2020 Oconee County Georgia
Medicare Advantage Plans

There are 30 Medicare Advantage Plans available in Oconee County GA from 8 different health insurance providers. 6 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $2500 and the highest out of pocket is $6700. Oconee County Georgia residents can also pick from 14 Medicare Special Needs Plans. The highest rated plan available in Oconee County received a 4 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 Plus Plan 1 (HMO-POS)
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$0 $275.00 $6,700 NoEnroll
AARP Medicare Advantage Plus Plan 2 (HMO-POS)
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$49.00 $175.00 $4,900 NoEnroll
Aetna Medicare Freedom Plan (PPO)
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$0 $200.00 $6,000 YesToo NewEnroll
Aetna Medicare Preferred Premium Plan (PPO)
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$28.00 $250.00 $5,900 YesToo NewEnroll
Allwell Medicare (HMO)
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$0 $280.00 $5,900 NoEnroll
Cigna-HealthSpring Preferred (HMO)
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$0 $0 $5,900 NoEnroll
Cigna-HealthSpring Preferred GA (HMO)
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$0 $300.00 $6,700 NoEnroll
Cigna-HealthSpring Premier (HMO-POS)
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$25.00 $0 $4,900 NoEnroll
EON CHOICE (PPO)
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$0 $150.00 $6,700 NoNAEnroll
EON SELECT (HMO)
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$0 $150.00 $6,700 NoNAEnroll
Humana Gold Plus H4141-019 (HMO)
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$0 $0 $6,700 NoEnroll
HumanaChoice H5216-142 (PPO)
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$28.00 $250.00 $6,700 NoEnroll
HumanaChoice H5216-145 (PPO)
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$34.00 $75.00 $6,700 NoEnroll
HumanaChoice H5216-154 (PPO)
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$0 $400.00 $6,700 NoEnroll
HumanaChoice H5216-203 (PPO)
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$0 $75.00 $6,700 NoEnroll
HumanaChoice R3392-002 (Regional PPO)
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$76.00 $340.00 $6,700 NoEnroll
UnitedHealthcare Medicare Advantage Choice (Regional PPO)
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$45.00 $195.00 $6,700 NoEnroll
WellCare Compass (HMO)
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$20.40 $435.00 $3,400 NoEnroll
WellCare Dividend (HMO)
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$0 $200.00 $6,700 NoEnroll
WellCare Flex Complete (PPO)
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$90.00 $0 $2,500 YesEnroll
WellCare Premier (PPO)
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$0 $75.00 $5,500 YesEnroll
WellCare Prime (PPO)
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$45.00 $0 $5,100 YesEnroll
WellCare Value (HMO)
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$0 $0 $3,400 YesEnroll


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Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
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Aetna Medicare Basics Plan (PPO)
$0 Local PPO * $5,900 Too New
Humana Honor (PPO)
$0 Local PPO * $6,700
HumanaChoice H5216-157 (PPO)
$0 Local PPO * $6,700
HumanaChoice R3392-001 (Regional PPO)
$0 Regional PPO * $6,700 Enroll
Lasso Healthcare (MSA)
MSA * $- NA
UnitedHealthcare Medicare Advantage Essential (Regional P
$0 Regional PPO * $6,700
WellCare Advance (HMO-POS)
$0 Local HMO * $4,500 Enroll





2020 Medicare Special Needs Plans in Oconee county Georgia

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Allwell Dual Medicare (HMO D-SNP)     $25.30 $345.0  No Dual-Eligible
Cigna-HealthSpring TotalCare (HMO D-SNP)     $23.90 $435.0  No Dual-Eligible
EON DELUXE (HMO D-SNP)     $25.30 $435.0  No Dual-EligibleNA
EON GOLD (PPO C-SNP)     $15.00 $250.0  No Chronic or Disabling ConditionNA
EON SILVER (HMO C-SNP)     $0 $250.0  No Chronic or Disabling ConditionNA
Humana Gold Plus SNP-DE H4141-003 (HMO D-SNP)     $22.00 $435.0  No Dual-Eligible
HumanaChoice SNP-DE H5216-205 (PPO D-SNP)     $25.00 $435.0  No Dual-Eligible
HumanaChoice SNP-DE H5216-206 (PPO D-SNP)     $23.60 $435.0  No Dual-Eligible
PruittHealth Premier D-SNP (HMO D-SNP)     $25.30 $435.0  No Dual-EligibleNA
UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP     $24.70 $435.0  No Dual-Eligible
UnitedHealthcare Medicare Gold (Regional PPO C-SNP)     $13.00 $210.0  No Chronic or Disabling Condition
UnitedHealthcare Medicare Silver (Regional PPO C-SNP)     $2.80 $435.0  No Chronic or Disabling Condition
WellCare Access (HMO D-SNP)     $25.30 $435.0  No Dual-Eligible
WellCare Liberty (HMO D-SNP)     $25.30 $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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