2020 Pima County Arizona
Medicare Advantage Plans

There are 29 Medicare Advantage Plans available in Pima County AZ from 12 different health insurance providers. 8 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $2600 and the highest out of pocket is $6700. Pima County Arizona residents can also pick from 12 Medicare Special Needs Plans. The highest rated plan available in Pima 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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AARP Medicare Advantage (HMO)
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$0 $0 $2,600 NoEnroll
AARP Medicare Advantage Plus (HMO-POS)
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$12.00 $225.00 $4,800 NoEnroll
AARP Medicare Advantage Walgreens (PPO)
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$0 $275.00 $5,000 NoEnroll
Aetna Medicare Freedom Plan (PPO)
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$0 $250.00 $6,500 YesEnroll
Aetna Medicare Platinum Plan (HMO)
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$0 $0 $4,900 YesEnroll
Aetna Medicare Platinum Plan (PPO)
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$48.00 $0 $6,100 YesEnroll
Aetna Medicare Premier Plan (HMO)
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$0 $0 $3,200 YesToo NewEnroll
Allwell Medicare (HMO)
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$33.00 $200.00 $6,700 NoEnroll
Allwell Medicare Essentials I (HMO)
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$30.90 $290.00 $6,700 NoNAEnroll
Allwell Medicare Premier (HMO)
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$0 $0 $3,400 NoEnroll
Amerivantage Care Access (HMO)
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$19.20 $435.00 $6,700 YesEnroll
Amerivantage Classic (HMO)
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$0 $0 $2,700 YesEnroll
Amerivantage Smart Value (HMO)
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$0 $0 $3,400 NoEnroll
Blue Medicare Advantage Classic (HMO)
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$0 $0 $3,400 NoEnroll
BlueJourney (PPO)
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$59.00 $0 $6,500 NoToo NewEnroll
BluePathway Plan 2 (HMO)
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$0 $0 $3,400 NoToo NewEnroll
Cigna-HealthSpring Preferred (HMO)
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$0 $0 $2,800 YesEnroll
Clover Health Choice (PPO)
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$0 $0 $3,400 NoEnroll
Humana Gold Plus H0028-021 (HMO)
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$0 $0 $2,800 NoEnroll
Humana Value Plus H5216-197 (PPO)
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$18.30 $435.00 $6,700 NoEnroll
HumanaChoice H5216-034 (PPO)
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$114.00 $225.00 $6,700 NoEnroll
HumanaChoice R7220-002 (Regional PPO)
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$94.00 $435.00 $6,700 NoEnroll
Imperial Health Insurance Traditional (HMO)
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$0 $0 $4,000 YesToo NewEnroll
WellCare Compass (HMO)
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$12.30 $435.00 $3,400 NoToo NewEnroll
WellCare Dividend (HMO)
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$0 $200.00 $3,400 NoToo NewEnroll
WellCare Value (HMO)
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$0 $0 $3,400 NoToo NewEnroll


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Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
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Humana Honor (PPO)
$0 Local PPO * $4,400
HumanaChoice R7220-001 (Regional PPO)
$0 Regional PPO * $6,700 Enroll
Lasso Healthcare (MSA)
MSA * $- NA





2020 Medicare Special Needs Plans in Pima county Arizona

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Allwell Dual Medicare (HMO D-SNP)     $32.10 $235.0  No Dual-EligibleNA
Amerivantage CareMore Care To You (HMO I-SNP)     $0 $0  Yes Institutional
Amerivantage CareMore ESRD (HMO C-SNP)     $0 $0  Yes Chronic or Disabling Condition
Amerivantage COPD (HMO C-SNP)     $0 $0  Yes Chronic or Disabling Condition
Amerivantage Diabetes (HMO C-SNP)     $0 $0  Yes Chronic or Disabling Condition
Amerivantage Heart Care (HMO C-SNP)     $0 $0  Yes Chronic or Disabling Condition
Banner - University Care Advantage (HMO D-SNP)     $32.10 $435.0  No Dual-Eligible
Banner - University Care Advantage (HMO D-SNP)     $32.10 $435.0  No Dual-Eligible
Mercy Care Advantage (HMO D-SNP)     $32.10 $435.0  No Dual-Eligible
Mercy Care Advantage (HMO D-SNP)     $32.10 $435.0  No Dual-Eligible
UnitedHealthcare Dual Complete LP (HMO D-SNP)     $24.80 $435.0  No Dual-Eligible
UnitedHealthcare Nursing Home Plan (PPO I-SNP)     $32.10 $435.0  No Institutional



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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