You are Currently Viewing the 2022 Medicare Plans.
Click here If you Would Like to See
The 2023 Medicare Advantage Plans in Durham County NC.
2022 Durham County North Carolina
Medicare Advantage Plans
There are 35 Medicare Advantage Plans available in Durham County NC from 9 different health insurance providers. 11 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3450 and the highest out of pocket is $7550. Durham County North Carolina residents can also pick from 14 Medicare Special Needs Plans. The best Medicare Advantage plan in Durham County North Carolina received a 5 overall star rating from CMS and the lowest rated plan is 3 stars.
(Click the Plan Name for More Details)
(⇅ Click the Header to Sort)
Return to 2022 Medicare Advantage Plans in North Carolina
Edgecombe County Medicare Advantage
Medicare Advantage Health Plans Without Drug Coverage
| Plan Name ⇅ | Premium | Type | MOOP | Overall Rating |
|---|---|---|---|---|
| AARP Medicare Advantage Patriot (HMO-POS) (H5253-040) | $0 | Local HMO * | $3,600 | |
| Aetna Medicare Eagle Plan (PPO) (H5521-241) | $0 | Local PPO * | $6,500 | |
| Blue Medicare Freedom+ (PPO) (H3404-004) | $0 | Local PPO * | $7,550 | |
| Blue Medicare Medical Only (HMO) (H3449-012) | $0 | Local HMO * | $3,900 | |
| Exemplar Health Freedom 1 (MSA) (H9295-001) | MSA * | $- | NA | |
| Exemplar Health Freedom 2 (MSA) (H9295-002) | MSA * | $- | NA | |
| Exemplar Health Freedom 3 (MSA) (H9295-003) | MSA * | $- | NA | |
| Humana Honor R1390-003 (Regional PPO) (R1390-003) | $0 | Regional PPO * | $7,550 | |
| HumanaChoice R1390-001 (Regional PPO) (R1390-001) | $0 | Regional PPO * | $6,950 | |
| Lasso Healthcare Growth (MSA) (H1924-001) | MSA * | $- | NA | |
| Lasso Healthcare Growth Plus (MSA) (H1924-004) | MSA * | $- | NA | |
| Wellcare Patriot No Premium Open (PPO) (H7175-005) | $0 | Local PPO * | $5,500 |
2022 Medicare Special Needs Plans in Durham county North Carolina
| Plan Name ⇅ | Monthly Premium |
Part D Deductible |
Gap | Special Needs Type |
Overall Rating |
|---|---|---|---|---|---|
| Aetna Medicare Assure Plan (HMO D-SNP) | $29.70 | $425.0 | No Gap Coverage | Dual-Eligible | |
| Cigna TotalCare (HMO D-SNP) | $35.80 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Healthy Blue + Medicare (HMO D-SNP) | $35.80 | $480.0 | Few Generics | Dual-Eligible | Too New |
| HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | $33.70 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Longevity Health Plan (HMO I-SNP) | $35.80 | $480.0 | No Gap Coverage | Institutional | Too New |
| PruittHealth Premier (HMO I-SNP) | $35.80 | $480.0 | No Gap Coverage | Institutional | NA |
| UnitedHealthcare Assisted Living Plan (HMO-POS I-SNP) | $35.80 | $200.0 | No Gap Coverage | Institutional | |
| UnitedHealthcare Dual Complete (HMO-POS D-SNP) | $35.80 | $480.0 | No Gap Coverage | Dual-Eligible | |
| UnitedHealthcare Dual Complete RP (Regional PPO D-SNP) | $35.70 | $480.0 | No Gap Coverage | Dual-Eligible | |
| UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) | $35.80 | $480.0 | No Gap Coverage | Institutional | |
| UnitedHealthcare Nursing Home Plan (PPO I-SNP) | $35.80 | $480.0 | No Gap Coverage | Institutional | |
| Wellcare Dual Access (HMO D-SNP) | $30.70 | $480.0 | No Gap Coverage | Dual-Eligible | Too New |
| Wellcare Dual Access Medicare (HMO D-SNP) | $34.00 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Wellcare Dual Liberty Open (PPO D-SNP) | $35.80 | $480.0 | No Gap Coverage | Dual-Eligible |
Plan Type Is the type of organization offering the Medicare Plan.
- HMO - Health Maintenance Organization
- PPO - Preferred Provider Organization
- PDP - Prescription Drug Plan
- SNP - Special Needs Plan
- POS - Point of Service
- PFFS - Private Fee For Service
Monthly Consolidated Premium (Includes Part C + D) Your premium may be lower depending on your eligibility for medical assistance. Call your provider for details.
Part D Total Premium: The Part D Total Premium is the sum of the Basic and Supplemental Premiums. Note: the Part D Total Premium is net of any Part A/B rebates applied to "buy down" the drug premium for Medicare Advantage; for some plans the total premium may be lower than the sum of the basic and supplemental premiums due to negative basic or supplemental premiums.
Benefit Type- (EA) Enhanced Alternative may offer additional gap coverage which is calculated as the percentage of generic formulary products with coverage above standard generic coverage gap cost-sharing benefit and/or the percentage of brand formulary products covered in addition to the coverage gap discount for applicable drugs.
- (DS) Defined Standard Benefit
- (BA) Basic Alternative
- (AE) Actuarially Equivalent Standard
GAP
- Many - Many Generics and Some Brands
- Some - Some Generics and Few Brands
Maximum Out-of-Pocket (MOOP) limit on enrollee spending that includes costs for all in-network Part A and Part B Services. NOT Part D - prescription drugs. N/A is defined as Not Applicable
Source: CMS.
Data as of September 1, 2021.
Plans are subject to change as contracts are finalized.
Includes 2022 approved contracts. Employer sponsored 800 series and plans under sanction are excluded. For 2022, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part-D benefit.