Plan ID: H8553-002

What You Need to Know:

  • WellCare Patriot (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 $0, which does not include your monthly Medicare Part B premium.
  • The annual deductible for this health plan is no drug coverage.
  • The plan includes an out-of-pocket maximum of $4,400 per year (in-network).
  • WellCare Patriot (PPO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is no drug coverage.
  • This plan's Part D Initial Coverage Limit is .

$0

Monthly Premium

Medicare Plan Features
Monthly Premium: $0
Part C Premium: NULL
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$0 NULL NULL NULL NULL NULL NULL
Gap Coverage: NULL
Benchmark: NULL
Type of Medicare Health: NULL
Health Plan Type: Local PPO *
Similar Plan: H8553-003
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: NULL
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $4,400
Annual Deductible: no drug coverage
Annual Initial Coverage Limit ICL: NULL
Number of Members enrolled in this plan in Pima, Arizona: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
59 members New plan - No summary rating as of yet. New plan - not yet rated. New plan - not yet rated.
Plan Offers Mail Order: NULL
Plan Health Benefits
Total # of Formulary Drugs: NULL
Number of Members Enrolled in this Plan in Pima, Arizona: NULL
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
NULL NULL NULL NULL
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
NULL NULL NULL NULL NULL NULL NULL
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)
NULL NULL NULL NULL NULL NULL NULL NULL NULL NULL

Other Medicare Advantage Plans in Pima, Arizona

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Humana Gold Plus H0028-021 (HMO) (2023)Local HMO$2,800$0
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AARP Medicare Advantage Walgreens Plan 1 (PPO) (2023)Local PPO$5,000$275
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AARP Medicare Advantage Patriot (PPO) (2023)Local PPO *$5,000$-
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AARP Medicare Advantage Walgreens Plan 2 (PPO) (2023)Local PPO$4,000$275
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Amerivantage Smart Value (HMO) (2023)Local HMO$3,450$0
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Amerivantage Classic (HMO) (2023)Local HMO$7,550$0
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Imperial Insurance Traditional Plus (HMO) (2023)Local HMO$2,999$445
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Aetna Medicare Premier Plan (HMO) (2023)Local HMO$3,600$0
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HumanaChoice H5216-034 (PPO) (2023)Local PPO$7,550$225
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Humana Value Plus H5216-197 (PPO) (2023)Local PPO$7,550$435
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Humana Honor (PPO) (2023)Local PPO *$4,400$-
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HumanaChoice H5216-224 (PPO) (2023)Local PPO$4,500$195
4
AARP Medicare Advantage Plus (HMO-POS) (2023)Local HMO$4,800$225
5
Aetna Medicare Freedom Plan (PPO) (2023)Local PPO$7,350$0
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Aetna Medicare Platinum Plan (PPO) (2023)Local PPO$6,500$0
5
Aetna Medicare Eagle Plan (PPO) (2023)Local PPO *$5,500$-
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WellCare Value (HMO) (2023)Local HMO$3,400$0
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Banner Medicare Advantage Prime (HMO) (2023)Local HMO$4,450$200
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4
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Medicare Advantage Plans by WellCare
WellCare Value (HMO) (2023)Local HMO$3,400$0
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WellCare Compass (HMO) (2023)Local HMO$3,400$445
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WellCare Dividend (HMO) (2023)Local HMO$3,400$0
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New plan - not yet rated.
WellCare Rx Plus (PPO) (2023)Local PPO$6,000$300
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