Medicare

2017 Medicare Advantage Rates for New York County

2017 Medicare Advantage Plans for NY


There are 36 Medicare Advantage plans available in New York, New York

 

Below, you’ll find a summary of plans and rates for each provider in your area. This chart is designed to give you a preview of your options. For detailed information or to enroll in a plan, you must do one of the following:

  • Sign up through the plan provider—use the information we provide below to visit the provider online or call the provider directly.
  • Go to Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) or 1-877-486-2048 (TTY).
  • Get help from a licensed insurance broker—a broker can help you compare plans and will enroll you in the plan you choose.

You’ll see that each plan on the list is one of the following types: HMO, PPO, PFFS, MSA, or SNP. For an explanation of these terms and an overview of how each kind of plan works, see our article Types of Medicare Plans.


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Provider: MetroPlus Health Plan ( Contract ID: H0423)

Plan: MetroPlus Platinum (HMO)

(www.metroplusmedicare.org - open in new window)

160 Water Street, New York, NY 10038
Toll Free: 1-866-986-0356

Type: HMO

Region: NYC - The Bronx Brooklyn Manhattan Queens

Network: 6001-6500 physicians and providers.

Plan ID: H0423-004

Premium:
$226.20
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $2.40

75% Subsidy level = $12.70

50% Subsidy level = $22.90

25% Subsidy level = $33.20

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$400.00

 

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Provider: UnitedHealthcare ( Contract ID: H3307)

Plan: AARP MedicareComplete Plan 1 (HMO)

(www.AARPMedicarePlans.com - open in new window)

3315 Central AVE, Hot Springs, AR 71913
Toll Free: 1-800-555-5757

Type: HMO

Region: New York City

Network: 20000 and above physicians and providers.

Plan ID: H3307-002

Premium:
$35.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $8.70

50% Subsidy level = $17.50

25% Subsidy level = $26.20

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$230.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $230.00 annual deductible only applies to drugs on certain tiers.

 

Plan: AARP MedicareComplete Mosaic (HMO)

(www.AARPMedicarePlans.com - open in new window)

3315 Central AVE, Hot Springs, AR 71913
Toll Free: 1-800-555-5757

Type: HMO

Region: New York City

Network: 8001-8500 physicians and providers.

Plan ID: H3307-015

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$5,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$245.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $245.00 annual deductible only applies to drugs on certain tiers.

 

Plan: AARP MedicareComplete Essential (HMO)

(www.AARPMedicarePlans.com - open in new window)

3315 Central AVE, Hot Springs, AR 71913
Toll Free: 1-800-555-5757

Type: HMO

Region: NYC and Rockland Orange and Westchester Counties

Network: 20000 and above physicians and providers.

Plan ID: H3307-018

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount

No Prescription Drug Benefit

 

Plan: AARP MedicareComplete Plan 3 (HMO)

(www.AARPMedicarePlans.com - open in new window)

3315 Central AVE, Hot Springs, AR 71913
Toll Free: 1-800-555-5757

Type: HMO

Region: New York City

Network: 10001-11000 physicians and providers.

Plan ID: H3307-024

Premium:
$66.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $8.60

50% Subsidy level = $17.20

25% Subsidy level = $25.90

Maximum Out Of Pocket:
$2,800.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$0.00

 

Provider: Aetna Medicare ( Contract ID: H3312)

Plan: Aetna Medicare Value Plan (HMO)

(www.aetnamedicare.com - open in new window)

P.O. Box 14088, Lexington, KY 40512
Toll Free: 1-855-338-7027

Type: HMO

Region: Metro (Queens Manhattan)

Network: 20000 and above physicians and providers.

Plan ID: H3312-060

Premium:
$39.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $5.90

50% Subsidy level = $11.90

25% Subsidy level = $17.80

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$350.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $350.00 annual deductible only applies to drugs on certain tiers.

 

Provider: Fidelis Care ( Contract ID: H3328)

Plan: Fidelis Medicare Advantage without Rx (HMO-POS)

(www.fideliscare.org - open in new window)

95-25 Queens Boulevard, Rego Park, NY 11374
Toll Free: 1-800-860-8707

Type: HMO with POS Option

Region: NY Counties

Network: 20000 and above physicians and providers.

Plan ID: H3328-001

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount

No Prescription Drug Benefit

 

Plan: Fidelis Medicare Advantage Flex (HMO-POS)

(www.fideliscare.org - open in new window)

95-25 Queens Boulevard, Rego Park, NY 11374
Toll Free: 1-800-247-1447

Type: HMO with POS Option

Region: NY Counties

Network: 20000 and above physicians and providers.

Plan ID: H3328-003

Premium:
$41.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $10.30

50% Subsidy level = $20.50

25% Subsidy level = $30.80

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$250.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $250.00 annual deductible only applies to drugs on certain tiers.

 

Plan: Fidelis Medicare $0 Premium (HMO)

(www.fideliscare.org - open in new window)

95-25 Queens Boulevard, Rego Park, NY 11374
Toll Free: 1-800-247-1447

Type: HMO

Region: Non-Mid Hudson Region

Network: 20000 and above physicians and providers.

Plan ID: H3328-020

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$0.00

 

Provider: EmblemHealth Medicare HMO ( Contract ID: H3330)

Plan: EmblemHealth VIP Gold (HMO)

(www.emblemhealth.com/our-plans/medicare - open in new window)

P.O. Box # 2859, New York, NY 10117
Toll Free: 1-800-447-9169

Type: HMO

Region: New York City Queens Nassau and Richmond Counties

Network: 20000 and above physicians and providers.

Plan ID: H3330-021

Premium:
$98.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $3.00

75% Subsidy level = $13.30

50% Subsidy level = $23.50

25% Subsidy level = $33.80

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$330.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $330.00 annual deductible only applies to drugs on certain tiers.

 

Plan: EmblemHealth VIP Essential (HMO)

(www.emblemhealth.com/our-plans/medicare - open in new window)

P.O. Box# 2859, New York, NY 10117
Toll Free: 1-800-447-9169

Type: HMO

Region: New York City Queens Nassau Richmond Counties

Network: 20000 and above physicians and providers.

Plan ID: H3330-032

Premium:
$41.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $10.30

50% Subsidy level = $20.50

25% Subsidy level = $30.80

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$400.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $400 annual deductible only applies to drugs on certain tiers.

 

Plan: EmblemHealth VIP Gold Plus (HMO)

(www.emblemhealth.com/our-plans/medicare - open in new window)

P.O. Box# 2859, New York, NY 10117
Toll Free: 1-800-447-9169

Type: HMO

Region: New York City Queens Nassau Richmond Counties

Network: 20000 and above physicians and providers.

Plan ID: H3330-033

Premium:
$295.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $11.50

75% Subsidy level = $21.80

50% Subsidy level = $32.00

25% Subsidy level = $42.30

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$330.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $330.00 annual deductible only applies to drugs on certain tiers.

 

Plan: EmblemHealth VIP Value (HMO)

(www.emblemhealth.com/our-plans/medicare - open in new window)

P.O. Box# 2859, New York, NY 10117
Toll Free: 1-800-447-9169

Type: HMO

Region: Counties of NYC Westchester and Long Island

Network: 20000 and above physicians and providers.

Plan ID: H3330-036

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$400.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $400 annual deductible only applies to drugs on certain tiers.

 

Provider: Liberty Health Advantage ( Contract ID: H3337)

Plan: Liberty Health Advantage Preferred Choice (HMO)

(www.lhany.com - open in new window)

One Huntington Quadrangle, Melville, NY 11747
Toll Free: 1-855-439-1660

Type: HMO

Region: Bronx Kings Nassau New York Queens Richmond

Network: 9001-10000 physicians and providers.

Plan ID: H3337-001

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$5,500.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$0.00

 

Provider: Elderplan ( Contract ID: H3347)

Plan: Elderplan Extra Help (HMO)

(www.elderplan.org - open in new window)

Elderplan Inc., Brooklyn, NY 11220
Toll Free: 1-866-695-8101

Type: HMO

Region: Brx Ki NY Qu Wes

Network: 20000 and above physicians and providers.

Plan ID: H3347-009

Premium:
$40.90
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $10.20

50% Subsidy level = $20.40

25% Subsidy level = $30.70

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$400.00

 

Provider: Healthfirst Medicare Plan ( Contract ID: H3359)

Plan: Healthfirst 65 Plus Plan (HMO)

(www.healthfirst.org/medicare - open in new window)

Healthfirst Medicare Plan, New York, NY 10274
Toll Free: 1-877-237-1303

Type: HMO

Region: New York City and Nassau County

Network: 20000 and above physicians and providers.

Plan ID: H3359-001

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$0.00

 

Plan: Healthfirst Increased Benefits Plan (HMO)

(www.healthfirst.org/medicare - open in new window)

Healthfirst Medicare Plan, New York, NY 10274
Toll Free: 1-877-237-1303

Type: HMO

Region: New York City and Nassau County

Network: 20000 and above physicians and providers.

Plan ID: H3359-019

Premium:
$37.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $9.20

50% Subsidy level = $18.50

25% Subsidy level = $27.70

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$400.00

 

Plan: Healthfirst Coordinated Benefits Plan (HMO)

(www.healthfirst.org/medicare - open in new window)

Healthfirst Medicare Plan, New York, NY 10274
Toll Free: 1-877-237-1303

Type: HMO

Region: New York City and Nassau County

Network: 20000 and above physicians and providers.

Plan ID: H3359-027

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount

No Prescription Drug Benefit

 

Plan: Healthfirst Mount Sinai Select (HMO)

(www.healthfirst.org/medicare - open in new window)

Healthfirst Medicare Plan, New York, NY 10274
Toll Free: 1-877-237-1303

Type: HMO

Region: Manhattan

Network: 20000 and above physicians and providers.

Plan ID: H3359-036

Premium:
$49.90
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $8.90

75% Subsidy level = $19.20

50% Subsidy level = $29.40

25% Subsidy level = $39.70

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$0.00

 

Provider: WellCare ( Contract ID: H3361)

Plan: WellCare Choice (HMO-POS)

(www.wellcare.com/medicare - open in new window)

PO Box 31685, Tampa, FL 33631
Toll Free: 1-866-527-0056

Type: HMO with POS Option

Region: Bronx Kings New York Queens Richmond Counties

Network: 20000 and above physicians and providers.

Plan ID: H3361-106

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$0.00

 

Plan: WellCare Rx (HMO)

(www.wellcare.com/medicare - open in new window)

PO Box 31685, Tampa, FL 33631
Toll Free: 1-866-527-0056

Type: HMO

Region: Bronx Kings New York Queens Richmond Counties

Network: 20000 and above physicians and providers.

Plan ID: H3361-130

Premium:
$7.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $1.70

50% Subsidy level = $3.50

25% Subsidy level = $5.20

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$400.00

 

Plan: WellCare Preferred (HMO-POS)

(www.wellcare.com/medicare - open in new window)

PO Box 31685, Tampa, FL 33631
Toll Free: 1-866-527-0056

Type: HMO with POS Option

Region: Select Counties in NY

Network: 20000 and above physicians and providers.

Plan ID: H3361-135

Premium:
$45.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $0.00

50% Subsidy level = $0.00

25% Subsidy level = $0.00

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$0.00

 

Provider: Empire BlueCross BlueShield ( Contract ID: H3370)

Plan: Empire MediBlue Plus (HMO)

(www.empireblue.com/shop - open in new window)

3 Huntington Quadrangle, Melville, NY 11747
Toll Free: 1-800-797-6159

Type: HMO

Region: New York County

Network: 20000 and above physicians and providers.

Plan ID: H3370-035

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$230.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $230.00 annual deductible only applies to drugs on certain tiers.

 

Provider: UnitedHealthcare ( Contract ID: H3379)

Plan: AARP MedicareComplete Plan 2 (HMO)

(www.AARPMedicarePlans.com - open in new window)

3315 Central AVE, Hot Springs, AR 71913
Toll Free: 1-800-555-5757

Type: HMO

Region: New York City

Network: 20000 and above physicians and providers.

Plan ID: H3379-001

Premium:
$19.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $4.70

50% Subsidy level = $9.50

25% Subsidy level = $14.20

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$330.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $330.00 annual deductible only applies to drugs on certain tiers.

 

Provider: Humana Health Company of New York, Inc. ( Contract ID: H3533)

Plan: Humana Gold Plus H3533-021 (HMO)

(www.humana-medicare.com - open in new window)

500 West Main Street, Louisville, KY 40202
Toll Free: 1-800-833-2364

Type: HMO

Region: Select Counties in New York

Network: 6001-6500 physicians and providers.

Plan ID: H3533-021

Premium:
$24.10
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $6.00

50% Subsidy level = $12.00

25% Subsidy level = $18.10

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$400.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $400 annual deductible only applies to drugs on certain tiers.

 

Provider: AgeWell New York ( Contract ID: H4922)

Plan: AgeWell New York LiveWell (HMO)

(www.agewellnewyork.com - open in new window)

1991 Marcus Ave, Lake Success, NY 11042
Toll Free: 1-866-586-8044

Type: HMO

Region: NYC Metro Area Nassau Westchester Counties

Network: 7501-8000 physicians and providers.

Plan ID: H4922-005

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$370.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $370.00 annual deductible only applies to drugs on certain tiers.

 

Provider: Aetna Medicare ( Contract ID: H5521)

Plan: Aetna Medicare Standard Plan (PPO)

(www.aetnamedicare.com - open in new window)

P.O. Box 14088, Lexington, KY 40512
Toll Free: 1-855-338-7027

Type: Local Preferred Provider Organization

Region: Metro (Manhattan Queens Staten Island)

Network: 20000 and above physicians and providers.

Plan ID: H5521-040

Premium:
$99.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $5.60

75% Subsidy level = $14.60

50% Subsidy level = $23.60

25% Subsidy level = $32.70

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$250.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $250.00 annual deductible only applies to drugs on certain tiers.
  • This plan's deductible only applies to out-of-network services.

 

Plan: Aetna Medicare Elite Plan (PPO)

(www.aetnamedicare.com - open in new window)

P.O. Box 14088, Lexington, KY 40512
Toll Free: 1-855-338-7027

Type: Local Preferred Provider Organization

Region: Metro NYC Long Island Westchester

Network: 20000 and above physicians and providers.

Plan ID: H5521-120

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$250.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $250.00 annual deductible only applies to drugs on certain tiers.

 

Provider: VNSNY CHOICE Medicare ( Contract ID: H5549)

Plan: VNSNY CHOICE Medicare Classic (HMO)

(www.vnsnychoice.org - open in new window)

1250 Broadway, New York, NY 10001
Toll Free: 1-866-867-0047

Type: HMO

Region: NYC Metro Area and Capital Region

Network: 20000 and above physicians and providers.

Plan ID: H5549-008

Premium:
$41.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $10.30

50% Subsidy level = $20.50

25% Subsidy level = $30.80

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$400.00

 

Provider: Affinity Health Plan ( Contract ID: H5991)

Plan: Affinity Medicare Passport Select (HMO)

(www.affinitymedicareplan.org - open in new window)

1776 Eastchester Rd., Bronx, NY 10461
Toll Free: 1-866-694-9812

Type: HMO

Region: NYC Nassau Orange Rockland Suffolk Westchester

Network: 20000 and above physicians and providers.

Plan ID: H5991-004

Premium:
$45.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $4.70

50% Subsidy level = $9.40

25% Subsidy level = $14.20

Maximum Out Of Pocket:
$5,900.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$0.00

 

Plan: Affinity Medicare Passport Essentials NYC (HMO)

(www.affinitymedicareplan.org - open in new window)

1776 Eastchester Rd, Bronx, NY 10461
Toll Free: 1-866-694-9812

Type: HMO

Region: NYC 5 Buroughs: NY Bronx Queens Kings Richmond

Network: 20000 and above physicians and providers.

Plan ID: H5991-006

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$300.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $300.00 annual deductible only applies to drugs on certain tiers.

 

Provider: Centers Plan for Healthy Living ( Contract ID: H6988)

Plan: Centers Plan for Medicare Advantage Care (HMO)

(www.centersplan.com - open in new window)

75 Vanderbilt Avenue, Staten Island, NY 10304
Toll Free: 1-877-940-9330

Type: HMO

Region: NYC Metro Area Rockland Erie Niagara Counties

Network: 9001-10000 physicians and providers.

Plan ID: H6988-001

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$0.00

 

Provider: UnitedHealthcare ( Contract ID: R5342)

Plan: UnitedHealthcare MedicareComplete Choice Plan 1 (Regional PPO)

(www.UHCMedicareSolutions.com - open in new window)

3315 Central AVE, Hot Springs, AR 71913
Toll Free: 1-800-555-5757

Type: Preferred Provider Organization

Region: State of New York

Network: 15001-16000 physicians and providers.

Plan ID: R5342-001

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Basic
Drug Benefit Type

Annual Drug Deductable:
$290.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $290.00 annual deductible only applies to drugs on certain tiers.

 

Plan: UnitedHealthcare MedicareComplete Choice Essential (Regional PPO)

(www.UHCMedicareSolutions.com - open in new window)

3315 Central AVE, Hot Springs, AR 71913
Toll Free: 1-800-555-5757

Type: Preferred Provider Organization

Region: State of New York

Network: 15001-16000 physicians and providers.

Plan ID: R5342-002

Premium:
$0.00
Monthly Consolidated Premium
(Includes: Part C & D)

Maximum Out Of Pocket:
$6,700.00
In-network, Maximum Out of Pocket Annual Amount

No Prescription Drug Benefit

 

Plan: UnitedHealthcare MedicareComplete Choice Plan 3 (Regional PPO)

(www.UHCMedicareSolutions.com - open in new window)

3315 Central AVE, Hot Springs, AR 71913
Toll Free: 1-800-555-5757

Type: Preferred Provider Organization

Region: State of New York

Network: 15001-16000 physicians and providers.

Plan ID: R5342-005

Premium:
$36.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $5.80

50% Subsidy level = $11.50

25% Subsidy level = $17.30

Maximum Out Of Pocket:
$5,900.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$150.00

Important Notes:

  • This plan does not charge an annual deductible for all drugs. The $150.00 annual deductible only applies to drugs on certain tiers.

 

Plan: UnitedHealthcare MedicareComplete Choice Plan 4 (Regional PPO)

(www.UHCMedicareSolutions.com - open in new window)

3315 Central AVE, Hot Springs, AR 71913
Toll Free: 1-800-555-5757

Type: Preferred Provider Organization

Region: State of New York

Network: 15001-16000 physicians and providers.

Plan ID: R5342-006

Premium:
$66.00
Monthly Consolidated Premium
(Includes: Part C & D)

Low Income Subsidized Rates For:

100% Subsidy level = $0.00

75% Subsidy level = $5.90

50% Subsidy level = $11.80

25% Subsidy level = $17.80

Maximum Out Of Pocket:
$5,400.00
In-network, Maximum Out of Pocket Annual Amount


Prescription Drug Benefits

Enhanced
Drug Benefit Type

Annual Drug Deductable:
$0.00