Plan ID: H2577-021

What You Need to Know:

  • AARP Medicare Advantage Choice (PPO) is a Medicare Advantage Health Maintenance Organization Local PPO 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 $35, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is .
  • The plan includes an out-of-pocket maximum of $4,900 per year (in-network).
  • AARP Medicare Advantage Choice (PPO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is .
  • This plan's Part D Initial Coverage Limit is $35.

$35

Monthly Premium

Medicare Plan Features
Monthly Premium: $35.00
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:
$35.00 $0 $35.00 $0 $35.00 $0 0.0
Gap Coverage: No
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local PPO
Similar Plan: H2577-001
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): $4,900
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Allegheny, Pennsylvania: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
344 members New plan - No summary rating as of yet. New plan - not yet rated. New plan - not yet rated.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,668 drugs
Number of Members Enrolled in this Plan in Allegheny, Pennsylvania: 876 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 $35.00 $0.00 $35.00
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 $26.20 $26.20 $17.50 $17.50 $8.70 $8.70
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)
303 $0.00 679 $10.00 870 $47.00 1015 $100.00 801 33%

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HumanaChoice R0923-002 (Regional PPO) (2023)Regional PPO$6,700$0
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Aetna Medicare Advantra Eagle (HMO) (2023)Local HMO *$4,000$-
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Aetna Medicare Gold Plan (PPO) (2023)Local PPO$7,550$0
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Security Blue HMO-POS Deluxe (HMO-POS) (2023)Local HMO$4,500$0
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Community Blue Medicare HMO Signature (HMO) (2023)Local HMO$7,550$0
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Aetna Medicare Advantra Gold (HMO) (2023)Local HMO$5,900$0
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Aetna Medicare Advantra Silver (HMO) (2023)Local HMO$7,550$0
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Security Blue HMO-POS ValueRx (HMO-POS) (2023)Local HMO$5,500$0
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Security Blue HMO-POS Basic (HMO-POS) (2023)Local HMO *$5,900$-
4
Freedom Blue PPO ValueRx (PPO) (2023)Local PPO$5,500$0
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Freedom Blue PPO Classic (PPO) (2023)Local PPO$4,500$0
4
UPMC for Life HMO Rx Enhanced (HMO) (2023)Local HMO$7,550$0
4
UPMC for Life HMO Rx (HMO) (2023)Local HMO$7,550$0
4
Security Blue HMO-POS Standard (HMO-POS) (2023)Local HMO$5,000$0
4
AARP Medicare Advantage Patriot (HMO) (2023)Local HMO *$5,500$-
5
Allwell Medicare Boost (HMO) (2023)Local HMO$7,550$0
4
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4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
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4
UPMC for Life HMO No Rx (HMO) (2023)Local HMO *$7,550$-
4
UPMC for Life HMO Deductible with Rx (HMO) (2023)Local HMO$7,550$0
4
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4
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4
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4
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5
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5
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5
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