2022 Upshur County Texas
Medicare Advantage Plans
There are 21 Medicare Advantage Plans available in Upshur County TX from 8 different health insurance providers. 6 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $4400 and the highest out of pocket is $7550. Upshur County Texas residents can also pick from 9 Medicare Special Needs Plans. The best Medicare Advantage plan in Upshur County Texas received a 4.5 overall star rating from CMS and the lowest rated plan is 3 stars.
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Return to 2022 Medicare Advantage Plans in Texas
Medicare Advantage Health Plans Without Drug Coverage
|Plan Name ⇅||Premium||Type||MOOP||Overall
|CHRISTUS Health Plan Guardian (HMO)
||$0||Local HMO *||$4,400||Enroll|
|Exemplar Health Freedom 1 (MSA)
|Exemplar Health Freedom 2 (MSA)
|Exemplar Health Freedom 3 (MSA)
|Humana Honor (PPO)
||$0||Local PPO *||$5,400||Enroll|
|HumanaChoice R4182-001 (Regional PPO)
||$0||Regional PPO *||$5,700||Enroll|
|Lasso Healthcare Growth (MSA)
|Lasso Healthcare Growth Plus (MSA)
2022 Medicare Special Needs Plans in Upshur county Texas
|Plan Name ⇅||Monthly
|Cigna TotalCare (HMO D-SNP)||$19.00||$480.0||No Gap Coverage||Dual-Eligible|
|Humana Gold Plus SNP-DE H0028-032 (HMO D-SNP)||$25.10||$460.0||No Gap Coverage||Dual-Eligible|
|Molina Medicare Complete Care (HMO D-SNP)||$25.10||$480.0||Some Generics||Dual-Eligible|
|Provider Partners Texas Advantage Plan (HMO I-SNP)||$25.10||$480.0||No Gap Coverage||Institutional||Too New|
|Provider Partners Texas Community Plan (HMO I-SNP)||$25.10||$480.0||No Gap Coverage||Institutional||Too New|
|UnitedHealthcare Dual Complete (HMO D-SNP)||$25.10||$480.0||No Gap Coverage||Dual-Eligible|
|UnitedHealthcare Dual Complete Choice (Regional PPO D-SNP||$25.10||$480.0||No Gap Coverage||Dual-Eligible|
|UnitedHealthcare Medicare Gold (Regional PPO C-SNP)||$29.00||$295.0||Some Generics||Chronic or Disabling Condition|
|UnitedHealthcare Medicare Silver (Regional PPO C-SNP)||$3.70||$480.0||No Gap Coverage||Chronic or Disabling Condition|
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
- 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
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.