2022 Banner Medicare Advantage Plus (PPO)

Banner Medicare Advantage Plus (PPO) H7273-004 is a 2022 Medicare Advantage Plan or Part-C by Banner Medicare Advantage Plus available to residents in Arizona. This plan includes additional prescription drug (Part-D) coverage. The Banner Medicare Advantage Plus (PPO) has a monthly premium of $25.00 and has an in-network maximum out-of-pocket limit of $4,500 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $4,500 out-of-pocket. This can be a extremely nice safety net.

Banner Medicare Advantage Plus (PPO) is a Local PPO. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of "preferred" providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

Banner Medicare Advantage Plus works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Banner Medicare Advantage Plus (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Banner Medicare Advantage Plus and not Original Medicare. With Medicare Advantage you are always covered for urgently needed and emergency care. Plus you receive all the benefits of Original Medicare from Banner Medicare Advantage Plus except hospice care. Original Medicare still provides you with hospice care even if you sign up for Medicare Advantage.

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2022 Banner Medicare Advantage Plus Medicare Advantage Plan Costs

Banner Medicare Advantage Plus (PPO)
Plan ID:
Provider:Banner Medicare Advantage Plus
Type: Local PPO
Monthly Premium C+D: $25.00
Part C Premium:$0.00
MOOP: $4,500
Part D (Drug) Premium:$25.00
Part D Supplemental Premium$0.00
Total Part D Premium:$25.00
Drug Deductible:$0.00
Tiers with No Deductible:0
Gap Coverage:Yes
Benchmark:not below the regional benchmark
Type of Medicare Health:Enhanced Alternative
Drug Benefit Type:Enhanced
Similar Plan: H7273-005
New Plan: 2023 H7273-005

Banner Medicare Advantage Plus (PPO) Part-C Premium

Banner Medicare Advantage Plus charges a $0.00 Part-C premium. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. You generally are also responsible for paying the Part B premium.

H7273-004 Part-D Deductible and Premium

Banner Medicare Advantage Plus (PPO) has a monthly drug premium of $25.00 and a $0.00 drug deductible. This Banner Medicare Advantage Plus plan offers a $25.00 Part-D Basic Premium that is not below the regional benchmark. This covers the basic prescription benefit only and does not cover enhanced drug benefits such as medical benefits or hospital benefits. The Part D Supplemental Premium is $0.00 this Premium covers any enhanced plan benefits offered by Banner Medicare Advantage Plus above and beyond the standard PDP benefits. This can include additional coverage in the gap, lower co-payments and coverage of non-Part D drugs. The Part D Total Premium is $25.00 . The Part D Total Premium is the addition of the supplemental and basic premiums for some plans this amount can be lowered due to negative basic or supplemental premiums.

Banner Medicare Advantage Plus Gap Coverage

In 2022 once you and your plan provider have spent $4430 on covered drugs. (combined amount plus your deductible) You will be in the coverage gap. (AKA "donut hole") You will be required to pay 25% for prescription drugs unless your plan offers additional coverage. This Banner Medicare Advantage Plus plan does offer additional coverage through the gap.

Premium Assistance

The Low Income Subsidy (LIS) helps people with Medicare pay for prescription drugs, and lowers the costs of Medicare prescription drug coverage. Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. The Banner Medicare Advantage Plus (PPO) medicare insurance offers a $0.00 premium obligation if you receive a full low-income subsidy (LIS) assistance. And the payment is $6.20 for 75% low income subsidy $12.50 for 50% and $18.70 for 25%.

Full LIS Premium:$0.00
75% LIS Premium:$6.20
50% LIS Premium:$12.50
25% LIS Premium:$18.70

H7273-004 Formulary or Drug Coverage

Banner Medicare Advantage Plus (PPO) formulary is divided into Tiers or levels of coverage based on usage and according to the medication costs. Each tier will have a defined copay that you must pay to receive the drug. Drugs in lower tiers will usually cost less than those in higher tiers. By reviewing different Medicare Drug formularies, you can pick a Medicare Advantage plan that covers your medications. Additionally, you can choose a plan that has your drugs listed at a lower price. You can see complete 2022 Banner Medicare Advantage Plus (PPO) H7273-004 Formulary here.

Drug Tier Copay
Tier 1 NA $0
Tier 2 NA $5
Tier 3 NA $47
Tier 4 NA $100
Tier 5 NA 33%
*Initial Coverage Phase and 30 day supply

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Coverage Area for Banner Medicare Advantage Plus (PPO)

(Click county to compare all available Advantage plans)

State: Arizona
County: Santa Cruz

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Source: CMS.
Data as of September 1, 2021.
Notes: Data are subject to change as contracts are finalized. 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. Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.

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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.