Medicare 2022
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 HMOPOS. They are explained below. Counties served: Indicates whether plans are available in Hernando (Her.), Hillsborough (Hills.), Pasco and Pinellas (Pin.) counties.
Premium: The monthly charge for the plan. If there is one, it is in addition to the standard Part B premium that most beneficiaries pay to Medicare, which was $148.50 for 2021. The 2022 Part B monthly premium was projected to remain at $148.50 as of late September.
Part B reduction: Some plans pay part of the 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 in their monthly Social Security check. The chart indicates whether a plan offers a premium reduction. Since reductions can differ based on each beneficiary’s situation, please contact the insurer to find out the amount.
Drug deductible: In some plans, a deductible is paid before drug coverage kicks in. A drug deductible may not apply to all medications or tiers.
Doctor copay: This is the cost of every visit to the 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 the cost every time a patient is admitted to a hospital — 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 estimated out-of-pocket costs under this plan, including the Part B premium and drug costs. It is based on an average person in good health, but could vary greatly depending on the actual drugs and services needed. The best way to project costs is to use Medicare’s Plan Finder.
Out-of-pocket cap: The maximum of payments 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 prescription drug costs.
Generics in the gap: Whether a plan pays for generic drugs in the coverage gap, or “donut hole,” which in 2022 starts when total drug costs paid by the plan hit $4,430. The beneficiary exits the donut hole when out-of-pocket costs (paid by the subscriber) reach $7,050.
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 health care costs that Original Medicare doesn’t cover. Shop for those plans here.
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 one has comparable coverage elsewhere, using these plans can result in stiff penalties if that person ever wants Medicare drug coverage in later years.
Medicare allows several types of private health plans, which cover all care. Here is how they differ:
HMO (Health Maintenance Organization): Generally requires the use of providers within a network. A personal physician usually coordinates care and may need to approve visits to specialists.
PPO (Preferred Provider Organization): Encourages the use of providers within a network, with low copayments, but also allows the use of providers outside the network at a higher cost. Usually allows the use of specialists within the network without prior approval of a personal physician. Some bigger companies allow the use of their PPOs in other states. Verify before signing up.
HMO-POS (HMO-Point of Service): A hybrid between an HMO and PPO. Usually requires staying within a network and may require the 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 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. The consumer should make sure they qualify before purchasing. People living in nursing homes may also qualify for special plans, as can those on Medicaid.
Medicare Advantage plan chart
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| PLAN | TYPE | COUNTIES SERVED | PREM. | PART B REDUCTION | DRUG DEDUCT. | DOCTOR COPAY (PER VISIT) | HOSPITAL COPAY | OUT-OF-POCKET CAP | GENERICS IN GAP? | RATINGS OUT OF 5 STARS |
|---|---|---|---|---|---|---|---|---|---|---|
| AARP Medicare Advantage H1045-028 Contact: 800-643-4845 |
HMO-POS | Her., Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $35 Out: N/A |
Net: $280 daily for 6 days Out: N/A |
Net: $4,900 Out: N/A |
Yes | ★★★★ |
| AARP Medicare Advantage Choice H2406-011 Contact: 800-643-4845 |
PPO | Her., Hills., Pasco, Pin. | $0.00 | No | $150 | Net: $5, $35 Out: $45, $70 |
Net: $295 daily for 5 days Out: 40% per stay |
Net: $5,500 In and Out of network: $10,000 |
Yes | ★★★★-1/2 |
| AARP Medicare Advantage Choice Plan 2 R0759-001 Contact: 800-643-4845 |
PPO | Her., Hills., Pasco, Pin. | $0.00 | No | $395 | Net: $10, $50 Out: $40, $70 |
Net: $395 daily for 4 days Out: 40% per stay |
Net: $6,700 In and Out of network: $10,000 |
No | ★★★★ |
| AARP Medicare Advantage Focus H1045-045 Contact: 800-627-7806 |
HMO-POS | Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $20 Out: N/A |
Net: $195 daily for 4 days Out: N/A |
Net: $3,400 Out: N/A |
Yes | ★★★★-1/2 |
| Aetna Medicare Choice H1609-028 Contact: 833-859-6031; TTY 711 |
HMO-POS | Hills., Pin. | $0.00 | No | $195 | Net: $0, $40 Out: Not available, $50 |
Net: $365 daily for 4 days Out: 50% per stay |
Net: $6,700 In and Out of network: $10,000 |
Yes | ★★★★-1/2 |
| Aetna Medicare Credit H1609-060 Contact: 833-859-6031; TTY 711 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | Yes | $0 | Net: $0, $25 Out: N/A |
Net: $150 daily for 7 days Out: N/A |
Net: $3,450 Out: N/A |
Yes | ★★★★-1/2 |
| Aetna Medicare Premier H5521-033 Contact: 833-859-6031; TTY 711 |
PPO | Her., Hills., Pasco, Pin. | $0.00 | No | $300 | Net: $15, $50 Out: $50, $50 |
Net: $395 daily for 4 days Out: 50% per stay |
Net: $6,700 In and Out of network: $10,000 |
Yes | ★★★★-1/2 |
| Aetna Medicare Premier Plus H5521-270 Contact: 833-859-6031; TTY 711 |
PPO | Her., Hills., Pasco, Pin. | $0.00 | No | $150 | Net: $0, $35 Out: $55, $70 |
Net: $295 daily for 4 days Out: 50% per stay |
Net: $5,500 In and Out of network: $10,000 |
Yes | ★★★★-1/2 |
| Aetna Medicare Select H1609-034 Contact: 833-859-6031; TTY 711 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $5 Out: N/A |
Net: $50 daily for 7 days Out: N/A |
Net: $2,500 Out: N/A |
Yes | ★★★★-1/2 |
| BayCare Plus Complete H2235-001 Contact: 866-947-5820; TTY 711 |
HMO | Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $15 Out: N/A |
Net: $175 daily for 5 days Out: N/A |
Net: $3,500 Out: N/A |
No | ★★★★★ |
| BayCarePlus Premier H2235-003 Contact: 866-947-5820; TTY 711 |
HMO | Hills., Pasco, Pin. | $34.00 | No | $0 | Net: $0, $10 Out: N/A |
Net: $150 daily for 5 days Out: N/A |
Net: $2,800 Out: No |
No | ★★★★★ |
| BayCarePlus Rewards H2235-002 Contact: 866-947-5820; TTY 711 |
HMO | Hills., Pasco, Pin. | $0.00 | Yes | $0 | Net: $0, $35 Out: N/A |
Net: $250 daily for 6 days Out: N/A |
Net: $4,500 Out: N/A |
No | ★★★★★ |
| BlueMedicare Choice R3332-001 Contact: 888-902-5708; TTY 800-955-8770 |
PPO | Her., Hills., Pasco, Pin. | $51.90 | No | $250 | Net: $10, $50 Out: 50% per visit |
Net: $345 daily for 5 days Out: $495 daily for 27 days |
Net: $6,500 In and Out of network: $10,000 |
Yes | ★★★★ |
| BlueMedicare Classic H1035-021 Contact: 888-902-5708; TTY 800-955-8770 |
HMO | Her., Hills., Pasco | $0.00 | No | $0 | Net: $0, $40 Out: N/A |
Net: $235 daily for 8 days Out: N/A |
Net: $4,900 Out: N/A |
Yes | ★★★★-1/2 |
| BlueMedicare Premier H1035-023 Contact: 888-902-5708; TTY 800-955-8770 |
HMO | Hills. | $0.00 | No | $0 | Net: $0, $15 Out: N/A |
Net: $125 daily for 6 days Out: N/A |
Net: $2,000 Out: N/A |
Yes | ★★★★-1/2 |
| BlueMedicare Premier H1035-034 Contact: 888-902-5708; TTY 800-955-8770 |
HMO | Her., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $10 Out: N/A |
Net: $125 daily for 6 days Out: N/A |
Net: $2,400 Out: N/A |
Yes | ★★★★-1/2 |
| BlueMedicare Saver H1035-037 Contact: 888-902-5708; TTY 800-955-8770 |
HMO | Hills., Pin. | $0.00 | Yes | $50 | Net: $0, $45 Out: N/A |
Net: $300 daily for 7 days Out: N/A |
Net: $6,700 Out: N/A |
Yes | ★★★★-1/2 |
| BlueMedicare Select H5434-002 Contact: 888-902-5708; TTY 800-955-8770 |
PPO | Hills., Pin. | $147.90 | No | $305 | Net: $5, $45 Out: $40 per visit |
Net: $225 daily for 7 days Out: $200 daily for 27 days |
Net: $5,900 In and Out of network: $10,000 |
Yes | ★★★★ |
| BlueMedicare Value H5434-023 Contact: 888-902-5708; TTY 800-955-8770 |
PPO | Pin. | $0.00 | No | $150 | Net: $0-10, $30-$43 Out: $50% per visit |
Net: $295 daily for 5 days Out: 50% per stay |
Net: $4,500 In and Out of network: $10,000 |
Yes | ★★★★ |
| BlueMedicare Value H5434-034 Contact: 888-902-5708; TTY 800-955-8770 |
PPO | Hills. | $0.00 | No | $150 | Net: $0, $35-$48 Out: 50% per visit |
Net: $275 daily for 6 days Out: 50% per stay |
Net: $4,000 Out: $10,000 |
Yes | ★★★★ |
| BlueMedicare Value H5434-035 Contact: 888-902-5708; TTY 800-955-8770 |
PPO | Her., Pasco | $0.00 | No | $150 | Net: $0-$10, $30-$43 Out: 50% per visit |
Net: $295 daily for 5 days Out: 50% per stay |
Net: $4,500 Out: $10,000 |
Yes | ★★★★ |
| Bright Advantage Health Dollars Plan H4709-001 Contact: 844-679-2028 |
HMO | Pasco | $0.00 | No | $0 | Net: $0, $0 Out: N/A |
Net: $50 daily for 5 days Out: N/A |
Net: $3,450 Out: N/A |
Yes | Too new to measure |
| Bright Advantage Health Dollars Plan H3281-001 Contact: 844-679-2028 |
PPO | Pasco | $0.00 | No | $0 | Net: $0, $15 Out: $0, $25 |
Net: $225 daily for 5 days Out: 40% days 1-90 |
Net: $4,400 In and Out of network: $10,000 |
Yes | Too new to measure |
| Bright Advantage Part B Savings Plan H4709-029 Contact: 844-679-2028 |
HMO | Pasco | $0.00 | Yes | $0 | Net: $0, $15 Out: N/A |
Net: $195 daily for 5 days Out: N/A |
Net: $2,500 Out: N/A |
Yes | Too new to measure |
| Bright Advantage Part B Savings Plan H3281-010 Contact: 844-679-2028 |
PPO | Pasco | $0.00 | Yes | $110 | Net: $0, $30 Out: $0-$40 |
In: $235 daily for 7 days Out: 40% days 1-90 |
Net: $4,400 In and Out of network: $10,000 |
Yes | Too new to measure |
| CareFree H1019-104 Contact: 800-794-4105 |
HMO | Hills., Pasco, Pin. | $0.00 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $125 daily for 4 days Out: N/A |
Net: $2,750 Out: N/A |
Yes | ★★★★★ |
| CareOne PLATINUM H1019-111 Contact: 800-794-4105 |
HMO | Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $10 Out: N/A |
Net: $40 daily for 5 days Out: N/A |
Net: $3,400 Out: N/A |
Yes | ★★★★★ |
| CareOne PLUS H1019-103 Contact: 800-794-4105 |
HMO | Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $5 Out: N/A |
Net: $20 daily for 5 days Out: N/A |
Net: $1,900 Out: N/A |
Yes | ★★★★★ |
| Cigna Preferred Medicare H5410-029 Contact: 855-980-3041 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $0 Out: N/A |
Net: $150 daily for 6 days Out: N/A |
Net: $3,650 Out: N/A |
No | ★★★★★ |
| Cigna Preferred Savings Medicare H5410-030 Contact: 855-980-3041 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | Yes | $0 | Net: $0, $15 Out: N/A |
Net: $199 daily for 7 days Out: N/A |
Net: $3,950 Out: N/A |
No | ★★★★★ |
| Cigna Primary Medicare H5410-035 Contact: 855-980-3041 |
HMO | Her., Hills., Pasco, Pin. | $22.40 | No | $480 | Net: $0, $0 Out: N/A |
Net: $25 daily for 6 days Out: N/A |
Net: $3,500 Out: N/A |
No | ★★★★★ |
| Cigna True Choice Medicare H7849-048 Contact: 855-980-3041 |
PPO | Her., Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $25 Out: $40, $55 |
Net: $240 daily for 7 days Out: 40% per stay |
Net: $5,650 In and Out of network: $11,150 |
No | ★★★-1/2 |
| Devoted Health Core Greater Tampa Bay H1290-036 Contact: 800-376-5889 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $5 Out: N/A |
Net: $25 daily for 5 days Out: N/A |
Net: $1,900 Out: N/A |
Yes | ★★★★-1/2 |
| Devoted Health Essentials Greater Tampa Bay H1290-016 Contact: 800-376-5889 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | Yes | $0 | Net: $0, $30 Out: N/A |
Net: $195 daily for 6 days Out: N/A |
Net: $3,400 Out: N/A |
No | ★★★★-1/2 |
| Devoted Health Latitude Greater Tampa Bay H9884-005 Contact: 800-376-5889 |
PPO | Her., Hills., Pasco, Pin. | $0.00 | No | $150 | Net: $0, $30 Out: $0-$60, $0-$60 |
Net: $295 daily for 5 days Out: $295 daily for 5 days |
Net: $4,900 In and Out of network: $10,000 |
Yes | Too new to measure |
| Devoted Health Prime H1290-038 Contact: 800-376-5889 |
HMO | Her., Hills., Pasco, Pin. | $34.30 | No | $480 | Net: $0, $0 Out: N/A |
Net: $0 Out: N/A |
Net: $2,900 Out: N/A |
No | ★★★★-1/2 |
| Freedom Medicare Plan Rx H5427-060 Contact: 888-300-9318 |
HMO | Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $35 Out: N/A |
Net: $150 daily for 7 days Out: N/A |
Net: $3,400 Out: N/A |
Yes | ★★★★-1/2 |
| HumanaChoice R5826-005 R5826-005 Contact: 800-833-2364 |
PPO | Her., Hills., Pasco, Pin. | $114.00 | No | $100 | Net: $5, $45 Out: $65, $65 |
Net: $250 daily for 7 days Out: 40% per stay |
Net: $6,700 In and Out of network: $10,000 |
No | ★★★-1/2 |
| HumanaChoice R5826-074 R5826-074 Contact: 800-833-2364 |
PPO | Her., Hills., Pasco, Pin. | $8.00 | No | $395 | Net: $35, $50 Out: 50%, 50% |
Net: $625 daily for 3 days Out: $725 daily for 14 days |
Net: $7,550 In and Out of network: $10,500 |
No | ★★★-1/2 |
| HumanaChoice Florida H5216-072 H5216-072 Contact: 800-833-2364 |
PPO | Her., Hills., Pasco, Pin. | $0.00 | No | $150 | Net: $5, $40 Out: $65, $65 |
Net: $290 daily for 4 days Out: $495 daily for 27 days |
Net: $5,000 In and Out of network: $10,000 |
No | ★★★★ |
| Humana Gold Plus H1036-025 H1036-025 Contact: 800-833-2364 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $5 Out: N/A |
Net: $20 daily for 5 days Out: N/A |
Net: $1,900 Out: N/A |
Yes | ★★★★-1/2 |
| Humana Gold Plus H1036-265 H1036-265 Contact: 800-833-2364 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | Yes | $0 | Net: $0, $25 Out: N/A |
Net: $150 daily for 8 days Out: N/A |
Net: $2,750 Out: N/A |
Yes | ★★★★-1/2 |
| Molina Medicare Choice Care H8130-010 Contact: 866-403-8293 |
HMO | Hills., Pasco, Pin. | $0.00 | No | $125 | Net: $0-$10 Out: N/A |
Net: $295 daily for 6 days Out: N/A |
Net: $7,550 Out: N/A |
No | ★★★-1/2 |
| Molina Medicare Choice Care Select H8130-011 Contact: 866-403-8293 |
HMO | Hills., Pasco, Pin. | $0.00 | Yes | $480 | Net: $0-$50 Out: N/A |
Net: $450 daily for 4 days Out: N/A |
Net: $7,550 Out: N/A |
No | ★★★-1/2 |
| Optimum Gold Plus Plan H5594-032 Contact: 888-300-9317 |
HMO | Her. | $0.00 | Yes | $0 | Net: $0, $15 Out: N/A |
Net: $75 daily for 5 days Out: N/A |
Net: $1,900 Out: N/A |
Yes | ★★★★-1/2 |
| Optimum Gold Rewards Plan H5594-001 Contact: 888-300-9317 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | Yes | $0 | Net: $0, $15 Out: N/A |
Net: $95 daily for 5 days Out: N/A |
Net: $1,900 Out: N/A |
Yes | ★★★★★ |
| Optimum Platinum Plan H5594-002 Contact: 888-300-9317 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $0 Out: N/A |
Net: $0 Out: N/A |
Net: $1,200 Out: N/A |
Yes | ★★★★★ |
| Premier by Ultimate H2962-001 Contact: 855-858-7526 |
HMO | Her. | $0.00 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $115 daily for 5 days Out: N/A |
Net: $2,800 Out: N/A |
Yes | ★★★★ |
| Premier by Ultimate H2962-013-3 Contact: 855-858-7526 |
HMO | Pasco | $0.00 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $125 for 5 days Out: N/A |
Net: $2,800 Out: N/A |
Yes | ★★★★ |
| Premier by Ultimate H2962-045 Contact: 855-858-7526 |
HMO | Hills., Pin | $0.00 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $120 for 5 days Out: N/A |
Net: $2,800 Out: N/A |
Yes | ★★★★ |
| Premier Plus by Ultimate H2962-014-1 Contact: 855-858-7526 |
HMO | Her., Pasco | $0.00 | No | $0 | Net: $0, $5 Out: N/A |
Net: $0 daily for 90 days Out: N/A |
Net: $1,500 Out: N/A |
Yes | ★★★★ |
| Simply Extra H5471-108 Contact: 855-679-0556 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | Yes | $0 | Net: $0, $20 Out: N/A |
Net: $175 daily for 6 days Out: N/A |
Net: $3,450 Out: N/A |
Yes | ★★★★-1/2 |
| Simply More H5471-078 Contact: 855-679-0556 |
HMO | Her., Hills., Pasco, Pin. | $0.00 | No | $0 | Net: $0, $5 Out: N/A |
Net: $50 daily for 8 days Out: N/A |
Net: $3,450 Out: N/A |
Yes | ★★★★-1/2 |
*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