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The 2023 Medicare Advantage Plans in Jefferson County PA.



2022 Jefferson County Pennsylvania
Medicare Advantage Plans

There are 58 Medicare Advantage Plans available in Jefferson County PA from 9 different health insurance providers. 24 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3450 and the highest out of pocket is $7550. Jefferson County Pennsylvania residents can also pick from 10 Medicare Special Needs Plans. The best Medicare Advantage plan in Jefferson County Pennsylvania received a 5 overall star rating from CMS and the lowest rated plan is 3.5 stars.



(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)

Name ⇅ Premium Deductible MOOP Gap Plan
Rating
Click
for
Formulary
AARP Medicare Advantage Choice Plan 1 (PPO)
(H2577-021)

$35.00$0$5,500YesBrowse
Formulary
AARP Medicare Advantage Choice Plan 2 (PPO)
(H2577-029)

$0$0$6,900YesBrowse
Formulary
AARP Medicare Advantage Plan 1 (HMO)
(H1944-010)

$0$0$6,700YesBrowse
Formulary
AARP Medicare Advantage Plan 2 (HMO)
(H1944-011)

$35.00$0$5,500YesBrowse
Formulary
Aetna Medicare Advantra Central Value (HMO)
(H3959-058)

$0$0$7,550YesBrowse
Formulary
Aetna Medicare Advantra Central Value (PPO)
(H5522-020)

$0$250.00$7,550YesBrowse
Formulary
Aetna Medicare Advantra Credit Value (PPO)
(H5522-017)

$0$250.00$7,550YesBrowse
Formulary
Aetna Medicare Advantra Gold (HMO)
(H3959-002)

$27.00$0$4,500YesBrowse
Formulary
Aetna Medicare Advantra Silver (HMO)
(H3959-011)

$0$0$5,900YesBrowse
Formulary
Aetna Medicare Advantra Silver (PPO)
(H5522-005)

$14.00$0$5,900YesBrowse
Formulary
Aetna Medicare Gold Plan (PPO)
(H5521-122)

$170.00$0$7,550YesBrowse
Formulary
Aetna Medicare PennHighlands Prime (HMO)
(H3959-045)

$0$0$6,300YesBrowse
Formulary
Aetna Medicare Silver (HMO)
(H3931-070)

$65.00$0$7,550YesBrowse
Formulary
Aetna Medicare Value (PPO)
(H5521-261)

$0$0$6,400YesBrowse
Formulary
Community Blue Medicare HMO Signature (HMO)
(H3957-047)

$0$0$7,550NoBrowse
Formulary
Complete Blue PPO Distinct (PPO)
(H3916-035)

$25.00$0$6,500NoBrowse
Formulary
Complete Blue PPO Signature (PPO)
(H3916-041)

$0$0$7,550NoBrowse
Formulary
Freedom Blue PPO Classic (PPO)
(H3916-002)

$253.00$0$4,500YesBrowse
Formulary
Freedom Blue PPO Select (PPO)
(H3916-024)

$130.00$0$5,000NoBrowse
Formulary
Freedom Blue PPO ValueRx (PPO)
(H3916-033)

$71.00$0$5,500NoBrowse
Formulary
Geisinger Gold Classic Advantage Rx (HMO)
(H3954-157)

$151.00$0$3,450YesBrowse
Formulary
Geisinger Gold Classic Complete Rx (HMO)
(H3954-158)

$38.00$0$4,900YesBrowse
Formulary
Geisinger Gold Classic Essential Rx (HMO)
(H3954-161)

$0$0$7,550YesBrowse
Formulary
Geisinger Gold Preferred Advantage Rx (PPO)
(H3924-059)

$111.00$0$4,000YesBrowse
Formulary
Geisinger Gold Preferred Complete Rx (PPO)
(H3924-065)

$0$0$6,700YesBrowse
Formulary
Geisinger Gold Preferred Enhanced Rx (PPO)
(H3924-062)

$45.00$0$7,550YesBrowse
Formulary
Humana Value Plus H5525-039 (PPO)
(H5525-039)

$31.30$480.00$7,550NoBrowse
Formulary
HumanaChoice H5525-007 (PPO)
(H5525-007)

$55.00$0$6,700NoBrowse
Formulary
HumanaChoice H5525-051 (PPO)
(H5525-051)

$0$0$7,550NoBrowse
Formulary
HumanaChoice R0923-002 (Regional PPO)
(R0923-002)

$72.00$0$6,700NoBrowse
Formulary
Security Blue HMO-POS Deluxe (HMO-POS)
(H3957-046)

$224.00$0$4,500YesBrowse
Formulary
Security Blue HMO-POS Standard (HMO-POS)
(H3957-045)

$164.00$0$5,000NoBrowse
Formulary
Security Blue HMO-POS ValueRx (HMO-POS)
(H3957-044)

$57.00$0$5,500NoBrowse
Formulary
UPMC for Life HMO Deductible Rx (HMO)
(H3907-037)

$22.00$0$7,550NoBrowse
Formulary
UPMC for Life HMO Rx (HMO)
(H3907-029)

$81.00$0$7,550YesBrowse
Formulary
UPMC for Life HMO Rx Choice (HMO)
(H3907-049)

$38.00$0$7,550NoBrowse
Formulary
UPMC for Life HMO Rx Enhanced (HMO)
(H3907-006)

$302.00$0$7,550NoBrowse
Formulary
UPMC for Life PPO High Deductible Rx (PPO)
(H5533-003)

$35.00$0$7,550NoBrowse
Formulary
UPMC for Life PPO Rx Enhanced (PPO)
(H5533-005)

$136.00$0$7,550NoBrowse
Formulary
Wellcare Assist (HMO)
(H2915-011)

$36.00$480.00$7,550NoBrowse
Formulary
Wellcare Assist Open (PPO)
(H2128-001)

$24.70$480.00$6,700NoToo NewBrowse
Formulary
Wellcare Giveback (HMO)
(H2915-012)

$0$0$7,550NoBrowse
Formulary
Wellcare Giveback Open (PPO)
(H2128-004)

$0$350.00$7,550YesToo NewBrowse
Formulary
Wellcare Low Premium Open (PPO)
(H2128-003)

$29.00$100.00$5,000NoToo NewBrowse
Formulary
Wellcare No Premium (HMO)
(H2915-003)

$0$0$6,700NoBrowse
Formulary
Wellcare No Premium Open (PPO)
(H2128-002)

$0$160.00$6,700NoToo NewBrowse
Formulary


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Juniata County Medicare Advantage





Medicare Advantage Health Plans Without Drug Coverage





2022 Medicare Special Needs Plans in Jefferson county Pennsylvania

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Aetna Medicare Advantra Cares (HMO D-SNP) $22.10$375.0No Gap CoverageDual-Eligible
AmeriHealth Caritas VIP Care (HMO D-SNP) $40.70$480.0No Gap CoverageDual-Eligible
Gateway Health Medicare Assured Diamond (HMO D-SNP) $40.70$480.0No Gap CoverageDual-Eligible
Gateway Health Medicare Assured Ruby (HMO D-SNP) $40.70$480.0No Gap CoverageDual-Eligible
Geisinger Gold Secure Rx (HMO D-SNP) $40.70$480.0No Gap CoverageDual-Eligible
UnitedHealthcare Dual Complete (HMO D-SNP) $33.90$480.0No Gap CoverageDual-Eligible
UnitedHealthcare Dual Complete Select (HMO D-SNP) $40.70$480.0No Gap CoverageDual-Eligible
UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP) $40.60$480.0No Gap CoverageInstitutional
UPMC for Life Complete Care (HMO D-SNP) $40.70$480.0No Gap CoverageDual-Eligible
Wellcare Dual Access (HMO D-SNP) $40.70$480.0No Gap CoverageDual-Eligible



Plan Type Is the type of organization offering the Medicare Plan.

  • 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
  • Many - Many Generics and Some Brands
  • Some - Some Generics and Few Brands

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 1, 2021.
Plans are subject to change as contracts are finalized.
Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2022, 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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MedicareHelp.org is a privately-owned Non-governmental agency. The government website can be found at HealthCare.gov.

Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options. Enrollment depends on the plan’s contract renewal.

Every year, Medicare evaluates plans based on a 5-star rating system.