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The 2022 Medicare Advantage Plans in Kootenai County ID.
2019 Medicare Advantage Plans in
Kootenai County Idaho
There are 17 Medicare Advantage Plans available in Kootenai County ID from 6 different health insurance providers. 2 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3000 and the highest out of pocket is $6700. Kootenai County Idaho residents can also pick from 2 Medicare Special Needs Plans. The highest rated plan available in Kootenai County received a 4 overall star rating from CMS and the lowest rated plan is 3.5 stars
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Medicare Advantage Health Plans Without Drug Coverage
|Plan Name ⇅||Premium||Type||MOOP||Overall
|HumanaChoice H5216-046 (PPO)
||$0||Local PPO *||$3,600||Enroll|
|PacificSource Medicare Explorer 12 (PPO)
||$0||Local PPO *||$6,700||Enroll|
|Regence MedAdvantage Basic (PPO)
||$29.00||Local PPO *||$5,000||Enroll|
|Secure Blue no Rx (PPO)
||$29.00||Local PPO *||$3,400||NA||Enroll|
|True Blue no Rx (HMO)
||$29.00||Local HMO *||$3,000||Enroll|
2019 Medicare Special Needs Plans in Kootenai county Idaho
|Plan Name ⇅||Monthly
|Molina Medicare Options Plus (HMO SNP)
|True Blue Special Needs Plan (HMO SNP)
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
In 2019 once you and your plan provider have spent $3820 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 25% of the plans cost for covered brand-name prescription drugs and 37% 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
Data as of September 5, 2018.
Star Rating as of October 10, 2018.
For More Information on Ratings Please See the CMS Tech Notes.
Plans are subject to change as contracts are finalized.
Includes 2019 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2019, 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.