2024 Kings County, NY Medicare Advantage Plans

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**There are 92 New York 2024 Medicare Advantage plans (MAPD) meeting your criteria.**
**Insulin on a Medicare Part D plan's formulary will have a monthly copay of $35 or less.**

Click on the plan name or details button below to access plan details and contact information.
2024 Medicare Advantage Plan Information Click here to jump to the Chart Legend & Search Tips
Plan Name			County	Monthly Prem. (Parts C & D)	Deduct- ible	(Donut Hole) Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance 30-Day Supply	MOOP for Part A & B Benefits
Cust. Service Rating	Member Plan Exper.	RxCost Info Rating	County	Monthly Prem. (Parts C & D)	Deduct- ible	(Donut Hole) Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance 30-Day Supply	MOOP for Part A & B Benefits
AARP Medicare Advantage Patriot No Rx NY-MA01 (HMO-POS) - H3307-018-0 Benefits & Contact Info			Kings	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$6,700

Aetna Medicare Eagle Plan (PPO) - H5521-320-0 Benefits & Contact Info			Kings	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$8,500

Anthem Veteran (HMO) - H8432-037-1 Benefits & Contact Info			Kings	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$8,300

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Anthem Veteran Select (HMO) - H8432-036-0 Benefits & Contact Info			Kings	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$6,700

Cigna True Choice Courage Medicare (PPO) - H7849-086-0 Benefits & Contact Info			Kings	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$6,700

Humana USAA Honor (PPO) - H5970-016-0 Benefits & Contact Info			Kings	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$4,500

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
UHC Medicare Advantage Patriot No Rx NY-MA02 (Regional PPO) - R5342-002-0 Benefits & Contact Info			Kings	$0.00	No Rx Coverage		This Plan does NOT include Prescription Drug coverage.	$6,700

AARP Medicare Advantage from UHC NY-0003 (HMO-POS) - H3307-015-0 Benefits & Contact Info			Kings	$0.00	$350 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 27% all covered insulin pay $35 or less	$7,550 Browse Formulary

AARP Medicare Advantage from UHC NY-0012 (PPO) - H3418-001-0 Benefits & Contact Info			Kings	$0.00	$350 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 27% all covered insulin pay $35 or less	$6,900 Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
AARP Medicare Advantage from UHC NY-0028 (HMO-POS) - H3379-051-0 Benefits & Contact Info			Kings	$0.00	$395 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 27% all covered insulin pay $35 or less	$8,300 Browse Formulary

Aetna Medicare Elite Plan (PPO) - H5521-120-0 Benefits & Contact Info			Kings	$0.00	$300 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28% all covered insulin pay $35 or less	$7,550 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Value Plan (HMO) - H3312-002-0 Benefits & Contact Info			Kings	$0.00	$300 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28% all covered insulin pay $35 or less	$8,500 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Aetna Medicare Value Select Plan (HMO) - H3312-074-0 Benefits & Contact Info			Kings	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 33% all covered insulin pay $35 or less	$8,500 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Centers Plan for Medicare Advantage Care (HMO) - H6988-001-0 Benefits & Contact Info			Kings	$0.00	$395 Tier 1 and 2 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: $47.00 Non-Preferred Brand: $100.00 Specialty Tier: 25% all covered insulin pay $35 or less	$7,550 Browse Formulary

Cigna True Choice Medicare (PPO) - H7849-082-0 Benefits & Contact Info			Kings	$0.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,400 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Elderplan Flex (HMO-POS) - H3347-016-0 Benefits & Contact Info			Kings	$0.00	$375 Tier 1, 2 and 3 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25% all covered insulin pay $35 or less	$7,550 Browse Formulary

Elderplan Select (HMO-POS I-SNP) - H3347-018-0 Benefits & Contact Info			Kings	$0.00	$545 Tier 1, 2 and 3 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $4.00 Generic: $14.00 Preferred Brand: $47.00 Non-Preferred Drug: 25% Specialty Tier: 25% all covered insulin pay $35 or less	n/a Browse Formulary

Healthfirst 65 Plus Plan (HMO) - H3359-001-0 Benefits & Contact Info			Kings	$0.00	$250 Tier 1, 2, 3 and 6 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $35.00 Non-Preferred Drug: $100.00 Specialty Tier: 26% Supplemental Drugs: $5.00 all covered insulin pay $35 or less	$8,850 Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Healthfirst Signature (HMO) - H5989-011-0 Benefits & Contact Info			Kings	$0.00	$250 Tier 1, 2, 3 and 6 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 26% Supplemental Drugs: $5.00 all covered insulin pay $35 or less	$6,700 Browse Formulary
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Healthfirst Signature (PPO) - H9678-001-0 Benefits & Contact Info			Kings	$0.00	$250 Tier 1, 2, 3 and 6 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 26% Supplemental Drugs: $5.00 all covered insulin pay $35 or less	$5,000 Browse Formulary
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Humana Gold Plus H3533-027 (HMO) - H3533-027-0 Benefits & Contact Info			Kings	$0.00	$425 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: 26% all covered insulin pay $35 or less	$7,995 Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Humana Gold Plus H3533-033 (HMO) - H3533-033-0 Benefits & Contact Info			Kings	$0.00	$350 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: 27% all covered insulin pay $35 or less	$7,995 Browse Formulary

HumanaChoice H5970-024 (PPO) - H5970-024-1 Benefits & Contact Info			Kings	$0.00	$425 Tier 1, 2 and 3 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: 26% all covered insulin pay $35 or less	$7,600 Browse Formulary

PHP Care Complete FIDA-IDD Plan (Medicare-Medicaid Plan) - H9869-001-0 Benefits & Contact Info			Kings	$0.00	$0	Yes, some additional gap coverage.	Tier 1: 0% Tier 2: 0% Tier 3: 0% all covered insulin pay $35 or less	n/a Browse Formulary
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Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Wellcare Giveback Open (PPO) - H2775-111-0 Benefits & Contact Info			Kings	$0.00	$500 Tier 1, 2 and 6 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 25% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$8,300 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Wellcare No Premium (HMO) - H4868-019-0 Benefits & Contact Info			Kings	$0.00	$425 Tier 1, 2 and 6 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: $42.00 Non-Preferred Drug: 47% Specialty Tier: 26% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$8,300 Browse Formulary
	--		Higher cost-sharing at standard network pharmacies. Details:
Wellcare No Premium Open (PPO) - H2775-106-0 Benefits & Contact Info			Kings	$0.00	$450 Tier 1, 2 and 6 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $7.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 26% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$6,700 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Anthem Medicare Advantage (HMO) - H8432-040-0 Benefits & Contact Info			Kings	$16.00	$350 Tier 1 and 2 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $15.00 Preferred Brand: $42.00 Non-Preferred Drug: $94.00 Specialty Tier: 27% all covered insulin pay $35 or less	$7,550 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Wellcare Assist Open (PPO) - H2775-113-0 Benefits & Contact Info			Kings	$20.60	$510 Tier 1 and 6 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 46% Specialty Tier: 25% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$6,700 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Elite Plan 3 (PPO) - H5521-310-0 Benefits & Contact Info			Kings	$22.00	$250 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 20% Non-Preferred Drug: 40% Specialty Tier: 29% all covered insulin pay $35 or less	$8,500 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
UHC Nursing Home Plan NY-F003 (HMO I-SNP) - H3379-002-0 Benefits & Contact Info			Kings	$22.20	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% all covered insulin pay $35 or less	n/a Browse Formulary

EmblemHealth VIP Dual (HMO D-SNP) - H5991-012-1 Benefits & Contact Info			Kings	$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: $5.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25% Select Care Drugs: $5.00 all covered insulin pay $35 or less	n/a Browse Formulary
	--
EmblemHealth VIP Dual Reserve (HMO D-SNP) - H5991-010-0 Benefits & Contact Info			Kings	$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: $5.00 Generic: $14.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25% Select Care Drugs: $5.00 all covered insulin pay $35 or less	n/a Browse Formulary
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Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
VNS Health EasyCare (HMO) - H5549-012-0 Benefits & Contact Info			Kings	$25.00	$145 Tier 1 and 6 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $15.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Brand: $100.00 Specialty Tier: 31% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$8,850 Browse Formulary

Senior Whole Health of New York NHC (HMO D-SNP) - H5992-007-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary
	--	--
UHC Nursing Home Plan NY-F002 (PPO I-SNP) - H2292-002-0 Benefits & Contact Info			Kings	$26.10	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: 25% Tier 2: 25% Tier 3: 25% Tier 4: 25% Tier 5: 25% all covered insulin pay $35 or less	n/a Browse Formulary
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Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Senior Whole Health Medicare Complete Care (HMO D-SNP) - H5992-009-2 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary
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Longevity Health Plan (HMO I-SNP) - H8457-001-0 Benefits & Contact Info			Kings	$26.90	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: 25% all covered insulin pay $35 or less	n/a Browse Formulary
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Humana Gold Plus H3533-032 (HMO) - H3533-032-1 Benefits & Contact Info			Kings	$29.00	$300 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% all covered insulin pay $35 or less	$6,900 Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
UHC Medicare Advantage NY-0020 (Regional PPO) - R5342-001-0 Benefits & Contact Info			Kings	$29.00	$295 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28% all covered insulin pay $35 or less	$7,900 Browse Formulary

Cigna True Choice Plus Medicare (PPO) - H7849-128-0 Benefits & Contact Info			Kings	$32.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$6,700 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Wellcare Assist (HMO) - H4868-016-0 Benefits & Contact Info			Kings	$32.30	$540 Tier 1 and 6 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 45% Specialty Tier: 25% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$6,700 Browse Formulary
	--		Higher cost-sharing at standard network pharmacies. Details:
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Elderplan For Medicaid Beneficiaries (HMO-POS D-SNP) - H3347-002-0 Benefits & Contact Info			Kings	$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% all covered insulin pay $35 or less	n/a Browse Formulary

Elderplan Assist (HMO-POS I-SNP) - H3347-015-0 Benefits & Contact Info			Kings	$34.50	$545 Tier 1, 2 and 3 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $4.00 Generic: $14.00 Preferred Brand: $47.00 Non-Preferred Drug: 25% Specialty Tier: 25% all covered insulin pay $35 or less	n/a Browse Formulary

Elderplan Extra Help (HMO-POS) - H3347-009-0 Benefits & Contact Info			Kings	$34.70	$545 Tier 1, 2 and 3 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $4.00 Generic: $10.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 25% all covered insulin pay $35 or less	$7,550 Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Aetna Medicare Discover Value Plan (PPO) - H5521-312-0 Benefits & Contact Info			Kings	$35.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 33% all covered insulin pay $35 or less	$8,500 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
UHC Care Advantage NY-E001 (PPO I-SNP) - H2292-003-0 Benefits & Contact Info			Kings	$35.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $2.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	n/a Browse Formulary
	--
Wellcare Dual Access (HMO D-SNP) - H4868-014-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary
	--
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Healthfirst Increased Benefits Plan (HMO) - H3359-019-0 Benefits & Contact Info			Kings	$39.20	$545 Tier 1 and 6 exempt	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $20.00 Preferred Brand: $47.00 Non-Preferred Drug: 50% Specialty Tier: 25% Supplemental Drugs: $5.00 all covered insulin pay $35 or less	$8,850 Browse Formulary

Hamaspik Medicare Choice (HMO D-SNP) - H0034-002-0 Benefits & Contact Info			Kings	$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% all covered insulin pay $35 or less	n/a Browse Formulary
	--
Hamaspik Medicare Select (HMO D-SNP) - H0034-001-0 Benefits & Contact Info			Kings	$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% all covered insulin pay $35 or less	n/a Browse Formulary
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Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
UHC Dual Complete NY-Q001 (HMO-POS D-SNP) - H3387-015-2 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

AARP Medicare Advantage from UHC NY-0005 (HMO-POS) - H3379-001-0 Benefits & Contact Info			Kings	$43.00	$350 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 27% all covered insulin pay $35 or less	$7,550 Browse Formulary

Healthfirst Life Improvement Plan (HMO D-SNP) - H3359-021-0 Benefits & Contact Info			Kings	$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: $5.00 Generic: $20.00 Preferred Brand: 16% Non-Preferred Drug: 50% Specialty Tier: 25% Supplemental Drugs: $0.00 all covered insulin pay $35 or less	n/a Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Wellcare Fidelis Dual Access (HMO D-SNP) - H5599-001-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

Healthfirst CompleteCare (HMO D-SNP) - H3359-034-0 Benefits & Contact Info			Kings	$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: $0.00 Generic: $20.00 Preferred Brand: 19% Non-Preferred Drug: 50% Specialty Tier: 25% all covered insulin pay $35 or less	n/a Browse Formulary

Elderplan Advantage For Nursing Home Residents (HMO-POS I-SNP) - H3347-003-0 Benefits & Contact Info			Kings	$48.00	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: 25% all covered insulin pay $35 or less	n/a Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Healthfirst Connection Plan (HMO D-SNP) - H3359-038-0 Benefits & Contact Info			Kings	$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: $0.00 Generic: $15.00 Preferred Brand: $47.00 Non-Preferred Drug: 44% Specialty Tier: 25% all covered insulin pay $35 or less	n/a Browse Formulary

Aetna Medicare Assure Plan (HMO D-SNP) - H3312-069-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

Aetna Medicare Assure Plus Plan (HMO D-SNP) - H3312-073-0 Sanctioned Plan			Kings	$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: tbd all covered insulin pay $35 or less	n/a Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Anthem Full Dual Advantage (HMO D-SNP) - H8432-007-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

Anthem Full Dual Advantage Select (HMO D-SNP) - H8432-028-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

Anthem HealthPlus Full Dual Advantage (HMO D-SNP) - H1732-003-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary
	--
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Anthem HealthPlus Full Dual Advantage LTSS (HMO D-SNP) - H1732-001-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary
	--
Centers Plan for Dual Coverage Care (HMO D-SNP) - H6988-002-0 Benefits & Contact Info			Kings	$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% all covered insulin pay $35 or less	n/a Browse Formulary

Centers Plan for Medicaid Advantage Plus (HMO D-SNP) - H6988-004-0 Benefits & Contact Info			Kings	$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% all covered insulin pay $35 or less	n/a Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Centers Plan for Nursing Home Care (HMO I-SNP) - H6988-003-0 Benefits & Contact Info			Kings	$48.70	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: 25% all covered insulin pay $35 or less	n/a Browse Formulary

Elderplan Plus Long Term Care (HMO-POS D-SNP) - H3347-007-0 Benefits & Contact Info			Kings	$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% all covered insulin pay $35 or less	n/a Browse Formulary

Humana Gold Plus SNP-DE H3533-034 (HMO D-SNP) - H3533-034-1 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
MetroPlus Advantage Plan (HMO D-SNP) - H0423-001-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

MetroPlus UltraCare (HMO D-SNP) - H0423-007-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

RiverSpring MAP (HMO D-SNP) - H6776-002-0 Benefits & Contact Info			Kings	$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% all covered insulin pay $35 or less	n/a Browse Formulary
	--
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
RiverSpring Star (HMO I-SNP) - H6776-001-0 Benefits & Contact Info			Kings	$48.70	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: 25% all covered insulin pay $35 or less	n/a Browse Formulary
	--
UHC Dual Complete NY-S001 (PPO D-SNP) - H0271-060-2 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

UHC Dual Complete NY-S002 (HMO-POS D-SNP) - H3387-014-2 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
VillageCareMAX Medicare Health Advantage FLEX Plan (HMO D-SNP) - H2168-003-0 Benefits & Contact Info			Kings	$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: $5.00 Generic: $11.00 Preferred Brand: 19% Non-Preferred Drug: 40% Specialty Tier: 25% all covered insulin pay $35 or less	n/a Browse Formulary

VillageCareMAX Medicare Health Advantage Plan (HMO D-SNP) - H2168-001-0 Benefits & Contact Info			Kings	$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: $5.00 Generic: $11.00 Preferred Brand: 21% Non-Preferred Drug: 37% Specialty Tier: 25% all covered insulin pay $35 or less	n/a Browse Formulary

VillageCareMAX Medicare Select Advantage Plan (HMO) - H2168-004-0 Benefits & Contact Info			Kings	$48.70	$545	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $6.00 Generic: $11.00 Preferred Brand: 23% Non-Preferred Drug: 33% Specialty Tier: 25% all covered insulin pay $35 or less	$8,300 Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
VillageCareMAX Medicare Total Advantage Plan (HMO D-SNP) - H2168-002-0 Benefits & Contact Info			Kings	$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: $6.00 Generic: $12.00 Preferred Brand: 24% Non-Preferred Drug: 33% Specialty Tier: 25% all covered insulin pay $35 or less	n/a Browse Formulary

VNS Health EasyCare Plus (HMO D-SNP) - H5549-011-0 Benefits & Contact Info			Kings	$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% all covered insulin pay $35 or less	n/a Browse Formulary

VNS Health Total (HMO D-SNP) - H5549-003-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Wellcare Dual Access Open (PPO D-SNP) - H2775-112-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

Wellcare Fidelis Dual Plus (HMO D-SNP) - H5599-003-0 Benefits & Contact Info			Kings	$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 all covered insulin pay $35 or less	n/a Browse Formulary

UHC Medicare Advantage NY-0021 (Regional PPO) - R5342-005-0 Benefits & Contact Info			Kings	$56.00	$195 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $14.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30% all covered insulin pay $35 or less	$7,500 Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
AARP Medicare Advantage from UHC NY-0001 (HMO-POS) - H3307-002-0 Benefits & Contact Info			Kings	$62.00	$295 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 28% all covered insulin pay $35 or less	$7,550 Browse Formulary

EmblemHealth VIP Gold (HMO) - H3330-021-1 Benefits & Contact Info			Kings	$82.00	$200 Tier 1, 2 and 6 exempt	Yes, some additional gap coverage.	Preferred Generic: $2.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 29% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$8,850 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Aetna Medicare Premier Plan (PPO) - H5521-040-0 Benefits & Contact Info			Kings	$87.00	$150 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $0.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 30% all covered insulin pay $35 or less	$5,000 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
UHC Medicare Advantage NY-0022 (Regional PPO) - R5342-006-0 Benefits & Contact Info			Kings	$88.00	$0	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $12.00 Preferred Brand: $47.00 Non-Preferred Drug: $100.00 Specialty Tier: 33% all covered insulin pay $35 or less	$7,200 Browse Formulary

Wellcare Premium Ultra Open (PPO) - H2775-105-0 Benefits & Contact Info			Kings	$110.00	$0	No additional gap coverage, only the Donut Hole Discount	Preferred Generic: $0.00 Generic: $5.00 Preferred Brand: $42.00 Non-Preferred Drug: 50% Specialty Tier: 33% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$3,400 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
MetroPlus Platinum Plan (HMO) - H0423-004-0 Benefits & Contact Info			Kings	$132.00	$545	No additional gap coverage, only the Donut Hole Discount	Tier 1: 25% all covered insulin pay $35 or less	$8,850 Browse Formulary

Plan Name			County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Service	Exper.	Cost Info	County	Monthly Prem.	Deduct- ible	Additional Gap Coverage	Preferred Pharmacy Copay/ Coinsurance	MOOP for A & B
Aetna Medicare Platinum Plan (PPO) - H5521-460-0 Benefits & Contact Info			Kings	$171.00	$250 Tier 1 and 2 exempt	Yes, some additional gap coverage.	Preferred Generic: $0.00 Generic: $10.00 Preferred Brand: 20% Non-Preferred Drug: 50% Specialty Tier: 29% all covered insulin pay $35 or less	$4,300 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:
EmblemHealth VIP Gold Plus (HMO) - H3330-038-0 Benefits & Contact Info			Kings	$241.00	$200 Tier 1, 2 and 6 exempt	Yes, some additional gap coverage.	Preferred Generic: $2.00 Generic: $10.00 Preferred Brand: $40.00 Non-Preferred Drug: $95.00 Specialty Tier: 29% Select Care Drugs: $0.00 all covered insulin pay $35 or less	$8,850 Browse Formulary
			Higher cost-sharing at standard network pharmacies. Details:

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2024 DrugFinder and Formulary Search
Compare Changes in the 2023 & 2024 Health Plans
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Chart Legend:

Below are a few notes to help with the understanding of the 2024 Medicare Advantage Plan chart above and Search Tips to help you narrow down your list of plans to those that best meet your needs.

Plan Name: This is the official plan name from the Centers for Medicare and Medicaid Services (CMS). The plan name is followed by the health plan type (HMO, HMO-POS, PPO, PFFS, etc). The same plan name generally has a different plan id in each state. (Search Tip: If you would like to reduce the plans shown to just plans for one or two specific carriers, you can select the carrier name in the "Plan Family" fields 1 and 2. Select the empty (blank) option at the top of the list to remove the criteria. You can also click the "National Plans" checkbox to limit your search to just national plans.)
CMS Plan Ratings: these are found under the Plan Name at the left side of the chart.
This is a 1 to 5 star rating system with five (5) stars as excellent, four (4) stars as very good, three (3) stars as good, two (2) stars as fair and one (1) star as poor.
- Cust. Service Rating - Drug Plan Customer Service - Medicare and members rate the drug plan and how well a drug plan provides customer service.
  
  This category includes measures of how drug plans rate on the following areas:
  - Time on Hold When Customer and Pharmacist Calls Drug Plan.
  - Calls Disconnected When Customer and Pharmacist Calls Drug Plan.
  - Drug Plan’s Timeliness in Giving a Decision for Members Who Make an Appeal.
  - Fairness of Drug Plan’s Denials to a Member’s Appeal, Based on an Independent Reviewer.
- Member Plan Exper. - Member Experience with Drug Plan - This category shows how well drug plans make prescription drugs available to their members.
  
  This category includes measures of how drug plans rate on the following areas:
  - Drug Plan Provides Information or Help When Members Need It.
  - Members’ Overall Rating of Drug Plan.
  - Members’ Ability to Get Prescriptions Filled Easily When Using the Drug Plan.
- RxCost Info Rating - This category shows how well drug plans are doing with pricing prescriptions and providing information on the Medicare website.
  
  This category includes measures of how drug plans rate on the following areas:
  - Completeness of the Drug Plan’s Information on Members Who Need Extra Help.
  - Drug Plan Provides Current Information on Costs and Coverage for Medicare’s Website (the same data is used on this Q1Medicare.com).
  - Drug Plan’s Prices that Did Not Increase More Than Expected During the Year.
  - Drug Plan’s Prices on Medicare’s Website (and this website) Are Similar to the Prices Members Pay at the Pharmacy.
  - Drug Plan’s Members 65 and Older Who Received Prescriptions for Certain Drugs with a High Risk of Side Effects, when There May Be Safer Drug Choices.
- County: Medicare Advantage Plans are only available in specific county and in some cases only in part of a county. This field will note the county where the plan is available or in some cases, "Statewide" if the plan is available in every county. (Search Tip: You must enter your 5-digit ZIP Code in the criteria field to begin your search. We will determine your county from your ZIP code and only show appropriate plans.)
- Monthly Premium: This is the amount you must pay each month to use the plan. This monthly premium must be paid even if you are in the initial deductible phase or the coverage gap (donut hole) phase. (Search Tip: If you would like to reduce the plans shown to just plans under a certain premium, enter this value in the "Maximum Premium" field.)
  
  (Search Tip: If you have selected an amount in the "LIS Subsidy Amount" filed, the premium shown is the premium based on your Low-Income Subsidy selection.
- Deductible: The standard CMS plan initial deductible is $545. Many Medicare plans do not have a deductible; however their plan premium may be higher. (Search Tip: If you would like to reduce the plans shown to just plans with a deductible under a certain value, enter this value in the "Maximum Deductible" field.) Some plans that have an annual deductible exempt certain drug tiers from the deductible. For example, "Tier 1 exempt" may be shown. This would mean that Tier 1 drugs purchased during the Deductible phase, would not fall into the deductible and would be charged the Initial Coverage Phase tier 1 cost-sharing.
- Gap Coverage: In the CMS Standard Plan, the beneficiary, or others on their behalf (e.g. the brand-name drug manufacturer discount), pay(s) up to $6,334 in drug costs, depending on your mix of generics and brand-name drugs. The Healthcare Reform provides that for plan year 2024, all formulary drugs will have at least a 75% discount in the coverage gap (Donut Hole). The Gap Coverage Types discussed in this section are supplemental coverage your plan pays in addition to the Healthcare Reform mandated discounts. In our chart, you will see one of the following:
  - No Rx Cov.: This plan does not include prescription drug coverage. You are 100% responsible for your medication costs. If you would like to see ONLY those plans that do include some type of prescription coverage, please select "Show only plans WITH Drug Coverage" in the "Prescription Drug Coverage" selector above (this is the default setting);
  - No Gap Coverage: You receive the 75% Donut Hole Discount and pay up to $6,334 depending on your mix of generics and brand-name drugs, before exiting into Catastrophic Coverage. Read more...
  - Yes: This plan offers some supplemental gap coverage in addition to the 75% Donut Hole Discount. See plan details for a description of the gap coverage. The description may read similar to: Under this plan you may pay even less for the brand and generic drugs on the formulary. Your cost varies by tier. You will need to use your formulary to locate your drug's tier. See the chart that follows to find out how much it will cost you.
- Plan ID: This is the unique id for this particular plan.
- Copay / Coinsurance - Cost Sharing - This is what you will pay for formulary drugs in the initial coverage phase of your plan. This is the phase after the initial deductible has been met and before you reach the Coverage Gap (Donut Hole). Plans often cover drugs in "tiers". Tiers are specific to the list of drugs covered by the plan. Plans may have several tiers, and the copay for a drug depends on the drug’s tier. Plans can form their own tiers, so you should contact the plan or reference their summary of benefits to find out what copays and limitations are associated with each tier. These cost sharing figures DO NOT necessarily apply to the Coverage Gap. The plan may have a separate copay/coinsurance for the same drug while in the Coverage Gap. (Search Tip: If you would like to reduce the plans shown to just plans that have a tier 1 (Generics) co-pay of up to a certain value (ex: $0 co-pay), enter the value (ex: 0) in the "Max. Co-pay Tier 1 (Generics)" field.)
  
  All forms of insulin covered by any Medicare Part D plan will have a copay of $35 or less through all phases of coverage. Please contact the drug plan for more details.
Additional Information Fields:
You can select one of the following additional pieces of plan information to display (Search Tip: to change the type of information shown in the last column of the chart, select the data to be shown in the "Additional Info" field.)
- Total Formulary Drugs (default) - This is the total number of medications on the plans formulary or drug list. This total drug count does not include "Bonus Drugs". These are non-Medicare Part D drugs which are covered by the plan, however they do not count toward your plan deductible, retail drug cost, or TrOOP.
- Plan’s Summary Star Rating - This is the overall star rating for the Medicare Part D plan. To learn more about the star ratings, please see our Plan Quality Star Ratings.
- Offers Mail Order - "Yes" is displayed if this plan offers mail order on any medications. It does NOT mean that ALL medications are available through mail order.
- Members in This Plan ID (January 2024 figures) - This is the total number of members in this plan's service area (a "Plan ID" is a specific contract ID and plan ID, for example H1234-001). The number of members for the selected county and the enrollment for the selected state are shown in addition to the plan ID enrollment on the plan details page. you can access the plan details by clicking the plan name, orange enroll options button, or the plan details icon.
- Initial Coverage Limit (ICL) - The Initial Coverage Phase of a Medicare Part D plan is the phase AFTER the initial deductible is met (if the plan has an initial deductible) and BEFORE the coverage gap (or donut hole) begins. The ICL is the phase of the prescription drug plan during which you and your plan share your prescription costs. During this phase you will pay either a co-payment (a flat fee per prescription) or co-insurance (a percentage of the drug cost). The details of the cost-sharing for the plan are shown in the Cost-Sharing column directly to the left of this column. The CMS standard Initial Coverage Limit for 2024 is $5,030 and increases each year.
- Medicare Part B Giveback Amount - If the plan rebates a portion of the Medicare Part B premium back to plan members, the amount will be shown in this column. This is also called "Part B premium Buy-Down", "Part B premium reduction", or "Part B premium give-back".
- MOOP for Part A & B Benefits - MOOP is the Maximum Out-of-Pocket limit set by the Medicare Advantage Plan. The figure shown is the beneficiaries yearly maximum out of pocket cost-sharing expenditure (co-payments / co-insurance) for Medicare Parts A & B (NOT Part D - prescription drug cost-sharing). Also see, What happens when I reach my Medicare Advantage plan maximum out of pocket limit (MOOP)? N/A means that this plan does not actually offer health cost-sharing benefits. Example: a Medicare Savings Account (MSA).
- Health Plan Type - This the organization type for the Medicare Advantage Plan. This could be Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), etc. (Search Tip: If you would like to limit your search to a specific type of Medicare Advantage Plans, please select the health plan type in the "Type of Health Coverage" field.)
- SNP Eligibility Requirements - Special Needs Plans (SNPs) have an eligibility requirement whereas all other Medicare Advantage plans do not. (Search Tip: If you would like to limit your search to specific types of Special Needs Medicare Advantage Plans, please check the appropriate boxes in the "Special Needs Plans (SNP) Options" field.)

(Chart Source: various files provided by the Centers for Medicare and Medicaid Services along with data from the Medicare.gov website plan finder.)

Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. However, we cannot guarantee the accuracy of this information. You should always verify cost and coverage information with your Medicare plan provider.

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