Plan ID: H6154-001

What You Need to Know:

  • Medica Advantage Solution H6154-001 (HMO-POS) is a Medicare Advantage Health Maintenance Organization Local HMO plan.
  • It must provide all of the same hospital and medical benefits as Medicare Part A and Part B, however, costs may be different.
  • It has additional benefits not included in Medicare Part A and Part B, including prescription drug coverage.
  • The plan's monthly premium is $0, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is $445 (Tier 1 excluded from the Deductible.).
  • The plan includes an out-of-pocket maximum of $7,550 per year (in-network).
  • Medica Advantage Solution H6154-001 (HMO-POS) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is $445 (Tier 1 excluded from the Deductible.).
  • This plan's Part D Initial Coverage Limit is $0.

$0

Monthly Premium

Medicare Plan Features
Monthly Premium: $0
Part C Premium: $0
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$0 $0 $0 $0 $0 $445.0 1.0
Gap Coverage: No
Benchmark: below the regional benchmark
Type of Medicare Health: Basic Alternative
Health Plan Type: Local HMO
Similar Plan: H6154-002
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: No additional gap coverage, only the Donut Hole Discount
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $7,550
Annual Deductible: $445 (Tier 1 excluded from the Deductible.)
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Ramsey, Minnesota: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
232 members 4 out of 5 Stars. New plan - not yet rated. 4 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,710 drugs
Number of Members Enrolled in this Plan in Ramsey, Minnesota: 1,371 members
Number of Drugs Per Tier: NULL
Preferred Pharmacy Cost Sharing During Initial Coverage Phase: NULL
Special Needs Plan SNP Eligibility Requirement: NULL
Monthly Premium Split as Follows:
Part C Premium Part D Base Premium Part D Supplemental Premium Total Premium
$0.00 $0.00 $0.00 $0.00
Monthly Premium with Extra Help Low Income Subsidy:
LIS100 Subsidy Total Monthly Premium with LIS Parts CD LIS25 Subsidy Monthly PartD Premium with LIS LIS25 Subsidy Total Monthly Premium with LIS Parts CD LIS50 Monthly PartD Premium with LIS LIS50 Subsidy Total Monthly Premium with LIS Parts CD LIS75 Monthly PartD Premium with LIS LIS75 Subsidy Total Monthly Premium with LIS Parts CD
$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00
Formulary Drug Details:
Tier 1 # of Drugs per Tier Tier 1 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 2 # of Drugs per Tier Tier 2 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 3 # of Drugs per Tier Tier 3 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 4 # of Drugs per Tier Tier 4 Preferred Pharmacy Cost Sharing (initial coverage phase) Tier 5 # of Drugs per Tier Tier 6 Preferred Pharmacy Cost Sharing (initial coverage phase)
388 $5.00 1024 $14.00 927 $47.00 583 50% 788 25%

Other Medicare Advantage Plans in Ramsey, Minnesota

Plan Name Type Premium MOOP Rx Deduct. Rating
AARP Medicare Advantage Riverbank (PPO) (2023)Local PPO$3,000$250
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Blue Cross Medicare Advantage Choice (PPO) (2023)Local PPO$3,100$300
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Humana Gold Plus H6622-062 (HMO-POS) (2023)Local HMO$3,000$100
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AARP Medicare Advantage Patriot (PPO) (2023)Local PPO *$6,700$-
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Humana Gold Plus H6622-073 (HMO-POS) (2023)Local HMO$5,500$350
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AARP Medicare Advantage Headwaters (PPO) (2023)Local PPO$5,900$395
5
AARP Medicare Advantage Lakeshore (PPO) (2023)Local PPO$4,000$295
5
Medica Advantage Solution H8889-001 (PPO) (2023)Local PPO$3,450$275
5
AARP Medicare Advantage Premier (PPO) (2023)Local PPO$4,900$445
5
Medica Advantage Solution H8889-003 (PPO) (2023)Local PPO$3,450$225
5
Medica Advantage Solution H8889-005 (PPO) (2023)Local PPO$7,550$350
5
Blue Cross Medicare Advantage Choice MA Only (PPO) (2023)Local PPO *$4,900$-
5
HumanaChoice H5216-092 (PPO) (2023)Local PPO$6,700$350
4
Blue Cross Medicare Advantage Complete (PPO) (2023)Local PPO$2,700$0
5
HumanaChoice H5216-063 (PPO) (2023)Local PPO$3,200$250
4
Allina Health Aetna Medicare Discover Plus (PPO) (2023)Local PPO$5,900$250
5
HumanaChoice H5216-080 (PPO) (2023)Local PPO$5,900$350
4
Allina Health Aetna Medicare Discover Premier (PPO) (2023)Local PPO$5,000$150
5
HumanaChoice H5216-167 (PPO) (2023)Local PPO$4,500$350
4
Allina Health Aetna Medicare Discover Grand (PPO) (2023)Local PPO$4,000$0
5
Blue Cross Medicare Advantage Core (PPO) (2023)Local PPO$5,900$445
5
Allina Health Aetna Medicare Discover Elite (PPO) (2023)Local PPO$3,500$0
5
Allina Health Aetna Medicare Discover Value (PPO) (2023)Local PPO *$5,900$-
5
HealthPartners Journey Stride (PPO) (2023)Local PPO$4,100$300
4
HealthPartners Journey Pace (PPO) (2023)Local PPO$6,100$300
4
Humana Honor (PPO) (2023)Local PPO *$6,700$-
4
HealthPartners Journey Steady (PPO) (2023)Local PPO$3,300$300
4
Humana Value Plus H5216-176 (PPO) (2023)Local PPO$6,700$230
4
HealthPartners Journey Dash (PPO) (2023)Local PPO$3,600$300
4
UCare Complete (HMO-POS) (2023)Local HMO$3,000$235
5
UCare Value (HMO-POS) (2023)Local HMO *$3,400$-
5
UCare Prime (HMO-POS) (2023)Local HMO$5,500$445
5
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
UCare Classic (HMO-POS) (2023)Local HMO$3,000$225
5
UCare Aware (HMO-POS) (2023)Local HMO$5,000$395
5
UCare Essentials Rx (HMO-POS) (2023)Local HMO$3,800$395
5
UCare Value Plus (HMO-POS) (2023)Local HMO *$5,500$-
5
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Medicare Advantage Plans by Medica
Medica Advantage Solution H8889-001 (PPO) (2023)Local PPO$3,450$275
5
Medica Advantage Solution H8889-003 (PPO) (2023)Local PPO$3,450$225
5
Medica Advantage Solution H8889-005 (PPO) (2023)Local PPO$7,550$350
5

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