand New Day Embrace Choice for Medi-Medi (HMO SNP)
(H0838- 036)		    $35.50 $405.00  No Chronic or Disabling Condition
Brand New Day Harmony Choice for Medi-Medi (HMO SNP)
(H0838- 020)		    $35.50 $405.00  No Chronic or Disabling Condition
Brand New Day Harmony Drug Savings (HMO SNP)
(H0838- 032)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Brand New Day In Control Choice for Medi-Medi (HMO SNP)
(H0838- 027)		    $35.50 $405.00  No Chronic or Disabling Condition
Brand New Day In Control Drug Savings (HMO SNP)
(H0838- 026)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Care1st TotalDual Plan (HMO SNP)
(H5928- 005)		    $35.50 $405.00  No Dual-Eligible
Central Health Focus Plan (HMO SNP)
(H5649- 006)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Health Net Jade (HMO SNP)
(H0562- 092)		    $0.00 $0.00  Yes Chronic or Disabling Condition
Health Net Seniority Plus Amber I (HMO SNP)
(H0562- 055)		    $35.50 $140.00  No Dual-Eligible
Health Net Seniority Plus Amber II (HMO SNP)
(H0562- 110)		    $35.50 $190.00  No Dual-Eligible
Heart First (HMO SNP)
(H5425- 028)		    $0.00 $0.00  Yes Chronic or Disabling Condition
OneCare (HMO SNP)
(H5433- 001)		    $31.90 $405.00  No Dual-Eligible
SCAN Balance (HMO SNP)
(H5425- 034)		    $0.00 $0.00  Yes Chronic or Disabling Condition
SCAN Healthy at Home (HMO SNP)
(H9104- 006)		    $0.00 $0.00  Yes Institutional
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
(H0524- 029)		    $32.00 $0.00  No Dual-Eligible
VillageHealth (HMO-POS SNP)
(H5943- 002)		    $35.50 $405.00  No 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.

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