2019 Medicare Advantage Plans in
Montgomery County Maryland

There are 13 Medicare Advantage Plans available in Montgomery County MD from 6 different health insurance providers. 4 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $2900 and the highest out of pocket is $6700. Montgomery County Maryland residents can also pick from 10 Medicare Special Needs Plans. The highest rated plan available in Montgomery County received a 5 overall star rating from CMS and the lowest rated plan is 3 stars


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Return to 2019 Medicare Advantage Plans in Maryland





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
Sign Up
Erickson Advantage Signature without Drugs (HMO-POS)
$160.00 Local HMO * $2,900
Kaiser Permanente Medicare Advantage w/o Part D (HMO)
$45.00 Local HMO * $6,700
Lasso Healthcare (MSA)
MSA * $- NA





2019 Medicare Special Needs Plans in Montgomery county Maryland

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Click
for
Formulary
Cigna-HealthSpring Achieve (HMO SNP)
(H2108- 029)
    $68.00 $280.0  No Chronic or Disabling ConditionBrowse
Formulary
Cigna-HealthSpring TotalCare (HMO SNP)
(H2108- 001)
    $21.40 $415.0  No Dual-EligibleBrowse
Formulary
Cigna-HealthSpring Traditions (HMO SNP)
(H2108- 020)
    $30.00 $415.0  No InstitutionalBrowse
Formulary
Erickson Advantage Champion (HMO-POS SNP)
(H5652- 004)
    $195.0 $0  No Chronic or Disabling ConditionBrowse
Formulary
Erickson Advantage Guardian (HMO-POS SNP)
(H5652- 003)
    $33.10 $0  No InstitutionalBrowse
Formulary
UMHA Dual (HMO SNP)
(H8854- 002)
    $27.80 $415.0  No Dual-EligibleBrowse
Formulary
UnitedHealthcare Assisted Living Plan (PPO SNP)
(H2228- 011)
    $30.00 $200.0  No InstitutionalBrowse
Formulary
UnitedHealthcare Dual Complete (HMO SNP)
(H4094- 001)
    $30.00 $415.0  No Dual-EligibleToo NewBrowse
Formulary
UnitedHealthcare Nursing Home Plan 1 (PPO SNP)
(H2228- 010)
    $30.00 $415.0  No InstitutionalBrowse
Formulary
UnitedHealthcare Nursing Home Plan 2 (PPO SNP)
(H0710- 032)
    $30.00 $415.0  No InstitutionalBrowse
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 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



Source: CMS. 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.


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