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The 2023 Medicare Advantage Plans in Montgomery County PA.



2022 Montgomery County Pennsylvania
Medicare Advantage Plans

There are 53 Medicare Advantage Plans available in Montgomery County PA from 9 different health insurance providers. 21 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3800 and the highest out of pocket is $7550. Montgomery County Pennsylvania residents can also pick from 16 Medicare Special Needs Plans. The best Medicare Advantage plan in Montgomery 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)
(H2228-037)

$45.00$0$6,700YesBrowse
Formulary
AARP Medicare Advantage Choice Plan 2 (PPO)
(H2228-085)

$0$0$6,700YesBrowse
Formulary
AARP Medicare Advantage Plan 1 (HMO)
(H1944-033)

$0$0$6,900YesBrowse
Formulary
AARP Medicare Advantage Plan 2 (HMO)
(H1944-009)

$27.00$0$6,700YesBrowse
Formulary
Aetna Medicare Advantra Credit Value (PPO)
(H5522-017)

$0$250.00$7,550YesBrowse
Formulary
Aetna Medicare Advantra Premier (HMO)
(H3959-033)

$16.00$0$7,550YesBrowse
Formulary
Aetna Medicare Advantra Premier Plus (PPO)
(H5522-014)

$50.00$0$6,700YesBrowse
Formulary
Aetna Medicare Advantra Value (HMO)
(H3959-052)

$0$0$7,550YesBrowse
Formulary
Aetna Medicare Elite (HMO)
(H3931-112)

$0$150.00$7,550YesBrowse
Formulary
Aetna Medicare Gold Plan (PPO)
(H5521-122)

$170.00$0$7,550YesBrowse
Formulary
Aetna Medicare Philly Suburban Value (HMO)
(H3931-105)

$0$150.00$7,550YesBrowse
Formulary
Aetna Medicare Premier (HMO-POS)
(H3931-064)

$96.00$0$7,550YesBrowse
Formulary
Aetna Medicare Premier Plus (HMO)
(H3931-004)

$146.00$0$7,550YesBrowse
Formulary
Aetna Medicare Silver (HMO)
(H3931-070)

$65.00$0$7,550YesBrowse
Formulary
Aetna Medicare Value (PPO)
(H5521-263)

$0$0$7,550YesBrowse
Formulary
Cigna Alliance Medicare (HMO)
(H3949-031)

$0$0$6,900YesBrowse
Formulary
Cigna Preferred Medicare (HMO)
(H3949-030)

$35.00$0$5,900YesBrowse
Formulary
Cigna Preferred Plus Medicare (HMO)
(H3949-013)

$135.00$0$4,900YesBrowse
Formulary
Cigna True Choice Medicare (PPO)
(H7849-006)

$0$0$7,200YesBrowse
Formulary
Cigna True Choice Plus Medicare (PPO)
(H7849-007)

$60.00$0$6,100YesBrowse
Formulary
Health Partners Medicare Complete (HMO-POS)
(H9207-012)

$0$0$7,550NoBrowse
Formulary
Health Partners Medicare Prime (HMO-POS)
(H9207-002)

$40.70$0$7,550NoBrowse
Formulary
Humana Gold Plus H6622-037 (HMO)
(H6622-037)

$0$0$6,900NoBrowse
Formulary
HumanaChoice H5216-120 (PPO)
(H5216-120)

$128.00$0$6,700NoBrowse
Formulary
HumanaChoice H5525-005 (PPO)
(H5525-005)

$62.00$0$6,700NoBrowse
Formulary
HumanaChoice H5525-051 (PPO)
(H5525-051)

$0$0$7,200NoBrowse
Formulary
HumanaChoice R0923-002 (Regional PPO)
(R0923-002)

$72.00$0$6,700NoBrowse
Formulary
Keystone 65 Basic Rx (HMO)
(H3952-056)

$0$0$7,550NoBrowse
Formulary
Keystone 65 Focus Rx (HMO-POS)
(H3952-054)

$15.00$0$6,500NoBrowse
Formulary
Keystone 65 Preferred Rx (HMO)
(H3952-045)

$258.00$0$3,800NoBrowse
Formulary
Keystone 65 Select Rx (HMO)
(H3952-051)

$83.50$0$4,900NoBrowse
Formulary
Personal Choice 65 Elite Rx (PPO)
(H3909-017)

$51.00$0$6,500NoBrowse
Formulary
Personal Choice 65 Prime Rx (PPO)
(H3909-015)

$0$0$7,550NoBrowse
Formulary
Personal Choice 65 Rx (PPO)
(H3909-009)

$165.00$0$5,000NoBrowse
Formulary
Personal Choice 65 Saver Rx (PPO)
(H3909-016)

$0$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)
(H2915-016)

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

$0$160.00$6,700NoToo NewBrowse
Formulary


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Montour County Medicare Advantage





Medicare Advantage Health Plans Without Drug Coverage





2022 Medicare Special Needs Plans in Montgomery county Pennsylvania

Plan Name ⇅ Monthly
Premium
Part D
Deductible
 Gap  Special Needs
Type
Overall
Rating
Aetna Medicare Advantra Cares (HMO D-SNP) $28.00$350.0No Gap CoverageDual-Eligible
Cigna Achieve Medicare (HMO C-SNP) $0$0No Gap CoverageChronic or Disabling Condition
Cigna TotalCare (HMO D-SNP) $29.80$480.0No Gap CoverageDual-Eligible
Cigna TotalCare Plus (HMO D-SNP) $29.80$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
Health Partners Medicare Special (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
Keystone First VIP Choice (HMO D-SNP) $40.70$480.0No Gap CoverageDual-Eligible
Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) $40.70$480.0No Gap CoverageInstitutionalNA
Provider Partners Pennsylvania Community Plan (HMO I-SNP) $40.70$480.0No Gap CoverageInstitutionalNA
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-EligibleNA
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.