Type: This chart shows three types of health plans with drug coverage: HMO, PPO and HMO-POS. They are explained below.
Premium: The monthly charge for the plan. This is in addition to whatever monthly Part B payment you make to Medicare.
Part B rebate: Some plans pay part of your monthly Part B premium. If you are new to Medicare in 2019 or your premium is not deducted from your Social Security check, Part B premiums are $135.50 per month (can be higher depending on income or other criteria). Note: The rebates you see in the chart were finalized before the new premiums were announced, so they are based on the 2018 premium of $134.
Drug deductible: In some plans, you pay a deductible before drug coverage kicks in. A drug deductible might not apply to all drugs or tiers.
Doctor copay: This is your cost every time you see a doctor. The first dollar figure is for primary care physicians; the second is for specialists. Costs are listed for physicians inside the network (Net) and outside the network (Out).
Hospital copay: This is your cost for each inpatient hospital admission — both inside the network (Net) and outside the network (Out). For outpatient hospital coverage, refer to Medicare’s Plan Finder.
Yearly cost (Est.): Medicare’s estimate of your out-of-pocket costs under this plan, including your Part B premium and drugs. It is based on an average person in good health, but could vary greatly depending on the actual drugs and services you need. The best way to project costs is with Medicare’s Plan Finder.
Out-of-pocket cap: Your maximum payment for the year inside the network (Net) and outside the network (Out). The lower the cap the better.
IMPORTANT: These out-of-pocket limits do not apply to your prescription drug costs.
Network size: The total number of providers in a network, including doctors, hospitals and other services. Some networks cover a specific region, others the entire state. Before signing up with any plan, check its provider network to see if its hospitals and doctors are acceptable to you.
Generics in the gap: Whether a plan pays for generic drugs in the coverage gap, or “donut hole,” which in 2019 will begin when total drug costs hit $3,820. You will exit the donut hole when your out-of-pocket costs reach $5,100.
Rating: Medicare rates plans from 1 to 5 stars, based on customer satisfaction and certain health measures. The top rating is a 5. People with Medicare can switch into a 5-star plan at any time during the year, even if it’s not during an enrollment period.
Private Fee for Service Plans (PFFS) and Special Needs Plans (SNPs): See explanation below and medicare.gov for details.
Medicare supplement plans: Also known as Medigap, this coverage helps pay some of the health care costs that Original Medicare doesn’t cover. Go here to shop for these plans.
Copayments for other services: Plans usually charge copayments for drugs, skilled nursing homes, ambulances, emergency rooms and many other services. Check individual plans for these details.
Goodies: Some plans offer some dental, hearing and vision coverage, exercise classes, transportation to the doctor and other extra benefits. Check plans for details.
Health plans without drugs: A few plans are cheaper because they do not offer drug coverage. Unless you have comparable coverage elsewhere, using these plans can result in stiff penalties if you ever want Medicare drug coverage in later years.
Medicare allows several types of private health plans, which cover all your care. Here is how they differ:
HMO (Health Maintenance Organization): Generally requires you to use providers within a network. A personal physician usually coordinates your care and may need to approve visits to specialists.
PPO (Preferred Provider Organization): Encourages you to use providers within a network, with low copayments, but also allows you to use providers outside the network at a higher cost. Usually allows you to see specialists within the network without prior approval of a personal physician. Some bigger companies allow you to use their PPOs in other states. Verify before signing up.
HMO-POS (HMO-Point of Service): A hybrid between an HMO and PPO. Usually requires you to stay within a network and may require you to seek approval of a personal physician before seeing network specialists. It may cover some care outside the network. Some POS plans approve very little coverage outside the network, so check plans for details.
PFFS (Private Fee for Service): Has network, but also allows members to get care outside the network if the provider will accept the plan’s payment, which many do not. Make sure provider will accept payment before incurring bills.
Special Needs Plans: People with certain chronic conditions like diabetes and COPD can sometimes qualify for a Special Needs Plan, which may include extra services for managing their disease. Make sure you qualify before purchasing. People living in nursing homes may also qualify for special plans, as can people on Medicaid.
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PLAN | TYPE | COUNTIES SERVED | PREM. | PART B REBATE | DRUG DEDUCT. | DOCTOR COPAY (PER VISIT) | HOSPITAL COPAY | YEARLY COST (EST.) | OUT-OF-POCKET CAP | NETWORK SIZE | GENERICS IN GAP? | RATINGS OUT OF 5 STARS |
---|---|---|---|---|---|---|---|---|---|---|---|---|
AARP MedicareComplete H1045-028 Contact: 800-842-6509 |
HMO | Her., Hills., Pasco. Pin. | $0 | $0 | $195 | 0000Net: $0, $45 Out: N/A |
0295Net: $295 daily for 6 days Out: N/A |
$3,320 | 4900Net: $4,900 Out: N/A |
2000120,001 and above | No | 4.5 |
AARP MedicareComplete Choice H2406-011 Contact: 800-842-6509 |
PPO | Her., Hills., Pasco, Pin. | $0 | $0 | $150 | 0010Net: $10, $35 Out: $45, $70 |
0295Net: $295 daily for 4 days Out: 40% per stay |
$3,120 | 5500Net: $5,500 In and Out of network: $10,000 |
2000120,001 and above | No | 4 |
AARP MedicareComplete Choice Plan 2 R7444-003 Contact: 800-842-6509 |
PPO | Her., Hills., Pasco, Pin. | $0 | $0 | $395 | 0015Net: $15, $50 Out: $45, $70 |
0395Net: $395 daily for 4 days Out: 40% per stay |
$3,480 | 6700Net: $6,700 In and Out of network: $10,000 |
2000120,001 and above | No | 4 |
AARP MedicareComplete Focus H1045-045 Contact: 800-842-6509 |
HMO | Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $20 Out: N/A |
01950Net: $195 daily for 8 days Out: N/A |
$2,780 | 4700Net: $4,700 Out: N/A |
050015,001-1,000 | Yes | 4.5 |
Aetna Medicare Choice Plan H1609-028 Contact: 833-859-6031 |
HMO-POS | Hills., Pin. | $0 | $0 | $195 | 0000Net: $0, $25 Out: $50 |
0350Net: $350 daily for 4 days Out: 50% per stay |
$2,820 | 6700Net: $6,700 In and Out of network: $10,000 |
075017,501-8,000 | Yes | 4.5 |
Aetna Medicare Premier Plan H5521-033 Contact: 833-859-6031 |
PPO | Her., Hills., Pasco, Pin. | $0 | $0 | $295 | 0000Net: $0, $50 Out: $50, $50 |
0395Net: $395 daily for 4 days Out: 50% per stay |
$3,110 | 6700Net: $6,700 In and Out of network: $10,000 |
090019,001-10,000 | Yes | 4 |
Allwell Medicare H9276-006 Contact: 877-826-3692 |
HMO | Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $40 Out: N/A |
0290Net: $290 daily for 7 days Out: N/A |
$2,980 | 6700Net: $6,700 Out: N/A |
015011,501-2,000 | Yes | Not available |
BayCarePlus Complete H2235-001 Contact: 877-549-1741 |
HMO | Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $35 Out: N/A |
0195Net: $195 daily for 6 days Out: N/A |
$2,900 | 3900Net: $3,900 Out: N/A |
020012,001-2,500 | No | Too new for rating |
BayCarePlus Rewards H2235-002 Contact: 877-549-1741 |
HMO | Hills., Pasco, Pin. | $0 | $100 | $0 | 0000Net: $0, $45 Out: N/A |
0250Net: $250 daily for 6 days Out: N/A |
$2,080 | 5900Net: $5,900 Out: N/A |
020012,001-2,500 | No | Too new for rating |
BlueMedicare Choice R3332-001 Contact: 855-601-9465 |
PPO | Her., Hills., Pasco, Pin. | $42 | $0 | $250* | 0010Net: $10, $45 Out: 50% per visit, 50% per visit |
0295Net: $295 daily for 5 days Out: $495 daily for 27 days |
$3,880 | 6700Net: $6,700 In and Out of network: $10,000 |
2000120,001 and above | Yes | 4 |
BlueMedicare Classic H1035-021 Contact: 855-601-9465 |
HMO | Her., Hills., Pasco | $0 | $0 | $0 | 0000Net: $0, $40 Out: N/A |
0225Net: $225 daily for 7 days Out: N/A |
$2,860 | 5500Net: $5,500 Out: N/A |
2000120,001 and above | Yes | 5 |
BlueMedicare Classic Plus H1035-023 Contact: 855-601-9465 |
HMO | Hills. | $0 | $0 | $0 | 0000Net: $0, $25 Out: N/A |
0150Net: $150 daily for 7 days Out: N/A |
$2,390 | 3400Net: $3,400 Out: N/A |
1000110,001-11,000 | Yes | 5 |
BlueMedicare Preferred H2758-006 Contact: 855-601-9465 |
HMO | Pin. | $0 | $0 | $0 | 0000Net: $0, $15 Out: N/A |
0120Net: $120 daily for 5 days Out: N/A |
$2,330 | 3400Net: $3,400 Out: N/A |
015011,501-2,000 | Yes | 4 |
Blue Medicare Preferred POS H2758-008 Contact: 855-601-9465 |
HMO-POS | Pin. | $0 | $0 | $0 | 0000Net: $0, $25 Out: $30, $45 |
0120Net: $120 daily for 5 days Out: Coming soon |
$2,780 | 4900Net: $4,900 Out: $8,000 |
015011,501-2,000 | Yes | 4.5 |
BlueMedicare Select H5434-002 Contact: 855-601-9465 |
PPO | Hills., Pin. | $147.80 | $0 | $305** | 0005Net: $5, $45 Out: 40% per visit, 40% per visit |
0225Net: $225 daily for 7 days Out: $200 per day for 27 days |
$4,640 | 5900Net: $5,900 In and Out of network: $10,000 |
2000120,001 and above | Yes | 4.5 |
BlueMedicare Value H5434-023 Contact: 855-601-9465 |
PPO | Pin. | $0 | $0 | $250*** | 0010Net: $10, $45 Out: 50% per visit, 50% per visit |
0350Net: $350 daily for 5 days Out: 50% per stay |
$3,420 | 6700Net: $6,700 In and Out of network: $10,000 |
2000120,001 and above | Yes | 4.5 |
CareFree H1019-060 Contact: 800-794-4105 |
HMO | Hills., Pasco, Pin. | $0 | $110 | $0 | 0000Net: $0, $20 Out: N/A |
0150Net: $150 daily for 5 days Out: N/A |
$1,160 | 2500Net: $2,500 Out: N/A |
025012,501-3,000 | No | 5 |
CareOne PLUS H1019-054 Contact: 800-794-4105 |
HMO | Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $10 Out: N/A |
0025Net: $25 daily for 7 days Out: N/A |
$2,080 | 1500Net: $1,500 Out: N/A |
025012,501-3,000 | Yes | 5 |
Coventry Medicare Summit Plan H1609-034 Contact: 833-859-6031 |
HMO | Her., Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $25 Out: N/A |
0095Net: $95 daily for 7 days Out: N/A |
$2,460 | 3400Net: $3,400 Out: N/A |
025012,501-3,000 | Yes | 4.5 |
Devoted Health Greater Tampa Bay H1290-004 Contact: 800-338-6833 |
HMO | Hills., Pin. | $0 | $0 | $0 | 0000Net: $0, $20 Out: N/A |
0090Net: $90 daily for 7 days Out: N/A |
$2,280 | 3400Net: $3,400 Out: N/A |
1000110,001-11,000 | Yes | Too new for rating |
Devoted Health Prime Greater Tampa Bay H1290-009 Contact: 800-338-6833 |
HMO | Hills., Pin. | $30.30 | $0 | $415 | 0000Net: $0, $0 Out: N/A |
0000Net: $0 Out: N/A |
$2,210 | 3400In: $3,400 Out: N/A |
1000110,001-11,000 | No | Too new for rating |
Freedom Medicare Plan Rx H5427-060 Contact: 800-401-2740 |
HMO | Her., Hills., Pasco | $0 | $0 | $0 | 0000Net: $0, $35 Out: N/A |
0150Net: $150 daily for 7 days Out: N/A |
$2,920 | 3400Net: $3,400 Out: N/A |
1300113,001-14,000 | Yes | 4.5 |
Freedom Medicare Plan Rx H5427-059 Contact: 800-401-2740 |
HMO | Pin. | $0 | $0 | $0 | 0000Net: $0, $30 Out: N/A |
0225Net: $225 daily for 7 days Out: N/A |
$2,890 | 3400Net: $3,400 Out: N/A |
1300113,001-14,000 | Yes | 4.5 |
HumanaChoice R5826-005 R5826-005 Contact: 855-795-9488 |
PPO | Her., Hills., Pasco, Pin. | $96 | $0 | $100 | 0005Net: $5, $40 Out: $45, $45 |
0195Net: $195 daily for 7 days Out: 40% per stay |
$4,120 | 6700Net: $6,700 In and Out of network: $10,000 |
2000120,001 and above | No | 3 |
HumanaChoice R5826-074 R5826-074 Contact: 855-795-9488 |
PPO | Her., Hills., Pasco, Pin. | $0 | $0 | $395 | 0015Net: $15, $50 Out: $60, $60 |
0395Net: $395 daily for 4 days Out: $495 daily for 27 days |
$3,530 | 6700Net: $6,700 In and Out of network: $10,000 |
2000120,001 and above | No | 3 |
HumanaChoice Florida H5216-072 H5216-072 Contact: 855-795-9488 |
PPO | Her., Hills., Pasco, Pin. | $0 | $0 | $150 | 0005Net: $5, $35 Out: $65, $65 |
0290Net: $290 daily for 5 days Out: $495 daily for 27 days |
$3,180 | 4900Net: $4,900 In and Out of network: $10,000 |
2000120,001 and above | No | 4 |
Humana Gold Plus H1036-025 H1036-025 Contact: 855-795-9488 |
HMO | Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $10 Out: N/A |
0050Net: $50 daily for 7 days Out: N/A |
$2,090 | 2500Net: $2,500 Out: N/A |
065006,500-7,000 | Yes | 4.5 |
Humana Gold Plus H1036-067 H1036-067 Contact: 855-795-9488 |
HMO | Her. | $0 | $0 | $0 | 0000Net: $0, $10 Out: N/A |
0050Net: $50 daily for 7 days Out: N/A |
$2,090 | 2500Net: $2,500 Out: N/A |
065006,500-7,000 | Yes | 4.5 |
Humana Gold Plus H1036-265 H1036-265 Contact: 855-795-9488 |
HMO | Her., Hills., Pasco, Pin. | $0 | $110 | $0 | 0000Net: $0, $25 Out: N/A |
0150Net: $150 daily for 8 days Out: N/A |
$1,270 | 3400Net: $3,400 Out: N/A |
065006,500-7,000 | No | 4.5 |
Optimum Gold Plus Plan H5594-032 Contact: 866-245-5360 |
HMO | Her. | $0 | $104.90 | $0 | 0000Net: $0, $20 Out: N/A |
0150Net: $150 daily for 7 days Out: N/A |
$1,430 | 3400Net: $3,400 Out: N/A |
1100111,001-12,000 | Yes | 4.5 |
Optimum Gold Rewards Plan H5594-001 Contact: 866-245-5360 |
HMO | Her., Hills., Pasco, Pin. | $0 | $100 | $0 | 0000Net: $0, $40 Out: N/A |
0195Net: $195 daily for 7 days Out: N/A |
$1,680 | 3400Net: $3,400 Out: N/A |
1100111,001-12,000 | Yes | 4.5 |
Optimum Platinum Plan H5594-002 Contact: 866-245-5360 |
HMO | Her., Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $5 Out: N/A |
0000Net: $0 Out: N/A |
$2,440 | 3400Net: $3,400 Out: N/A |
1100111,001-12,000 | Yes | 4.5 |
Simply More H5471-078 Contact: 888-577-0212 |
HMO | Her., Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $10 Out: N/A |
0050Net: $50 daily for 8 days Out: N/A |
$2,050 | 6700Net: $6,700 Out: N/A |
1100111,001-12,000 | Yes | 4 |
Simply Select H5471-099 Contact: 888-577-0212 |
HMO | Her., Hills., Pasco, Pin. | $30.30 | $0 | $415 | 0000Net: $0, $5 Out: N/A |
0025Net: $25 daily for 8 days Out: N/A |
$2,340 | 6700Net: $6,700 Out: N/A |
1100111,001-12,000 | Yes | 4 |
Solis Health Plans H0982-009 Contact: 813-559-0311 |
HMO | Hills. | $0 | $0 | $0 | 0000Net: $0-35, $0-$50 Out: N/A |
0175Net: $175 daily for 7 days Out: N/A |
3370$3,370 | 3400Net: $3,400 Out: N/A |
010011,001-1,500 | Yes | Too new for rating |
Ultimate Acclaim H2962-011 Contact: 855-858-7526 |
HMO | Pin. | $0 | $105 | $0 | 0000Net: $0, $20 Out: N/A |
0090Net: $90 daily for 5 days Out: N/A |
$1,240 | 3400Net: $3,400 Out: N/A |
010011,001-1,500 | Yes | 4.5 |
Ultimate Acclaim Plus H2962-012 Contact: 855-858-7526 |
HMO | Pin. | $0 | $0 | $0 | 0000Net: $0, $0 Out: N/A |
0000Net: $0 Out: N/A |
$2,160 | 3400Net: $3,400 Out: N/A |
010011,001-1,500 | Yes | 4.5 |
Ultimate Elite H2962-003 Contact: 855-858-7526 |
HMO | Pasco | $0 | $105 | $0 | 0000Net: $0, $20 Out: N/A |
0090Net: $90 daily for 5 days Out: N/A |
$1,240 | 3400Net: $3,400 Out: N/A |
010011,001-1,500 | Yes | 4.5 |
Ultimate Premier H2962-001 Contact: 855-858-7526 |
HMO | Her. | $0 | $105 | $0 | 0000Net: $0, $20 Out: N/A |
0090Net: $90 daily for 5 days Out: N/A |
$1,240 | 3400Net: $3,400 Out: N/A |
010011,001-1,500 | Yes | 4.5 |
Ultimate Premier Plus H2962-002 Contact: 855-858-7526 |
HMO | Her., Pasco | $0 | $0 | $0 | 0000Net: $0, $0 Out: N/A |
0000Net: $0 Out: N/A |
$2,160 | 3400Net: $3,400 Out: N/A |
010011,001-1,500 | Yes | 4.5 |
WellCare Dividend H1032-032 Contact: 877-829-3045 (TTY 711) |
HMO | Her., Hills., Pin. | $0 | $90 | $0 | 0000Net: $0, $25 Out: N/A |
0150Net: $150 daily for 5 days Out: N/A |
$1,670 | 6700Net: $6,700 Out: N/A |
050015,001-5,500 | Yes | 4 |
WellCare Dividend H1032-187 Contact: 877-829-3045 (TTY 711) |
HMO | Pasco | $0 | $115 | $0 | 0000Net: $0, $35 Out: N/A |
0250Net: $250 daily for 6 days Out: N/A |
$1,520 | 6700Net: $6,700 Out: N/A |
1300113,001-14,000 | Yes | 4 |
WellCare Dividend Prime H1032-200 Contact: 877-829-3045 (TTY 711) |
HMO | Her., Hills., Pasco, Pin. | $0 | $131 | $0 | 0000Net: $0, $40 Out: N/A |
0200Net: $200 daily for 5 days Out: N/A |
$1,380 | 3400Net: $3,400 Out: N/A |
070017,001-7,500 | Yes | 4.5 |
WellCare Elite H1032-201 Contact: 877-829-3045 (TTY 711) |
HMO | Her., Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $5 Out: N/A |
0050Net: $50 daily for 10 days Out: N/A |
$2,280 | 3400Net: $3,400 Out: N/A |
070017,001-7,500 | Yes | 4 |
WellCare Essential H1032-174 Contact: 877-829-3045 (TTY 711) |
HMO-POS | Her., Hills., Pasco, Pin. | $0 | $0 | $0 | 0000Net: $0, $20 Out: 45% per visit, 45% per visit |
0100Net: $100 daily for 6 days Out: 45% per stay |
$2,640 | 6700Net: $6,700 Out: $6,700 In and Out: $6,700 |
055015,501-6,000 | Yes | 4 |
WellCare Premier H5199-001 Contact: 877-829-3045 (TTY 711) |
PPO | Her., Pasco | $0 | $0 | $150 | 0005Net: $5, $40 Out: 40% per visit, 40% per visit |
0325Net: $325 daily for 4 days Out: 40% daily for 150 days |
$3,120 | 5000Net: $5,000 In and Out of network: $10,000 |
020012,001-2,500 | Yes | Too new for rating |
* This plan’s deductible does not apply to Tiers 1, 2 or 6.
** This plan’s deductible does not apply to Tier 6.
*** This plan’s deductible does not apply to Tiers 1 or 6.