Medicare 2019

Medicare Advantage: Health plans with drug coverage

What’s in the chart

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.

What’s not in the chart

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.

Health plans: how they differ

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.

You can sort the table by clicking in the column header. Use any term in the search box below to filter your results.

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 Net: $0, $45
Out: N/A
Net: $295 daily for 6 days
Out: N/A
$3,320 Net: $4,900
Out: N/A
20,001 and above No 4.5
AARP MedicareComplete Choice
H2406-011
Contact: 800-842-6509
PPO Her., Hills., Pasco, Pin. $0 $0 $150 Net: $10, $35
Out: $45, $70
Net: $295 daily for 4 days
Out: 40% per stay
$3,120 Net: $5,500
In and Out of network: $10,000
20,001 and above No 4
AARP MedicareComplete Choice Plan 2
R7444-003
Contact: 800-842-6509
PPO Her., Hills., Pasco, Pin. $0 $0 $395 Net: $15, $50
Out: $45, $70
Net: $395 daily for 4 days
Out: 40% per stay
$3,480 Net: $6,700
In and Out of network: $10,000
20,001 and above No 4
AARP MedicareComplete Focus
H1045-045
Contact: 800-842-6509
HMO Hills., Pasco, Pin. $0 $0 $0 Net: $0, $20
Out: N/A
Net: $195 daily for 8 days
Out: N/A
$2,780 Net: $4,700
Out: N/A
5,001-1,000 Yes 4.5
Aetna Medicare Choice Plan
H1609-028
Contact: 833-859-6031
HMO-POS Hills., Pin. $0 $0 $195 Net: $0, $25
Out: $50
Net: $350 daily for 4 days
Out: 50% per stay
$2,820 Net: $6,700
In and Out of network: $10,000
7,501-8,000 Yes 4.5
Aetna Medicare Premier Plan
H5521-033
Contact: 833-859-6031
PPO Her., Hills., Pasco, Pin. $0 $0 $295 Net: $0, $50
Out: $50, $50
Net: $395 daily for 4 days
Out: 50% per stay
$3,110 Net: $6,700
In and Out of network: $10,000
9,001-10,000 Yes 4
Allwell Medicare
H9276-006
Contact: 877-826-3692
HMO Hills., Pasco, Pin. $0 $0 $0 Net: $0, $40
Out: N/A
Net: $290 daily for 7 days
Out: N/A
$2,980 Net: $6,700
Out: N/A
1,501-2,000 Yes Not available
BayCarePlus Complete
H2235-001
Contact: 877-549-1741
HMO Hills., Pasco, Pin. $0 $0 $0 Net: $0, $35
Out: N/A
Net: $195 daily for 6 days
Out: N/A
$2,900 Net: $3,900
Out: N/A
2,001-2,500 No Too new for rating
BayCarePlus Rewards
H2235-002
Contact: 877-549-1741
HMO Hills., Pasco, Pin. $0 $100 $0 Net: $0, $45
Out: N/A
Net: $250 daily for 6 days
Out: N/A
$2,080 Net: $5,900
Out: N/A
2,001-2,500 No Too new for rating
BlueMedicare Choice
R3332-001
Contact: 855-601-9465
PPO Her., Hills., Pasco, Pin. $42 $0 $250* Net: $10, $45
Out: 50% per visit,
50% per visit
Net: $295 daily for 5 days
Out: $495 daily for 27 days
$3,880 Net: $6,700
In and Out of network: $10,000
20,001 and above Yes 4
BlueMedicare Classic
H1035-021
Contact: 855-601-9465
HMO Her., Hills., Pasco $0 $0 $0 Net: $0, $40
Out: N/A
Net: $225 daily for 7 days
Out: N/A
$2,860 Net: $5,500
Out: N/A
20,001 and above Yes 5
BlueMedicare Classic Plus
H1035-023
Contact: 855-601-9465
HMO Hills. $0 $0 $0 Net: $0, $25
Out: N/A
Net: $150 daily for 7 days
Out: N/A
$2,390 Net: $3,400
Out: N/A
10,001-11,000 Yes 5
BlueMedicare Preferred
H2758-006
Contact: 855-601-9465
HMO Pin. $0 $0 $0 Net: $0, $15
Out: N/A
Net: $120 daily for 5 days
Out: N/A
$2,330 Net: $3,400
Out: N/A
1,501-2,000 Yes 4
Blue Medicare Preferred POS
H2758-008
Contact: 855-601-9465
HMO-POS Pin. $0 $0 $0 Net: $0, $25
Out: $30, $45
Net: $120 daily for 5 days
Out: Coming soon
$2,780 Net: $4,900
Out: $8,000
1,501-2,000 Yes 4.5
BlueMedicare Select
H5434-002
Contact: 855-601-9465
PPO Hills., Pin. $147.80 $0 $305** Net: $5, $45
Out: 40% per visit,
40% per visit
Net: $225 daily for 7 days
Out: $200 per day for 27 days
$4,640 Net: $5,900
In and Out of network: $10,000
20,001 and above Yes 4.5
BlueMedicare Value
H5434-023
Contact: 855-601-9465
PPO Pin. $0 $0 $250*** Net: $10, $45
Out: 50% per visit,
50% per visit
Net: $350 daily for 5 days
Out: 50% per stay
$3,420 Net: $6,700
In and Out of network: $10,000
20,001 and above Yes 4.5
CareFree
H1019-060
Contact: 800-794-4105
HMO Hills., Pasco, Pin. $0 $110 $0 Net: $0, $20
Out: N/A
Net: $150 daily for 5 days
Out: N/A
$1,160 Net: $2,500
Out: N/A
2,501-3,000 No 5
CareOne PLUS
H1019-054
Contact: 800-794-4105
HMO Hills., Pasco, Pin. $0 $0 $0 Net: $0, $10
Out: N/A
Net: $25 daily for 7 days
Out: N/A
$2,080 Net: $1,500
Out: N/A
2,501-3,000 Yes 5
Coventry Medicare Summit Plan
H1609-034
Contact: 833-859-6031
HMO Her., Hills., Pasco, Pin. $0 $0 $0 Net: $0, $25
Out: N/A
Net: $95 daily for 7 days
Out: N/A
$2,460 Net: $3,400
Out: N/A
2,501-3,000 Yes 4.5
Devoted Health Greater Tampa Bay
H1290-004
Contact: 800-338-6833
HMO Hills., Pin. $0 $0 $0 Net: $0, $20
Out: N/A
Net: $90 daily for 7 days
Out: N/A
$2,280 Net: $3,400
Out: N/A
10,001-11,000 Yes Too new for rating
Devoted Health Prime Greater Tampa Bay
H1290-009
Contact: 800-338-6833
HMO Hills., Pin. $30.30 $0 $415 Net: $0, $0
Out: N/A
Net: $0
Out: N/A
$2,210 In: $3,400
Out: N/A
10,001-11,000 No Too new for rating
Freedom Medicare Plan Rx
H5427-060
Contact: 800-401-2740
HMO Her., Hills., Pasco $0 $0 $0 Net: $0, $35
Out: N/A
Net: $150 daily for 7 days
Out: N/A
$2,920 Net: $3,400
Out: N/A
13,001-14,000 Yes 4.5
Freedom Medicare Plan Rx
H5427-059
Contact: 800-401-2740
HMO Pin. $0 $0 $0 Net: $0, $30
Out: N/A
Net: $225 daily for 7 days
Out: N/A
$2,890 Net: $3,400
Out: N/A
13,001-14,000 Yes 4.5
HumanaChoice R5826-005
R5826-005
Contact: 855-795-9488
PPO Her., Hills., Pasco, Pin. $96 $0 $100 Net: $5, $40
Out: $45, $45
Net: $195 daily for 7 days
Out: 40% per stay
$4,120 Net: $6,700
In and Out of network: $10,000
20,001 and above No 3
HumanaChoice R5826-074
R5826-074
Contact: 855-795-9488
PPO Her., Hills., Pasco, Pin. $0 $0 $395 Net: $15, $50
Out: $60, $60
Net: $395 daily for 4 days
Out: $495 daily for 27 days
$3,530 Net: $6,700
In and Out of network: $10,000
20,001 and above No 3
HumanaChoice Florida H5216-072
H5216-072
Contact: 855-795-9488
PPO Her., Hills., Pasco, Pin. $0 $0 $150 Net: $5, $35
Out: $65, $65
Net: $290 daily for 5 days
Out: $495 daily for 27 days
$3,180 Net: $4,900
In and Out of network: $10,000
20,001 and above No 4
Humana Gold Plus H1036-025
H1036-025
Contact: 855-795-9488
HMO Hills., Pasco, Pin. $0 $0 $0 Net: $0, $10
Out: N/A
Net: $50 daily for 7 days
Out: N/A
$2,090 Net: $2,500
Out: N/A
6,500-7,000 Yes 4.5
Humana Gold Plus H1036-067
H1036-067
Contact: 855-795-9488
HMO Her. $0 $0 $0 Net: $0, $10
Out: N/A
Net: $50 daily for 7 days
Out: N/A
$2,090 Net: $2,500
Out: N/A
6,500-7,000 Yes 4.5
Humana Gold Plus H1036-265
H1036-265
Contact: 855-795-9488
HMO Her., Hills., Pasco, Pin. $0 $110 $0 Net: $0, $25
Out: N/A
Net: $150 daily for 8 days
Out: N/A
$1,270 Net: $3,400
Out: N/A
6,500-7,000 No 4.5
Optimum Gold Plus Plan
H5594-032
Contact: 866-245-5360
HMO Her. $0 $104.90 $0 Net: $0, $20
Out: N/A
Net: $150 daily for 7 days
Out: N/A
$1,430 Net: $3,400
Out: N/A
11,001-12,000 Yes 4.5
Optimum Gold Rewards Plan
H5594-001
Contact: 866-245-5360
HMO Her., Hills., Pasco, Pin. $0 $100 $0 Net: $0, $40
Out: N/A
Net: $195 daily for 7 days
Out: N/A
$1,680 Net: $3,400
Out: N/A
11,001-12,000 Yes 4.5
Optimum Platinum Plan
H5594-002
Contact: 866-245-5360
HMO Her., Hills., Pasco, Pin. $0 $0 $0 Net: $0, $5
Out: N/A
Net: $0
Out: N/A
$2,440 Net: $3,400
Out: N/A
11,001-12,000 Yes 4.5
Simply More
H5471-078
Contact: 888-577-0212
HMO Her., Hills., Pasco, Pin. $0 $0 $0 Net: $0, $10
Out: N/A
Net: $50 daily for 8 days
Out: N/A
$2,050 Net: $6,700
Out: N/A
11,001-12,000 Yes 4
Simply Select
H5471-099
Contact: 888-577-0212
HMO Her., Hills., Pasco, Pin. $30.30 $0 $415 Net: $0, $5
Out: N/A
Net: $25 daily for 8 days
Out: N/A
$2,340 Net: $6,700
Out: N/A
11,001-12,000 Yes 4
Solis Health Plans
H0982-009
Contact: 813-559-0311
HMO Hills. $0 $0 $0 Net: $0-35, $0-$50
Out: N/A
Net: $175 daily for 7 days
Out: N/A
$3,370 Net: $3,400
Out: N/A
1,001-1,500 Yes Too new for rating
Ultimate Acclaim
H2962-011
Contact: 855-858-7526
HMO Pin. $0 $105 $0 Net: $0, $20
Out: N/A
Net: $90 daily for 5 days
Out: N/A
$1,240 Net: $3,400
Out: N/A
1,001-1,500 Yes 4.5
Ultimate Acclaim Plus
H2962-012
Contact: 855-858-7526
HMO Pin. $0 $0 $0 Net: $0, $0
Out: N/A
Net: $0
Out: N/A
$2,160 Net: $3,400
Out: N/A
1,001-1,500 Yes 4.5
Ultimate Elite
H2962-003
Contact: 855-858-7526
HMO Pasco $0 $105 $0 Net: $0, $20
Out: N/A
Net: $90 daily for 5 days
Out: N/A
$1,240 Net: $3,400
Out: N/A
1,001-1,500 Yes 4.5
Ultimate Premier
H2962-001
Contact: 855-858-7526
HMO Her. $0 $105 $0 Net: $0, $20
Out: N/A
Net: $90 daily for 5 days
Out: N/A
$1,240 Net: $3,400
Out: N/A
1,001-1,500 Yes 4.5
Ultimate Premier Plus
H2962-002
Contact: 855-858-7526
HMO Her., Pasco $0 $0 $0 Net: $0, $0
Out: N/A
Net: $0
Out: N/A
$2,160 Net: $3,400
Out: N/A
1,001-1,500 Yes 4.5
WellCare Dividend
H1032-032
Contact: 877-829-3045 (TTY 711)
HMO Her., Hills., Pin. $0 $90 $0 Net: $0, $25
Out: N/A
Net: $150 daily for 5 days
Out: N/A
$1,670 Net: $6,700
Out: N/A
5,001-5,500 Yes 4
WellCare Dividend
H1032-187
Contact: 877-829-3045 (TTY 711)
HMO Pasco $0 $115 $0 Net: $0, $35
Out: N/A
Net: $250 daily for 6 days
Out: N/A
$1,520 Net: $6,700
Out: N/A
13,001-14,000 Yes 4
WellCare Dividend Prime
H1032-200
Contact: 877-829-3045 (TTY 711)
HMO Her., Hills., Pasco, Pin. $0 $131 $0 Net: $0, $40
Out: N/A
Net: $200 daily for 5 days
Out: N/A
$1,380 Net: $3,400
Out: N/A
7,001-7,500 Yes 4.5
WellCare Elite
H1032-201
Contact: 877-829-3045 (TTY 711)
HMO Her., Hills., Pasco, Pin. $0 $0 $0 Net: $0, $5
Out: N/A
Net: $50 daily for 10 days
Out: N/A
$2,280 Net: $3,400
Out: N/A
7,001-7,500 Yes 4
WellCare Essential
H1032-174
Contact: 877-829-3045 (TTY 711)
HMO-POS Her., Hills., Pasco, Pin. $0 $0 $0 Net: $0, $20
Out: 45% per visit,
45% per visit
Net: $100 daily for 6 days
Out: 45% per stay
$2,640 Net: $6,700
Out: $6,700
In and Out: $6,700
5,501-6,000 Yes 4
WellCare Premier
H5199-001
Contact: 877-829-3045 (TTY 711)
PPO Her., Pasco $0 $0 $150 Net: $5, $40
Out: 40% per visit,
40% per visit
Net: $325 daily for 4 days
Out: 40% daily for 150 days
$3,120 Net: $5,000
In and Out of network: $10,000
2,001-2,500 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.