2020 Loudoun County Virginia
Medicare Advantage Plans

There are 35 Medicare Advantage Plans available in Loudoun County VA from 9 different health insurance providers. 13 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. Loudoun County Virginia residents can also pick from 13 Medicare Special Needs Plans. The highest rated plan available in Loudoun 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 Plan
Rating
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AARP Medicare Advantage Plan 1 (HMO)
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$19.00 $95.00 $6,700 NoEnroll
AARP Medicare Advantage Plan 2 (HMO)
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$86.00 $0 $4,900 NoEnroll
AARP Medicare Advantage Walgreens (PPO)
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$0 $195.00 $6,700 NoToo NewEnroll
Aetna Medicare Choice Plan (PPO)
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$98.00 $150.00 $6,700 YesEnroll
Aetna Medicare Prime Plan (HMO)
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$27.00 $150.00 $6,700 YesEnroll
Anthem MediBlue Plus (HMO)
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$0 $325.00 $6,700 YesEnroll
ApexAscend (HMO)
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$39.00 $125.00 $5,700 YesToo NewEnroll
ApexBold (HMO)
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$0 $250.00 $5,900 YesToo NewEnroll
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
Humana Gold Choice H8145-004 (PFFS)
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$88.00 $160.00 $- NoEnroll
Humana Gold Plus H5619-047 (HMO)
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$0 $160.00 $6,700 NoEnroll
Humana Gold Plus H6622-041 (HMO)
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$15.00 $435.00 $6,700 NoEnroll
HumanaChoice H5216-027 (PPO)
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$63.00 $215.00 $6,700 NoEnroll
HumanaChoice R1390-002 (Regional PPO)
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$82.00 $360.00 $6,700 NoEnroll
Innovation Health-Aetna Medicare Connect (HMO)
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$0 $0 $4,800 YesEnroll
Innovation Health-Aetna Medicare Premier (PPO)
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$144.00 $0 $3,400 YesNAEnroll
Innovation Health-Aetna Medicare Voyager (PPO)
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$88.00 $0 $6,500 YesNAEnroll
Kaiser Permanente Medicare Advantage High VA (HMO)
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$142.00 $0 $5,500 YesEnroll
Kaiser Permanente Medicare Advantage Standard VA (HMO)
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$25.00 $0 $6,700 YesEnroll
Kaiser Permanente Medicare Advantage Value VA (HMO)
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$0 $0 $6,700 YesEnroll
Kaiser Permanente Medicare Plus Basic w/D (AB) (Cost)
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$60.00 $435.00 $6,700 NoEnroll
Kaiser Permanente Medicare Plus High w/Part D (AB) (Cost)
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$142.00 $0 $5,000 YesEnroll
Kaiser Permanente Medicare Plus Std w/Part D (AB) (Cost)
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$54.00 $280.00 $6,700 YesEnroll
Optima Medicare Prime (HMO)
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$55.00 $130.00 $3,400 NoEnroll
Optima Medicare Value (HMO)
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$0 $150.00 $3,600 NoEnroll
Sunrise Advantage Community Plan (HMO)
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$59.00 $0 $5,700 NoNAEnroll


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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
HumanaChoice H5216-152 (PPO)
$0 Local PPO * $3,400
HumanaChoice R1390-001 (Regional PPO)
$0 Regional PPO * $5,400 Enroll
Kaiser Permanente Medicare Advantage w/o Part D (HMO)
$30.00 Local HMO * $6,700
Kaiser Permanente Medicare Plus Basic w/o D (AB) (Cost)
$10.00 Cost * $6,700
Kaiser Permanente Medicare Plus High w/o D (AB) (Cost)
$105.00 Cost * $5,000
Kaiser Permanente Medicare Plus Std w/o D (AB) (Cost)
$25.00 Cost * $6,700





2020 Medicare Special Needs Plans in Loudoun county Virginia

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Aetna Better Health, Inc. (HMO D-SNP)     $27.90 $275.0  No Dual-EligibleNA
Anthem MediBlue Care On Site (HMO I-SNP)     $9.30 $0  Yes Institutional
Anthem MediBlue Dual Advantage (HMO D-SNP)     $27.90 $435.0  Yes Dual-Eligible
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
Magellan Complete Care of Virginia, LLC (HMO D-SNP)     $27.90 $435.0  No Dual-EligibleToo New
Optima Community Complete (HMO D-SNP)     $22.20 $435.0  No Dual-Eligible
Reflections (HMO C-SNP)     $59.00 $0  No Chronic or Disabling ConditionNA
Sunrise Advantage Plan (HMO I-SNP)     $0 $0  No InstitutionalNA
UnitedHealthcare Dual Complete (HMO D-SNP)     $19.60 $435.0  No Dual-Eligible
UnitedHealthcare Dual Complete RP (Regional PPO D-SNP)     $18.30 $435.0  No Dual-Eligible
UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP)     $29.40 $435.0  No Institutional
Virginia Premier Advantage Elite (HMO D-SNP)     $27.90 $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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