Optima Medicare Prime (HMO) in Fluvanna, Virginia (2023)
Optima Medicare Prime (HMO) in Fluvanna County, Virginia costs $65/mo. This affordable Regional PPO plan (H2563-013) is a top choice for those living in Fluvanna County with a $130 prescription deductible and out-of-pocket limits at $3,600. Learn more about Medicare Part C by AARP in Fluvanna County, Virginia below.
UPDATED: Sep 23, 2023
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4 out of 5 stars* for plan year 2024
Plan ID: H2563-013
What You Need to Know:
- Optima Medicare Prime (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 $65, which does not include your monthly Medicare Part B premium.
- The annual deductible for this health plan is $130 (Tier 1, 2 and 3 excluded from the Deductible.).
- The plan includes an out-of-pocket maximum of $3,600 per year (in-network).
- Optima Medicare Prime (HMO) includes a Part D prescription drug plan for prescription medication coverage. The annual deductible is $130 (Tier 1, 2 and 3 excluded from the Deductible.).
- This plan's Part D Initial Coverage Limit is $53.
* Every year, the Centers for Medicare & Medicaid Services (CMS) evaluates plans based on a 5-star rating system.
$65
Monthly Premium
Medicare Plan Features | |||||||||
---|---|---|---|---|---|---|---|---|---|
Monthly Premium: | $65.00 | ||||||||
Part C Premium: | $12.20 | ||||||||
Monthly Premium: | Part C Premium: | Part D Drug Premium: | Part D Supplemental Premium: | Total Part D Premium: | Drug Deductible: | Tiers with No Deductible: | |||
$65.00 | $12.20 | $52.80 | $0 | $52.80 | $130.0 | 1.0 | |||
Gap Coverage: | No | ||||||||
Benchmark: | not below the regional benchmark | ||||||||
Type of Medicare Health: | Enhanced Alternative | ||||||||
Health Plan Type: | Local HMO | ||||||||
Similar Plan: | H2563-014 | ||||||||
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): | $3,600 | ||||||||
Annual Deductible: | $130 (Tier 1, 2 and 3 excluded from the Deductible.) | ||||||||
Annual Initial Coverage Limit ICL: | $4,130 | ||||||||
Number of Members enrolled in this plan in Fluvanna, Virginia: | Plans Summary Star Rating: | Customer Service Rating: | Drug Cost Rating: | ||||||
less than 10 members | 3.5 out of 5 Stars. | 4 out of 5 Stars. | 3 out of 5 Stars. | ||||||
Plan Offers Mail Order: | Yes | ||||||||
Plan Health Benefits | |||||||||
Total # of Formulary Drugs: | 4,162 drugs | ||||||||
Number of Members Enrolled in this Plan in Fluvanna, Virginia: | less than 10 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 | ||||||
$12.20 | $52.80 | $0.00 | $65.00 | ||||||
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 | |||
$33.60 | $45.00 | $57.20 | $37.10 | $49.30 | $29.30 | $41.50 | |||
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) |
459 | $2.00 | 1353 | $8.00 | 302 | $45.00 | 1043 | $90.00 | 1005 | 30% |
Other Medicare Advantage Plans in Fluvanna, Virginia
Plan Name | Type | Premium MOOP | Rx Deduct. | Rating |
---|---|---|---|---|
HumanaChoice R1390-001 (Regional PPO) (2023) | Regional PPO * | $5,400 | $- | |
Anthem MediBlue Access (PPO) (2023) | Local PPO | $7,550 | $95 | |
HumanaChoice R1390-002 (Regional PPO) (2023) | Regional PPO | $7,550 | $360 | |
Humana Honor R1390-003 (Regional PPO) (2023) | Regional PPO * | $6,700 | $- | |
Humana Gold Plus H6622-041 (HMO) (2023) | Local HMO | $7,550 | $445 | |
AARP Medicare Advantage Choice (PPO) (2023) | Local PPO | $6,700 | $195 | New plan - not yet rated. |
Optima Medicare Classic (HMO) (2023) | Local HMO * | $3,400 | $- | |
AARP Medicare Advantage Patriot (PPO) (2023) | Local PPO * | $6,700 | $- | New plan - not yet rated. |
Optima Medicare Value (HMO) (2023) | Local HMO | $3,400 | $150 | |
Aetna Medicare UVA Health System Prime (HMO) (2023) | Local HMO | $7,550 | $195 | |
Medicare Advantage Plans by Optima Medicare | ||||
Optima Medicare Classic (HMO) (2023) | Local HMO * | $3,400 | $- | |
Optima Medicare Value (HMO) (2023) | Local HMO | $3,400 | $150 |
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