Medicare 2021
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 the standard Part B premium most beneficiaries pay to Medicare, which is projected to be $148.50 for 2021.
Part B reduction: Some plans pay part of your monthly Part B premium. This “premium reduction,” also called a rebate or a “premium give back,” is considered an additional benefit offered by a plan. It’s usually returned to consumers as part of their monthly Social Security check. The chart indicates whether or not a plan offers a premium reduction. Since reductions can differ based on each beneficiary’s situation, you will need to contact the insurer for the amount.
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.
Generics in the gap: Whether a plan pays for generic drugs in the coverage gap, or “donut hole,” which in 2021 will begin when total drug costs hit $4,130. You will exit the donut hole when your out-of-pocket costs reach $6,550.
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.
Medicare Advantage plan chart
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 REDUCTION | DRUG DEDUCT. | DOCTOR COPAY (PER VISIT) | HOSPITAL COPAY | YEARLY COST (EST.) | OUT-OF-POCKET CAP | GENERICS IN GAP? | RATINGS OUT OF 5 STARS |
|---|---|---|---|---|---|---|---|---|---|---|---|
| AARP Medicare Advantage Choice Plan 2 R0759-001 Contact: 800-555-5757 |
PPO | Her., Hills., Pasco, Pin. | $0 | No | $395 | Net: $10, $50 Out: $40, $70 |
Net: $395 daily for 4 days Out: 40% per stay |
$3,631 | Net: $6,700 In and Out of network: $10,000 |
No | ★★★-1/2 |
| AARP Medicare Advantage Choice H2406-011 Contact: 800-555-5757 |
PPO | Her., Hills., Pasco, Pin. | $0 | No | $150 | Net: $5, $35 Out: $45, $70 |
Net: $295 daily for 5 days Out: 40% per stay |
$3,199 | Net: $5,500 In and Out of network: $10,000 |
No | ★★★-1/2 |
| AARP Medicare Advantage Focus H1045-045 Contact: 800-555-5757 |
HMO-POS | Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $20 Out: N/A |
Net: $195 daily for 5 days Out: N/A |
$2,947 | Net: $3,400 Out: N/A |
Yes | ★★★-1/2 |
| AARP Medicare Advantage H1045-028 Contact: 800-555-5757 |
HMO-POS | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $35 Out: N/A |
Net: $280 daily for 6 days Out: N/A |
$3,127 | Net: $4,900 Out: N/A |
No | ★★★-1/2 |
| Aetna Medicare Choice H1609-028 Contact: 833-859-6031; TTY 711 |
HMO-POS | Hills., Pin. | $0 | No | $195 | Net: $0, $40 Out: Not available, $50 |
Net: $350 daily for 4 days Out: 50% per stay |
$3,211 | Net: $6,700 In and Out of network: $10,000 |
Yes | ★★★★ |
| Aetna Medicare Premier Plus H5521-270 Contact: 833-859-6031; TTY 711 |
PPO | Her., Hills., Pasco, Pin. | $0 | No | $150 | Net: $0, $35 Out: $55, $70 |
Net: $295 daily for 4 days Out: 50% per stay |
$3,175 | Net: $5,500 In and Out of network: $10,000 |
Yes | ★★★★ |
| Aetna Medicare Premier H5521-033 Contact: 833-859-6031; TTY 711 |
PPO | Her., Hills., Pasco, Pin. | $0 | No | $300 | Net: $15, $50 Out: $50, $50 |
Net: $395 daily for 4 days Out: 50% per stay |
$3,439 | Net: $6,700 In and Out of network: $10,000 |
Yes | ★★★★ |
| Aetna Medicare Select H1609-034 Contact: 833-859-6031; TTY 711 |
HMO | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $20 Out: N/A |
Net: $75 daily for 7 days Out: N/A |
$2,707 | Net: $3,200 Out: N/A |
Yes | ★★★★ |
| BayCare Plus Complete H2235-001 Contact: 877-549-1741; TTY 711 |
HMO | Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $15 Out: N/A |
Net: $175 daily for 5 days Out: N/A |
$2,827 | Net: $3,500 Out: N/A |
No | Too new to measure |
| BayCarePlus Premier H2235-003 Contact: 877-549-1741; TTY 711 |
HMO | Pin. | $33 | No | $0 | Net: $0, $10 Out: N/A |
Net: $150 daily for 5 days Out: N/A |
$3,103 | Net: $2,800 Out: No |
No | Too new to measure |
| BayCarePlus Rewards H2235-H2235-002 Contact: 877-549-1741; TTY 711 |
HMO | Hills., Pasco, Pin. | $0 | Yes | $0 | Net: $0, $35 Out: N/A |
Net: $250 daily for 6 days Out: N/A |
$1,771 | Net: $4,500 Out: N/A |
No | Too new to measure |
| BayCarePlus Signature H2235-004 Contact: 877-549-1741; TTY 711 |
HMO | Hills., Pasco | $28 | No | $0 | Net: $0, $10 Out: N/A |
Net: $150 daily for 5 days Out: N/A |
$3,043 | Net: $2,800 Out: N/A |
No | Too new to measure |
| BlueMedicare Choice R3332-001 Contact: 844-396-2763; TTY 800-955-8770 |
PPO | Her., Hills., Pasco, Pin. | $47.90 | No | $250 | Net: $10, $50 Out: 50%, 50% |
Net: $345 daily for 5 days Out: $495 daily for 27 days |
$4,230 | Net: $6,500 In and Out of network: $10,000 |
Yes | ★★★-1/2 |
| BlueMedicare Classic H1035-021 Contact: 844-396-2763; TTY 800-955-8770 |
HMO | Her., Hills., Pin. | $0 | No | $0 | Net: $0, $40 Out: N/A |
Net: $225 daily for 7 days Out: N/A |
$3,079 | Net: $4,900 Out: N/A |
Yes | ★★★★-1/2 |
| BlueMedicare Premier H1035-034 Contact: 844-396-2763; TTY 800-955-8770 |
HMO | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $20 Out: N/A |
Net: $125 daily for 8 days Out: N/A |
$2,635 | Net: $3,400 Out: N/A |
Yes | ★★★★-1/2 |
| BlueMedicare Saver H1035-037 Contact: 844-396-2763; TTY 800-955-8770 |
HMO | Hills, Pin. | $0 | Yes | $50 | Net: $0, $45 Out: N/A |
Net: $275 daily for 7 days Out: N/A |
$2,563 | Net: $6,700 Out: N/A |
Yes | ★★★★-1/2 |
| BlueMedicare Select H5434-002 Contact: 844-396-2763; TTY 800-955-8770 |
PPO | Hills, Pin. | $146.80 | No | $305 | Net: $5, $45 Out: 40%, 40% |
Net: $225 daily for 7 days Out: $200 daily for 27 days |
$4,973 | Net: $5,900 In and Out of network: $10,000 |
Yes | ★★★-1/2 |
| BlueMedicare Value H5434-035 Contact: 844-396-2763; TTY 800-955-8770 |
PPO | Her., Hills., Pasco, Pin. | $0 | No | $150 | Net: $10, $45 Out: 50%, 50% |
Net: $325 daily for 6 days Out: $50% per stay |
$3,331 | Net: $4,500 In and Out of network: $10,000 |
Yes | ★★★-1/2 |
| Bright Advantage Choice H3281-003 Contact: 877-930-3323; TTY 711 |
PPO | Pasco | $0 | No | $0 | Net: $0, $20 Out: $0, $20 |
Net: $250 daily for 5 days Out: 40% daily for 90 days |
$3,055 | Net: $5,400 In and Out of network: $10,000 |
Yes | Too new to measure |
| Bright Advantage Health Dollars H4709-003 Contact: 877-930-3323; TTY 711 |
HMO | Pasco | $0 | No | $0 | Net: $0, $0 Out: N/A |
Net: $190 daily for 7 days Out: N/A |
$2,383 | Net: $3,400 Out: N/A |
Yes | Too new to measure |
| Bright Advantage Part B Savings H3281-010 Contact: 877-930-3323; TTY 711 |
PPO | Pasco | $0 | Yes | $400 | Net: $0, $40 Out: $0, $40 |
Net: $295 daily for 6 days Out: 30% daily for 90 days |
$2,311 | Net: $6,700 In and Out of network: $10,000 |
Yes | Too new to measure |
| CareFree H1019-104-2 Contact: 800-794-4105 |
HMO | Hills., Pasco, Pin. | $0 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $125 daily for 4 days Out: N/A |
$1,243 | Net: $2,750 Out: N/A |
No | ★★★★★ |
| CareOne PLATINUM H1019-111 Contact: 800-794-4105 |
HMO | Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $10 Out: N/A |
Net: $50 daily for 5 days Out: N/A |
$2,479 | Net: $3,400 Out: N/A |
Yes | ★★★★★ |
| CareOne PLUS H1019-103-2 Contact: 800-794-4105 |
HMO | Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $5 Out: N/A |
Net: $20 daily for 5 days Out: N/A |
$2,431 | Net: $1,900 Out: N/A |
Yes | ★★★★★ |
| Cigna Preferred Medicare H5410-029 Contact: 855-980-3046 |
HMO | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $0 Out: N/A |
Net: $150 daily for 6 days Out: N/A |
$2,707 | Net: $3,650 Out: N/A |
No | ★★★★★ |
| Cigna Preferred Savings Medicare H5410-030 Contact: 855-980-3046 |
HMO | Her., Hills., Pasco, Pin. | $0 | Yes | $0 | Net: $0, $15 Out: N/A |
Net: $175 daily for 6 days Out: N/A |
$1,651 | Net: $3,950 Out: N/A |
No | ★★★★★ |
| Cigna Primary Medicare H5410-035 Contact: 855-980-3046 |
HMO | Her., Hills., Pasco, Pin. | $18 | No | $445 | Net: $0, $0 Out: N/A |
Net: $500 per stay Out: N/A |
$2,898 | Net: $3,500 Out: N/A |
No | ★★★★★ |
| Devoted Health Core Greater Tampa Bay H1290-004 Contact: 800-376-5889 |
HMO | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $10 Out: N/A |
Net: $90 daily for 7 days Out: N/A |
$2,599 | Net: $2,900 Out: N/A |
Yes | Too new to measure |
| Devoted Health Essentials Greater Tampa Bay H1290-016 Contact: 800-376-5889 |
HMO | Her., Hills., Pasco, Pin. | $0 | Yes | $0 | Net: $0, $30 Out: N/A |
Net: $195 daily for 6 days Out: N/A |
$1,639 | Net: $3,400 Out: N/A |
No | Too new to measure |
| Devoted Health Prime Greater Tampa Bay H1290-009 Contact: 800-376-5889 |
HMO | Her., Hills., Pasco, Pin. | $31 | No | $445 | Net: $0, $0 Out: N/A |
Net: $0 Out: N/A |
$2,873 | Net: $3,400 Out: N/A |
No | Too new to measure |
| Freedom Medicare Plan Rx H5427-060 Contact: 800-401-2740 |
HMO | Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $35 Out: N/A |
Net: $150 daily for 7 days Out: N/A |
$3,271 | Net: $3,400 Out: N/A |
Yes | ★★★★ |
| Humana Gold Plus H1036-025 H1036-025 Contact: 855-795-9488 |
HMO | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $5 Out: N/A |
Net: $25 daily for 5 days Out: N/A |
$2,347 | Net: $1,900 Out: N/A |
Yes | ★★★★-1/2 |
| Humana Gold Plus H1036-265 H1036-265 Contact: 855-795-9488 |
HMO | Her., Hills., Pasco, Pin. | $0 | Yes | $0 | Net: $0, $25 Out: N/A |
Net: $150 daily for 8 days Out: N/A |
$1,315 | Net: $2,750 Out: N/A |
No | ★★★★-1/2 |
| HumanaChoice Florida H5216-072 H5216-072 Contact: 855-795-9488 |
PPO | Her., Hills., Pasco, Pin. | $0 | No | $150 | Net: $5, $40 Out: $65, $65 |
Net: $343 daily for 4 days Out: $495 daily for 27 days |
$3,463 | Net: $4,900 In and Out of network: $10,000 |
No | ★★★★ |
| HumanaChoice R5826-005 R5826-005 Contact: 855-795-9488 |
PPO | Her., Hills., Pasco, Pin. | $105.00 | No | $100 | Net: $5, $45 Out: $65, $65 |
Net: $250 daily for 7 days Out: 40% per stay |
$4,687 | Net: $6,700 In and Out of network: $10,000 |
No | ★★★-1/2 |
| HumanaChoice R5826-074 R5826-074 Contact: 855-795-9488 |
PPO | Her., Hills., Pasco, Pin. | $0 | No | $395 | Net: $35, $50 Out: 50%, 50% |
Net: $625 daily for 3 days Out: $725 daily for 14 days |
$4,015 | Net: $7,550 In and Out of network: $10,500 |
No | ★★★-1/2 |
| Optimum Gold Plus Plan H5594-032 Contact: 866-245-5360 |
HMO | Her. | $0 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $125 daily for 7 days Out: N/A |
$1,399 | Net: $1,900 Out: N/A |
Yes | ★★★★-1/2 |
| Optimum Gold Rewards Plan H5594-001 Contact: 866-245-5360 |
HMO | Her., Hills., Pasco, Pin. | $0 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $150 daily for 7 days Out: N/A |
$1,495 | Net: $1,900 Out: N/A |
Yes | ★★★★-1/2 |
| Optimum Platinum Plan H5594-002 Contact: 866-245-5360 |
HMO | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $5 Out: N/A |
Net: $0 Out: N/A |
$2,731 | Net: $1,500 Out: N/A |
Yes | ★★★★-1/2 |
| Premier by Ultimate H2962-001 Contact: 855-858-7526 |
HMO | Her., Hills., Pasco, Pin. | $0 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $125 daily for 5 days Out: N/A |
$1,255 | Net: $2,800 Out: N/A |
Yes | ★★★★ |
| Premier Plus by Ultimate H2962-014 Contact: 855-858-7526 |
HMO | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $0 Out: N/A |
Net: $0 Out: N/A |
$2,431 | Net: $1,500 Out: N/A |
Yes | ★★★★ |
| Simply More H5471-078 Contact: 888-870-7138 |
HMO | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $10 Out: N/A |
Net: $50 daily for 8 days Out: N/A |
$2,287 | Net: $3,450 Out: N/A |
Yes | ★★★★ |
| Simply Select H5471-099 Contact: 888-870-7138 |
HMO | Her., Hills., Pasco, Pin. | $30.80 | No | $445 | Net: $0, $5 Out: N/A |
Net: $25 daily for 8 days Out: N/A |
$2,669 | Net: $3,450 Out: N/A |
Yes | ★★★★ |
| SOLIS SPF 009 H0982-009 Contact: 844-447-6547 |
HMO | Hills. | $0 | No | $0 | Net: $0, $5 Out: N/A |
Net: $80 daily for 7 days Out: N/A |
$2,779 | Net: $3,400 Out: N/A |
Yes | Too new to measure |
| WellCare Dividend Prime H1032-200 Contact: 866-527-0056 |
HMO | Her., Hills., Pasco, Pin. | $0 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $100 daily for 5 days Out: N/A |
$1,416 | Net: $2,500 Out: N/A |
Yes | ★★★★ |
| WellCare Elite H1032-201 Contact: 866-527-0056 |
HMO | Her., Hills., Pasco, Pin. | $0 | No | $0 | Net: $0, $5 Out: N/A |
Net: $50 daily for 10 days Out: N/A |
$2,599 | Net: $1,200 Out: N/A |
Yes | ★★★★ |
| WellCare Premier H5199-012 Contact: 866-527-0056 |
PPO | Her., Hills., Pasco, Pin. | $0 | No | $100 | Net: $0, $25 Out: $0, $0-$275 |
Net: $225 daily for 6 days Out: $225 daily for 6 days |
$3,223 | Net: $3,400 In and Out of network: $5,100 |
Yes | Too new to measure |
| WellCare Prime H5199-010 Contact: 866-527-0056 |
PPO | Her., Hills., Pasco, Pin. | $75 | No | $0 | Net: $0, $15 Out: $0, $15 |
Net: $100 daily for 6 days Out: $100 daily for 6 days |
$3,715 | Net: $1,700 In and Out of network: $5,000 |
Yes | Too new to measure |
*Drug deductible applies only to tiers 1 and 2 from a preferred cost-sharing retail pharmacy.
Compiled by Times correspondent Donna Winchester
Source: Centers for Medicare & Medicaid Services