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The 2023 Medicare Advantage Plans in Lexington County SC.



2022 Lexington County South Carolina
Medicare Advantage Plans

There are 36 Medicare Advantage Plans available in Lexington County SC from 8 different health insurance providers. 14 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 $7550. Lexington County South Carolina residents can also pick from 13 Medicare Special Needs Plans. The best Medicare Advantage plan in Lexington County South Carolina 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
Click
for
Formulary
AARP Medicare Advantage Choice Plan 1 (PPO)
(H2577-006)

$0$95.00$5,900YesBrowse
Formulary
AARP Medicare Advantage Choice Plan 2 (PPO)
(H2577-026)

$29.00$395.00$6,900YesBrowse
Formulary
AARP Medicare Advantage Plan 1 (HMO-POS)
(H8748-002)

$0$0$5,900YesBrowse
Formulary
AARP Medicare Advantage Plan 2 (HMO-POS)
(H8748-025)

$24.00$0$4,500YesBrowse
Formulary
Aetna Medicare Premier Plan (PPO)
(H5521-245)

$0$0$6,700YesBrowse
Formulary
Aetna Medicare Prime Plan (HMO-POS)
(H3146-014)

$0$0$5,900YesBrowse
Formulary
Aetna Medicare Value Plan (PPO)
(H5521-251)

$16.00$150.00$6,700YesBrowse
Formulary
Aetna Medicare Value Plus Plan (HMO)
(H3146-011)

$24.00$95.00$6,900YesBrowse
Formulary
BlueCross Total (PPO)
(H8003-002)

$15.00$50.00$6,500YesBrowse
Formulary
BlueCross Total Value (PPO)
(H8003-005)

$0$75.00$6,900YesBrowse
Formulary
Humana Gold Plus H5619-144 (HMO)
(H5619-144)

$0$0$7,550NoBrowse
Formulary
HumanaChoice H5216-142 (PPO)
(H5216-142)

$0$250.00$6,800NoBrowse
Formulary
HumanaChoice H5216-154 (PPO)
(H5216-154)

$0$400.00$7,550NoBrowse
Formulary
HumanaChoice H5216-279 (PPO)
(H5216-279)

$0$0$3,450NoBrowse
Formulary
HumanaChoice H5216-280 (PPO)
(H5216-280)

$31.10$480.00$7,550NoBrowse
Formulary
HumanaChoice H5216-282 (PPO)
(H5216-282)

$0$0$5,900NoBrowse
Formulary
HumanaChoice R3392-002 (Regional PPO)
(R3392-002)

$103.00$340.00$6,700NoBrowse
Formulary
Molina Medicare Choice Care (HMO)
(H8176-003)

$0$125.00$7,550NoBrowse
Formulary
UnitedHealthcare Medicare Advantage Choice (Regional PPO)
(R2604-001)

$49.00$295.00$6,700YesBrowse
Formulary
Wellcare Assist (HMO)
(H4847-005)

$28.20$480.00$3,400NoBrowse
Formulary
Wellcare Giveback Open (PPO)
(H7326-003)

$0$90.00$6,700YesBrowse
Formulary
Wellcare Low Premium Open (PPO)
(H7326-002)

$44.00$0$6,000NoBrowse
Formulary
Wellcare No Premium (HMO)
(H4847-002)

$0$0$3,400YesBrowse
Formulary
Wellcare No Premium Medicare (HMO)
(H1436-004)

$0$0$7,550NoBrowse
Formulary
Wellcare No Premium Open (PPO)
(H7326-001)

$0$100.00$5,500YesBrowse
Formulary


Return to 2022 Medicare Advantage Plans in South Carolina

Marion County Medicare Advantage





Medicare Advantage Health Plans Without Drug Coverage





2022 Medicare Special Needs Plans in Lexington county South Carolina

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
First Choice VIP Care (HMO D-SNP) $31.10$480.0No Gap CoverageDual-EligibleToo New
Humana Gold Plus SNP-DE H5619-082 (HMO D-SNP) $26.90$480.0No Gap CoverageDual-Eligible
Humana Together in Health (PPO I-SNP) $24.70$480.0No Gap CoverageInstitutional
HumanaChoice - Diabetes and Heart (PPO C-SNP) $0$145.0No Gap CoverageChronic or Disabling Condition
HumanaChoice SNP-DE H5216-277 (PPO D-SNP) $25.20$480.0No Gap CoverageDual-Eligible
Molina Medicare Complete Care (HMO D-SNP) $31.10$480.0No Gap CoverageDual-Eligible
NHC Advantage (HMO I-SNP) $32.80$480.0No Gap CoverageInstitutional
UnitedHealthcare Dual Complete (PPO D-SNP) $31.10$480.0No Gap CoverageDual-Eligible
UnitedHealthcare Medicare Gold (Regional PPO C-SNP) $19.00$210.0Some GenericsChronic or Disabling Condition
UnitedHealthcare Medicare Silver (Regional PPO C-SNP) $9.20$480.0No Gap CoverageChronic or Disabling Condition
UnitedHealthcare Nursing Home Plan (PPO I-SNP) $31.10$480.0No Gap CoverageInstitutional
Wellcare Dual Access (HMO D-SNP) $31.10$480.0No Gap CoverageDual-Eligible
Wellcare Dual Liberty (HMO D-SNP) $31.10$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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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.