Medicare 2023

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: Medicare recipients will see a reduction in their Medicare Part B premiums for 2023. The new monthly premium will be $164.90, a decrease of $5.20 per month. The lower premium is a welcome change after the jump that recipients experienced in 2022.

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: Once you and your plan have spent $4,660 on covered drugs in 2023, you're in the coverage gap. Once you reach the coverage gap, you'll pay no more than 25% of the cost for your plan's covered brand-name prescription drugs. Some plans may offer you even lower costs in the coverage gap. The discount will come off the price that your plan has set with the pharmacy for that specific drug. 

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 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.

Health plans: how they differ

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.

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
OUT-OF-POCKET CAP GENERICS
IN GAP?
RATINGS OUT
OF 5 STARS
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: $200 daily for 6 days
Out: N/A
Net: $4,000
Out: N/A
Yes ★★★-1/2
AARP Medicare Advantage Choice
H2406-011
Contact: 800-555-5757
PPO Her., Hills., Pasco, Pin. $0 No $0 Net: $0, $35
Out: $45, $70
Net: $295 daily for 5 days
Out: 40% per stay
Net: $4,900
In and Out of network: $8,950
Yes ★★★-1/2
AARP Medicare Advantage Choice Plan 2
R0759-001
Contact: 800-555-5757
PPO Her., Hills., Pasco, Pin. $0 No $195 Net: $0, $50
Out: $40, $70
Net: $395 daily for 4 days
Out: 40% per stay
Net: $6,700
In and Out of network: $10,000
Yes ★★★-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: $150 daily for 4 days
Out: N/A
Net: $2,900
Out: N/A
Yes ★★★-1/2
AARP Medicare Advantage Premier
H1045-043
Contact: 800-555-5757
HMO-POS Her. $0 No $0 Net: $0, $15
Out: N/A
Net: $100 daily for 5 days
Out: N/A
Net: $2,900
Out: N/A
Yes ★★★-1/2
Aetna Medicare Choice
H1609-028
Contact: 833-859-6031; TTY 711
HMO-POS Hills., Pin. $0 No $195 Net: $0, $35
Out: N/A, $50
Net: $365 daily for 4 days
Out: 50% per stay
Net: $6,700
In and Out of network: $10,000
Yes ★★★★
Aetna Medicare Credit
H1609-060
Contact: 833-859-6031; TTY 711
HMO Her., Hills., Pasco, Pin. $0 Yes $0 Net: $0, $30
Out: N/A
Net: $200 daily for 7 days
Out: N/A
Net: $3,450
Out: N/A
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
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 No $150 Net: $0, $30
Out: $55, $70
Net: $275 daily for 6 days
Out: 50% per stay
Net: $5,500
In and Out of network: $8,950
Yes ★★★-1/2
Aetna Medicare Select
H1609-034
Contact: 833-859-6031; TTY 711
HMO Her., Hills., Pasco, Pin. $0 No $0 Net: $0, $5
Out: N/A
Net: $50 daily for 7 days
Out: N/A
Net: $1,900
Out: N/A
Yes ★★★★
BayCare Plus Complete
H2235-001
Contact: 866-508-7148; TTY 711
HMO Hills., Pasco, Pin. $0 No $0 Net: $0, $15
Out: N/A
Net: $175 daily for 5 days
Out: N/A
Net: $3,100
Out: N/A
No ★★★★-1/2
BayCarePlus Premier
H2235-003
Contact: 866-508-7148; TTY 711
HMO Hills., Pasco, Pin. $34 No $0 Net: $0, $15
Out: N/A
Net: $150 daily for 5 days
Out: N/A
Net: $2,500
Out: No
No ★★★★-1/2
BayCarePlus Rewards
H2235-002
Contact: 866-508-7148; TTY 711
HMO Hills., Pasco, Pin. $0 Yes $0 Net: $0, $40
Out: N/A
Net: $250 daily for 6 days
Out: N/A
Net: $4,500
Out: N/A
No ★★★★-1/2
BlueMedicare Choice
R3332-001
Contact: 855-601-9465
PPO Her., Hills., Pasco, Pin. $49.90 No $250 Net: $10, $50
Out: 45%, 45%
Net: $345 daily for 5 days
Out: $495 daily for 27 days
Net: $6,500
In and Out of network: $12,450
Yes ★★★
BlueMedicare Classic
H1035-021
Contact: 855-601-9465
HMO Her., Hills., Pasco $0 No $0 Net: $0, $40
Out: N/A
Net: $210 daily for 8 days
Out: N/A
Net: $4,900
Out: N/A
Yes ★★★-1/2
BlueMedicare Premier
H1035-023
Contact: 855-601-9465
HMO Hills. $0 No $0 Net: $0, $10
Out: N/A
Net: $85 daily for 6 days
Out: N/A
Net: $1,900
Out: N/A
Yes ★★★-1/2
BlueMedicare Premier
H1035-034
Contact: 855-601-9465
HMO Her., Pasco, Pin. $0 No $0 Net: $0, $10
Out: N/A
Net: $85 daily for 6 days
Out: N/A
Net: $2,400
Out: N/A
Yes ★★★-1/2
BlueMedicare Saver
H1035-037
Contact: 855-601-9465
HMO Hills., Pin. $0 Yes $50 Net: $0, $45
Out: N/A
Net: $260 daily for 7 days
Out: N/A
Net: $6,700
Out: N/A
Yes ★★★-1/2
BlueMedicare Select
H5434-002
Contact: 855-601-9465
PPO Hills., Pin. $108.70 No $305 Net: $5, $45
Out: 40%, 40%
Net: $225 daily for 7 days
Out: $200 daily for 27 days
Net: $5,900
In and Out of network: $8,950
Yes ★★★-1/2
BlueMedicare Value
H5434-023
Contact: 855-601-9465
PPO Pin. $0 No $150 Net: $0, $30-$39
Out: 47%, 47%
Net: $295 daily for 5 days
Out: 47% per stay
Net: $4,500
In and Out of network: $8,950
Yes ★★★-1/2
BlueMedicare Value
H5434-034
Contact: 855-601-9465
PPO Hills. $0 No $150 Net: $0, $35-$45
Out: 47%, 47%
Net: $275 daily for 6 days
Out: 47% per stay
Net: $4,000
Out: $8,950
Yes ★★★-1/2
BlueMedicare Value
H5434-035
Contact: 855-601-9465
PPO Her., Pasco $0 No $150 Net: $0, $30-$40
Out: 47%, 47%
Net: $295 daily for 5 days
Out: 47% per stay
Net: $4,500
In and Out of network: $8,950
Yes ★★★-1/2
Bright Advantage Health Dollars Plan
H4709-011
Contact: 844-679-2028
HMO Pasco $0 No $0 Net: $0, $0
Out: N/A
Net: $0
Out: N/A
Net: $1,199
Out: N/A
Yes Too new to measure
Bright Advantage Part B Savings Plan
H4709-029
Contact: 844-679-2028
HMO Pasco $0 Yes $0 Net: $0, $0
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 Yes $110 Net: $0, $20
Out: $30-$60
In: $235 daily for 7 days
Out: 40% days 1-90
Net: $4,900
In and Out of network: $8,950
Yes Too new to measure
CareFree
H1019-104-002
Contact: 855-450-1352; TTY 711
HMO Hills., Pasco, Pin. $0 Yes $0 Net: $0, $20
Out: N/A
Net: $125 daily for 4 days
Out: N/A
Net: $2,500
Out: N/A
Yes ★★★★
CareOne Platinum
H1019-111
Contact: 855-450-1352; TTY 711
HMO Hills., Pasco, Pin. $0 No $0 Net: $0, $10
Out: N/A
Net: $40 daily for 5 days
Out: N/A
Net: $3,000
Out: N/A
Yes ★★★★
CareOne Plus
H1019-103-002
Contact: 855-450-1352; TTY 711
HMO Her., Hills., Pasco, Pin. $0 No $0 Net: $0, $5
Out: N/A
Net: $20 daily for 5 days
Out: N/A
Net: $1,700
Out: N/A
Yes ★★★★★
Cigna Preferred Medicare
H5410-029
Contact: 800-313-0973
HMO Her., Hills., Pasco, Pin. $0 No $0 Net: $0, $0
Out: N/A
Net: $85 daily for 6 days
Out: N/A
Net: $2,200
Out: N/A
No ★★★★-1/2
Cigna Preferred Savings Medicare
H5410-030
Contact: 800-313-0973
HMO Her., Hills., Pasco, Pin. $0 Yes $0 Net: $0, $15
Out: N/A
Net: $190 daily for 7 days
Out: N/A
Net: $2,700
Out: N/A
No ★★★★-1/2
Cigna Primary Medicare
H5410-035
Contact: 800-313-0973
HMO Her., Hills., Pasco, Pin. $18.60 No $505 Net: $0, $0
Out: N/A
Net: $25 daily for 6 days
Out: N/A
Net: $3,500
Out: N/A
No ★★★★-1/2
Cigna True Choice Medicare
H7849-048
Contact: 800-313-0973
PPO Her., Hills., Pasco, Pin. $0 No $0 Net: $0, $25
Out: $40, $55
Net: $230 daily for 7 days
Out: 40% per stay
Net: $5,200
In and Out of network: $8,950
No ★★★
Devoted CHOICE GIVEBACK Tampa
H9884-005
Contact: 800-376-5889
PPO Her., Hills., Pasco, Pin. $0 Yes $150* Net: $0, $30
Out: $45, $60
Net: $295 daily for 5 days
Out: $295 daily for 5 days
Net: $5,500
In and Out of network: $8,950
Yes Too new to measure
Devoted Core Tampa
H1290-036-001
Contact: 800-376-5889
HMO Her., Hills., Pasco $0 No $0 Net: $0, $5
Out: N/A
Net: $50 daily for 5 days
Out: N/A
Net: $1,900
Out: N/A
Yes ★★★★-1/2
Devoted Core Tampa
H1290-036-002
Contact: 800-376-5889
HMO Pin. $0 No $0 Net: $0, $10
Out: N/A
Net: $50 daily for 7 days
Out: N/A
Net: $2,900
Out: N/A
★★★★-1/2
Devoted ESSENTIALS Tampa
H1290-051
Contact: 800-376-5889
HMO Her., Hills., Pasco $0 Yes $0 Net: $0, $15
Out: N/A
Net: $195 daily for 6 days
Out: N/A
Net: $3,400
Out: N/A
Yes ★★★★-1/2
Devoted ESSENTIALS Tampa
H1290-151
Contact: 800-376-5889
HMO Pin. $0 Yes $0 Net: $0, $35
Out: N/A
Net: $250 daily for 6 days
Out: N/A
Net: $3,400
Out: N/A
Yes ★★★★-1/2
Devoted PRIME
H1290-037
Contact: 800-376-5889
HMO Her., Hills., Pasco, Pin. $32 No $505* Net: $0, $0
Out: N/A
Net: $0
Out: N/A
Net: $2,900
Out: N/A
Yes ★★★★-1/2
Freedom Medicare Plan Rx
H5427-060
Contact: 888-300-9318
HMO Hills., Pasco $0 No $0 Net: $0, $35
Out: N/A
Net: $150 daily for 7 days
Out: N/A
Net: $2,750
Out: N/A
Yes ★★★★-1/2
Freedom Medicare Plan Rx
H5427-059
Contact: 888-300-9318
HMO Pin. $0 No $0 Net: $0, $30
Out: N/A
Net: $225 daily for 7 days
Out: N/A
Net: $3,000
Out: N/A
Yes ★★★★-1/2
HumanaChoice R5826-005
R5826-005
Contact: 800-833-2364
PPO Her., Hills., Pasco, Pin. $111 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 ★★★
HumanaChoice R5826-074
R5826-074
Contact: 800-833-2364
PPO Her., Hills., Pasco, Pin. $4 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 ★★★
HumanaChoice Florida H5216-072
H5216-072
Contact: 800-833-2364
PPO Her., Hills., Pasco, Pin. $0 No $150* Net: $5, $40
Out: $65, $65
Net: $290 daily for 4 days
Out: $495 daily for 27 days
Net: $4,900
In and Out of network: $8,900
Yes ★★★★-1/2
HumanaChoice Florida H5216-304
H5216-304
Contact: 800-833-2364
PPO Her., Hills., Pasco, Pin. $0 No $0 Net: $0, $30
Out: $55, $65
Net: $275 daily for 4 days
Out: $495 daily for 27 days
Net: $4,700
In and Out of network: $8,900
Yes ★★★★-1/2
Humana Gold Plus H1036-025
H1036-025
Contact: 800-833-2364
HMO Her., Hills., Pasco, Pin. $0 No $0 Net: $0, $5
Out: N/A
Net: $20 daily for 5 days
Out: N/A
Net: $1,800
Out: N/A
Yes ★★★★-1/2
Humana Gold Plus H1036-265-001
H1036-265
Contact: 800-833-2364
HMO Her., Hills., Pasco, Pin. $0 Yes $0 Net: $0, $10
Out: N/A
Net: $125 daily for 4 days
Out: N/A
Net: $2,400
Out: N/A
Yes ★★★★-1/2
Molina Medicare Choice Care
H8130-010
Contact: 866-403-8293
HMO Hills., Pasco, Pin. $0 No $125 Net: $0-$10
Out: N/A
Net: $295 daily for 6 days
Out: N/A
Net: $8,300
Out: N/A
No ★★-1/2
Molina Medicare Choice Care Select
H8130-011
Contact: 866-403-8293
HMO Hills., Pasco, Pin. $0 Yes $450 Net: $0-$50
Out: N/A
Net: $450 daily for 4 days
Out: N/A
Net: $8,300
Out: N/A
No ★★-1/2
Optimum Gold Plus Plan
H5594-032
Contact: 888-300-9317
HMO Her. $0 Yes $0 Net: $0, $15
Out: N/A
Net: $75 daily for 5 days
Out: N/A
Net: $1,900
Out: N/A
Yes ★★★★★
Optimum Gold Rewards Plan
H5594-001
Contact: 888-300-9317
HMO Her., Hills., Pasco, Pin. $0 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 No $0 Net: $0, $0
Out: N/A
Net: $0
Out: N/A
Net: $1,000
Out: N/A
Yes ★★★★★
Premier by Ultimate
H2962-001
Contact: 855-858-7526
HMO Her. $0 Yes $0 Net: $0, $10
Out: N/A
Net: $60daily for 5 days
Out: N/A
Net: $1,900
Out: N/A
Yes ★★★-1/2
Premier by Ultimate
H2962-013
Contact: 855-858-7526
HMO Pasco $0 Yes $0 Net: $0, $10
Out: N/A
Net: $95 for 5 days
Out: N/A
Net: $1,900
Out: N/A
Yes ★★★-1/2
Premier by Ultimate
H2962-045
Contact: 855-858-7526
HMO Hills., Pin $0 Yes $0 Net: $0, $15
Out: N/A
Net: $90 for 5 days
Out: N/A
Net: $2,800
Out: N/A
Yes ★★★-1/2
Premier Plus by Ultimate
H2962-032
Contact: 855-858-7526
HMO Her., Pasco $0 No $0 Net: $0, $0
Out: N/A
Net: $0
Out: N/A
Net: $1,200
Out: N/A
Yes ★★★-1/2
Simply Extra
H5471-108
Contact: 855-679-0556
HMO Her., Hills., Pasco, Pin. $0 Yes $0 Net: $0, $30
Out: N/A
Net: $175 daily for 6 days
Out: N/A
Net: $3,450
Out: N/A
Yes ★★★★-1/2
Simply Freedom
H9469-008
Contact: 855-679-0556
PPO Her., Hills., Pasco, Pin. $0 No $150 Net: $0, $30
Out: $40, $70
Net: $250 daily for 5 days
Out: 40% per stay
Net: $5,000
In and Out of network: $8,950
Yes Too new to measure
Simply Freedom Extra
H9469-005
Contact: 855-679-0556
PPO Her., Hills., Pasco, Pin. $0 Yes $150 Net: $0, $40
Out: $50, $75
Net: $350 daily for 5 days
Out: 40% per stay
Net: $6,100
In and Out of network: $11,000
No Too new to measure
Simply More
H5471-078
Contact: 855-679-0556
HMO Her., Hills., Pasco, Pin. $0 No $0 Net: $0, $0
Out: N/A
Net: $50 daily for 8 days
Out: N/A
Net: $3,450
Out: N/A
Yes ★★★★-1/2
SOLIS SPF 009
H0982-009
Contact: 844-447-6547
HMO Hills. $0 No $0 Net: $0, $5
Out: N/A
Net: $60 daily for 7 days
Out: N/A
Net: $3,400
Out: N/A
Yes ★★★-1/2
WellCare Giveback
H1032-200
Contact: 844-917-0175
HMO Her., Hills., Pasco, Pin. $0 Yes $0 Net: $0, $20
Out: N/A
Net: $100 daily for 5 days
Out: N/A
Net: $2,500
Out: N/A
Yes ★★★
WellCare No Premium
H1032-201
Contact: 844-917-0175
HMO Her., Hills., Pasco, Pin. $0 No $0 Net: $0, $0
Out: N/A
Net: $50 daily for 10 days
Out: N/A
Net: $1,200
Out: N/A
Yes ★★★
WellCare No Premium Open
H5199-012
Contact: 844-917-0175
PPO Her., Hills., Pasco, Pin. $0 No $100 Net: $0, $25
Out: 40%, 40%
Net: $275 daily for 6 days
Out: 40% days 1-90
Net: $3,400
In and Out of network: $5,100
Yes ★★
WellCare Premium Enhanced Open
H5199-010
Contact: 844-917-0175
PPO Her., Hills., Pasco, Pin. $99 No $0 Net: $0, $15
Out: 40%, 40%
Net: $225daily for 6 days
Out: 40% per stay
Net: $3,500
In and Out of network: $5,000
Yes ★★

*Drug deductible applies only to tiers 3 through 5.

Compiled by Times correspondent Donna Winchester

Source: Centers for Medicare & Medicaid Services


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