2020 Essex County Massachusetts
Medicare Advantage Plans

There are 35 Medicare Advantage Plans available in Essex County MA from 6 different health insurance providers. 7 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. Essex County Massachusetts residents can also pick from 9 Medicare Special Needs Plans. The highest rated plan available in Essex County received a 5 overall star rating from CMS and the lowest rated plan is 3.5 stars



(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)

Name ⇅ Premium Deductible MOOP Gap Plan
Rating
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AARP Medicare Advantage Choice (Regional PPO)
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$47.00 $295.00 $5,500 NoEnroll
AARP Medicare Advantage Plan 1 (HMO)
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$0 $250.00 $5,700 NoEnroll
AARP Medicare Advantage Plan 2 (HMO)
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$49.00 $225.00 $4,900 NoEnroll
AARP Medicare Advantage Plan 3 (HMO)
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$79.00 $120.00 $4,200 NoEnroll
AARP Medicare Advantage Walgreens (PPO)
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$0 $195.00 $6,700 NoToo NewEnroll
Aetna Medicare Explorer Plan (PPO)
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$0 $250.00 $6,700 YesEnroll
Aetna Medicare Explorer Premier Plan (PPO)
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$56.00 $0 $6,700 YesEnroll
Aetna Medicare Value Plan (HMO)
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$0 $250.00 $6,700 YesEnroll
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
Fallon Medicare Plus Blue HMO (HMO)
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$174.00 $0 $3,400 NoEnroll
Fallon Medicare Plus Green HMO (HMO)
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$73.00 $300.00 $6,700 NoEnroll
Fallon Medicare Plus Orange HMO (HMO)
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$0 $300.00 $6,700 NoEnroll
Fallon Medicare Plus Super Saver HMO (HMO)
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$40.00 $435.00 $6,700 NoEnroll
Harvard Pilgrim Stride Basic Rx (HMO)
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$0 $435.00 $4,500 YesEnroll
Harvard Pilgrim Stride Value Rx (HMO)
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$67.00 $350.00 $3,400 YesEnroll
Harvard Pilgrim Stride Value Rx Plus (HMO)
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$168.00 $0 $3,400 YesEnroll
Medicare HMO Blue FlexRx (HMO-POS)
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$96.00 $260.00 $3,900 NoEnroll
Medicare HMO Blue PlusRx (HMO)
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$266.00 $200.00 $3,400 NoEnroll
Medicare HMO Blue SaverRx (HMO)
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$0 $320.00 $6,700 NoEnroll
Medicare HMO Blue ValueRx (HMO)
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$36.00 $320.00 $4,900 NoEnroll
Medicare PPO Blue PlusRx (PPO)
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$262.00 $200.00 $3,400 NoEnroll
Medicare PPO Blue SaverRx (PPO)
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$0 $405.00 $6,700 NoEnroll
Medicare PPO Blue ValueRx (PPO)
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$76.00 $320.00 $4,900 NoEnroll
Tufts Medicare Preferred HMO Basic Rx (HMO)
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$55.00 $225.00 $3,400 NoEnroll
Tufts Medicare Preferred HMO Prime Rx (HMO)
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$188.00 $0 $3,400 NoEnroll
Tufts Medicare Preferred HMO Prime Rx Plus (HMO)
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$220.00 $0 $3,400 YesEnroll
Tufts Medicare Preferred HMO Saver Rx (HMO)
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$0 $250.00 $6,700 NoEnroll
Tufts Medicare Preferred HMO Value Rx (HMO)
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$155.00 $200.00 $3,400 NoEnroll


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Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
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Erickson Advantage Liberty without Drugs (HMO)
$0 Local HMO * $6,700
Fallon Medicare Plus Saver No Rx HMO (HMO)
$44.00 Local HMO * $6,700
Tufts Medicare Preferred HMO Basic No Rx (HMO)
$28.00 Local HMO * $3,400
Tufts Medicare Preferred HMO Prime No Rx (HMO)
$156.00 Local HMO * $3,400
Tufts Medicare Preferred HMO Value No Rx (HMO)
$123.00 Local HMO * $3,400





2020 Medicare Special Needs Plans in Essex county Massachusetts

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
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
NaviCare (HMO D-SNP)     $34.80 $435.0  No Dual-Eligible
Senior Care Options Program (HMO D-SNP)     $34.80 $435.0  No Dual-Eligible
Senior Whole Health (HMO D-SNP)     $34.80 $435.0  No Dual-Eligible
Senior Whole Health NHC (HMO D-SNP)     $34.80 $435.0  No Dual-Eligible
Tufts Health Plan Senior Care Options (HMO D-SNP)     $34.80 $435.0  No Dual-Eligible
UnitedHealthcare Senior Care Options (HMO D-SNP)     $18.80 $435.0  No Dual-Eligible
UnitedHealthcare Senior Care Options NHC (HMO D-SNP)     $29.30 $435.0  No Dual-Eligible



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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