2020 Muskegon County Michigan
Medicare Advantage Plans

There are 31 Medicare Advantage Plans available in Muskegon County MI from 7 different health insurance providers. 12 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3400 and the highest out of pocket is $6400. Muskegon County Michigan residents can also pick from 6 Medicare Special Needs Plans. The highest rated plan available in Muskegon 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 Premier (PPO)
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$9.00 $0 $4,500 YesEnroll
Aetna Medicare Value (PPO)
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$0 $0 $4,950 YesEnroll
BCN Advantage HMO HealthySaver (HMO)
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$16.00 $100.00 $4,500 YesEnroll
BCN Advantage HMO HealthyValue (HMO)
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$0 $250.00 $4,500 YesEnroll
BCN Advantage HMO MyChoice Wellness (HMO)
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$42.00 $0 $3,800 NoEnroll
BCN Advantage HMO-POS Basic (HMO-POS)
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$0 $200.00 $4,500 YesEnroll
BCN Advantage HMO-POS Classic (HMO-POS)
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$79.30 $0 $3,800 YesEnroll
BCN Advantage HMO-POS Prestige (HMO-POS)
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$181.00 $0 $3,400 YesEnroll
HAP Choice Medicare - Option 1 (HMO)
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$0 $0 $4,800 YesEnroll
HAP Choice Medicare - Option 2 (HMO)
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$26.00 $0 $3,900 YesEnroll
Humana Gold Choice H8145-006 (PFFS)
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$98.00 $435.00 $- NoEnroll
Humana Gold Plus H8908-002 (HMO)
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$8.00 $0 $6,000 NoEnroll
HumanaChoice H5216-009 (PPO)
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$74.00 $105.00 $5,900 NoEnroll
HumanaChoice H8087-001 (PPO)
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$19.00 $195.00 $5,900 NoToo NewEnroll
HumanaChoice R3887-002 (Regional PPO)
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$119.00 $210.00 $5,300 NoEnroll
Medicare Plus Blue PPO Assure (PPO)
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$199.00 $0 $3,425 YesEnroll
Medicare Plus Blue PPO Essential (PPO)
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$7.00 $200.00 $6,400 NoEnroll
Medicare Plus Blue PPO Signature (PPO)
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$96.00 $0 $4,700 YesEnroll
Medicare Plus Blue PPO Vitality (PPO)
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$39.00 $100.00 $5,000 YesEnroll
PriorityMedicare (HMO-POS)
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$98.00 $0 $4,500 NoEnroll
PriorityMedicare Ideal (PPO)
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$14.00 $125.00 $6,000 NoEnroll
PriorityMedicare Key (HMO-POS)
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$0 $100.00 $5,500 NoEnroll
PriorityMedicare Merit (PPO)
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$68.00 $0 $4,100 NoEnroll
PriorityMedicare Select (PPO)
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$151.00 $0 $3,500 NoEnroll
PriorityMedicare Value (HMO-POS)
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$27.00 $75.00 $5,000 NoEnroll
WellCare Essential (HMO-POS)
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$0 $0 $4,000 NoEnroll
WellCare Plus (HMO)
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$20.60 $435.00 $3,400 NoEnroll


Return to 2020 Medicare Advantage Plans in Michigan





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
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BCN Advantage HMO-POS Elements (HMO-POS)
$8.00 Local HMO * $4,500 Enroll
Humana Gold Choice H8145-121 (PFFS)
$75.00 PFFS * $- Enroll
Humana Honor (PPO)
$0 Local PPO * $5,500
HumanaChoice R3887-001 (Regional PPO)
$0 Regional PPO * $5,500 Enroll





2020 Medicare Special Needs Plans in Muskegon county Michigan

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Align Connect (HMO C-SNP)     $0 $435.0  No Chronic or Disabling ConditionToo New
Align Thrive (HMO I-SNP)     $30.20 $435.0  No InstitutionalToo New
HumanaChoice SNP-DE H8087-003 (PPO D-SNP)     $23.60 $395.0  No Dual-EligibleToo New
Molina Medicare Complete Care (HMO D-SNP)     $30.20 $435.0  No Dual-Eligible
PriorityMedicare D-SNP (HMO D-SNP)     $30.20 $435.0  No Dual-EligibleToo New
WellCare Extra Plus (HMO-POS D-SNP)     $18.70 $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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