Taunton, Massachusetts Medicare Companies and Plans (2022)

Taunton, Massachusetts Medicare plans include Advantage plans from private health insurance companies as well as standalone Part D prescription drug coverage. For those that prefer original Medicare, Taunton, MA supplemental plans are also available. Medicare plans in Taunton, Massachusetts are sold by both large national companies and local insurers.

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The Highlights

  • Options for Medicare supplement in Taunton, Massachusetts include Medigap Core Plan and Medigap Supplement 1 Plan
  • You can buy Medicare supplement coverage in Taunton, Massachusetts if you have original Medicare and want coverage for out-of-pocket costs
  • Taunton, MA Medicare options include Advantage, standalone Part D, and Medicare supplement

If you’re eligible for Medicare in Taunton, Massachusetts, you have a lot of choices. Major health insurance companies provide Taunton, Massachusetts Medicare Advantage plans with a variety of coverage options to choose from. You can choose a plan that includes Taunton, MA Part D coverage or buy prescription coverage as a standalone policy.

Taunton, Massachusetts Medicare supplement plans are available from a number of companies if you choose to stick with original Medicare. These plans can pay for the out-of-pocket costs that Taunton original Medicare plans don’t cover, like coinsurance and deductibles.

Ready to buy Taunton, Massachusetts Medicare coverage? Enter your ZIP code to compare Taunton, MA Medicare options available to you right now.

Medicare Advantage Companies in Taunton, Massachusetts

Medicare Advantage in Taunton, Massachusetts is offered by some of the same local health insurance companies you may have been covered by before. Take a look at which companies in Taunton, MA offer Medicare Advantage as well as which plans they offer to find the coverage and provider network that’s best for you.

Medicare Advantage Companies in Taunton, Massachusetts

Plan Name Monthly Prem. (Parts C & D) Deductible Additional Gap Coverage Preferred Pharmacy Copay/ Coinsurance 30-Day Supply MOOP for Part A & B Benefits
AARP Medicare Advantage Choice (Regional PPO) – R7444-001-0 $49.00 $295 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% $6,700
AARP Medicare Advantage Patriot (PPO) – H3442-005-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $6,700
AARP Medicare Advantage Plan 1 (HMO) – H1944-005-0 $0.00 $250 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $5,700
AARP Medicare Advantage Plan 2 (HMO) – H1944-006-0 $49.00 $225 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $3.00, Generic: $12.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% $4,900
AARP Medicare Advantage Walgreens (PPO) – H3442-004-0 $0.00 $195 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29% $6,700
Aetna Medicare Eagle Plan (PPO) – H5521-296-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $6,700
Aetna Medicare Explorer Plan (PPO) – H5521-159-0 $0.00 $150 . Tier 1, 2 and 3 exempt Yes, some additional gap coverage. Preferred Generic: $5.00, Generic: $7.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 30% $6,700
Aetna Medicare Explorer Premier Plan (PPO) – H5521-221-0 $99.00 $0 Yes, some additional gap coverage. Preferred Generic: $2.00, Generic: $5.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 33% $6,700
Aetna Medicare Value Plan (HMO) – H5793-018-0 $0.00 $250 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $3.00, Generic: $7.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $6,700
BMC HealthNet Plan Senior Care Options (HMO D-SNP) – H9585-001-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00 n/a
Commonwealth Care Alliance (Medicare-Medicaid Plan) – H0137-001-0 $0.00 $0 All Generics, All Brands Tier 1: 0%, Tier 2: 0%, Tier 3: 0%, Tier 4: 0%, Tier 5: 0% n/a
Fallon Medicare Plus Blue HMO (HMO) – H9001-031-17 $180.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $37.00, Non-Preferred Brand: $86.00, Specialty Tier: 33%, Select Care Drugs: $0.00 $3,400
Fallon Medicare Plus Green HMO (HMO) – H9001-030-17 $89.00 $300 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $37.00, Non-Preferred Brand: $86.00, Specialty Tier: 27%, Select Care Drugs: $0.00 $6,700
Fallon Medicare Plus Orange HMO (HMO) – H9001-034-17 $0.00 $300 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $7.00, Preferred Brand: $37.00, Non-Preferred Brand: $86.00, Specialty Tier: 27%, Select Care Drugs: $0.00 $7,550
Fallon Medicare Plus Saver No Rx HMO (HMO) – H9001-029-17 $49.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $7,550
Fallon Medicare Plus Super Saver HMO (HMO) – H9001-032-17 $51.00 $445 . Tier Yes exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $9.00, Preferred Brand: $42.00, Non-Preferred Brand: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 $7,550
Harvard Pilgrim Stride Basic Rx (HMO) – H1660-014-0 $0.00 $445 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $15.00, Preferred Brand: $47.00, Non-Preferred Brand: $100.00, Specialty Tier: 25% $4,500
Harvard Pilgrim Stride Value Rx (HMO) – H1660-016-2 $67.00 $350 . Tier 1 and 2 exempt Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Brand: $100.00, Specialty Tier: 26% $3,400
Harvard Pilgrim Stride Value Rx Plus (HMO) – H1660-017-2 $168.00 $0 Yes, some additional gap coverage. Preferred Generic: $0.00, Generic: $10.00, Preferred Brand: $47.00, Non-Preferred Brand: $100.00, Specialty Tier: 33% $3,400
Humana Honor (PPO) – H5216-059-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $4,500
HumanaChoice H5216-138 (PPO) – H5216-138-0 $0.00 $295 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $6.00, Generic: $16.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 27% $7,550
HumanaChoice H5216-249 (PPO) – H5216-249-0 $0.00 $275 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $2.00, Generic: $9.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $6,700
HumanaChoice H5216-250 (PPO) – H5216-250-0 $20.00 $250 . Tier 1, 2 and 3 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28% $6,500
Lasso Healthcare Growth (MSA) – H1924-001-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. n/a
Lasso Healthcare Growth Plus (MSA) – H1924-004-0 $0.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. n/a
Medicare HMO Blue FlexRx (HMO-POS) – H2261-023-1 $96.00 $260 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $1.00, Generic: $5.00, Preferred Brand: $42.00, Non-Preferred Brand: $95.00, Specialty Tier: 28% $3,900
Medicare HMO Blue PlusRx (HMO) – H2261-005-0 $267.00 $200 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $1.00, Generic: $5.00, Preferred Brand: $42.00, Non-Preferred Brand: $95.00, Specialty Tier: 29% $3,400
Medicare HMO Blue SaverRx (HMO) – H2261-024-0 $0.00 $320 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $2.00, Generic: $8.00, Preferred Brand: $42.00, Non-Preferred Brand: $95.00, Specialty Tier: 27%, Select Care Drugs: $0.00 $7,550
Medicare HMO Blue ValueRx (HMO) – H2261-022-1 $36.00 $320 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $2.00, Generic: $6.00, Preferred Brand: $42.00, Non-Preferred Brand: $95.00, Specialty Tier: 27%, Select Care Drugs: $0.00 $4,900
Medicare PPO Blue PlusRx (PPO) – H2230-002-0 $263.00 $200 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $1.00, Generic: $5.00, Preferred Brand: $42.00, Non-Preferred Brand: $95.00, Specialty Tier: 29% $3,400
Medicare PPO Blue SaverRx (PPO) – H2230-017-0 $0.00 $405 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $2.00, Generic: $10.00, Preferred Brand: $42.00, Non-Preferred Brand: $95.00, Specialty Tier: 25%, Select Care Drugs: $0.00 $7,550
Medicare PPO Blue ValueRx (PPO) – H2230-018-1 $76.00 $320 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $2.00, Generic: $6.00, Preferred Brand: $42.00, Non-Preferred Brand: $95.00, Specialty Tier: 27%, Select Care Drugs: $0.00 $4,900
NaviCare (HMO D-SNP) – H9001-019-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00 n/a
Senior Care Options Program (HMO D-SNP) – H2225-001-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Preferred Generic: 25%, Generic: 25%, Preferred Brand: 25%, Non-Preferred Brand: 25%, Specialty Tier: 25% n/a
Senior Whole Health (HMO D-SNP) – H2224-001-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: 15% n/a
Senior Whole Health NHC (HMO D-SNP) – H2224-003-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: 15% n/a
Tufts Health Plan Senior Care Options (HMO D-SNP) – H2256-029-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00, Tier 6: $0.00 n/a
Tufts Medicare Preferred HMO Basic Rx (HMO) – H2256-026-2 $46.00 $225 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $4.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 29%, Vaccines: $0.00 $3,450
Tufts Medicare Preferred HMO Prime No Rx (HMO) – H2256-016-2 $133.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $3,450
Tufts Medicare Preferred HMO Prime Rx (HMO) – H2256-015-2 $180.00 $0 No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $8.00, Preferred Brand: $45.00, Non-Preferred Drug: $100.00, Specialty Tier: 33%, Vaccines: $0.00 $3,450
Tufts Medicare Preferred HMO Prime Rx Plus (HMO) – H2256-001-2 $214.00 $0 Yes, some additional gap coverage. Preferred Generic: $2.00, Generic: $4.00, Preferred Brand: $30.00, Non-Preferred Drug: $80.00, Specialty Tier: 33%, Vaccines: $0.00 $3,450
Tufts Medicare Preferred HMO Saver Rx (HMO) – H2256-028-0 $0.00 $250 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $0.00, Generic: $4.00, Preferred Brand: $47.00, Non-Preferred Drug: $100.00, Specialty Tier: 28%, Vaccines: $0.00 $7,550
Tufts Medicare Preferred HMO Value No Rx (HMO) – H2256-019-7 $103.00 No Rx Coverage No Rx Coverage This Plan does NOT include Prescription Drug coverage. $3,450
Tufts Medicare Preferred HMO Value Rx (HMO) – H2256-018-7 $150.00 $200 . Tier 1 and 2 exempt No additional gap coverage, only the Donut Hole Discount Preferred Generic: $4.00, Generic: $8.00, Preferred Brand: $45.00, Non-Preferred Drug: $100.00, Specialty Tier: 29%, Vaccines: $0.00 $3,450
UnitedHealthcare Senior Care Options (HMO D-SNP) – H2226-001-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 n/a
UnitedHealthcare Senior Care Options NHC (HMO D-SNP) – H2226-003-0 $0.00 for people who qualify for both Medicare and Medicaid. $0 for people who qualify for both Medicare and Medicaid. No additional gap coverage, only the Donut Hole Discount Tier 1: $0.00, Tier 2: $0.00, Tier 3: $0.00, Tier 4: $0.00, Tier 5: $0.00 n/a

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Medicare Supplement Companies in Taunton, Massachusetts

Original Medicare leaves you with some out-of-pocket costs such as deductibles and coinsurance. With a Taunton, Massachusetts Medicare supplement plan, you can get coverage for some or all of those costs. Medicare supplement plans in Massachusetts are standardized, but companies can choose which plans they will sell. Take a look at which companies sell Medicare supplement (Medigap) insurance and which plans they offer.

Medicare Supplement Companies in Taunton, Massachusetts

Company Plans
AARP – UnitedHealthcare Insurance Company (Standard 15% Disc) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
AARP – UnitedHealthcare Insurance Company (Standard 15% Disc/Household) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
AARP – UnitedHealthcare Insurance Company (Standard) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
AARP – UnitedHealthcare Insurance Company (Standard/Household) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Blue Cross and Blue Shield of Massachusetts Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Fallon Health and Life Assurance Company Inc. Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Harvard Pilgrim Health Care Inc. Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Harvard Pilgrim Health Care Inc. (10% Disc) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Harvard Pilgrim Health Care Inc. (15% Disc) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Harvard Pilgrim Health Care Inc. (5% Disc) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Health New England Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Humana (Humana Insurance Company) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Humana (Humana Insurance Company) (15% Disc) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Humana (Humana Insurance Company) (15% Disc/Household) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Humana (Humana Insurance Company) (Household) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Humana Healthy Living (Humana Insurance Company) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Humana Healthy Living (Humana Insurance Company) (15% Disc) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Humana Healthy Living (Humana Insurance Company) (15% Disc/Household) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Humana Healthy Living (Humana Insurance Company) (Household) Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan
Tufts Insurance Company Medigap Core Plan,
Medigap Supplement 1 Plan,
Medigap Supplement 1A Plan

Taunton, Massachusetts Standard Medicare Plan Coverage

Wondering what’s covered by each of the standard Massachusetts Medicare supplement plans? Take a look at all of the Taunton, Massachusetts Medicare supplement plans with coverage details.

Taunton, Massachusetts Standard Medicare Plan Coverage

Plan Name Monthly Cost Copays Coinsurance Deductibles Plan Benefits
Medigap Core Plan Premiums range from $108-$204 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $1,484 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: No
Part A deductible: No
Part B deductible: No
Part B excess charges: No
Foreign travel emergency: No
Medigap Supplement 1 Plan Premiums range from $206-$330 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$0 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: Yes
Part B excess charges: Yes
Foreign travel emergency: Yes
Medigap Supplement 1A Plan Premiums range from $161-$320 depending on your age, sex, health status, and when you buy. $0 Generally your cost for approved Part B services $0 Hospital (Part A) deductible,
$203 Medical (Part B) deductible
Skilled nursing facility: Yes
Part A deductible: Yes
Part B deductible: No
Part B excess charges: Yes
Foreign travel emergency: Yes

Standalone Medicare Part D Plans in Taunton, Massachusetts

Prescription drug coverage for Medicare in Taunton, Massachusetts is covered by a Part D plan. You can purchase Part D coverage in Taunton, Massachusetts as a standalone plan if it’s not included in your Medicare Advantage coverage. Take a look at the options for standalone Part D plans here.

Standalone Medicare Part D Plans in Taunton, Massachusetts

Plan Details Tiers
SilverScript SmartRx (PDP)
S5601 – 177 – 0
by Aetna Medicare
Monthly Premium: $7.20
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $19.00
Tier 3: $46.00
Tier 4: 49%
Tier 5: 25%
Elixir RxPlus (PDP)
S7694 – 125 – 0
by Elixir Insurance
Monthly Premium: $14.30
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $6.00
Tier 3: $43.00
Tier 4: 45%
Tier 5: 25%
WellCare Wellness Rx (PDP)
S4802 – 171 – 0
by WellCare
Monthly Premium: $14.40
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $8.00
Tier 3: $40.00
Tier 4: 46%
Tier 5: 25%
WellCare Value Script (PDP)
S4802 – 137 – 0
by WellCare
Monthly Premium: $16.20
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $8.00
Tier 3: $43.00
Tier 4: 47%
Tier 5: 25%
Humana Walmart Value Rx Plan (PDP)
S5884 – 182 – 0
by Humana
Monthly Premium: $17.20
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: 17%
Tier 4: 35%
Tier 5: 25%
Cigna Secure-Essential Rx (PDP)
S5617 – 281 – 0
by Cigna
Monthly Premium: $24.00
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 18%
Tier 4: 49%
Tier 5: 25%
Mutual of Omaha Rx Premier (PDP)
S7126 – 072 – 0
by Mutual of Omaha Rx
Monthly Premium: $25.10
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 23%
Tier 4: 45%
Tier 5: 25%
WellCare Medicare Rx Select (PDP)
S5810 – 276 – 0
by WellCare
Monthly Premium: $26.40
Annual Deductable: $400
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $3.00
Tier 3: $47.00
Tier 4: 42%
Tier 5: 25%
Express Scripts Medicare – Saver (PDP)
S5660 – 219 – 0
by Express Scripts Medicare
Monthly Premium: $27.40
Annual Deductable: $285
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $35.00
Tier 4: 50%
Tier 5: 28%
WellCare Classic (PDP)
S4802 – 076 – 0
by WellCare
Monthly Premium: $31.00
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $30.00
Tier 4: 34%
Tier 5: 25%
AARP MedicareRx Saver Plus (PDP)
S5921 – 348 – 0
by UnitedHealthcare
Monthly Premium: $31.90
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $5.00
Tier 3: $31.00
Tier 4: 40%
Tier 5: 25%
Express Scripts Medicare – Value (PDP)
S5660 – 105 – 0
by Express Scripts Medicare
Monthly Premium: $32.80
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $30.00
Tier 4: 50%
Tier 5: 25%
SilverScript Choice (PDP)
S5601 – 004 – 0
by Aetna Medicare
Monthly Premium: $32.90
Annual Deductable: $225
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $5.00
Tier 3: $35.00
Tier 4: 41%
Tier 5: 29%
Elixir RxSecure (PDP)
S7694 – 002 – 0
by Elixir Insurance
Monthly Premium: $34.40
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $7.00
Tier 3: 15%
Tier 4: 32%
Tier 5: 25%
Humana Basic Rx Plan (PDP)
S5884 – 102 – 0
by Humana
Monthly Premium: $35.10
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $1.00
Tier 3: 20%
Tier 4: 35%
Tier 5: 25%
WellCare Medicare Rx Saver (PDP)
S5810 – 036 – 0
by WellCare
Monthly Premium: $35.70
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $42.00
Tier 4: 37%
Tier 5: 25%
Cigna Secure Rx (PDP)
S5617 – 008 – 0
by Cigna
Monthly Premium: $36.50
Annual Deductable: $445
Zero Premium If Full LIS Benefits: Yes
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $3.00
Tier 3: $41.00
Tier 4: 50%
Tier 5: 25%
AARP MedicareRx Walgreens (PDP)
S5921 – 385 – 0
by UnitedHealthcare
Monthly Premium: $37.90
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $6.00
Tier 3: $40.00
Tier 4: 40%
Tier 5: 25%
Cigna Secure-Extra Rx (PDP)
S5617 – 247 – 0
by Cigna
Monthly Premium: $40.90
Annual Deductable: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $4.00
Tier 2: $10.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 31%
Blue MedicareRx Value Plus (PDP)
S2893 – 001 – 0
by Anthem Blue Cross and Blue Shield
Monthly Premium: $50.50
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $6.00
Tier 3: $36.00
Tier 4: 40%
Tier 5: 25%
Humana Premier Rx Plan (PDP)
S5884 – 149 – 0
by Humana
Monthly Premium: $65.40
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $45.00
Tier 4: 49%
Tier 5: 25%
SilverScript Plus (PDP)
S5601 – 005 – 0
by Aetna Medicare
Monthly Premium: $72.00
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $0.00
Tier 2: $2.00
Tier 3: $47.00
Tier 4: 45%
Tier 5: 33%
WellCare Medicare Rx Value Plus (PDP)
S5768 – 126 – 0
by WellCare
Monthly Premium: $74.40
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $1.00
Tier 2: $4.00
Tier 3: $47.00
Tier 4: 47%
Tier 5: 33%
Express Scripts Medicare – Choice (PDP)
S5660 – 206 – 0
by Express Scripts Medicare
Monthly Premium: $76.40
Annual Deductable: $100
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $2.00
Tier 2: $7.00
Tier 3: $42.00
Tier 4: 50%
Tier 5: 31%
AARP MedicareRx Preferred (PDP)
S5820 – 002 – 0
by UnitedHealthcare
Monthly Premium: $86.00
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $5.00
Tier 2: $10.00
Tier 3: $45.00
Tier 4: 40%
Tier 5: 33%
Mutual of Omaha Rx Plus (PDP)
S7126 – 002 – 0
by Mutual of Omaha Rx
Monthly Premium: $87.10
Annual Deductable: $445
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: No
Tier 1: $0.00
Tier 2: $2.00
Tier 3: 20%
Tier 4: 39%
Tier 5: 25%
Blue MedicareRx Premier (PDP)
S2893 – 003 – 0
by Anthem Blue Cross and Blue Shield
Monthly Premium: $135.00
Annual Deductable: $0
Zero Premium If Full LIS Benefits: No
ICL: $4,130
Additional Gap Coverage: Yes
Tier 1: $1.00
Tier 2: $7.00
Tier 3: $30.00
Tier 4: 35%
Tier 5: 33%

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