Plan ID: H5199-010

What You Need to Know:

  • WellCare Prime (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 $75, 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 $1,700 per year (in-network).
  • WellCare Prime (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 $25.

$75

Monthly Premium

Medicare Plan Features
Monthly Premium: $75.00
Part C Premium: $49.90
Monthly Premium: Part C Premium: Part D Drug Premium: Part D Supplemental Premium: Total Part D Premium: Drug Deductible: Tiers with No Deductible:
$75.00 $49.90 $25.10 $0 $25.10 $0 0.0
Gap Coverage: Yes
Benchmark: not below the regional benchmark
Type of Medicare Health: Enhanced Alternative
Health Plan Type: Local PPO
Similar Plan: H5199-012
Special Needs Type: NULL
Chronic Condition: NULL
Additional Gap Coverage: Yes, some additional gap coverage.
Maximum Out-of-Pocket Limit for Parts A & B (Moop): $1,700
Annual Deductible: NULL
Annual Initial Coverage Limit ICL: $4,130
Number of Members enrolled in this plan in Citrus, Florida: Plans Summary Star Rating: Customer Service Rating: Drug Cost Rating:
13 members New plan - No summary rating as of yet. New plan - not yet rated. 3 out of 5 Stars.
Plan Offers Mail Order: Yes
Plan Health Benefits
Total # of Formulary Drugs: 3,390 drugs
Number of Members Enrolled in this Plan in Citrus, Florida: 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
$49.90 $25.10 $0.00 $75.00
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
$49.90 $18.80 $68.70 $12.50 $62.40 $6.30 $56.20
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)
546 $0.00 1539 $0.00 314 $47.00 319 $100.00 672 33%

Other Medicare Advantage Plans in Citrus, Florida

Plan Name Type Premium MOOP Rx Deduct. Rating
HumanaChoice R5826-018 (Regional PPO) (2023)Regional PPO *$7,550$-
4
BlueMedicare Choice (Regional PPO) (2023)Regional PPO$6,500$250
4
AARP Medicare Advantage Choice Plan 2 (Regional PPO) (2023)Regional PPO$6,700$395
5
Aetna Medicare Select (HMO) (2023)Local HMO$3,450$0
5
Humana Gold Plus H1036-140 (HMO) (2023)Local HMO$3,400$0
4
HumanaChoice Florida H5216-072 (PPO) (2023)Local PPO$4,900$150
4
Lasso Healthcare Growth Plus (MSA) (2023)MSA *$-$-
4
Humana Gold Plus H1036-266 (HMO) (2023)Local HMO$4,000$0
4
Freedom Savings Plan (HMO) (2023)Local HMO *$3,400$-
4
HumanaChoice R5826-074 (Regional PPO) (2023)Regional PPO$7,550$395
4
Humana Gold Choice H8145-061 (PFFS) (2023)PFFS$-$200
4
Humana Honor (HMO) (2023)Local HMO *$4,500$-
4
AARP Medicare Advantage Choice (PPO) (2023)Local PPO$4,900$175
5
HumanaChoice R5826-005 (Regional PPO) (2023)Regional PPO$6,700$100
4
AARP Medicare Advantage Patriot (Regional PPO) (2023)Regional PPO *$6,700$-
5
WellCare Dividend Prime (HMO) (2023)Local HMO$2,500$0
4
Aetna Medicare Premier (PPO) (2023)Local PPO$6,700$300
5
WellCare Elite (HMO) (2023)Local HMO$1,200$0
4
Lasso Healthcare Growth (MSA) (2023)MSA *$-$-
4
AARP Medicare Advantage (HMO-POS) (2023)Local HMO$3,900$0
5
WellCare Premier (PPO) (2023)Local PPO$3,400$100
New plan - not yet rated.
BlueMedicare Classic (HMO) (2023)Local HMO$4,900$0
4
Medicare Advantage Plans by WellCare
WellCare Dividend Prime (HMO) (2023)Local HMO$2,500$0
4
WellCare Elite (HMO) (2023)Local HMO$1,200$0
4
WellCare Premier (PPO) (2023)Local PPO$3,400$100
New plan - not yet rated.

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