2021 Stanislaus County California
Medicare Advantage Plans

There are 29 Medicare Advantage Plans available in Stanislaus County CA from 11 different health insurance providers. 17 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $1499 and the highest out of pocket is $7550. Stanislaus County California residents can also pick from 15 Medicare Special Needs Plans. The best Medicare Advantage plan in Stanislaus County California received a 5 overall star rating from CMS and the lowest rated plan is 3 stars.



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Name ⇅ Premium Deductible MOOP Gap Plan
Rating
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AARP Medicare Advantage SecureHorizons Focus (HMO)
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$0 $0 $3,400 NoEnroll
AARP Medicare Advantage SecureHorizons Plan 1 (HMO)
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$99.00 $100.00 $3,400 NoEnroll
AARP Medicare Advantage SecureHorizons Plan 2 (HMO)
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$9.00 $100.00 $4,900 NoEnroll
Aetna Medicare Elite Plan (PPO)
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$0 $0 $7,550 YesEnroll
AllCare Preferred Plan (HMO)
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$0 $0 $2,900 YesEnroll
Anthem MediBlue Connect Plus (HMO)
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$23.50 $445.00 $7,550 YesEnroll
Anthem MediBlue StartSmart Plus (HMO)
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$0 $0 $3,400 NoEnroll
Anthem MediBlue Value (HMO)
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$0 $0 $3,400 YesEnroll
Anthem MediBlue Value Plus (HMO)
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$49.00 $0 $3,400 YesEnroll
Balance (PPO)
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$0 $0 $2,850 YesToo NewEnroll
Blue Shield AdvantageOptimum Plan (HMO)
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$0 $0 $3,400 YesEnroll
Blue Shield Coordinated Choice Plan (HMO)
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$31.50 $445.00 $6,700 YesEnroll
Blue Shield Inspire (HMO)
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$0 $0 $3,400 YesEnroll
CalPlus (HMO)
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$20.10 $445.00 $4,900 NoEnroll
Connected Care (HMO)
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$0 $0 $1,499 YesEnroll
Health Net Healthy Heart (HMO)
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$125.00 $250.00 $3,400 NoEnroll
Health Net Ruby (HMO)
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$0 $0 $3,450 NoEnroll
Health Net Sapphire (HMO)
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$28.50 $445.00 $3,450 NoEnroll
Humana Gold Plus H5619-032 (HMO)
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$0 $0 $3,450 NoEnroll
Imperial Traditional (HMO)
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$0 $0 $2,999 YesToo NewEnroll
Imperial Traditional Plus (HMO)
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$31.50 $445.00 $2,999 YesToo NewEnroll
Kaiser Permanente Senior Advantage Basic Stanis (HMO)
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$15.00 $0 $5,900 YesEnroll
Kaiser Permanente Senior Advantage Enhanced Stanis (HMO)
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$75.00 $0 $3,400 YesEnroll
My Choice (HMO)
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$0 $0 $4,900 YesEnroll
My Choice (PPO)
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$79.00 $0 $4,200 YesToo NewEnroll
SCAN Classic (HMO)
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$0 $0 $3,400 YesEnroll
SCAN Plus (HMO)
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$31.50 $445.00 $7,550 NoEnroll
UnitedHealthcare Medicare Advantage Assure (HMO)
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$21.20 $445.00 $7,550 NoEnroll


Return to 2021 Medicare Advantage Plans in California





Medicare Advantage Health Plans Without Drug Coverage

Plan Name ⇅ Premium Type MOOP Overall
Rating
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Health Net Green (HMO)
$0 Local HMO * $3,400 Enroll





2021 Medicare Special Needs Plans in Stanislaus county California

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Anthem MediBlue Care On Site (HMO I-SNP)     $0 $0  Yes Institutional
Anthem MediBlue Diabetes (HMO C-SNP)     $59.00 $0  Yes Chronic or Disabling Condition
Anthem MediBlue Diabetes Care (HMO C-SNP)     $0 $0  Yes Chronic or Disabling Condition
Anthem MediBlue ESRD Care (PPO C-SNP)     $31.50 $130.0  Yes Chronic or Disabling Condition
Anthem MediBlue Heart (HMO C-SNP)     $59.00 $0  Yes Chronic or Disabling Condition
Anthem MediBlue Heart Care (HMO C-SNP)     $0 $0  Yes Chronic or Disabling Condition
Anthem MediBlue Lung (HMO C-SNP)     $59.00 $0  Yes Chronic or Disabling Condition
Anthem MediBlue Lung Care (HMO C-SNP)     $0 $0  Yes Chronic or Disabling Condition
Blue Shield Inspire (HMO D-SNP)     $31.50 $445.0  Yes Dual-Eligible
CalPlusDuals (HMO D-SNP)     $20.80 $445.0  No Dual-Eligible
Connected Care Select (HMO C-SNP)     $0 $0  Yes Chronic or Disabling Condition
Humana Gold Plus SNP-DE H5619-038 (HMO D-SNP)     $8.90 $445.0  No Dual-Eligible
Imperial Senior Value (HMO C-SNP)     $0 $0  Yes Chronic or Disabling ConditionToo New
SCAN Balance (HMO C-SNP)     $0 $0  Yes Chronic or Disabling Condition
Senior Advantage Medicare Medi-Cal Plan North (HMO D-SNP)     $30.50 $445.0  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 2021 once you and your plan provider have spent $4130 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 8, 2020.
Plans are subject to change as contracts are finalized.
Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2021, 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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