2020 Delaware County Pennsylvania
Medicare Advantage Plans

There are 51 Medicare Advantage Plans available in Delaware County PA from 12 different health insurance providers. 11 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. Delaware County Pennsylvania residents can also pick from 18 Medicare Special Needs Plans. The highest rated plan available in Delaware County received a 4.5 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 Plan
Rating
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Aetna Medicare Advantra Credit Value (PPO)
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$0 $250.00 $6,700 YesEnroll
Aetna Medicare Advantra Premier (HMO)
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$43.00 $0 $6,700 YesEnroll
Aetna Medicare Advantra Premier Plus (PPO)
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$66.00 $0 $6,600 YesEnroll
Aetna Medicare Advantra Value (HMO)
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$0 $0 $6,700 YesEnroll
Aetna Medicare Elite (HMO)
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$0 $150.00 $6,700 YesEnroll
Aetna Medicare Gold Plan (PPO)
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$146.00 $0 $6,700 YesEnroll
Aetna Medicare Main Line Health Prime (HMO)
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$0 $300.00 $6,700 YesEnroll
Aetna Medicare Premier (HMO)
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$86.00 $0 $6,700 YesEnroll
Aetna Medicare Premier Plus (HMO)
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$178.00 $0 $6,700 YesEnroll
Aetna Medicare Silver (HMO)
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$59.00 $0 $6,700 YesEnroll
Aetna Medicare Value (PPO)
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$0 $0 $6,700 YesEnroll
Allwell Medicare (HMO)
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$0 $0 $6,700 NoNAEnroll
Cigna-HealthSpring Alliance (HMO)
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$0 $0 $6,700 NoEnroll
Cigna-HealthSpring Preferred (HMO)
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$20.00 $0 $5,900 NoEnroll
Cigna-HealthSpring PreferredPlus (HMO)
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$135.00 $0 $4,900 NoEnroll
Cigna-HealthSpring True Choice (PPO)
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$0 $0 $6,700 NoToo NewEnroll
Cigna-HealthSpring True Choice Plus (PPO)
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$59.00 $0 $5,500 NoToo NewEnroll
Clover Health Choice (PPO)
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$0 $0 $6,700 NoEnroll
Clover Health Choice Value (PPO)
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$35.60 $435.00 $6,700 NoEnroll
Erickson Advantage Freedom (HMO-POS)
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$60.00 $200.00 $4,200 NoEnroll
Erickson Advantage Liberty with Drugs (HMO)
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$25.00 $250.00 $6,700 NoEnroll
Erickson Advantage Signature with Drugs (HMO-POS)
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$195.00 $0 $2,900 NoEnroll
Health Partners Medicare Prime (HMO-POS)
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$35.60 $350.00 $6,700 NoEnroll
Health Partners Medicare Simple (HMO-POS)
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$0 $350.00 $6,700 NoEnroll
Humana Gold Plus H6622-037 (HMO)
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$0 $0 $5,900 NoEnroll
HumanaChoice H5216-122 (PPO)
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$156.00 $0 $6,700 NoEnroll
HumanaChoice H5525-005 (PPO)
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$53.00 $0 $6,700 NoEnroll
HumanaChoice H5525-038 (PPO)
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$0 $0 $6,700 NoEnroll
HumanaChoice H5525-047 (PPO)
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$0 $0 $6,700 NoEnroll
HumanaChoice R0923-002 (Regional PPO)
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$71.00 $0 $6,700 NoEnroll
Keystone 65 Basic Rx (HMO)
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$0 $0 $6,700 NoEnroll
Keystone 65 Focus Rx (HMO-POS)
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$19.00 $0 $6,700 NoEnroll
Keystone 65 Preferred Rx (HMO)
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$256.00 $0 $4,000 NoEnroll
Keystone 65 Select Rx (HMO)
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$80.50 $0 $5,500 NoEnroll
Personal Choice 65 Prime Rx PPO (PPO)
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$0 $0 $6,700 NoEnroll
Personal Choice 65 Rx (PPO)
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$159.00 $0 $5,500 NoEnroll
Sunrise Advantage Community Plan (HMO)
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$39.00 $0 $5,700 NoNAEnroll
UPMC for Life HMO Deductible with Rx (HMO)
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$16.50 $0 $5,500 NoEnroll
UPMC for Life HMO Rx (HMO)
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$82.40 $0 $3,400 NoEnroll
UPMC for Life HMO Rx Enhanced (HMO)
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$301.00 $0 $3,400 NoEnroll
UPMC for Life PPO High Deductible with Rx (PPO)
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$35.00 $0 $6,700 NoEnroll
UPMC for Life PPO Rx Enhanced (PPO)
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$135.00 $0 $6,700 NoEnroll


Return to 2020 Medicare Advantage Plans in Pennsylvania





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
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Cigna-HealthSpring Advantage (HMO)
$0 Local HMO * $6,700 Enroll
Erickson Advantage Liberty without Drugs (HMO)
$0 Local HMO * $6,700
Humana Honor (PPO)
$0 Local PPO * $6,700
HumanaChoice H5216-116 (PPO)
$0 Local PPO * $3,900 Enroll
HumanaChoice R0923-001 (Regional PPO)
$0 Regional PPO * $4,900 Enroll
Keystone 65 Preferred Medical Only (HMO)
$194.00 Local HMO * $4,000
Keystone 65 Select Medical Only (HMO)
$49.50 Local HMO * $5,500
Lasso Healthcare (MSA)
MSA * $- NA
UPMC for Life HMO No Rx (HMO)
$0 Local HMO * $3,400





2020 Medicare Special Needs Plans in Delaware county Pennsylvania

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Aetna Medicare Advantra Cares (HMO D-SNP)     $16.40 $275.0  No Dual-Eligible
Allwell Dual Medicare (HMO D-SNP)     $34.00 $435.0  No Dual-EligibleNA
Cigna-HealthSpring Achieve (HMO C-SNP)     $0 $0  No Chronic or Disabling Condition
Cigna-HealthSpring TotalCare (HMO D-SNP)     $34.30 $435.0  No Dual-Eligible
Cigna-HealthSpring Traditions (HMO I-SNP)     $35.60 $435.0  No Institutional
Erickson Advantage Champion (HMO-POS C-SNP)     $195.0 $0  No Chronic or Disabling Condition
Erickson Advantage Guardian (HMO-POS I-SNP)     $29.30 $0  No Institutional
Gateway Health Medicare Assured Diamond (HMO D-SNP)     $35.60 $435.0  No Dual-Eligible
Gateway Health Medicare Assured Ruby (HMO D-SNP)     $35.60 $435.0  No Dual-Eligible
Health Partners Medicare Special (HMO D-SNP)     $35.60 $435.0  No Dual-Eligible
Humana Gold Plus SNP-DE H6622-038 (HMO D-SNP)     $28.20 $410.0  No Dual-Eligible
Keystone First VIP Choice (HMO D-SNP)     $35.60 $435.0  No Dual-Eligible
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP)     $35.60 $435.0  No InstitutionalNA
Reflections (HMO C-SNP)     $39.00 $0  No Chronic or Disabling ConditionNA
Sunrise Advantage Plan (HMO I-SNP)     $0 $0  No InstitutionalNA
UnitedHealthcare Dual Complete (HMO D-SNP)     $22.90 $435.0  No Dual-Eligible
UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP)     $35.40 $435.0  No Institutional
UPMC for Life Dual (HMO D-SNP)     $35.60 $435.0  No Dual-EligibleToo New



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 2020 once you and your plan provider have spent $4020 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 25% 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 3, 2019.
Star Rating as of October 11, 2019.
For More Information on Ratings Please See the CMS Tech Notes.
Plans are subject to change as contracts are finalized.
Includes 2020 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2020, 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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