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The 2023 Medicare Advantage Plans in Monroe County PA.



2022 Monroe County Pennsylvania
Medicare Advantage Plans

There are 47 Medicare Advantage Plans available in Monroe County PA from 9 different health insurance providers. 20 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. Monroe County Pennsylvania residents can also pick from 11 Medicare Special Needs Plans. The best Medicare Advantage plan in Monroe 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 (PPO)
(H2577-028)

$0$0$6,700YesBrowse
Formulary
Aetna Medicare Advantra Credit Value (PPO)
(H5522-017)

$0$250.00$7,550YesBrowse
Formulary
Aetna Medicare Advantra Gold (HMO-POS)
(H3959-037)

$0$0$7,550YesBrowse
Formulary
Aetna Medicare Advantra Premier (HMO-POS)
(H3959-039)

$17.00$0$7,550YesBrowse
Formulary
Aetna Medicare Advantra Premier Plus (PPO)
(H5522-002)

$48.00$0$4,500YesBrowse
Formulary
Aetna Medicare Advantra Silver (PPO)
(H5522-004)

$0$0$7,550YesBrowse
Formulary
Aetna Medicare Advantra Silver Plus (PPO)
(H5522-013)

$20.00$0$7,000YesBrowse
Formulary
Aetna Medicare Gold Plan (PPO)
(H5521-122)

$170.00$0$7,550YesBrowse
Formulary
Aetna Medicare Silver (HMO)
(H3931-070)

$65.00$0$7,550YesBrowse
Formulary
Aetna Medicare The Valley Plan (PPO)
(H5521-294)

$0$0$7,550YesBrowse
Formulary
Aetna Medicare Value (PPO)
(H5521-263)

$0$0$7,550YesBrowse
Formulary
Community Blue Medicare HMO Signature (HMO)
(H3957-042)

$0$0$6,700NoBrowse
Formulary
Community Blue Medicare PPO Distinct (PPO)
(H3916-034)

$25.00$0$6,500NoBrowse
Formulary
Community Blue Medicare PPO Signature (PPO)
(H3916-037)

$0$0$7,550NoBrowse
Formulary
Freedom Blue PPO Deluxe (PPO)
(H3916-005)

$288.00$0$4,500YesBrowse
Formulary
Freedom Blue PPO Standard (PPO)
(H3916-015)

$174.00$0$5,000NoBrowse
Formulary
Freedom Blue PPO ValueRx (PPO)
(H3916-018)

$69.00$0$5,500NoBrowse
Formulary
Geisinger Gold Classic 360 Rx (HMO)
(H3954-160)

$0$0$7,550YesBrowse
Formulary
Geisinger Gold Classic Advantage Rx (HMO)
(H3954-157)

$122.00$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)

$86.00$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)

$0$0$7,550YesBrowse
Formulary
Humana Gold Plus H6622-036 (HMO)
(H6622-036)

$0$0$6,700NoBrowse
Formulary
Humana Value Plus H5216-117 (PPO)
(H5216-117)

$36.50$480.00$6,700NoBrowse
Formulary
HumanaChoice H5216-120 (PPO)
(H5216-120)

$128.00$0$6,700NoBrowse
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
Vibra Essential Advocate (PPO)
(H9408-006)

$0$0$7,500NoBrowse
Formulary
Vibra Health Plan Enhanced Complete (PPO)
(H9408-005)

$27.00$0$6,500NoBrowse
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


Return to 2022 Medicare Advantage Plans in Pennsylvania

Montgomery County Medicare Advantage





Medicare Advantage Health Plans Without Drug Coverage





2022 Medicare Special Needs Plans in Monroe 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
Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) $23.70$450.0No 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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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.