2014 Medicare Advantage Plans in New York County New York


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2014 Medicare Advantage Plans in New York County New York

There are 42 Medicare Advantage Plans available in New York County NY from 20 health insurance providers and 40 Special Needs Plans available. 5 Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $ and the highest out of pocket is $6700. The highest rated plan available in New York County received a 4.5 overall star rating from CMS and the lowest rated plan is 2.5 stars.

(Click the Plan Name for More Details)

Plan Name Type Premium C+D Part D
Deductible
Gap Max Out of Pocket Overall Rating
Return to Counties In New York
AARP MedicareComplete Essential (HMO)
(H3307-018)
Local HMO * $0 $5,900
AARP MedicareComplete Mosaic (HMO)
(H3307-015)
Local HMO $0 $0 No Gap Coverage $3,900
AARP MedicareComplete Plan 1 (HMO)
(H3307-002)
Local HMO $0 $0 No Gap Coverage $5,900
AARP MedicareComplete Plan 2 (HMO)
(H3379-001)
Local HMO $0 $0 No Gap Coverage $4,200
Access Medicare Gold (HMO)
(H4866-003)
Local HMO $0 $0 No Gap Coverage $5,000
Access Medicare Platinum (HMO)
(H4866-002)
Local HMO $37.20 $310.00 No Gap Coverage $5,000
ActiveSaver MSA (MSA)
(H9788-004)
MSA * NA
Aetna Medicare Standard Plan (PPO)
(H5521-040)
Local PPO $87.00 $0 Few Generics $6,700
Aetna Medicare Value Plan (HMO)
(H3312-060)
Local HMO $0 $0 Few Generics $6,700
AlphaCare Renew (HMO)
(H9122-001)
Local HMO $0 $0 No Gap Coverage $3,400 Too New
Amerivantage Balance + Rx (HMO)
(H6181-009)
Local HMO $0 $0 No Gap Coverage $3,400
Amida Care True Life Plus (HMO)
(H6745-001)
Local HMO $0 $0 No Gap Coverage $3,400 Too New
CPHL Advantage Care (HMO)
(H6988-001)
Local HMO $0 $310.00 No Gap Coverage $6,700 Too New
Easy Choice Rewards (HMO)
(H9285-001)
Local HMO $0 $0 No Gap Coverage $3,400 NA
Easy Choice Value (HMO)
(H9285-002)
Local HMO $0 $0 Many Generics $3,400 NA
Elderplan Classic: Zero Premium (HMO)
(H3347-005)
Local HMO $0 $310.00 No Gap Coverage $6,700
Elderplan Extra Help (HMO)
(H3347-009)
Local HMO $37.20 $310.00 No Gap Coverage $6,700
EmblemHealth Essential (HMO)
(H3330-032)
Local HMO $0 $0 No Gap Coverage $3,400
EmblemHealth PPO I (PPO)
(H5528-001)
Local PPO * $25.00 $3,400
EmblemHealth PPO II (PPO)
(H5528-002)
Local PPO $0 $0 No Gap Coverage $3,400
EmblemHealth PPO III (PPO)
(H5528-003)
Local PPO $89.00 $0 All Generics $3,400
EmblemHealth VIP (HMO)
(H3330-021)
Local HMO $0 $0 No Gap Coverage $3,400
EmblemHealth VIP High Option (HMO)
(H3330-033)
Local HMO $161.50 $0 No Gap Coverage $3,400
Empire MediBlue Plus (HMO)
(H3370-001)
Local HMO $0 $0 No Gap Coverage $5,900
Fidelis Medicare $0 Premium (HMO)
(H3328-019)
Local HMO $0 $0 No Gap Coverage $6,700
Fidelis Medicare Advantage Flex (HMO-POS)
(H3328-003)
Local HMO $37.20 $240.00 No Gap Coverage $6,700
Fidelis Medicare Advantage without Rx (HMO-POS)
(H3328-001)
Local HMO * $0 $6,700
Healthfirst 65 Plus Plan (HMO)
(H3359-001)
Local HMO $0 $0 No Gap Coverage $6,700
Healthfirst Coordinated Benefits Plan (HMO)
(H3359-027)
Local HMO * $0 $6,700
Healthfirst Increased Benefits Plan (HMO)
(H3359-019)
Local HMO $30.00 $310.00 No Gap Coverage $6,700
Liberty Health Advantage Preferred Choice (HMO)
(H3337-001)
Local HMO $0 $0 All Generics $5,500
MetroPlus Platinum (HMO)
(H0423-004)
Local HMO $47.90 $310.00 No Gap Coverage $6,700
Touchstone Health Medicare Clear (HMO-POS)
(H3327-039)
Local HMO * $0 $3,400
Touchstone Health Medicare Freedom (HMO-POS)
(H3327-038)
Local HMO $0 $0 No Gap Coverage $3,400
Touchstone Health Medicare Power (HMO)
(H3327-001)
Local HMO $0 $0 No Gap Coverage $3,400
Touchstone Health Medicare Total (HMO)
(H3327-002)
Local HMO $37.20 $0 No Gap Coverage $3,400
UnitedHealthcare MedicareComplete Choice (Regional PPO)
(R5342-001)
Regional PPO $0 $0 No Gap Coverage $5,200
UnitedHealthcare MedicareComplete Choice Essential (Regiona
(R5342-002)
Regional PPO * $0 $5,200
VNSNY CHOICE Medicare Classic (HMO)
(H5549-008)
Local HMO $37.20 $310.00 No Gap Coverage $6,700
VNSNY CHOICE Medicare Enhanced (HMO)
(H5549-004)
Local HMO $0 $0 No Gap Coverage $6,700
WellCare Choice (HMO-POS)
(H3361-106)
Local HMO $0 $0 No Gap Coverage $6,700
WellCare Rx (HMO)
(H3361-130)
Local HMO $22.90 $0 No Gap Coverage $6,700

* Plan Type Indicates plan does not offer Part D drug coverage.



Medicare Special Needs Plans in New York county New York

Plan Name Type Consolidated Premium C+D Part D
Deductible
Gap Special Needs Type Overall Rating
Access Medicare Pearl (HMO SNP)
(H4866- 005)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
Affinity Medicare Solutions (HMO SNP)
(H5991- 002)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
Affinity Medicare Ultimate (HMO SNP)
(H5991- 001)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
AlphaCare Resilience (HMO SNP)
(H9122- 002)
Local HMO $37.20 $310.00 No Gap Coverage InstitutionalToo New
AlphaCare Total (HMO SNP)
(H9122- 003)
Local HMO $37.20 $310.00 No Gap Coverage Dual-EligibleToo New
Amerivantage Specialty + Rx (HMO SNP)
(H6181- 007)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
Amida Care Live Life Advantage (HMO SNP)
(H6745- 003)
Local HMO $37.20 $310.00 No Gap Coverage Chronic or Disabling ConditionToo New
Amida Care True Life Advantage (HMO SNP)
(H6745- 002)
Local HMO $37.20 $310.00 No Gap Coverage Dual-EligibleToo New
ArchCare Advantage (HMO SNP)
(H1777- 007)
Local HMO $37.20 $310.00 No Gap Coverage InstitutionalNA
CenterLight Direct Total Plan (HMO SNP)
(H5989- 008)
Local HMO $33.90 $310.00 No Gap Coverage Dual-EligibleNA
CenterLight Healthcare Direct Complete Plan (HMO SNP)
(H5989- 002)
Local HMO $34.00 $310.00 No Gap Coverage InstitutionalNA
Easy Choice Diamond Rewards (HMO SNP)
(H9285- 003)
Local HMO $0 $0 No Gap Coverage Chronic or Disabling ConditionNA
Elderplan Advantage For Nursing Home Residents (HMO SNP)
(H3347- 003)
Local HMO $37.20 $310.00 No Gap Coverage Institutional
Elderplan For Medicaid Beneficiaries (HMO SNP)
(H3347- 002)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
Elderplan Medicaid Advantage (HMO SNP)
(H3347- 008)
Local HMO $37.40 $310.00 No Gap Coverage Dual-Eligible
Elderplan Plus Long Term Care (HMO SNP)
(H3347- 007)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
EmblemHealth Dual Eligible (HMO SNP)
(H3330- 029)
Local HMO $34.00 $310.00 No Gap Coverage Dual-Eligible
EmblemHealth Dual Eligible (PPO SNP)
(H5528- 018)
Local PPO $34.00 $310.00 No Gap Coverage Dual-Eligible
Fidelis Dual Advantage (HMO SNP)
(H3328- 002)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
Fidelis Dual Advantage Flex (HMO SNP)
(H3328- 017)
Local HMO $37.20 $310.00 Some Generics Dual-Eligible
Fidelis Long Term Care Advantage (HMO SNP)
(H3328- 018)
Local HMO $44.50 $310.00 No Gap Coverage Institutional
Fidelis Medicaid Advantage Plus (HMO SNP)
(H3328- 016)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
GuildNet Gold (HMO-POS SNP)
(H6864- 001)
Local HMO $37.20 $310.00 No Gap Coverage Dual-EligibleNA
GuildNet Health Advantage (HMO-POS SNP)
(H6864- 002)
Local HMO $33.10 $310.00 No Gap Coverage Dual-EligibleNA
Healthfirst AssuredCare (HMO SNP)
(H3359- 035)
Local HMO $37.20 $310.00 No Gap Coverage Institutional
Healthfirst CompleteCare (HMO SNP)
(H3359- 034)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
Healthfirst Life Improvement Plan (HMO SNP)
(H3359- 021)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
Healthfirst Maximum Plan (HMO SNP)
(H3359- 033)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
HHH Choices Gold (HMO SNP)
(H3635- 001)
Local HMO $37.20 $310.00 No Gap Coverage Dual-EligibleToo New
MetroPlus Advantage Plan (HMO SNP)
(H0423- 001)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
MetroPlus Medicare Partnership in Care Plan (HMO SNP)
(H0423- 002)
Local HMO $134.00 $310.00 No Gap Coverage Chronic or Disabling Condition
MetroPlus Select Plan (HMO SNP)
(H0423- 003)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
Senior Whole Health of New York (HMO SNP)
(H5992- 006)
Local HMO $37.20 $310.00 Call plan for details Dual-EligibleNA
Senior Whole Health of New York NHC (HMO SNP)
(H5992- 007)
Local HMO $37.20 $310.00 Call plan for details Dual-EligibleNA
UnitedHealthcare Dual Complete (HMO SNP)
(H3387- 010)
Local HMO $24.10 $310.00 No Gap Coverage Dual-Eligible
UnitedHealthcare Nursing Home Plan (HMO SNP)
(H3379- 002)
Local HMO $28.30 $310.00 No Gap Coverage Institutional
VNSNY CHOICE Medicare Maximum (HMO SNP)
(H5549- 006)
Local HMO $31.50 $310.00 No Gap Coverage Dual-Eligible
VNSNY CHOICE Medicare Preferred (HMO SNP)
(H5549- 002)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
VNSNY CHOICE Total (HMO SNP)
(H5549- 003)
Local HMO $37.20 $310.00 No Gap Coverage Dual-Eligible
WellCare Access (HMO SNP)
(H3361- 109)
Local HMO $36.00 $310.00 No Gap Coverage Dual-Eligible


Source: CMS.

Plans as of September 3, 2013.

Plans are subject to change as contracts are finalized.

Includes 2014 approved contracts/plans. Employer sponsored 800 series plans and plans under sanction are excluded.



Plan Type Is the type of organization offering the Medicare Plans.

  • HMO - Health Maintenance Organization
  • PPO - Preferred Provider Organization
  • PDP - Prescrition 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 plan 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 plans; 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

Enhanced Alternative plans 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.

GAP

Coverage gap ("donut hole"). This means there's a temporary limit on what the drug plan will cover for drugs. (Unless you get the low-income subsidy) Once you reach the coverage gap in 2014, you will pay 47.5% of the plan's cost for covered brand-name prescription drugs. You get these savings if you buy your prescriptions at a pharmacy or order them through the mail.

Additional gap coverage levels are determined separately for formulary generic and brand products and are described as follows:

  • All: 100% of formulary drugs are covered through the gap
  • Many: 65% to 100% of formulary drugs are covered through the gap
  • Some: 10% to 65 % of formulary drugs are covered through the gap
  • Few: 0% to 10% of formulary drugs are covered through the gap (and must also be >15 "brand" products covered through the gap)
  • No Gap Coverage: 0% of formulary drugs are covered through the gap (or 15 "brand" products covered through the gap)
  • All Formulary Drugs: cover 100% of “generic” and 100% of “brand” products (either by covering all formulary drug products in the gap or by having no initial coverage limit)

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

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