2019 Medicare Advantage Plans in
Orange County California

There are 38 Medicare Advantage Plans available in Orange County CA from 16 different health insurance providers. 25 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $999 and the highest out of pocket is $6700. Orange County California residents can also pick from 20 Medicare Special Needs Plans. The highest rated plan available in Orange County received a 5 overall star rating from CMS and the lowest rated plan is 3 stars


(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)
Name ⇅ Premium Deductible MOOP Gap Click
for
Formulary
Plan
Rating
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Aetna Medicare Choice Plan (PPO)
$73.00 $0 $6,700 YesBrowse
Formulary
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Aetna Medicare Prime Plan (HMO)
$0 $0 $2,200 YesBrowse
Formulary
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Aetna Medicare Select Plan (HMO)
$0 $0 $2,000 YesBrowse
Formulary
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Alignment Health Plan CalPlus (HMO)
$30.50 $415.00 $6,700 NoBrowse
Formulary
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Alignment Health Plan My Choice (HMO)
$0 $0 $3,400 YesBrowse
Formulary
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Alignment Health Plan Platinum (HMO)
$0 $0 $1,499 YesBrowse
Formulary
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Anthem MediBlue Access (PPO)
$159.00 $370.00 $6,700 NoBrowse
Formulary
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Blue Shield 65 Plus (HMO)
$0 $0 $999 YesBrowse
Formulary
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Blue Shield 65 Plus Choice Plan (HMO)
$0 $0 $1,899 YesBrowse
Formulary
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Blue Shield Promise AdvantageOptimum Plan (HMO)
$0 $0 $999 YesBrowse
Formulary
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Blue Shield Promise Coordinated Choice Plan (HMO)
$34.80 $415.00 $6,700 YesBrowse
Formulary
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Brand New Day Classic Care I Plan (HMO)
$0 $0 $3,400 YesBrowse
Formulary
Brand New Day Classic Care II Plan (HMO)
$0 $0 $3,400 YesBrowse
Formulary
Brand New Day Classic Choice Medi-Medi Plan (HMO)
$34.80 $415.00 $6,700 NoBrowse
Formulary
Central Health Medicare Plan (HMO)
$0 $0 $3,400 YesBrowse
Formulary
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Central Health Premier Plan (HMO)
$34.80 $415.00 $6,700 YesBrowse
Formulary
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Easy Choice Best Plan (HMO)
$0 $0 $2,500 YesBrowse
Formulary
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Easy Choice Plus Plan (HMO)
$25.00 $415.00 $2,500 NoBrowse
Formulary
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Easy Choice Rx (HMO)
$12.00 $415.00 $2,000 YesBrowse
Formulary
Golden State (HMO)
$0 $0 $1,499 YesBrowse
Formulary
Health Net Gold Select (HMO)
$0 $0 $2,000 YesBrowse
Formulary
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Health Net Healthy Heart (HMO)
$16.00 $0 $2,400 YesBrowse
Formulary
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Health Net Seniority Plus Sapphire (HMO)
$34.80 $340.00 $6,700 NoBrowse
Formulary
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Health Net Seniority Plus Sapphire Premier (HMO)
$34.80 $285.00 $6,700 NoBrowse
Formulary
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Health Net Seniority Plus Sapphire Premier II (HMO)
$34.80 $280.00 $6,700 NoBrowse
Formulary
Humana Gold Plus H5619-021 (HMO)
$0 $0 $1,300 YesBrowse
Formulary
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Humana Value Plus H5619-037 (HMO)
$33.30 $415.00 $6,700 NoBrowse
Formulary
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Inter Valley Health Plan Service To Seniors (HMO)
$0 $0 $2,000 NoBrowse
Formulary
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Inter Valley Health Plan Value Preferred Choice (HMO)
$34.80 $415.00 $5,900 NoBrowse
Formulary
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Kaiser Permanente Senior Advantage LA, Orange Co. (HMO)
$0 $0 $4,900 YesBrowse
Formulary
SCAN Classic (HMO)
$0 $0 $1,500 YesBrowse
Formulary
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SCAN Plus (HMO)
$34.80 $415.00 $6,700 NoBrowse
Formulary
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SCAN Prime (HMO)
$26.00 $0 $1,500 YesBrowse
Formulary


Return to 2019 Medicare Advantage Plans in California





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
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2019 Medicare Special Needs Plans in Orange county California

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Click
for
Formulary
Alignment Health Plan Heart & Diabetes (HMO SNP)
(H3815- 010)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Blue Shield Promise TotalDual Plan (HMO SNP)
(H5928- 005)
    $34.80 $415.0  No Dual-EligibleBrowse
Formulary
Brand New Day Bridges Care Plan (HMO SNP)
(H0838- 028)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Bridges Choice Medi-Medi Plan (HMO SNP)
(H0838- 029)
    $34.80 $415.0  No Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Dual Access Plan (HMO SNP)
(H0838- 024)
    $34.80 $415.0  No Dual-EligibleBrowse
Formulary
Brand New Day Embrace Care Plan (HMO SNP)
(H0838- 039)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Embrace Choice Medi-Medi Plan (HMO SNP)
(H0838- 040)
    $34.80 $415.0  No Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Harmony Care Plan (HMO SNP)
(H0838- 032)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Harmony Choice Plan (HMO SNP)
(H0838- 020)
    $34.80 $415.0  No Chronic or Disabling ConditionBrowse
Formulary
Brand New Day Select Care Plan (HMO SNP)
(H0838- 041)
    $34.80 $415.0  No InstitutionalBrowse
Formulary
Central Health Focus Plan (HMO SNP)
(H5649- 006)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Health Net Jade (HMO SNP)
(H0562- 092)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
Health Net Seniority Plus Amber I (HMO SNP)
(H0562- 055)
    $34.80 $320.0  No Dual-EligibleBrowse
Formulary
Health Net Seniority Plus Amber II (HMO SNP)
(H0562- 110)
    $34.80 $300.0  No Dual-EligibleBrowse
Formulary
Heart First (HMO SNP)
(H5425- 028)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
OneCare (HMO SNP)
(H5433- 001)
    $33.70 $0  Yes Dual-EligibleBrowse
Formulary
SCAN Balance (HMO SNP)
(H5425- 034)
    $0 $0  Yes Chronic or Disabling ConditionBrowse
Formulary
SCAN Healthy at Home (HMO SNP)
(H9104- 006)
    $0 $0  Yes InstitutionalNABrowse
Formulary
Senior Advantage Medicare Medi-Cal Plan South (HMO SNP)
(H0524- 029)
    $34.80 $0  No Dual-EligibleBrowse
Formulary
VillageHealth (HMO-POS SNP)
(H5943- 002)
    $34.80 $415.0  No Chronic or Disabling ConditionBrowse
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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