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The 2023 Medicare Advantage Plans in Philadelphia County PA.
2022 Philadelphia County Pennsylvania
Medicare Advantage Plans
There are 56 Medicare Advantage Plans available in Philadelphia County PA from 10 different health insurance providers. 21 of these Medicare Advantage plans offer additional gap coverage. The plan with the lowest out of pocket expense is $3800 and the highest out of pocket is $7550. Philadelphia County Pennsylvania residents can also pick from 16 Medicare Special Needs Plans. The best Medicare Advantage plan in Philadelphia County Pennsylvania received a 5 overall star rating from CMS and the lowest rated plan is 3.5 stars.
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Pike County Medicare Advantage
Medicare Advantage Health Plans Without Drug Coverage
| Plan Name ⇅ | Premium | Type | MOOP | Overall Rating |
|---|---|---|---|---|
| AARP Medicare Advantage Patriot (HMO) (H1944-030) | $0 | Local HMO * | $5,500 | |
| Aetna Medicare Advantra Eagle (HMO) (H3959-057) | $0 | Local HMO * | $4,000 | |
| Cigna Fundamental Medicare (HMO) (H3949-026) | $0 | Local HMO * | $5,900 | |
| Humana Honor (PPO) (H5216-221) | $0 | Local PPO * | $6,700 | |
| HumanaChoice H5216-116 (PPO) (H5216-116) | $0 | Local PPO * | $3,900 | |
| HumanaChoice R0923-001 (Regional PPO) (R0923-001) | $0 | Regional PPO * | $4,500 | |
| Keystone 65 Preferred Medical Only (HMO) (H3952-008) | $178.00 | Local HMO * | $3,800 | |
| Keystone 65 Select Medical Only (HMO) (H3952-048) | $34.50 | Local HMO * | $4,900 | |
| Lasso Healthcare Growth (MSA) (H1924-001) | MSA * | $- | NA | |
| Lasso Healthcare Growth Plus (MSA) (H1924-004) | MSA * | $- | NA | |
| Personal Choice 65 Medical Only (PPO) (H3909-007) | $179.00 | Local PPO * | $5,000 | |
| Wellcare Patriot Giveback (HMO) (H2915-013) | $0 | Local HMO * | $4,900 |
2022 Medicare Special Needs Plans in Philadelphia county Pennsylvania
| Plan Name ⇅ | Monthly Premium |
Part D Deductible |
Gap | Special Needs Type |
Overall Rating |
|---|---|---|---|---|---|
| Aetna Medicare Advantra Cares (HMO D-SNP) | $28.00 | $350.0 | No Gap Coverage | Dual-Eligible | |
| Cigna Achieve Medicare (HMO C-SNP) | $0 | $0 | No Gap Coverage | Chronic or Disabling Condition | |
| Cigna TotalCare (HMO D-SNP) | $29.80 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Cigna TotalCare Plus (HMO D-SNP) | $29.80 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Gateway Health Medicare Assured Diamond (HMO D-SNP) | $40.70 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Gateway Health Medicare Assured Ruby (HMO D-SNP) | $40.70 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Health Partners Medicare Special (HMO D-SNP) | $40.70 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Humana Gold Plus SNP-DE H6622-078 (HMO D-SNP) | $23.70 | $450.0 | No Gap Coverage | Dual-Eligible | |
| Keystone First VIP Choice (HMO D-SNP) | $40.70 | $480.0 | No Gap Coverage | Dual-Eligible | |
| Provider Partners Pennsylvania Advantage Plan (HMO I-SNP) | $40.70 | $480.0 | No Gap Coverage | Institutional | NA |
| Provider Partners Pennsylvania Community Plan (HMO I-SNP) | $40.70 | $480.0 | No Gap Coverage | Institutional | NA |
| UnitedHealthcare Dual Complete (HMO D-SNP) | $33.90 | $480.0 | No Gap Coverage | Dual-Eligible | |
| UnitedHealthcare Dual Complete Select (HMO D-SNP) | $40.70 | $480.0 | No Gap Coverage | Dual-Eligible | |
| UnitedHealthcare Nursing Home Plan 2 (PPO I-SNP) | $40.60 | $480.0 | No Gap Coverage | Institutional | |
| UPMC for Life Complete Care (HMO D-SNP) | $40.70 | $480.0 | No Gap Coverage | Dual-Eligible | NA |
| Wellcare Dual Access (HMO D-SNP) | $40.70 | $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.