WellCare Dividend (HMO) in Chattahoochee, Georgia (2023)
WellCare Dividend (HMO) in Chattahoochee County, Georgia costs $0/mo. This affordable Regional PPO plan (H1112-042) is a top choice for those living in Chattahoochee County with a $200 prescription deductible and out-of-pocket limits at $6,700. Learn more about Medicare Part C by AARP in Chattahoochee County, Georgia below.
UPDATED: Sep 19, 2023
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5 out of 5 stars* for plan year 2024
Plan ID: H1112-042
What You Need to Know:
- WellCare Dividend (HMO) 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 $200 (Tier 1 and 2 excluded from the Deductible.).
- The plan includes an out-of-pocket maximum of $6,700 per year (in-network).
- WellCare Dividend (HMO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is $200 (Tier 1 and 2 excluded from the Deductible.).
- This plan's Part D Initial Coverage Limit is $0.
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$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 | $200.0 | 1.0 | |||
Gap Coverage: | No | ||||||||
Benchmark: | not below the regional benchmark | ||||||||
Type of Medicare Health: | Enhanced Alternative | ||||||||
Health Plan Type: | Local HMO | ||||||||
Similar Plan: | H1112-043 | ||||||||
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): | $6,700 | ||||||||
Annual Deductible: | $200 (Tier 1 and 2 excluded from the Deductible.) | ||||||||
Annual Initial Coverage Limit ICL: | $4,130 | ||||||||
Number of Members enrolled in this plan in Chattahoochee, Georgia: | Plans Summary Star Rating: | Customer Service Rating: | Drug Cost Rating: | ||||||
less than 10 members | 3.5 out of 5 Stars. | 5 out of 5 Stars. | 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 Chattahoochee, Georgia: | 7,540 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) |
546 | $4.00 | 1539 | $15.00 | 314 | $47.00 | 319 | 45% | 672 | 29% |
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